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Introduction: There are scant data on long-term outcomes of treatment of inflammatory bowel disease (IBD) with a combination of advanced therapies, including after de-escalation. Method(s): We identified patients with IBD at a tertiary center who began therapy with vedolizumab (VDZ) in combination with another advanced therapy (biologic or JAK inhibitor) between 2016 and 2020 and examined their outcomes through 6/1/22. We defined biochemical remission as CRP, 5 mg/L and calprotectin < 150 mcg/g, and endoscopic remission as Mayo endoscopic subscore 0 or simple endoscopic score for Crohn's disease (CD) 0. Short-term outcomes of this cohort were previously reported. Result(s): Fourteen patients with a median of 322 (IQR 251-322) weeks of follow up were identified. 10 had ulcerative colitis, 3 CD, and 1 indeterminate colitis. VDZ was combined with tofacitinib in 9 patients, ustekinumab in 3 and adalimumab in 2. Median time on combination therapy was 94 weeks (IQR 17-133). Eight patients achieved objective remission (3 biochemical, 5 endoscopic), 1 changed combination with subsequent endoscopic remission, 2 had primary non-response, 1 had secondary non-response, 1 stopped within 1 month due to reported adverse effect (paresthesia), and 1 lacked follow-up data. Eight patients de-escalated to a single agent, 4 at physician direction and 4 due to insurance denial. Before de-escalation, 6 had objective remission (2 biochemical, 4 endoscopic). After de-escalation, 3 patients maintained objective remission (2 biochemical, 1 endoscopic), 3 had disease flare, of which 1 required colectomy, and 2 lacked data. All 3 patients with disease flare had de-escalated following an insurance denial. Two patients remained on combination therapy through follow up: 1 has endoscopic remission after changing one drug of their combination and 1 has ongoing moderate endoscopic disease despite combination therapy. There were 2 infections requiring hospitalization (rotavirus, C. difficile), and 8 non-serious infections (5 mild SARS-COV-2, 1 peristomal cellulitis, 1 pneumonia, 1 sinus) while on combination therapy. Conclusion(s): In long-term follow up of this small cohort, there were no new signals on effectiveness or safety of combining advanced agents. De-escalation to a single agent was tolerated in half of patients with follow-up data;all patients who flared following de-escalation had adjusted therapy due to insurance denial. More data is needed to inform de-escalation decisions.
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Background Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) variants, which have emerged due to several mutations in spike protein, have a potential to escape immune protection provided by the first-generation vaccines, thereby resulting in breakthrough infections. Objective To identify the socio-demographic factors, clinical features, and outcomes in both vaccinated and unvaccinated hospitalized patients infected with SARS-CoV-2. Method Socio-demographic details, clinical features, and the outcomes among fully vaccinated (double for Covishield/AstraZeneca and BBIBP-CorV and single for Janssen), partially vaccinated, and unvaccinated hospitalized patients with coronavirus disease of 2019 (COVID-19) were collected and analyzed using SPSS version 17. Result Among the hospitalized COVID-19 patients (n=299), 175 (58.5%) patients received a single-dose, 82 (27.4%) double-dose, and 124 (41.5%) did not receive any dose of the COVID-19 vaccines. The risk of SARS-CoV-2 infection when compared between vaccinated and unvaccinated patients was found to be associated among professional degree holders (23.4% versus 9.7%) (p<0.05), professional workers (43.4% vs. 25.0%) (p<0.05), hospitalization to general ward (76.6% vs. 72.6%) (p<0.05), and presence of multiple symptoms (> or equel 3) (86.8% vs. 75.0%) (p>0.05) and comorbidities (> or equal 2) (15.5% vs. 13.7%) (p>0.05). Despite such approximate incidences, the risk of in-hospital mortality among the vaccinated patients was reduced (0.6% vs. 3.2%) (p>0.05), when compared to the unvaccinated patients. The risk of in-hospital mortality was associated with the older age and the presence of multiple comorbidities including bronchial asthma, diabetes, and hypertension. Conclusion Full or partial vaccination against the SARS-CoV-2 variants of concerns might be effective in preventing in-hospital mortality among COVID-19 patients.
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COVID-19 Vaccines , COVID-19 , Humans , SARS-CoV-2 , ChAdOx1 nCoV-19ABSTRACT
Low-income households generally experience a high energy burden;however, the factors influencing energy burdens are beyond socio-economics. This study explores the relationships between the multidimensionality of community vulnerability factors and energy burden across multiple geospatial levels in the United States. Our study found the distribution of energy burden in 2020 showed a great deal of variety, ranging from a minimum of 2.93 % to a maximum of 30.45 % across 3142 counties. The results of non-spatial and spatial regressions showed that the vulnerability ranks of socioeconomic, household composition and disability, minority and language, household type and transportation, and COVID mortality rate are significant predictors of energy burdens at the national level. However, at the regional level, only socioeconomic, minority and language significantly influence energy burdens. Minority and language negatively impact energy burdens except for the South East-Central region. Additionally, our analyses highlight the need to consider community vulnerability indicators' spatial homogeneity and heterogeneity. At the national level, only the epidemiological factors index is a spatially homogeneous predictor;on the regional and state level, the spatially homogeneous predictors such as socioeconomic status, household composition and disability, and household type and transportation vary by region. Such a region-sensitive relationship between energy burden and the predictors indicates spatial heterogeneity. This study suggests policy recommendations through the lens of the multidimensionality of community vulnerability factors. Implementing flexible national energy policies while making particular energy assistance policies for the vulnerable population at the regional or state levels is essential. © 2023
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Background The COVID-19 pandemic has caused lockdown situation impeding all educational institutions including dental colleges. The circumstance demanded online classes as the alternative strategy for continuation of education. Objective To assess current practice and perception about online education among faculties of dental colleges in Nepal. Method A cross-sectional study was conducted among 208 faculties of all dental colleges in Nepal. Data collection was done through structured online questionnaire comprising demographic information, practice and perception of the respondents towards online education. Descriptive statistics surveyed the frequency distribution and Chi-square test assessed the difference in perception among the faculties of different universities. Result The response rate was 74.3%. Faculties commonly used PowerPoint presentation (96.6%) on Zoom platform (83.3%) using laptop (94.7%) with Wi-Fi connection (91.8%). Majority of faculties had good or satisfactory access to internet (94.8%). The faculties believed that the online class environment was interactive (95.2%);but it was not effective (86.5%) as live classroom. Majority of the faculties (79.4%) felt tracking of students' presence was difficult. There was no significant difference on perception towards online class among the faculties of Kathmandu University, Tribhuvan University and BP Koirala Institute Health Sciences at p <0.05. Conclusion The COVID-19 pandemic has paved the way for e-learning in dental education in Nepal. Faculties agree to complete the theory syllabus and conduct sessional exams as an alternative during the lockdown period. However, they show strong reservations in carrying out practical/clinical simulations and university exams online. Training on e-learning and institutional strategy for online education is recommended. Copyright © 2020, Kathmandu University. All rights reserved.
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Spontaneous pneumothorax as an initial presentation is very rare in COVID-19 patient. We present a case where the initial presentation was that of a mild disease and on investigation was found to have pneumothorax without any predisposing risk factors. © 2022, Kathmandu University. All rights reserved.
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Background Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) variants, which have emerged due to several mutations in spike protein, have a potential to escape immune protection provided by the first-generation vaccines, thereby resulting in breakthrough infections. Objective To identify the socio-demographic factors, clinical features, and outcomes in both vaccinated and unvaccinated hospitalized patients infected with SARS-CoV-2. Method Socio-demographic details, clinical features, and the outcomes among fully vaccinated (double for Covishield/AstraZeneca and BBIBP-CorV and single for Janssen), partially vaccinated, and unvaccinated hospitalized patients with coronavirus disease of 2019 (COVID-19) were collected and analyzed using SPSS version 17. Result Among the hospitalized COVID-19 patients (n=299), 175 (58.5%) patients received a single-dose, 82 (27.4%) double-dose, and 124 (41.5%) did not receive any dose of the COVID-19 vaccines. The risk of SARS-CoV-2 infection when compared between vaccinated and unvaccinated patients was found to be associated among professional degree holders (23.4% versus 9.7%) (p<0.05), professional workers (43.4% vs. 25.0%) (p<0.05), hospitalization to general ward (76.6% vs. 72.6%) (p<0.05), and presence of multiple symptoms (>=3) (86.8% vs. 75.0%) (p>0.05) and comorbidities (>=2) (15.5% vs. 13.7%) (p>0.05). Despite such approximate incidences, the risk of in-hospital mortality among the vaccinated patients was reduced (0.6% vs. 3.2%) (p>0.05), when compared to the unvaccinated patients. The risk of in-hospital mortality was associated with the older age and the presence of multiple comorbidities including bronchial asthma, diabetes, and hypertension. Conclusion Full or partial vaccination against the SARS-CoV-2 variants of concerns might be effective in preventing in-hospital mortality among COVID-19 patients. Copyright © 2022, Kathmandu University. All rights reserved.
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Introduction COVID-19 is a global health crisis for every health professional including radiographers. Adequate knowledge, a good attitude, and safe practice are very important in the present scenario. In this present study, we aim to determine the knowledge, attitude, and practice (KAP) of COVID-19 among radiographers in the kingdom of Himalayas, Nepal. Methods An electronic questionnaire survey consisting of 15 questions, 5 questions for each knowledge, attitude, and practice including socio-demographic variables (gender, age, academic qualification, work experience, workplace, and work province) was conducted from January 5 to February 15, 2021. A score of 1 was given for each correct answer and a score of 0 was given for each incorrect answer. The score 0-60% was considered inadequate and above 60% was considered adequate. Data were analysed using SPSS version 27 (IBM Chicago, United States). A non-parametric test was used since the data did not follow a normal distribution. The p-value was set at a 5% level of significance. Results Total 390 radiographers, 262 male, and 128 females, mean age 27.17±5.64 years, range 20 to 50 were included in this study. The mean knowledge, attitude, and practice were 4.46±0.54, 89.20%, 3.94±0.96, 78.80%, and 4.40±0.77, 88.00% respectively. There was not a statistically significant difference in knowledge and practice according to socio-demographic variables. However, there was a statistically significant difference in attitude according to gender and work province but was not statistically significant by age group, academic qualification, work experience, and workplace. Conclusion The radiographers in Nepal had adequate knowledge, a good attitude, and safe practice during the COVID-19 crisis.
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Background/Case Studies: TACO is a leading cause of reported fatalities, presenting as respiratory distress with cardiogenic pulmonary edema. The objective was to assess TACO occurrence and potential risk factors among the U.S. population ages 65 and older transfused in the inpatient setting before and during COVID-19 pandemic. Study Design/Methods: This is a hypothesis-generating study utilizing large Medicare databases for January 1, 2011-December 31, 2021. Transfusions were identified by recorded procedure and revenue center codes, and TACO by diagnosis codes. We evaluated unadjusted TACO rates (per 100,000 inpatient transfusion stays): overall, 2 years pre- and during pandemic, by immunocompromised (IC) and COVID-19 status, calendar year, demographics, blood components and number of units. We also assessed inpatient mortality, Charlson Comorbidity Index (CCI) score, ICU/CCU admission, and length of stay (LOS). Fisher's exact tests were performed to compare rates, and Cochran-Armitage tests to ascertain trends by year, age, and units. Results/Findings: Of 13,352,710 inpatient transfusion stays, 12,483 had a TACO diagnosis, an overall rate of 93.5 per 100,000 stays, with 2-year pre- and pandemic rates of 122.7 and 117.4. The annual TACO rates ranged from 61.9 in 2011 to 122.3 in 2021 (p < 0.001). Rates by units increased from 47.2 for 1 unit to 200.8 for >9 units (p < 0.001). Rates by blood components were for convalescent plasma only: 26.5;platelets only: 52.3;plasma only: 64.5;RBCs only: 97.9;RBCs and plasma: 203.0;RBCs and platelets: 237.8;and RBCs, plasma, and platelets: 223.1. Rates by age group ranged from 69.8 for 65-69 to 118.2 for 85+ (p < 0.001). Rates among females and males were 102.2 and 82.8 (p < 0.001);whites and nonwhites: 98.0 and 71.7 (p < 0.001). For IC vs. non-IC, rates were 138.9 vs. 81.7 [rate ratio 1.7 (95% CI 1.6-1.8)]. During pandemic, TACO rates were 39.3 for transfusion stays with vs. 127.8 without COVID-19 (p < 0.001). TACO cases with vs. without COVID-19 were ages 85+ (18.1% vs. 25.0%), females (50.0% vs. 58.4%);had CCI>=3 (50.0% vs. 66.2%), ICU/CCU admission (69.4% vs. 59.3%), mechanical ventilation (40.3% vs. 11.1%), LOS>=11 - days (51.4% vs. 28.1%), and inpatient mortality (45.8% vs. 8.5%). Conclusion(s): Our 11-year population-based study shows significantly increasing TACO trends over time, with greater number of units and advancing age. The study identified similar TACO risk during and pre-pandemic. By components, the highest TACO risk was for RBCs, either alone or in combination, while one of the lowest risks was for convalescent plasma only. Findings show higher rates for IC vs. non-IC, females vs. males, and whites vs. non-whites. For stays with COVID-19, TACO rates were substantially lower, but with marked case severity, which requires further investigation.
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Background The nationwide lockdown was imposed upon by the Government of Nepal with regards to the COVID-19 pandemic. Even during times of limited mobility and travel, trauma cases were presenting to the hospital. Objective To asses trauma patterns among patients presented to the Emergency department in Dhulikhel hospital during the lockdown period. The assessment of the burden of trauma during the pandemic could aid in planning allocation of resources and improving trauma care. Method A retrospective cross-sectional study design was used to assess all patients with a history of trauma during the period of lockdown announced by the Government of Nepal for COVID-19 from March 24 to June 14, 2020. Result Among 2097 patients that visited the emergency department, 23% were trauma cases. In comparison to the corresponding time-period in 2019, trauma cases reduced by more than half (54.5%). The majority of patients utilized ambulances as a means of transportation;a few patients utilized Dhulikhel emergency medical services. The most common mechanism of injury was fall injury, followed by motor vehicle accident and physical assault. Traumatic brain injury occurred in 30% of patients. Of all patients, 71% were discharged after initial treatment, 26% were admitted to different wards and 3% were referred to other health centres. Conclusion Fall injury is a crucial public health concern followed by motor vehicle accident among trauma patients even during the pandemic condition. Thus, emergency rooms should aid in planning for preparedness, mitigation of trauma during situations like these, in planning the allocation of resources and improving trauma care. Copyright © 2022, Kathmandu University. All rights reserved.
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Background The coronavirus pandemic preparedness and response activities began in Nepal after the detection of the first case on 24 January 2020. Highest daily case record in June 2020 was 671, but it reached above 5,000 in October 2020. Objective This study assessed preparedness and response status of government designated COVID-19 clinics and various level hospitals. Method A web-based survey was conducted among government designated COVID-19 clinics and Level hospitals in June 2020. The Medical Operations Division of the COVID-19 Crisis Management Center (CCMC) retained contact list of focal person in each facility for regular updates. Forty-nine out of 125 clinics and all level hospitals (five Level-1, 12 Level-2, three Level-3) provided responses. Result There were 25 or less isolation beds in the majority of COVID-19 clinics (83.7%) and Level-1 hospitals (60%), whereas the majority of Level-2 (92%) and Level-3 hospitals (67%) had arranged >25 beds. Only five clinics, one Level-1 hospital, six Level-2 and two Level-3 hospitals had a surge capacity of additional 20 or more isolation beds. Only one-fourth of the designated health facilities had arranged separate isolation facility for vulnerable population. Majority of the designated clinics and Level-1 hospitals had five or less functional ICU beds and functional ventilators. Very few Level-2 hospitals had > 10 ICU beds and > 10 ventilators. Healthcare workers in the majority of facilities were trained on donning/doffing, hand washing, swab collection, and healthcare waste management, but, a very few received formal training on patient transport, dead body management, epidemic drill, and critical care. Conclusion This study revealed insufficient preparation in COVID-19 facilities during the initial phase of pandemic. The findings were utilized by the government stakeholders at central, provincial and local levels for scaling up surge capacity and improving health services at the time of case surge. As the pandemic itself is a dynamic process, periodic assessments are needed to gauze preparedness and response during different phases of disease outbreak. Copyright © 2022, Kathmandu University. All rights reserved.
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Background: Our 2019 Clinical Audit for non-operatively managed hip fractures at our Trust was 9.76% against the national standard of 5% at The National Hip Fracture Database (NHFD) annual report 2017. A re-audit was conducted to review reasons for higher incidence as recommended by NICE and improve outcomes. Method: Hip fracture patients admitted between 1st April 2019 and 31st August 2020 to Southport and Ormskirk NHS Trust were reviewed clinico-radiologically. Data was collected from NHFD, EVOLVE patient records, and PACS imaging systems. Following appropriate “Primary Diagnosis” of hip fracture, confirmation of operative or non-operative management was undertaken following a joint assessment by the Orthopaedic staff and the Clinical Coding department evaluating reasons behind the decision. Secondary outcome measures compared 30-day and one-year mortality with the previous cohort. Results: In the re-audit, 512 cases were reviewed, 50 patients excluded following correct Clinical Coding, 440 hips were operated and 22 (4.8%) managed non-operatively. However, 30-day mortality rose from 30.5% during the audit to 54.50% possibly due to the effect of COVID-19. Conclusions: The newly introduced “Neck of Femur Proforma” has remarkably improved the quality and organization of clinical documentation of diagnosis. Appropriate Clinical Coding allows correct information for the NHFD Trust figures.
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Background With the surge of COVID-19 cases worldwide, vaccines against COVID-19 are also developing across the countries. However, the acceptability of COVID-19 vaccination among general people is questionable. The availability of several vaccines’ options against COVID-19 has perplexed people regarding individual vaccines’ efficacy and safety. Therefore, we aim to determine the acceptance, preferences, impact factors of future COVID-19 vaccines in Malaysia and the factors influencing the COVID-19 vaccination acceptance among vaccine demand and vaccine delay groups. Material and methods An online-based cross-sectional survey was conducted among Malaysian residents 18 years and above of either gender using the snowball sampling technique. A self-administered questionnaire was made available to participants through various social media networks, email, and telegram. The data obtained from the survey were analyzed using SPSS version 25.0. Association between background characteristics and respondents were analyzed using the Chi-square test in the vaccine delay group and vaccine acceptance group. Results Total of 1282 responses were considered for the study, mainly from male respondents (71%). Among the respondents, 95.9% thought that vaccination would be an effective way to prevent and control COVID-19, and 96% would accept vaccination if the COVID-19 vaccine were successfully developed and approved for listing in the future. Essential factors influencing vaccination decisions were vaccine convenience (95.7%) and doctor's recommendation (97.3%). Bivariate analysis revealed that age less than 24 years, Malay race, living in urban areas, tertiary education, students, single marital status, family income (Malaysian ringgits) RM 4,850 to RM 10,959 and >RM 10,960 were significantly associated with vaccine acceptance of COVID19 vaccination. Conclusion All the factors influencing COVID-19 vaccine acceptance rates throughout the country should be studied on a larger scale, and appropriate steps to ensure vaccine acceptance among the public should be meticulously devised by the government and related authorities.
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Background: COVID-19 pandemic has caused an extraordinary situation, especially for the healthcare workers (HCWs), leading to increased psychological stress. The aim of the study was to estimate the prevalence of different grades of anxiety and depression across different centers in the Philippines and identify demographic factors associated with them. Design and Method: A cross-sectional, web-based, multi-center study was conducted among HCWs of Philippines from April 20- May 20, 2020. The study instruments used were the Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire (PHQ-9). Risk perception scores were analyzed using Mann-Whitney and Kruskal-Wallis test. Logistic regression was done to identify factors significantly associated with symptoms of anxiety and depression determined. Results: A total of 516 HCWs were included in the study. Most of them have anxiety symptoms (70.74%), but only half of them have symptoms of depression (50.97%). In addition, gender, age, marital status, living status, occupation, work premises, and availability of mental health services were significantly associated with the participants' anxiety symptoms. In contrast, gender, marital status, occupation, and work premises were significantly associated with depression symptoms. Conclusion: This study reiterates the fact and demonstrates that COVID-19 has disrupted the mental well-being of HCWs in the Philippines. Majority of HCW was psychologically affected by COVID-19. Therefore, there is a dire need to address mental illness amongst HCWs and frame guidelines based on proven algorithms to overcome these mental illnesses.
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Introduction: Coronavirus disease (COVID-19) pandemic has affected large number of people globally and has continued to spread. Preparedness of individual nations and the hospitals is important to effectively deal with the surge of cases. We aimed to obtain nation wide data from Nepal, about hospital preparedness for COVID-19.
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In the twenty-first century, Internet of Things (IoT) has boomed to be impossible to not to relate to. From computers, mobile phones, smart watches or your virtual assistants, everything is connected to the complex web of IoT. With the technological development in this century, healthcare sector has also had its fair share of innovations including innovation related to healthcare, diagnostics, sensors, or even data analytic along with development in Machine Learning and Artificial Intelligence. IoT in healthcare is expected to help improve the quality of life for the people due to the flexibility that it provides. We looked at the significant amount of work done in this sector, and found a trend that COVID-19 has only spurred the development of this field. We explored both the benefits and challenges that IoT in Healthcare might possess and have addressed challenges such as data security, cloud integration problems. Additionally, we looked at the issue of data security in depth and along with the current method of LSCSH being used, we have recommended that Zero-trust architecture being used as well as it caters to the needs of the evolving data management space. From 2013, IoT in healthcare has dominated the space as new devices are released and there has been a boom of devices that are being developed and being researched on. Most of the devices are affordable and some can even be accessed with a small subscription fee. Our results show us that IoT has started to pick up its popularity since 2015 as companies succeeded to win the trust of the market. Even though most of the development for these technologies look to come in the future, the progress made in the recent years look promising. © 2021 IEEE.
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In 2020, there was a sudden and internationally widespread shift towards remote learning, primarily stemming from a need to facilitate learning while also maintaining the physical safety of students and community members. While there are benefits to remote learning, increased integration and use of Internet Communication Technology (ICT) has the potential to create opportunities for cyber threats that exist within the digital environment. These threats can range from unauthorized use of webcam, an increased risk for phishing, to increased time spent online and risk of cyberbullying as well. To this aid, our goal is to seek to understand the users' privacy concerns and security risks related to the remote learning process. For this, we conducted a survey-based study with 520 participants. Through thematic analysis we obtained an understanding of the perceptions of parents, teachers, and caregivers of children attending online educational institutions. We found that most participants have experienced a cybersecurity or privacy-related incident pertaining to remote learning. We conclude by providing suggestions based on our findings to create a more secure and privacy-preserving online education experience for the users. © 2021 ACM.
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The course of the coronavirus disease (COVID-19) pandemic has significantly affected the healthcare systems in multiple ways, the programs of control and the management of patients with other infectious diseases as well as with chronic and acute non-communicable diseases, including those conditions requiring blood transfusions. Blood donations have been decreasing over time in multiple countries with their expected consequences. Although the spread of SARS-CoV-2 has not been detected via blood transfusion, the increasing fear and anxiety among communities have led to a substantial decrease in blood donations. Several research groups have raised concerns about the consequences associated with the scarcity of blood. However, it is critical to understand the underlying causes of the sharp decline in blood donations, as well as the consequences. Hence, we discuss the impact of blood scarcity at the blood banks during the COVID-19 pandemic as well as strategies to promote blood donations, given the experience in some countries with this situation. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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Background: With the surge of COVID-19 cases worldwide, vaccines against COVID-19 are also developing across the countries. However, the acceptability of COVID-19 vaccination among general people is questionable. The availability of several vaccines' options against COVID-19 has perplexed people regarding individual vaccines' efficacy and safety. Therefore, we aim to determine the acceptance, preferences, impact factors of future COVID-19 vaccines in Malaysia and the factors influencing the COVID-19 vaccination acceptance among vaccine demand and vaccine delay groups. Material and methods: An online-based cross-sectional survey was conducted among Malaysian residents 18 years and above of either gender using the snowball sampling technique. A self-administered questionnaire was made available to participants through various social media networks, email, and telegram. The data obtained from the survey were analyzed using SPSS version 25.0. Association between background characteristics and respondents were analyzed using the Chi-square test in the vaccine delay group and vaccine acceptance group. Results: Total of 1282 responses were considered for the study, mainly from male respondents (71%). Among the respondents, 95.9% thought that vaccination would be an effective way to prevent and control COVID-19, and 96% would accept vaccination if the COVID-19 vaccine were successfully developed and approved for listing in the future. Essential factors influencing vaccination decisions were vaccine convenience (95.7%) and doctor's recommendation (97.3%). Bivariate analysis revealed that age less than 24 years, Malay race, living in urban areas, tertiary education, students, single marital status, family income (Malaysian ringgits) RM 4,850 to RM 10,959 and >RM 10,960 were significantly associated with vaccine acceptance of COVID19 vaccination. Conclusion: All the factors influencing COVID-19 vaccine acceptance rates throughout the country should be studied on a larger scale, and appropriate steps to ensure vaccine acceptance among the public should be meticulously devised by the government and related authorities.
Antecedentes: Con el aumento de casos de COVID-19 en todo el mundo, las vacunas contra la COVID-19 también están en desarrollo en todos los países. Sin embargo, la aceptabilidad de la vacuna COVID-19 entre la gente en general es cuestionable. La disponibilidad de varias opciones de vacunas contra COVID-19 ha dejado perpleja a la gente con respecto a la eficacia y seguridad de las vacunas individuales. Por lo tanto, tenemos como objetivo determinar la aceptación, las preferencias y los factores de impacto de las futuras vacunas COVID-19 en Malasia y los factores que influyen en la aceptación de la vacunación COVID-19 entre la demanda de vacunas y los grupos de demora de la vacuna. Material y métodos: Se realizó una encuesta transversal en línea entre residentes de Malasia de 18 años o más de cualquier género utilizando la técnica de muestreo de bola de nieve. Se puso a disposición de los participantes un cuestionario autoadministrado a través de varias redes sociales, correo electrónico y telegrama. Los datos obtenidos de la encuesta se analizaron con el programa SPSS versión 25.0. La asociación entre las características de fondo y los encuestados fueron analizados usando la prueba de χ2 en el grupo de demora de la vacuna y el grupo de aceptación de la vacuna. Resultados: Se consideró un total de 1.282 respuestas para el estudio, principalmente de hombres encuestados (71%). Entre los encuestados, el 95,9% pensó que la vacunación sería una forma eficaz de prevenir y controlar la COVID-19, y el 96% aceptaría la vacunación si la vacuna COVID-19 se desarrollara con éxito y se aprobara para su inclusión en el futuro. Factores esenciales que influyeron en las decisiones de vacunación fueron la conveniencia de la vacuna (95,7%) y la recomendación del médico (97,3%). El análisis bivariado reveló que la edad < 24 años, la raza malaya, la vida en áreas urbanas, educación terciaria, estudiantes, estado civil soltero, ingresos familiares RM 4,850 a RM 10,959 y > RM 10,960 (en ringgits, moneda malaya), se asociaron significativamente con la aceptación de la vacuna COVID-19. Conclusión: Todos los factores que influyen en las tasas de aceptación de la vacuna COVID-19 en todo el país deben estudiarse a mayor escala, y el gobierno y las autoridades relacionadas deben diseñar meticulosamente los pasos apropiados para asegurar la aceptación de la vacuna entre el público.