ABSTRACT
Background: Bangladesh with its large population is highly vulnerable to the devastating blows of coronavirus disease 2019 (COVID-19) and rural people are more at risks due to demographic characteristics and unequal health facilities. Currently, focuses are more on testing and clinical management of COVID-19 but initiatives or innovations on behavioural changes are almost unseen to prevent the spread of the disease which is more urgent until getting specific treatment or vaccine. Objective: The study was aimed to determine significant predictors in the preventive health practices during COVID-19 pandemic. Methods: The study was conducted among 810 rural adults of Bangladesh in 2020. Multistage sampling method was done and data were collected through face-to-face interview using a pretested questionnaire. Significant factors of COVID-19 prevention behaviour were determined through hierarchical regression and path relationships were explained through causal model. Results: Almost half of the rural adults showed poor COVID-19 prevention behaviour during the pandemic crisis. Poor knowledge and attitude regarding COVID-19 prevention were also common scenarios in rural areas. Majority of the rural adults were not well motivated and lack of seriousness made them more vulnerable for COVID-19. Socio-demographic and regional variation showed significance predicting health practices of rural adults regarding COVID-19 prevention. Information, attitude, motivation and intention were also found significant in hierarchical regression to predict the outcome. The causal model of preventive health behaviour was justified through all the significant direct and indirect path relationships (p<0.001). Conclusion: Socio-economic disparity should be reduced for behavioural changes of rural adults to ensure healthy practices during the pandemic. This study has great implications regarding designing health programs by emphasizing significant predictors to improve community behaviour to prevent the spread of coronavirus.
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SESSION TITLE: Fellows Chest Infections Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: October 18-21, 2020 INTRODUCTION: From Raja Ampat, Indonesia to the Red Sea of Indian Ocean, marine corals have attracted myriad of divers and hobbyists around the world with their rainbow-like colors, assorted shapes and unique symbiotic roles. However, certain species contain some of the deadliest toxins known to human that can subject handlers to health problems and even life-threatening conditions. We report a case of Palythoa coral exposure induced respiratory failure. CASE PRESENTATION: A 44-year-old man with childhood asthma presented to the emergency room with sudden onset of shortness of breath. His symptoms started one hour prior to his arrival and included chills, dyspnea, chest tightness, pleuritic pain and nausea. Further questioning revealed that our patient was cleaning some Palythoa sp. corals out from his saltwater aquarium two hours before he fell sick. He ran a piece of coral over hot water to kill it. It emitted a strong foul odor immediately afterwards. He had never attempted such cleaning process before. He was not wearing any protective equipment but denied using any cleaning chemicals. There was no other pertinent history. Initial vital signs included heart rate of 117, respiratory rate of 28 bpm, blood pressure 123/59, and oxygen saturation of 97% on 75%, 40 liters/min High-Flow Nasal Canula. He was in mild distress. Auscultation revealed decreased bilateral air entry, faint wheezing and mild apical rales. Cardiac, abdominal and neurological exams were otherwise benign. ABG showed pH of 7.42, PaCO2 41, PaO2 52 and HCO3 26. Chest CT revealed diffuse centrilobular ground-glass opacities in an upper-lobe-predominant distribution. Lab studies were significant for lactic acid of 3.4, troponin of 0.44 and BNP at 666 pg/ml. CRP was 293 mg/L and procalcitonin of 15. WBC was 27.3 with 85% neutrophils without eosinophilia. Complete septic workups including atypical pneumonia pathogens, HIV and COVID-19 were negative. Patient’s symptoms subsequently improved with nebulized albuterol treatments, IV steroids and supplemental oxygen. He remained on regular floor with intent for discharge in the following days. DISCUSSION: Palytoxin (PTX), originally described in a Hawaiian legend, is an extremely poisonous substance synthesized by certain species of corals and dinoflagellates. Its lethal power stems from the ability of inactivating the sodium/potassium ATPase pump, thereby destroying cellular ion gradient. Ensuing cardiac, respiratory, renal and hematologic dysfunctions have been observed. Fewer than 300 cases were ever reported worldwide. Most were due to ingestion of contaminated fish, though dermal and inhalational exposure, such as our patient, have been documented. CONCLUSIONS: It thus becomes necessary to take PTX poisoning into consideration, whenever compatible history is provided. While in vitro and in vivo animal studies have been conducted, there is no known antidote. Management is usually supportive. Reference #1: Hamade AK, Deglin SE, McLaughlin JB, et al. Suspected Palytoxin Inhalation Exposures Associated with Zoanthid Corals in Aquarium Shops and Homes - Alaska, 2012-2014. MMWR Morb Mortal Wkly Rep 2015;64:852. Reference #2: Ramos V, Vasconcelos V. Palytoxin and analogs: biological and ecological effects. Mar Drugs. 2010;8(7):2021-2037. Published 2010 Jun 30. doi:10.3390/md8072021 Reference #3: Thakur LK, Jha KK. Palytoxin-induced acute respiratory failure. Respir Med Case Rep. 2016;20:4-6. Published 2016 Oct 21. doi:10.1016/j.rmcr.2016.10.014 DISCLOSURES: No relevant relationships by Mourad Ismail, source=Web Response No relevant relationships by TAWFIQ KARADSHEH, source=Web Response No relevant relationships by William Meng, source=Web Response No relevant relationships by Richard Miller, source=Web Response No relevant relationships by Roberto Solis, source=Web Response No relevant relationships by Yasmeen Sultana, source=Web Response no disclosure on file for Qizhi Wang