The Mental Health Impact of the COVID-19 Pandemic on Healthcare Workers in the Eastern Mediterranean Region: A Scoping Review.

Objectives: This scoping review is to investigate the existing literature on the mental health of Healthcare workers, including stress or distress, anxiety, depression, burnout, insomnia, and fear or phobia within the different countries in the Eastern Mediterranean region (EMR) during the COVID-19 pandemic. Methods: We systematically searched to consolidate studies across EMR countries regarding the mental health morbidity studied, the scales, and the methodology used. The review focused on peer-reviewed academic literature published from March 2020 to November 2021. Results: One hundred sixty-seven articles were included in the review. Most publications came from lower-middle-income countries such as Iran, Pakistan, and Egypt. Most of the literature was specific to Stress/Distress (n = 94), followed by anxiety (n = 93), depression (n = 66), burnout (n = 27), insomnia (n = 20), and fear/phobia (n = 12). Conclusion: Fear, phobia, and insomnia have all been examined extensively worldwide, yet they were among the Eastern Mediterranean region's least explored outcomes. In addition, most underdeveloped countries have a low rate of publication.

Acceptance of COVID-19 Vaccine Booster Doses Using the Health Belief Model: A Cross-Sectional Study in Low-Middle- and High-Income Countries of the East Mediterranean Region.

Coronavirus disease (COVID-19) booster doses decrease infection transmission and disease severity. This study aimed to assess the acceptance of COVID-19 vaccine booster doses in low, middle, and high-income countries of the East Mediterranean Region (EMR) and its determinants using the health belief model (HBM). In addition, we aimed to identify the causes of booster dose rejection and the main source of information about vaccination. Using the snowball and convince sampling technique, a bilingual, self-administered, anonymous questionnaire was used to collect the data from 14 EMR countries through different social media platforms. Logistic regression analysis was used to estimate the key determinants that predict vaccination acceptance among respondents. Overall, 2327 participants responded to the questionnaire. In total, 1468 received compulsory doses of vaccination. Of them, 739 (50.3%) received booster doses and 387 (26.4%) were willing to get the COVID-19 vaccine booster doses. Vaccine booster dose acceptance rates in low, middle, and high-income countries were 73.4%, 67.9%, and 83.0%, respectively (p < 0.001). Participants who reported reliance on information about the COVID-19 vaccination from the Ministry of Health websites were more willing to accept booster doses (79.3% vs. 66.6%, p < 0.001). The leading causes behind booster dose rejection were the beliefs that booster doses have no benefit (48.35%) and have severe side effects (25.6%). Determinants of booster dose acceptance were age (odds ratio (OR) = 1.02, 95% confidence interval (CI): 1.01-1.03, p = 0.002), information provided by the Ministry of Health (OR = 3.40, 95% CI: 1.79-6.49, p = 0.015), perceived susceptibility to COVID-19 infection (OR = 1.88, 95% CI: 1.21-2.93, p = 0.005), perceived severity of COVID-19 (OR = 2.08, 95% CI: 137-3.16, p = 0.001), and perceived risk of side effects (OR = 0.25, 95% CI: 0.19-0.34, p < 0.001). Booster dose acceptance in EMR is relatively high. Interventions based on HBM may provide useful directions for policymakers to enhance the population's acceptance of booster vaccination.

No association between the SARS-CoV-2 variants and mortality rates in the Eastern Mediterranean Region.

As the novel coronavirus SARS-CoV-2 continues to spread in all countries, there is a growing interest in monitoring and understanding the impact of emerging strains on virus transmission and disease severity. Here, we analyzed SARS-CoV-2 genomic sequences reported in the Eastern Mediterranean Region (EMR) countries, as of 1 January 2021. The majority (~75%) of these sequences originated from three out of 22 EMR countries, and 65.8% of all sequences belonged to GISAID clades GR, GH, G and GV. A delay ranging between 30 and 150 days from sample collection to sequence submission was observed across all countries, limiting the utility of such data in informing public health policies. We identified ten common non-synonymous mutations represented among SARS-CoV-2 in the EMR and several country-specific ones. Two substitutions, spike_D614G and NSP12_P323L, were predominantly concurrent in most countries. While the single incidence of NSP12_P323L was positively correlated with higher case fatality rates in EMR, no such association was established for the double (spike_D614G and NSP12_P323L) concurrent variant across the region. Our study identified critical data gaps in EMR highlighting the importance of enhancing surveillance and sequencing capacities in the region.