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1.
researchsquare; 2022.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-1947709.v1

ABSTRACT

Introduction: Infection Prevention and Control (IPC) is key in the control of COVID-19 pandemic and one of the pillars considered in the WHO COVID-19 Strategic Preparedness and Response Plan 2020. We conducted an Intra-Action Review (IAR) of IPC response efforts to COVID-19 pandemic in Rohingya refugee camps in Cox’s Bazar, Bangladesh to identify best practices, challenges, and recommendations for improvement of the current and future responses.Methods: Two meetings were conducted with a total of 54 participants purposively selected from different organizations and agencies that had been involved in frontline implementation of IPC in Cox’s Bazar district. We used the IPC trigger questions from the WHO country COVID-19 IAR: trigger question database to guide the discussions. Meetings notes and transcripts were analysed manually using content analysis and results presented in text and quotes.Results: Best practices included: assessments, response plan, working group, trainings, early case identification and isolation, hand hygiene in HFs, monitoring and feedback, general masking in HFs, supportive supervision, design, infrastructure and environmental controls in Severe Acute Respiratory Infection Isolation and Treatment Centres (SARI ITCs) and HFs and waste management. Challenges included: frequent breakdown of incinerators, limited PPE supply, inconsistent adherence to IPC, lack of working uniforms and lack of culture- and gender adapted work uniforms and Personal Protective Equipment (PPE). Recommendations were: institutionalization of IPC, establishment of IPC monitoring mechanisms in all HCFs, strengthening IPC education and training and public health and social measures in communities. Conclusion:  IPC monitoring and continuous training provides critical support in promoting consistent and adaptive IPC implementation. Response to pandemic crisis combined with concurrent emergencies, like a protracted displacement with many, diverse actors, can only be successful with highly coordinated planning, leadership, resource mobilization and close supervision.


Subject(s)
COVID-19
2.
ssrn; 2020.
Preprint in English | PREPRINT-SSRN | ID: ppzbmed-10.2139.ssrn.3728587

ABSTRACT

Background: Rohingya (Forcefully Displaced Myanmar Nationals or FDMNs) in Bangladesh are at increased risk of 2019 coronavirus disease (COVID-19), especially the older population. Given low health literacy among the FDMNs and the adverse situation of their residential camps, there are possibilities of misinformation related to COVID-19 among the older FDMNs who are at greater risk. Therefore, the present research aimed to assess the level of misconceptions and the factors associated with it among the older FDMNs in Bangladesh. Methods: This cross-sectional study was conducted among 416 FDMNs, aged 60 years and above, from a Rohingya camp situated in Cox’s Bazar, a South-Eastern district of Bangladesh. We collected information on 14 different locally relevant misconceptions related to the spread, prevention, and treatment of COVID-19, scored each misconception as one, and obtained a cumulative score of the 14-items, ranging from 0 to 14, with a higher score indicating a higher level of misconceptions. With backward selection based on the Akaike information criterion, a multiple linear regression model explored the factors associated with misconceptions. Findings: The participants had an average of five misconceptions. The most prevalent misconceptions were related to the prevention of COVID-19, i.e., everyone should wear personal protective equipment when outside (86.6%), and its prevention by nutritious food (62.5%) and drinking water (59.3%). Other notable misconceptions included the spread of COVID-19 through mosquito bites (42%) and its transmissions only to the non/less-religious person (31.5%). In regression analyses, memory or concentration problems, communication frequency with social networks, pre-existing conditions, and receiving information from health workers were significantly associated with higher COVID-19 misconceptions. These misconceptions were less likely among those overwhelmed by the pandemic, having COVID-19 diagnosed friends or family members, and receiving information from friends and family. Interpretation: Overall, we found that misconceptions were prevalent among the older FDMNs in Bangladesh. The associations have important implications for programs to prevent and manage COVID-19 in these settings. Health workers need to be adequately trained to provide clear communication and counter misconceptions. Funding: No funding was received for this study.Declaration of Interests: The authors have no conflict of interest to disclose.Ethics Approval Statement: The institutional review board of the Institute of Health Economics, University of Dhaka, Bangladesh, approved the study protocol. Informed written consent was sought from the participants (thumb impressions from those who could not read and write) before administering the survey. Participation was voluntary, and participants did not receive any compensation. Written approval was also sought from the Office of the Refugee Relief and Repatriation Commissioner (RRRC) prior to accessing the camps and conducting the survey.


Subject(s)
Coronavirus Infections , COVID-19
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