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1.
Public Health ; 202: 93-99, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1517449

ABSTRACT

OBJECTIVES: The Government of India prohibited the sale of tobacco products during the COVID-19 lockdown to prevent the spread of the SARS-CoV-2 virus. This study assessed the tobacco cessation behaviour and its predictors among adult tobacco users during the initial COVID-19 lockdown period in India. METHODS: A cross-sectional study was conducted with 801 adult tobacco users (both smoking and smokeless tobacco) in two urban metropolitan cities of India over a 2-month period (July to August 2020). The study assessed complete tobacco cessation and quit attempts during the lockdown period. Logistic and negative binomial regression models were used to study the correlates of tobacco cessation and quit attempts, respectively. RESULTS: In total, 90 (11.3%) tobacco users reported that they had quit using tobacco after the COVID-19 lockdown period. Overall, a median of two quit attempts (interquartile range 0-6) was made by tobacco users. Participants with good knowledge on the harmful effects of tobacco use and COVID-19 were significantly more likely to quit tobacco use (odds ratio [OR] 2.2; 95% confidence interval [CI] 1.2-4.0) and reported more quit attempts (incidence risk ratio 5.7; 95% CI 2.8-11.8) compared to those with poor knowledge. Participants who had access to tobacco products were less likely to quit tobacco use compared to those who had no access (OR 0.3; 95% CI 0.2-0.5]. CONCLUSIONS: Access restrictions and correct knowledge on the harmful effects of tobacco use and COVID-19 can play an important role in creating a conducive environment for tobacco cessation among users.


Subject(s)
COVID-19 , Smoking Cessation , Tobacco Use Cessation , Adult , Communicable Disease Control , Cross-Sectional Studies , Humans , India , SARS-CoV-2
2.
Diabetes Metab Res Rev ; : e3506, 2021 Oct 22.
Article in English | MEDLINE | ID: covidwho-1479398

ABSTRACT

INTRODUCTION: The COVID-19 pandemic might have a multifaceted effect on children with type 1 diabetes (T1D), either directly through infection itself or indirectly due to measures implemented by health authorities to control the pandemic. OBJECTIVE: To compare data on children newly diagnosed with T1D in Kuwait during the COVID-19 pandemic to the pre-pandemic period. RESEARCH DESIGN AND METHODS: We analysed data on children aged 12 years or less registered in the Childhood-Onset Diabetes electronic Registry (CODeR) in Kuwait. Data were incidence rate (IR), diabetic ketoacidosis (DKA), and its severity and admission to the paediatric intensive care unit (PICU). RESULTS: The IR of T1D was 40.2 per 100,000 (95% CI; 36.0-44.8) during the COVID-19 pandemic period and was not statistically different from pre-pandemic. A higher proportion of incident T1D cases presented with DKA and were admitted to the PICU during the pandemic (52.2% vs. 37.8%: p Ë‚ 0.001, 19.8% vs. 10.9%; p = 0.002, respectively). The COVID-19 pandemic was positively associated with presentation of DKA and admission to PICU (AOR = 1.73; 95% CI, 1.13-2.65; p = 0.012, AOR = 2.04; 95% CI, 1.13-3.67; p = 0.018, respectively). Children of families with a positive history for diabetes were less likely to present with DKA and get admitted to the PICU during the COVID-19 pandemic (AOR = 0.38; 95% CI, 0.20-0.74; p = 0.004, AOR = 0.22; 95% CI, 0.08-0.61; p = 0.004, respectively). CONCLUSION: High rates of DKA at presentation and admission to PICU in incident T1D cases during the COVID-19 pandemic warrant further studies and effective mitigation efforts through increasing awareness, early detection, and timely intervention.

3.
5.
J Med Internet Res ; 23(7): e27682, 2021 07 08.
Article in English | MEDLINE | ID: covidwho-1278297

ABSTRACT

The COVID-19 pandemic created numerous barriers to the implementation of participant-facing research. For most, the pandemic required rapid transitioning to all virtual platforms. During this pandemic, the most vulnerable populations are at highest risk of falling through the cracks of engagement in clinical care and research. Nonetheless, we argue that we should reframe the discussion to consider how this transition may create opportunities to engage extensively to reach populations. Here, we present our experience in Atlanta (Georgia, United States) in transitioning a group visit model for South Asian immigrants to a virtual platform and the pivotal role community members in the form of community health workers can play in building capacity among participants. We provide details on how this model helped address common barriers to group visit models in clinical practice and how our community health worker team innovatively addressed the digital challenges of working with an elderly population with limited English proficiency.


Subject(s)
COVID-19 , Community Health Workers , Digital Divide , Emigrants and Immigrants , Pandemics , Telemedicine , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Capacity Building , Female , Georgia/epidemiology , Humans , Male , Middle Aged , SARS-CoV-2 , Vulnerable Populations
6.
BMJ Open ; 11(6): e048926, 2021 06 18.
Article in English | MEDLINE | ID: covidwho-1276965

ABSTRACT

OBJECTIVE: People with chronic conditions are known to be vulnerable to the COVID-19 pandemic. This study aims to describe patients' lived experiences, challenges faced by people with chronic conditions, their coping strategies, and the social and economic impacts of the COVID-19 pandemic. DESIGN, SETTING AND PARTICIPANTS: We conducted a qualitative study using a syndemic framework to understand the patients' experiences of chronic disease care, challenges faced during the lockdown, their coping strategies and mitigators during the COVID-19 pandemic in the context of socioecological and biological factors. A diverse sample of 41 participants with chronic conditions (hypertension, diabetes, stroke and cardiovascular diseases) from four sites (Delhi, Haryana, Vizag and Chennai) in India participated in semistructured interviews. All interviews were audio recorded, transcribed, translated, anonymised and coded using MAXQDA software. We used the framework method to qualitatively analyse the COVID-19 pandemic impacts on health, social and economic well-being. RESULTS: Participant experiences during the COVID-19 pandemic were categorised into four themes: challenges faced during the lockdown, experiences of the participants diagnosed with COVID-19, preventive measures taken and lessons learnt during the COVID-19 pandemic. A subgroup of participants faced difficulties in accessing healthcare while a few reported using teleconsultations. Most participants reported adverse economic impact of the pandemic which led to higher reporting of anxiety and stress. Participants who tested COVID-19 positive reported experiencing discrimination and stigma from neighbours. All participants reported taking essential preventive measures. CONCLUSION: People with chronic conditions experienced a confluence (reciprocal effect) of COVID-19 pandemic and chronic diseases in the context of difficulty in accessing healthcare, sedentary lifestyle and increased stress and anxiety. Patients' lived experiences during the pandemic provide important insights to inform effective transition to a mixed realm of online consultations and 'distanced' physical clinic visits.


Subject(s)
COVID-19 , Pandemics , Chronic Disease , Communicable Disease Control , Humans , India/epidemiology , Patient Outcome Assessment , Perception , Qualitative Research , SARS-CoV-2
7.
BMC Public Health ; 21(1): 685, 2021 04 08.
Article in English | MEDLINE | ID: covidwho-1175313

ABSTRACT

BACKGROUND: People with chronic conditions are disproportionately prone to be affected by the COVID-19 pandemic but there are limited data documenting this. We aimed to assess the health, psychosocial and economic impacts of the COVID-19 pandemic on people with chronic conditions in India. METHODS: Between July 29, to September 12, 2020, we telephonically surveyed adults (n = 2335) with chronic conditions across four sites in India. Data on participants' demographic, socio-economic status, comorbidities, access to health care, treatment satisfaction, self-care behaviors, employment, and income were collected using pre-tested questionnaires. We performed multivariable logistic regression analysis to examine the factors associated with difficulty in accessing medicines and worsening of diabetes or hypertension symptoms. Further, a diverse sample of 40 participants completed qualitative interviews that focused on eliciting patient's experiences during the COVID-19 lockdowns and data analyzed using thematic analysis. RESULTS: One thousand seven hundred thirty-four individuals completed the survey (response rate = 74%). The mean (SD) age of respondents was 57.8 years (11.3) and 50% were men. During the COVID-19 lockdowns in India, 83% of participants reported difficulty in accessing healthcare, 17% faced difficulties in accessing medicines, 59% reported loss of income, 38% lost jobs, and 28% reduced fruit and vegetable consumption. In the final-adjusted regression model, rural residence (OR, 95%CI: 4.01,2.90-5.53), having diabetes (2.42, 1.81-3.25) and hypertension (1.70,1.27-2.27), and loss of income (2.30,1.62-3.26) were significantly associated with difficulty in accessing medicines. Further, difficulties in accessing medicines (3.67,2.52-5.35), and job loss (1.90,1.25-2.89) were associated with worsening of diabetes or hypertension symptoms. Qualitative data suggest most participants experienced psychosocial distress due to loss of job or income and had difficulties in accessing in-patient services. CONCLUSION: People with chronic conditions, particularly among poor, rural, and marginalized populations, have experienced difficulties in accessing healthcare and been severely affected both socially and financially by the COVID-19 pandemic.


Subject(s)
COVID-19 , Chronic Disease , Pandemics , Aged , COVID-19/economics , COVID-19/epidemiology , COVID-19/psychology , Chronic Disease/epidemiology , Chronic Disease/therapy , Female , Health Services Accessibility/statistics & numerical data , Health Status , Humans , India/epidemiology , Male , Middle Aged , Qualitative Research , Quarantine , Socioeconomic Factors , Surveys and Questionnaires
8.
Remote Sens (Basel) ; 13(7)2021 Apr.
Article in English | MEDLINE | ID: covidwho-1167697

ABSTRACT

China implemented an aggressive nationwide lockdown procedure immediately after the COVID-19 outbreak in January 2020. As China emerges from the impact of COVID-19 on national economic and industrial activities, it has become the site of a large-scale natural experiment to evaluate the impact of COVID-19 on regional air quality. However, ground measurements of fine particulate matters (PM2.5) concentrations do not offer comprehensive spatial coverage, especially in suburban and rural regions. In this study, we developed a machine learning method with satellite aerosol remote sensing data, meteorological fields and land use parameters as major predictor variables to estimate spatiotemporally resolved daily PM2.5 concentrations in China. Our study period consists of a reference semester (1 November 2018-30 April 2019) and a pandemic semester (1 November 2019-30 April 2020), with six modeling months in each semester. Each period was then divided into subperiod 1 (November and December), subperiod 2 (January and February) and subperiod 3 (March and April). The reference semester model obtained a 10-fold cross-validated R2 (RMSE) of 0.79 (17.55 µg/m3) and the pandemic semester model obtained a 10-fold cross-validated R2 (RMSE) of 0.83 (13.48 µg/m3) for daily PM2.5 predictions. Our prediction results showed high PM2.5 concentrations in the North China Plain, Yangtze River Delta, Sichuan Basin and Xinjiang Autonomous Region during the reference semester. PM2.5 levels were lowered by 4.8 µg/m3 during the pandemic semester compared to the reference semester and PM2.5 levels during subperiod 2 decreased most, by 18%. The southeast region was affected most by the COVID-19 outbreak with PM2.5 levels during subperiod 2 decreasing by 31%, followed by the Northern Yangtze River Delta (29%) and Pearl River Delta (24%).

10.
Int J Infect Dis ; 104: 169-174, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-988036

ABSTRACT

INTRODUCTION: There was a low level of pandemic preparedness in South Asia, but the region has done well in mounting an appropriate response to the coronavirus disease 2019 (COVID-19) pandemic. The rate and proportion of deaths attributed to COVID-19 are lower despite case surges similar to the rest of the world. RESULTS: The COVID-19 pandemic has revealed the glaring vulnerabilities of the health system. In addition, the high burden of non-communicable diseases in South Asia multiplies the complexities in combating present and future health crises. The advantage offered by the younger population demographics in South Asia may not be sustained with the rising burden of non-communicable diseases and lack of priority setting for improving health systems. CONCLUSION: The COVID-19 pandemic has provided a window for introspection, scaling up preparedness for future pandemics, and improving the health of the population overall.


Subject(s)
COVID-19/epidemiology , Pandemics/prevention & control , SARS-CoV-2/isolation & purification , Asia/epidemiology , COVID-19/prevention & control , COVID-19/virology , Humans
12.
Circ Heart Fail ; 13(10): e007218, 2020 10.
Article in English | MEDLINE | ID: covidwho-805484

ABSTRACT

Currently, South Asia accounts for a quarter of the world population, yet it already claims ≈60% of the global burden of heart disease. Besides the epidemics of type 2 diabetes mellitus and coronary heart disease already faced by South Asian countries, recent studies suggest that South Asians may also be at an increased risk of heart failure (HF), and that it presents at earlier ages than in most other racial/ethnic groups. Although a frequently underrecognized threat, an eventual HF epidemic in the densely populated South Asian nations could have dramatic health, social and economic consequences, and urgent interventions are needed to flatten the curve of HF in South Asia. In this review, we discuss recent studies portraying these trends, and describe the mechanisms that may explain an increased risk of premature HF in South Asians compared with other groups, with a special focus on highly relevant features in South Asian populations including premature coronary heart disease, early type 2 diabetes mellitus, ubiquitous abdominal obesity, exposure to the world's highest levels of air pollution, highly prevalent pretransition forms of HF such as rheumatic heart disease, and underdevelopment of healthcare systems. Other rising lifestyle-related risk factors such as use of tobacco products, hypertension, and general obesity are also discussed. We evaluate the prognosis of HF in South Asian countries and the implications of an anticipated HF epidemic. Finally, we discuss proposed interventions aimed at curbing these adverse trends, management approaches that can improve the prognosis of prevalent HF in South Asian countries, and research gaps in this important field.


Subject(s)
Epidemics , Heart Failure/ethnology , Age of Onset , Asia/epidemiology , Health Services Needs and Demand , Heart Failure/diagnosis , Heart Failure/prevention & control , Humans , Needs Assessment , Prevalence , Preventive Health Services , Prognosis , Risk Assessment , Risk Factors , Time Factors
14.
Diabetes Res Clin Pract ; 164: 108215, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-273235

ABSTRACT

Individuals with non-communicable diseases (NCDs) such as diabetes are susceptible to communicable diseases (CDs) as the current COVID-19 pandemic illustrates. The co-occurrence of diabetes as well as other co-morbid conditions with COVID-19 augurs greater risk for severe outcomes and mortality. Hence, NCD and CD pandemics are closely linked and require global efforts to thwart and disrupt their nexus before the next viral outbreaks occurs. This will require steadfast dedication and resolve to address NCDs previously committed to by the global community.


Subject(s)
Coronavirus Infections/epidemiology , Diabetes Mellitus/epidemiology , Pneumonia, Viral/epidemiology , Public Health/methods , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/metabolism , Diabetes Mellitus/virology , Female , Global Health , Humans , Male , Pandemics , Pneumonia, Viral/metabolism , SARS-CoV-2
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