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1.
East Mediterr Health J ; 28(7): 469-477, 2022 Jul 31.
Article in English | MEDLINE | ID: covidwho-2002925

ABSTRACT

Background: The COVID-19 pandemic has adversely affected the delivery of noncommunicable diseases (NCDs) services globally as health systems are overwhelmed by the response to the pandemic. Aims: The World Health Organization (WHO) Regional Office for the Eastern Mediterranean conducted an assessment to evaluate the impact of COVID-19 on NCD-related services, programmes, funding and consideration of NCDs in COVID-19 response. Methods: Data were collected from countries of the WHO Eastern Mediterranean Region (EMR) in mid-2020 through a web-based questionnaire on NCD services-related infrastructure, policies and plans, staffing, funding, NCD services disruptions and their causes, disruption mitigation strategies, data collection on comorbidity, surveillance, and suggestions for WHO technical guidance. The data were exported into Microsoft Excel and summarized. Countries were grouped according to socioeconomic level. Results: Nineteen of the 22 countries in the EMR responded: 95% had NCD staff reallocated to support their COVID-19 response. Lower-income countries were less likely to include NCDs in their pandemic response plans and more likely to report disruption of services. The most commonly disrupted services were hypertension management (10 countries 53%), dental care (10 countries 53%), rehabilitation (9 countries 47%), palliative care (9 countries 47%) and asthma management (9 countries 47%). Conclusion: The COVID-19 pandemic has disrupted the continuity of NCD-related services in EMR countries. The ability to mitigate service disruptions varied noticeably between countries. The mitigation measures implemented included triaging of patients, novel NCD medicines supply chains and dispensing interventions, and the use of digital health and telemedicine. Guidance and support for systems resilience, preparedness and response to crises are recommended.


Subject(s)
COVID-19 , Noncommunicable Diseases , COVID-19/epidemiology , Humans , Mediterranean Region/epidemiology , Noncommunicable Diseases/epidemiology , Noncommunicable Diseases/therapy , Pandemics , World Health Organization
2.
BMJ Glob Health ; 7(Suppl 5)2022 07.
Article in English | MEDLINE | ID: covidwho-1923216

ABSTRACT

Emergency health kits are a vital way of providing essential medicines and supplies to health clinics during humanitarian crises. The WHO non-communicable diseases (NDCs) kit was developed 5 years ago, recognising the increasing challenge of providing continuity of care and secondary prevention of NCDs and exacerbations, in such settings. Monitoring and evaluation of emergency health kits is an important process to ensure the contents are fit for purpose and to assess usability and utility. However, there are also challenges and limitations in collecting the relevant data to do so.This Practice paper provides a summary of the key methodologies, findings and limitations of NCD kit assessments conducted in Libya and Yemen. Methodologies included a combination of semistructured interviews, surveys with healthcare workers, NCD knowledge tests and quantifying the remaining contents.The kit was able to support the vital delivery of NCD patient care in some complex humanitarian settings and was appreciated by health facilities. However, there were also some challenges affecting kit use. Some kit contents were found to be in greater or lesser quantities than required, and medicine brands and country of origin affected acceptability. Supply chains were affected by the humanitarian situations, with some kits being held up for months prior to arrival. Furthermore, healthcare staff had received limited NCD training and were unable to dispense certain medicines, such as psychotropics, at the primary care level. Further granularity of kit modules, predeployment facility assessments, increased NCD training opportunities and a monitoring system could improve the utility of the kits.


Subject(s)
Noncommunicable Diseases , Delivery of Health Care , Emergencies , Humans , Libya , Yemen
3.
Sci Rep ; 11(1): 23294, 2021 12 02.
Article in English | MEDLINE | ID: covidwho-1550340

ABSTRACT

Cancer patients are at risk for severe complications or death from COVID-19 infection. Therefore, the need for routine COVID-19 testing in this population was evaluated. Between 1st August and 30th October 2020, 150 cancer patients were included. Symptoms of COVID-19 infection were evaluated. All eligible individuals went through RT-PCR and serological tests for COVID-19. At the same time, 920 non-cancer patients were recruited from a random sample of individuals who were subject to routine molecular and anti-body screening tests. Of 150 cancer patients, 7 (4.7%) were RT-PCR positive. Comorbidity made a significant difference in the RT-PCR positivity of cancer patients, 71.4% positive versus 25.8% negative (P-value = 0.02). The average age for negative and positive groups was 53.3 and 58.2 respectively (P-value = 0.01). No significant difference was observed between cancer and non-cancer patients regarding COVID-19 antibody tests. However, cancer patients were 3 times less likely to have a positive RT-PCR test result OR = 0.33 (CI: 0.15-0.73). The probability of cancer patients having a positive routine test was significantly lower than non-cancer patients, and the concept that all cancer patients should be routinely tested for COVID-19 may be incorrect. Nevertheless, there may be a subgroup of patients with comorbidities or older age who may benefit from routine COVID-19 testing. Importantly, these results could not be subjected to multivariate analysis.


Subject(s)
COVID-19 Testing/methods , COVID-19/diagnosis , Diagnostic Tests, Routine/methods , Neoplasms , Adult , Aged , COVID-19/blood , COVID-19/complications , COVID-19/genetics , Female , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Male , Middle Aged , Neoplasms/complications , Retrospective Studies
5.
Eastern Mediterranean Health Journal ; 26(6):626-629, 2020.
Article in English | ProQuest Central | ID: covidwho-1220407

ABSTRACT

[...]work has been done to support implementation of a package of emergency care tools including: the Integrated Interagency Triage Tool (prehospital, routine and mass casualty);Emergency Medical and Trauma Care Checklists;the Basic Emergency Care - an open-access training course for frontline health-care providers who manage acute illness and injury with limited resources;and the International Registry of Trauma and Emergency care to help gather essential data about the performance of emergency care systems (6,7). Despite countries' efforts to control patient flow by directing suspected COVID-19 patients to dedicated facilities, many "self-present" to facilities of their choosing. [...]patients presenting for unrelated emergencies (e.g., trauma) may also be co-infected with COVID-19 - whether or not they are symptomatic. Additionally, many EMR countries lack legislation guaranteeing access to emergency care for all (a key WHO Health System Building Block under governance), which limits access to marginal communities (10). Since the Region is host to the largest number of displaced persons in the world, region-specific guidance has been developed to guide health system response to COVID-19 in the context of displacement (22). [...]there is a paucity of high-quality published data on emergency care systems in the Region and an urgent need for operational research to understand the emergency care needs and emergency care systems performance in EMR countries.

6.
East Mediterr Health J ; 26(11): 1318-1319, 2020 Nov 11.
Article in English | MEDLINE | ID: covidwho-995095

ABSTRACT

This year, World Diabetes Day on 14 November coincides with the International Year of the Nurse and the Midwife, and therefore focuses on highlighting the role of nurses in the prevention and management of diabetes.Diabetes is recognized as an important cause of premature death and disability globally and in the Eastern Mediterranean Region, where its prevalence has been steadily increasing since 1990. Although the annual decline of the risk of dying from a major noncommunicable disease between the ages of 30 and 70 years is slowing globally, diabetes is showing a 5% increase in attributed premature mortality. In 2016, diabetes was the direct cause of 1.6 million deaths globally and 43% of all deaths before the age of 70 years occur due to high blood glucose. Overweight and obesity are the strongest risk factors for type 2 diabetes. In addition, diabetes increases the risk of heart disease and stroke and is a leading cause of blindness, lower limb amputation and kidney failure. A study conducted in 35 countries indicated that people living with diabetes are more likely to experience catastrophic health expenditures with an estimated increase of 4% between diabetic and non-diabetic individuals, regardless of their insurance status.


Subject(s)
Diabetes Mellitus, Type 2 , Noncommunicable Diseases , Nurses , Adult , Aged , Humans , Middle Aged , Obesity , Risk Factors
7.
East Mediterr Health J ; 26(6): 626-629, 2020 Jun 24.
Article in English | MEDLINE | ID: covidwho-634614

ABSTRACT

The COVID-19 pandemic began as a cluster of reported cases of acute respiratory illness in China on 31 December 2019 and went on to spread with exponential growth across the globe. By the time it was characterized as a global pandemic on 11 March 2020, 17 of 22 countries in the Eastern Mediterranean Region (EMR) had reports of infected persons. EMR countries are particularly susceptible to such outbreaks due to the presence of globally interconnected markets; complex emergencies in more than half of the countries; religious mass gatherings that draw tens of millions of pilgrims annually; and variation in emergency care systems capacity and health systems performance within and between countries.


Subject(s)
Coronavirus Infections/therapy , Emergency Medical Services/organization & administration , Emergency Service, Hospital/organization & administration , Epidemiology/education , International Cooperation , Pneumonia, Viral/therapy , Public Health/education , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Health Policy , Health Services Accessibility , Humans , Mediterranean Region/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Public Health Practice , SARS-CoV-2 , World Health Organization
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