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1.
Int J Environ Res Public Health ; 19(20)2022 Oct 14.
Article in English | MEDLINE | ID: covidwho-2071452

ABSTRACT

To date, there is a lack of comprehensive understanding regarding the effect of coronavirus disease 2019 (COVID-19) on the healthcare-seeking behavior and utilization of health services in rural areas where healthcare resources are scarce. We aimed to quantify the long-term impact of COVID-19 on hospital visits of rural residents in China. We collected data on the hospitalization of all residents covered by national health insurance schemes in a county in southern China from April 2017 to March 2021. We analyzed changes in residents' hospitalization visits in different areas, i.e., within-county, out-of-county but within-city, and out-of-city, via a controlled interrupted time series approach. Subgroup analyses based on gender, age, hospital levels, and ICD-10 classifications for hospital visits were examined. After experiencing a significant decline in hospitalization cases after the COVID-19 outbreak in early 2020, the pattern of rural residents' hospitalization utilization differed markedly by disease classification. Notably, we found that the overall demand for hospitalization utilization of mental and neurological illness among rural residents in China has been suppressed during the pandemic, while the utilization of inpatient services for other common chronic diseases was redistributed across regions. Our findings suggest that in resource-poor areas, focused strategies are urgently needed to ensure that people have access to adequate healthcare services, particularly mental and neurological healthcare, during the COVID-19 pandemic.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Interrupted Time Series Analysis , Pandemics , Rural Population , China/epidemiology , Hospitals
2.
Int J Environ Res Public Health ; 19(19)2022 Sep 22.
Article in English | MEDLINE | ID: covidwho-2043722

ABSTRACT

Given the growing body of evidence on COVID-19 vaccine hesitancy among Black populations, the aim of this systematic review was to identify the interventions and strategies used to improve COVID-19 vaccine confidence and uptake among Black populations globally. To identify relevant studies, we conducted a systematic review of the literature based on a systematic search of 10 electronic databases: MEDLINE, Embase, PsycINFO, CINAHL, Scopus, Cochrane Library, Web of Science, Sociological Abstracts, Dissertations and Theses Global, and SocINDEX. We screened a total of 1728 records and included 14 peer-reviewed interventional studies that were conducted to address COVID-19 vaccine hesitancy among Black populations. A critical appraisal of the included studies was performed using the Newcastle-Ottawa Quality Assessment Scale. The intervention strategies for increasing COVID-19 vaccine uptake were synthesized into three major categories: communication and information-based interventions, mandate-based interventions, and incentive-based interventions. Interventions that incorporated communication, community engagement, and culturally inclusive resources significantly improved vaccine uptake among Black populations, while incentive- and mandate-based interventions had less impact. Overall, this systematic review revealed that consideration of the sociocultural, historical, and political contexts of Black populations is important, but tailored interventions that integrate culture-affirming strategies are more likely to decrease COVID-19 vaccine hesitancy and increase uptake among Black populations.


Subject(s)
COVID-19 , Vaccines , Blacks , COVID-19/prevention & control , COVID-19 Vaccines , Communication , Humans
3.
PLoS One ; 17(4): e0266200, 2022.
Article in English | MEDLINE | ID: covidwho-1779762

ABSTRACT

BACKGROUND: Effective migration often requires supports for new arrivals, referred to as settlement services. Settlement services literacy (SSL) is key to ensuring new migrants have the capability to access and utilise the information and services designed to support the resettlement process and achieve positive settlement outcomes. To date, however, no research has sought to empirically validate measures of SSL or to assess individual migrants' levels of SSL. The aim of this study was to establish the psychometric properties of constructs from the conceptual SSL framework. DESIGN: Using a snowball sampling approach, trained multilingual research assistants collected data on 653 participants. The total sample was randomly divided into two split-half samples: one for the exploratory factor analysis (EFA; N = 324) and the other for the confirmatory factor analysis (CFA; N = 329) and scale validation. The final SSL scale included 30 questions. The full data set was used to test the nomological validity of the scale regarding whether the components of SSL impact on migrants' level of acculturative stress. RESULTS: The EFA yielded five factors: knowledge (eight items, α = 0.88), empowerment (five items, α = 0.89), competence (four items, α = 0.86), community influence (four items, α = 0.82), and political (two items, α = 0.81). In the CFA, the initial model demonstrated a poor to marginal fit model. Its re-specification by examining modification indices resulted in a good model fit: CMIN/DF = 3.07, comparative fit index = 0.92, root mean square error of approximation = 0.08 and standardised root mean square residual = 0.07, which are consistent with recommendations. All the path coefficients between the second-order construct (SSL) and its five dimensions (knowledge, empowerment, competence, community influence and political) were significant at an α = .05 level, giving evidence for the validity of different SSL dimensions. We found that SSL is significantly related to migrants' acculturative stress (ß = - 0.39, p < 0.05) in the nomological model. CONCLUSIONS: The study provides evidence of the construct validity and reliability of the SSL tool. It provides the basis for integrating the measures of SSL into evaluation of settlement services. This will allow for more effective decision-making in designing and implementing settlement services as well as funding and service agreements to address any deficiencies.


Subject(s)
Literacy , Transients and Migrants , Factor Analysis, Statistical , Humans , Psychometrics , Reproducibility of Results , Surveys and Questionnaires
4.
Vaccines (Basel) ; 10(2)2022 Feb 11.
Article in English | MEDLINE | ID: covidwho-1687062

ABSTRACT

Objectives: The highly transmissible COVID-19 Delta variant (DV) has contributed to a surge in cases and exacerbated the worldwide public health crisis. Several COVID-19 vaccines play a significant role in a high degree of protection against the DV. The primary purpose of this meta-analysis is to estimate the pooled effectiveness of the COVID-19 vaccines against the DV in terms of risk ratio (RR) among fully vaccinated, compared to unvaccinated populations. Methods: We carried out a systematic review, with meta-analysis of original studies focused on COVID-19 vaccines effectiveness against a DV clinical perspective among fully COVID-19 vaccinated populations, compared to placebo (unvaccinated populations), published between 1 May 2021 and 30 September 2021. Eleven studies containing the data of 17.2 million participants were identified and included in our study. Pooled estimates of COVID-19 vaccines effectiveness (i.e., risk ratio, RR) against the DV with 95% confidence intervals were assessed using random-effect models. Publication bias was assessed using Egger's regression test and funnel plot to investigate potential sources of heterogeneity and identify any differences in study design. Results: A total population of 17.2 million (17,200,341 people) were screened for the COVID-19 vaccines' effectiveness against the DV. We found that 61.13% of the study population were fully vaccinated with two doses of COVID-19 vaccines. The weighted pooled incidence of COVID-19 infection was more than double (20.07%) among the unvaccinated population, compared to the fully vaccinated population (8.16%). Overall, the effectiveness of the COVID-19 vaccine against the DV was 85% (RR = 0.15, 95% CI: 0.07-0.31). The effectiveness of COVID-19 vaccines varied slidably by study designs, 87% (RR = 0.13, 95% CI: 0.06-0.30) and 84% (RR = 0.16, 95% CI: 0.02, 1.64) for cohort and case-control studies, respectively. Conclusions: The effectiveness of COVID-19 vaccines were noted to offer higher protection against the DV among populations who received two vaccine doses compared with the unvaccinated population. This finding would help efforts to maximise vaccine coverage (i.e., at least 60% to 70% of the population), with two doses among vulnerable populations, in order to have herd immunity to break the chain of transmission and gain greater overall population protection more rapidly.

5.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-295378

ABSTRACT

Objectives: The highly transmissible COVID-19 delta variant (DV) has contributed to the surge in cases and has now been exacerbated the worldwide public health crisis. Several COVID-19 vaccines play a significant role in a high degree of protection against DV. The primary purpose of this meta-analysis is to estimate the pooled effectiveness of the COVID-19 vaccines against DV in terms of risk ratio (RR) among fully vaccinated, compared to unvaccinated populations. Methods: We carried out a systematic review with meta-analysis of original studies focused on COVID-19 vaccines effectiveness of COVID-19 vaccines against B.1.617.2 clinical perspective among fully COVID-19 vaccinated populations, compared to placebo (unvaccinated populations), published before September 30, 2021. Eleven studies containing data of 17.2 million participants were identified and included in our study. Pooled estimates of COVID-19 vaccines effectiveness (i.e., risk ratio, RR) against delta variant with 95% confidence intervals were assessed using random-effect models. Publication bias was assessed using Egger's regression test and funnel plot to investigate potential sources of heterogeneity and identify any differences in study design. Results: A total population of 17.2 million (17,200,341 peoples) were screened for the COVID-19 vaccines' effectiveness against delta variant. We found 61.13% of study population were fully vaccinated with 2-dose of COVID-19 vaccines. Weighted pooled incidence of COVID-19 infection was more than double (20.07%) among unvaccinated populations, compared to the fully vaccinated population (8.16%). Overall, the effectiveness of COVID-19 vaccine against DV was 85% (RR = 0.15, 95% CI: 0.07-0.31). The effectiveness of COVID-19 vaccines varied slidably by study designs, 87% (RR = 0.13, 95% CI: 0.06-0.30) and 84% (RR = 0.16, 95% CI:0.02, 1.64) for cohort and case-control studies, respectively. Conclusion: Effectiveness COVID-19 vaccines were noted to offer higher protection against delta variant among populations who received two vaccine doses compared with unvaccinated populations. This finding would help efforts to maximise vaccine coverage (i.e., at least 60 to 70% of the population) with two doses among vulnerable populations to have herd immunity to breat the chain of transmission and gain greater overall population protection more rapidly.

6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-293521

ABSTRACT

Objectives: The highly transmissible COVID-19 delta variant (DV) has contributed to the surge in cases and has now been exacerbated the worldwide public health crisis. Several COVID-19 vaccines play a significant role in a high degree of protection against DV. The primary purpose of this meta-analysis is to estimate the pooled effectiveness of the COVID-19 vaccines against DV in terms of risk ratio (RR) among fully vaccinated, compared to unvaccinated populations. Methods: We carried out a systematic review with meta-analysis of original studies focused on COVID-19 vaccines effectiveness of COVID-19 vaccines against B.1.617.2 clinical perspective among fully COVID-19 vaccinated populations, compared to placebo (unvaccinated populations), published before September 30, 2021. Eleven studies containing data of 17.2 million participants were identified and included in our study. Pooled estimates of COVID-19 vaccines effectiveness (i.e., risk ratio, RR) against delta variant with 95% confidence intervals were assessed using random-effect models. Publication bias was assessed using Egger's regression test and funnel plot to investigate potential sources of heterogeneity and identify any differences in study design. Results: A total population of 17.2 million (17,200,341 peoples) were screened for the COVID-19 vaccines' effectiveness against delta variant. We found 61.13% of study population were fully vaccinated with 2-dose of COVID-19 vaccines. Weighted pooled incidence of COVID-19 infection was more than double (20.07%) among unvaccinated populations, compared to the fully vaccinated population (8.16%). Overall, the effectiveness of COVID-19 vaccine against DV was 85% (RR = 0.15, 95% CI: 0.07-0.31). The effectiveness of COVID-19 vaccines varied slidably by study designs, 87% (RR = 0.13, 95% CI: 0.06-0.30) and 84% (RR = 0.16, 95% CI:0.02, 1.64) for cohort and case-control studies, respectively. Conclusion: Effectiveness COVID-19 vaccines were noted to offer higher protection against delta variant among populations who received two vaccine doses compared with unvaccinated populations. This finding would help efforts to maximise vaccine coverage (i.e., at least 60 to 70% of the population) with two doses among vulnerable populations to have herd immunity to breat the chain of transmission and gain greater overall population protection more rapidly.

7.
Risk Anal ; 41(5): 831-836, 2021 05.
Article in English | MEDLINE | ID: covidwho-781021

ABSTRACT

The 2014-2016 Ebola outbreak in West Africa extracted huge health, social, and economic costs. How can lessons learnt during the 2014-2016 Ebola outbreak in West Africa help to mitigate the likelihood of a long-term devastating effect of the coronavirus disease (COVID-19) outbreak on the African continent? Despite COVID-19 spreading quickly across the globe after being first reported in Wuhan, China on December 31, 2019, African countries remained relatively unaffected until the second week of March 2020. The majority of Africa countries have been at low to moderate risk. However, they have experienced many sociocultural, economic, political, and structural challenges. These have included laboratory capacity and logistical challenges; ill-equipped public health systems; land border permeability, and delayed preparedness to transnational threats; and abject economic deprivation, lack of basic infrastructure, and associated sociocultural implications. There needs to be a strong country-level leadership to coordinate and own all aspects of the responses to the COVID-19 pandemic in a collaborative, transparent, and accountable way. Strategic and sustained response plans to fight the pandemic should incorporate culturally competent strategies that harness different cultural practices and strengthen cultural security. They should also promote and strengthen the implementation of the International Health Regulations.


Subject(s)
COVID-19/epidemiology , Human Migration , Pandemics , SARS-CoV-2/isolation & purification , Africa/epidemiology , COVID-19/virology , Disease Outbreaks , Humans , Socioeconomic Factors
9.
Infection ; 48(6): 813-833, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-722872

ABSTRACT

PURPOSE: The main purpose of this study was to examine the overall distribution of chronic comorbidities in coronavirus disease-19 (COVID-19) infected populations and the risk of the underlying burden of disease in terms of the case fatality ratio (CFR). METHODS: We carried out a systematic review and meta-analysis of studies on COVID-19 patients published before 10th April 2020. Twenty-three studies containing data for 202,005 COVID-19 patients were identified and included in our study. Pooled effects of chronic comorbid conditions and CFR with 95% confidence intervals were calculated using random-effects models. RESULTS: A median age of COVID-19 patients was 56.4 years and 55% of the patients were male. The most prevalent chronic comorbid conditions were: any type of chronic comorbidity (37%; 95% CI 32-41%), hypertension (22%; 95% CI 17-27%), diabetes (14%; 95% CI 12-17%), respiratory diseases (5%; 95% CI 3-6%), cardiovascular diseases (13%; 95% CI 10-16%) and other chronic diseases (e.g., cancer) (8%; 95% CI 6-10%). Furthermore, 37% of COVID-19 patients had at least one chronic comorbid condition, 28% of patients had two conditions, and 19% of patients had three or more chronic conditions. The overall pooled CFR was 7% (95% CI 6-7%). The crude CFRs increased significantly with increasing number of chronic comorbid conditions, ranging from 6% for at least one chronic comorbid condition to 13% for 2 or 3 chronic comorbid conditions, 12% for 4 chronic comorbid conditions, 14% for 5 chronic comorbid conditions, and 21% for 6 or more chronic comorbid conditions. Furthermore, the overall CFRs also significantly increased with higher levels of reported clinical symptoms, ranging from 14% for at least four symptoms, to 15% for 5 or 6 symptoms, and 21% for 7 or more symptoms. CONCLUSIONS: The chronic comorbid conditions were identified as dominating risk factors, which should be considered in an emergency disease management and treatment choices. There is urgent need to further enhance systematic and real-time sharing of epidemiologic data, clinical results, and experience to inform the global response to COVID-19.


Subject(s)
COVID-19/epidemiology , COVID-19/virology , SARS-CoV-2 , COVID-19/diagnosis , COVID-19/mortality , Chronic Disease , Comorbidity , Cost of Illness , Cross-Sectional Studies , Female , Humans , Male , Mass Screening , Mortality , Public Health Surveillance , Publication Bias , Risk Factors
10.
Int J Environ Res Public Health ; 17(10)2020 05 15.
Article in English | MEDLINE | ID: covidwho-276329

ABSTRACT

The coronavirus disease (COVID-19) has spread quickly across the globe with devastating effects on the global economy as well as the regional and societies' socio-economic fabrics and the way of life for vast populations. The nonhomogeneous continent faces local contextual complexities that require locally relevant and culturally appropriate COVID-19 interventions. This paper examines demographic, economic, political, health, and socio-cultural differentials in COVID-19 morbidity and mortality. The health systems need to be strengthened through extending the health workforce by mobilizing and engaging the diaspora, and implementing the International Health Regulations (2005) core capacities. In the absence of adequate social protection and welfare programs targeting the poor during the pandemic, sub-Saharan African countries need to put in place flexible but effective policies and legislation approaches that harness and formalise the informal trade and remove supply chain barriers. This could include strengthening cross-border trade facilities such as adequate pro-poor, gender-sensitive, and streamlined cross-border customs, tax regimes, and information flow. The emphasis should be on cross-border infrastructure that not only facilitates trade through efficient border administration but can also effectively manage cross-border health threats. There is an urgent need to strengthen social protection systems to make them responsive to crises, and embed them within human rights-based approaches to better support vulnerable populations and enact health and social security benefits. The COVI-19 response needs to adhere to the well-established 'do no harm' principle to prevent further damage or suffering as a result of the pandemic and examined through local lenses to inform peace-building initiatives that may yield long-term gains in the post-COVID-19 recovery efforts.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Socioeconomic Factors , Africa South of the Sahara/epidemiology , Betacoronavirus , COVID-19 , Coronavirus Infections/mortality , Culture , Delivery of Health Care/legislation & jurisprudence , Delivery of Health Care/organization & administration , Health Workforce , Humans , Pandemics , Pneumonia, Viral/mortality , SARS-CoV-2
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