ABSTRACT
Introduction: The aims of this study were to determine the prevalence and post-immunisation adverse events of COVID-19 vaccination in chronic hemodialysis patients in Senegal and to assess the factors associated with their occurrence. Method(s): This was a cross-sectional, multicenter, descriptive and analytical study from 1 April to 1 July 2021 including all chronic hemodialysis patients in the targeted centers who received at least one dose of COVID-19 vaccine and consented to participate in the study. Chronic hemodialysis patients unable to complete the questionnaire are not included. For each patient included, the following parameters were studied: socio-demographic data, history and comorbidities and COVID-19 vaccination (type of vaccine, existence of side effects and their type, and time of occurrence). Result(s): Of 535 chronic hemodialysis patients surveyed, 367 were included, representing a prevalence of 68.6% of COVID-19 vaccination. The median age was 51 years with extremes of 20 and 100 years and a sex ratio of 1.08. The most representative age group was over 60 years with 30.3%. The median duration of dialysis was 44.5 months with an interquartile range of [25;73] and extremes of 3 and 183 months. Patients with less than 30 months on dialysis (31.9%) were more represented. Hypertensive nephropathy was the most frequent cause of chronic kidney disease. It was observed in 128 patients (34.9%). The AstraZeneca vaccine was the most widely administered vaccine (98.4%). Post-immunisation adverse events were noted in 52.6% of patients. They were dominated by local side effects (65.6%) followed by influenza-like illness (60.8%). Other side effects were digestive (11,1%), neurological (9%), otorhinolaryngological (5,3%) and cardiovascular (4,8%). No deaths were recorded. One case of post-vaccination cellulitis was noted. Coagulation of the extracorporeal circuit during the 4 sessions of hemodialysis following the vaccination, despite the anticoagulation of the latter, was observed in one patient. Side effects occurred mainly on the day after vaccination in 56% of patients. Age < 50 years, diabetes and anticoagulation were associated with post-immunisation adverse events in the bivariate analysis. In the multivariate analysis, age < 50 years was a risk factor and anticoagulation had a protective effect. Conclusion(s): Vaccination against COVID-19 is well tolerated in chronic hemodialysis patients. No conflict of interestCopyright © 2023
ABSTRACT
Introduction The COVID-19 crisis has disrupted health systems all over the world. In a survey by the WHO, 93% of the countries reported disruption in their mental health services. This research assessed the extent to which mental health was included in the national response to the COVID-19 pandemic in African countries. It also explored barriers and enablers to mental health integration into the COVID-19 response. Lessons learned from COVID-19 can help improve the response to future public health emergencies. Methods A web-based survey was sent to mental health focal points in 55 African countries. The survey assessed the perceived degree of implementation of the Inter-Agency Standing Committee (IASC) “14 Globally Recommended Activities” for mental health response to COVID-19. This was followed by in-depth interviews to explore barriers and enablers to mental health integration into the COVID-19 response. Results Responses were received from 28 countries. Lack of political will, poor funding, limited human resources, and weak pre-existing mental health systems were the key challenges in addressing mental health needs during COVID-19. Participants highlighted the need to capitalize on the increased attention to mental health during COVID-19 to support its integration into the emergency preparedness and response plans and strengthen health systems in the longer term. They have also stressed the importance of sustaining and strengthening the new partnerships and service delivery models that emerged during the COVID-19 pandemic. Conclusions The number of recommended mental health activities implemented during the COVID-19 pandemic varied considerably across African countries. Several factors limit mental health integration into emergency response. However, there are signs of optimism, as mental health gained some attention during COVID-19, which can be built on to integrate mental health into emergency response and strengthen health systems in the long term. Key messages • Capitalize on the increased attention to mental health during COVID-19 to support its integration into the emergency preparedness and response plans and strengthen health systems in the long term. • Sustain and strengthen the new partnerships and service delivery models that emerged during the COVID-19 pandemic.