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1.
Dialogues in Health ; 2:100095, 2023.
Article in English | ScienceDirect | ID: covidwho-2165216

ABSTRACT

Background The stigma associated with monkeypox (mpox) may prevent people from following recommended guidelines. Using a "model of stigma communication,” this study maps and determines the mpox stigma on Twitter among LGBTQ+ (Lesbian, gay, bisexual, transgender, queer and more) community. Methods The tweets that contained the terms ‘#monkeypox', ‘#MPVS', ‘#stigma', and ‘#LGBTQ+' and were published between May 01, 2022 and Sept 07, 2022 were extracted. For sentiment analysis, the VADER, Text Blob, and Flair analysers were implemented. This study evaluated the dynamics of stigma communication based on the "model of stigma communication”. A total of 70,832 tweets were extracted, from which 66,387 tweets were passed to the sentiment analyser and 3100 tweets were randomly selected for manual coding. Consolidated Criteria for Reporting Qualitative Research (COREQ) criteria was adopted to report this study. Findings This research provided insight on the cause, communication, and patterns of mpox stigma in the LGBTQ+ community. In the community, stigmatisation was influenced by the group's labelling as the source of monkeypox. Some users believed that mpox resembled previously observed diseases such as HIV/AIDS, and COVID-19. Despite officials and media outlets disseminating information about preventing mpox and stigmatisation, a number of individuals failed to comply. The LGBTQ+ community faced peril in the form of violence due to escalating stigma. Misinformation and misinterpretation spread further stigmatisation. Interpretation This study indicates that authorities must address misinformation, stigmatization of the LGBTQ+ community, and the absence of a comprehensive risk-communication plan to improve the system. The effects of stigmatization on the vulnerable population must be handled in conjunction with a well-developed risk communication plan, without jeopardizing their wellbeing.

2.
Seizure ; 99: 40-42, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-2132338

ABSTRACT

PURPOSE: The Arabic word "Assarɛ" (الصرع) continues to be used to stigmatize Moroccan people with epilepsy (PWE), affecting their quality of life and reducing their likelihood of visiting a doctor. METHODS: 298 participants responded to an automated questionnaire, administered via social media, which investigated the socio-demographic information and proposed new terms to replace or salvage the term "Assarε." RESULTS: Most of the participants refused the use of "Assarɛ" term when referring to Epilepsy. "Brain Electrical Disorder" (الإعتلال الكهربائي للدماغ) and "Lipilipsy" (لبيليبسي) were the most commonly nominated terms to replace "Assarɛ". Independent variables, such as age over 35 years, education level, and the number of people living with epilepsy, influenced the respondents' choices. CONCLUSION: The desire of most participants in the survey to change the label "Assarɛ" demonstrates the widespread and severe stigmatisation and marginalisation of PWE.


Subject(s)
Epilepsy , Quality of Life , Adult , Humans , Social Stigma , Stereotyping , Surveys and Questionnaires
3.
J Public Health Policy ; 2022 Nov 14.
Article in English | MEDLINE | ID: covidwho-2119343

ABSTRACT

We conducted a community-based cross-sectional survey of 416 participants from Meghalaya, India to assess knowledge, perceptions, and practices toward recommended COVID-19 preventive measures, and to explore health-seeking behavior and stigma during early phase of the pandemic. Most participants had knowledge of the signs and symptoms of COVID-19 (94%) and its spread (96%), and reported positive behavior change such as handwashing ≥ 6 times/day (41% pre-COVID-19 vs. 81% during COVID-19, P < 0.001), sneezing or coughing into sleeves (65% pre-COVID-19 vs. 89% during COVID-19, P < 0.001) and staying home if having flu-like symptoms (44% pre-COVID-19 vs. 94% during COVID-19, P < 0.001). We found delayed healthcare seeking for non-COVID-19 illnesses (16%). Fear of losing life was reported by 26% participants, as was discrimination toward migrant returnees, with 35% blaming returnees for the spread of COVID-19. We highlight the need for a holistic approach toward pandemic control, including social and mental health interventions, in public health strategies.

4.
Int J Environ Res Public Health ; 19(20)2022 Oct 11.
Article in English | MEDLINE | ID: covidwho-2071409

ABSTRACT

INTRODUCTION: Since the advent of 2019 novel coronavirus (COVID-19), the coexistence between social stigma and depression symptoms (depression hereafter) in COVID-19 patients has been mentioned, but the mechanisms involved remains unclear. This study aimed to explore how the stigma affects depression during the mid-pandemic period. METHODS: A cross-sectional survey using non-probability sampling was conducted among asymptomatic COVID-19 carriers in Shanghai, China (April 2022). An online questionnaire was used to obtain information on demographic characteristics and psychological traits. Logistic regression and path analysis were performed to analyze the depression risk factors and examine the mediation model, respectively. RESULTS: A total of 1283 participants (59.6% men) were involved in this study, in which 44.7% of carriers reported having depression. Univariate analyses found that education level (OR 0.575; 95% CI 0.448-0.737) and doses of vaccine (OR 1.693; 95% CI 1.042-2.750), were significantly associated with depression among asymptomatic carriers. The association between social stigma and depression was fully mediated by their feelings of entrapment and decadence (indirect effect = 0.204, p < 0.001; direct effect = -0.059, p = 0.058). The mediating role of entrapment between stigma and depression was moderated by age group (estimate = 0.116, p = 0.008). CONCLUSION: Mental health issues resulting from the COVID-19 pandemic are increasingly apparent in China and require urgent attention and responses. These findings provide new perspectives for the early prevention of depression in asymptomatic carriers.


Subject(s)
COVID-19 , Social Stigma , Male , Humans , Female , Pandemics , COVID-19/epidemiology , Depression/psychology , Cross-Sectional Studies , China/epidemiology , Anxiety/psychology
5.
Journal of the Korean Academy of Fundamentals of Nursing ; 29(3):350-362, 2022.
Article in Korean | EuropePMC | ID: covidwho-2067173

ABSTRACT

Purpose: The purpose of this study was to obtain a deep understanding of experiences of stigma among people infected with COVID-19 in South Korea. Methods: Data were collected through in-depth interviews from March 2021 to November 2021 with nine people who had been infected with COVID-19. The data were analyzed using Colaizzi's phenomenological method. Results: Six theme clusters emerged from participants' stigma experiences: “I've become the coronavirus itself”, “a desperate defense to protect myself”, “pointing a finger at oneself”, “a scapegoat for the public interest”, “the aftereffects caused by social prejudice” and “an isolated loner”. Conclusion: The results of this study suggest that people infected with COVID-19 suffered considerable emotional distress and were hindered in their daily life recovery due to stigma. Based on this study, medical staff who treat patients infected with COVID-19 should understand their stigma in depth and strive to develop and implement the necessary instruments and nursing intervention programs to reduce this stigma. © 2022 Korean Academy of Fundamentals of Nursing.

6.
Journal of Acute Disease ; 11(4):127-132, 2022.
Article in English | EMBASE | ID: covidwho-2066824

ABSTRACT

This narrative review aims to highlight some of the factors contributing to challenges faced by many countries in controlling the spread of COVID-19 pandemic that continues to rage around the world, especially after stoppage of official prevention and control activities. A literature search was conducted on PubMed, and Google using search terms 'COVID-19', 'challenges', 'prevention', and 'control' in different combinations. COVID-19 prevention and control challenges are related to health-system, vaccines, administration, and society culture. Controlling the spread of COVID-19 necessitates cooperation between community leaders, healthcare professionals, religious leaders, and the public.

7.
Open Access Macedonian Journal of Medical Sciences ; 10(E):1420-1425, 2022.
Article in English | EMBASE | ID: covidwho-2066706

ABSTRACT

BACKGROUND: Indonesia’s lowest COVID-19 vaccine coverage of 6.5% is found in Teluk Makmur Village, Dumai City, Riau province. The success of the COVID-19 vaccination program is determined by vaccine hesitancy, which comprises numerous and presumably complex factors that vary over time and between countries or between regions of one given country. AIM: The aim of the study was to determine COVID-19 vaccine hesitancy prevalence and influencing factors in the community. MATERIALS AND METHODS: A cross-sectional study was conducted from September to November 2021 at Teluk Makmur Village, Dumai City, Riau Province, Indonesia, involving 149 respondents aged 25–93 years and using a questionnaire on respondents’ sociodemographic characteristics and their opinions on possible COVID-19 vaccines. COVID-19 vaccine hesitancy factors were analyzed by multivariable logistic regression (p ˂ 0.05). RESULTS: COVID-19 vaccine hesitancy was present in 51.7% of respondents. Multivariable logistic regression findings: Comorbidities, fear of dying from COVID-19, feelings of shame/stigmatization if known to be infected with COVID-19 were not significantly associated with vaccine hesitancy. Education and distrust of government COVID-19 related policy were significantly associated with vaccine hesitancy. CONCLUSION: Half of respondents were hesitant about COVID-19 vaccines. COVID-19 vaccine hesitancy factors consisted of education and distrust of government policy.

8.
Chest ; 162(4):A1468, 2022.
Article in English | EMBASE | ID: covidwho-2060824

ABSTRACT

SESSION TITLE: Rare Pulmonary Infections SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/18/2022 01:35 pm - 02:35 pm INTRODUCTION: Tuberculosis (TB) rates in the USA are currently at the lowest in history. During 2010-17, only 5175 TB cases occurred in children in the USA. Even in Hidalgo County on the Texas-Mexico border there were only 36 cases of TB among all age groups in 2020. CASE PRESENTATION: An asymptomatic 3-year-old male presented to the PICU with a positive PPD and an infiltrate in the right lower lobe on chest x-ray. Once three morning gastric aspirates were obtained child was started on a 4 drug regimen recommended by the health department, and sent to the pulmonology clinic for further care awaiting identification and sensitivity of an organism. Child was born at 35 weeks gestation, spent 8 days in NICU for unclear reasons requiring intubation and oxygen. Upon review of patient history and chest x-ray, diagnosis of TB became less likely. This was further confirmed by gastric aspirate revealing no organisms and negative QuantiFERON Gold. CT with oral and IV contrast revealed a right-sided congenital diaphragmatic hernia (CDH) in the foramen of Morgagni. Patient received definitive outpatient surgery in October 2021. At 3-month follow-up there were no surgical complaints and patient reported increased exercise tolerance. DISCUSSION: TB is very rare in the US, even in the Rio Grande Valley where the proportion of cases are higher. This child received 42 doses of TB treatment after a positive PPD and consolidation on chest x-ray. However, x-ray did not clearly indicate TB infection and in fact was suspicious for bowel in the chest cavity. This case clearly indicates the need for careful examination of radiographs and ordering more tests such as the QuantiFERON Gold as needed before jumping to what may seem to be the obvious conclusion. Even though CDH are uncommon and Morgagni hernias are rare making up only 2-3% of CDH, a closer look at the case was warranted. This child's misdiagnosis led to more than simply unnecessary medical treatment, it also led to social stigma for the family that culminated in the father being terminated from his job. This child's surgical repair was delayed due to missed diagnosis of Morgagni hernia in NICU, PICU, and health department and delayed ordering of confirmatory TB tests. Furthermore, patient was referred to surgery in March 2020 but was delayed by 19 months due to COVID-19. The pandemic was also the stimulus for the outpatient nature of the complicated surgery. It is unclear why patient's PPD was positive. It is of note that mother's PPD was also positive due to contact with active TB years prior to child's birth. One hypothesis is this may have caused positive PPD in child and is a future question to pursue. CONCLUSIONS: We want to emphasize to look before you leap and investigate before you treat. There was harm to the child and family done by treating aggressively that could have been prevented and an opportunity to help the child that was delayed. Reference #1: Cowger TL, Wortham JM, Burton DC. Epidemiology of tuberculosis among children and adolescents in the USA, 2007–17: An Analysis of National Surveillance Data. The Lancet Public Health. 2019;4(10). doi:10.1016/s2468-2667(19)30134-3 Reference #2: Leeuwen L, Fitzgerald DA. Congenital diaphragmatic hernia. Journal of Paediatrics and Child Health. 2014;50(9):667-673. doi:10.1111/jpc.12508 Reference #3: Mohamed M, Al-Hillan A, Shah J, Zurkovsky E, Asif A, Hossain M. Symptomatic congenital Morgagni hernia presenting as a chest pain: A case report. Journal of Medical Case Reports. 2020;14(1). doi:10.1186/s13256-019-2336-9 DISCLOSURES: No relevant relationships by Isha Mittal No relevant relationships by Barbara Stewart

9.
Index de Enfermeria ; 31(3), 2022.
Article in Spanish | Scopus | ID: covidwho-2045256

ABSTRACT

Main objective: to understand the life experiences of people diagnosed with Covid-19 during the quarantine period in Santiago de Chile city. Design: a descriptive phenomenological qualitative study with an exploratory approach. Methodology: Participants aged between 18 and 65 years, with previous Covid-19 infection and positive PCR. Purposive sampling with 11 informants was used. The information was collected through in-depth online interviews, recorded, and manually transcribed. Data were analyzed using Colaizzi’s seven-step method. Main results: intense emotions, support from family and neighbors, stigma and self-care were the four categories that emerged from the analysis. Main conclusion: people with Covid-19 had a high risk for emotional and social problems. However, the pandemic also had a positive effect on family relationships, meaning of life, self-control, and self-care. © 2022, Fundacion Index. All rights reserved.

10.
Forced Migration Review ; 67:29-33, 2021.
Article in English | CAB Abstracts | ID: covidwho-2044773

ABSTRACT

In the face of COVID-19, innovation, adaptation, and learning from experience have all been crucial to meeting the needs of those who have been displaced. In order to respond to this new disease, the humanitarian community had to get familiar with COVID-19. It was understood from the beginning that basic hygiene precautions, such adequate handwashing, could aid in preventing its transmission. However, a lot of displacement settings lack the infrastructure needed to put household and community-level infection prevention and control (IPC) measures into place. They might also have inadequate governance structures for overseeing and maintaining WASH services. Some of the hardest-to-reach populations are found in displacement contexts like Ethiopia, Somalia, and South Sudan, where people lack the resources to defend themselves and deal with health threats. Disease vulnerability may be exacerbated by overcrowding and restricted access to proper WASH facilities. In the meantime, xenophobia and stigma can develop due to the fear surrounding COVID-19 as well as the dissemination of false information. As new information became available and lessons were discovered, IOM teams operating in these environments had to modify their Risk Communication and Community Engagement (RCCE) and IPC efforts. Any disaster response has traditionally included funding for capacity building for hygiene promotion to strengthen local responses, but COVID-19 demanded more localisation because of the absence of international travel. It demonstrated how supporting local structures can help solidify hygiene promotion capacities while obviating the requirement for a high degree of international assistance in the event of future outbreaks by highlighting considerable local capacity and willingness in some communities.

12.
J Multidiscip Healthc ; 15: 2053-2066, 2022.
Article in English | MEDLINE | ID: covidwho-2039539

ABSTRACT

Purpose: Children diagnosed with ASD usually have impaired social functions, exhibit repetitive, stereotyped and self-stimulatory behaviors, which make them prone to be stigmatized by the public. However, stigma not only affects those with stigmatization characteristics such as children with ASD but also tends to include other people related to them including parents. This is called affiliate stigma. However, affiliate stigma is unlikely to occur if public awareness is high. Considering that awareness of ASD is still comparatively low in this region and that, as a review of the literature showed, there have been limited studies on stigma and ASD conducted in South-East Asia, particularly in Malaysia, this study is of great significance, especially in the context of the East and other developing countries. The aim of this study was to explore parents' experiences of caring and perceptions of affiliate stigma, resilience and quality of life (QoL) when caring for a child with ASD. Methods: This paper is part of the sequential explanatory mixed-methods study in which, after a cross-sectional study of 144 parents, a qualitative approach was used to explore parents' experiences of caring and their perceptions of affiliate stigma, resilience, and QoL. Participants were recruited when they were accompanying their children to therapy at two tertiary public hospitals in one of the north-eastern states of Malaysia. Eleven parents of children with ASD aged 2-12 years participated. Qualitative data analysis followed Braun and Clarke's methodology of thematic analysis. Results: Four themes were identified: the meaning of QoL, ASD and life adjustment, perceived stigma, and resilience. Conclusion: This is the first Southeast Asian study on parent-perceived affiliate stigma, resilience, and QoL in the context of ASD. These findings can inform healthcare personnel and policymakers into day-to-day parenting realities and therefore an effort to coordinate support services across all disciplines could be made to improve outcomes for both parents and children.

13.
Encephale ; 2022 Sep 19.
Article in English | MEDLINE | ID: covidwho-2031266

ABSTRACT

BACKGROUND AND OBJECTIVES: Stigma was a major issue during the COVID-19 pandemic. It posed a serious threat to the lives of healthcare workers (HCWs) who were expected to experience higher levels of stigma and increased psychological distress. This is the first survey to investigate forms and correlates of perceived stigma in Tunisian HCWs during the COVID-19 pandemic. METHODS: A cross-sectional web-based survey was conducted between October 8th and November 10th 2020, among 250 Tunisian HCWs. Data were collected using an online questionnaire using the Google Forms® platform. We used a self-reported instrument measuring COVID-19-related stigma, and the Multidimensional Scale of Perceived Social Support (MSPSS) to measure the perceived adequacy of social support from three sources: family, friends, and significant other. RESULTS: The mean stigma score was 18.6±8. Participants sometimes to often experienced stigma in their relationships with friends (22%), neighbors (27.2%), parents (22,4%), and in social activities (30.8%). This stigma was perceived mainly through avoidance (68.4%), and rarely through verbal (6%) or physical aggression (1.2%). The mean MSPSS total score was 5.26±1.24. In multivariate analysis, depression history (P<0.001), long working experience (P<0.001), having presented ageusia/anosmia (P=0.007) and lower total social support scale (P<0.001) were significantly associated with higher perceived stigma score. CONCLUSION: Our findings showed that HCWs perceived stigma in professional, societal and familial domains. Social support from family, friends and others seemed to protect against perceived stigma. Proper health education targeting the public appears to be an effective method to prevent social harassment of both HCWs and COVID-19 survivors.

14.
PLoS Global Public Health ; 2(6), 2022.
Article in English | CAB Abstracts | ID: covidwho-2021478

ABSTRACT

Historically, infectious diseases have generated fears among populations. Unhealthy handling of these fears result in the stigma and discrimination of infected patients. Globally, measures taken so far by governments to curb the spread of the novel coronavirus disease-2019 (COVID-19) pandemic, although helpful, have created fears in people. Consequently, there are reported Ghanaian media cases of stigmatisation against persons who were infected and recovered from COVID-19. However, these reports remain unsubstantiated. This study, therefore, sought to examine stigma and discriminatory tendencies towards COVID-19 survivors among the adult population in Ghana. This was a population-based cross-sectional study among 3,259 adults. A multi-stage sampling technique was used to recruit study participants. Descriptive and inferential statistics comprising frequency, percentage, chi-square, and multivariable logistic regression were employed in analysing the data. Knowledge on COVID-19 was poor among 33.6% of the participants. Forty-three per cent had a good attitude towards COVID-19. Nearly half (45.9%) exhibited stigma and discriminatory tendencies towards COVID-19 survivors. Participants who had poor COVID-19 related knowledge (aOR = 1.91, 95%CI = 1.59-2.29, p<0.001) and poor attitude towards COVID-19 (aOR = 5.83, 95% CI = 4.85-6.98, p < 0.001) were more likely to exhibit stigma and discriminatory tendencies towards COVID-19 survivors. Our study found relatively high proportions of poor knowledge and negative attitudes towards COVID-19. Stigma and discriminatory tendencies were consequently high. Our findings call for increased public education on COVID-19 by the Ghana Health Service and the Information Services Department, to increase the level of knowledge on the pandemic while reducing stigma and discrimination associated with it.

15.
SEARCH Journal of Media and Communication Research ; 2021(Special Issue):111-125, 2021.
Article in English | Scopus | ID: covidwho-2011409

ABSTRACT

Individuals with COVID-19 who become aware of their condition and disclose their COVID-19 status may either receive support or face social stigma. To some people, withholding their status is preferred to avoid social stigma, which has been a “silent driver” in the rise of COVID-19 cases. The study aims to examine the motives behind the withholding and disclosure of COVID-19 positive status as well as to explore the positive and negative impacts of such behaviour. A study using the phenomenological research approach involving 10 informants from three provinces in Indonesia who had contracted COVID-19 was conducted. Informants between the ages of 22 and 55 from three different educational backgrounds were selected. Five informants withheld their COVID-19 status;while others disclosed their status. Face-to-face interviews, telephone calls, video calls, and Zoom meetings were carried out as data collection methods. The study reveals that the motives for withholding COVID-19 status tend to be associated with maintaining personal interests, while the motives for disclosing COVID-19 status tend to be associated with maintaining public interest. The positive impact of status withholding is to avoid social stigma, while the positive impact of disclosure is to obtain material or immaterial support. The negative impact of withholding is the feeling of guilt or inability of obtaining material and immaterial support, while the negative impact of disclosure is social stigma. Thus, stigmatisation is a crucial factor in determining the withholding or disclosure of COVID-19 status. © SEARCH Journal 2021.

16.
BMC Public Health ; 22(1): 1681, 2022 09 05.
Article in English | MEDLINE | ID: covidwho-2009375

ABSTRACT

BACKGROUND: COVID-19 related stigma has been identified as a critical issue since the beginning of the pandemic. We developed a valid and reliable questionnaire to measure COVID-19 related enacted stigma, inflicted by the non-infected general population. We applied the questionnaire to measure COVID-19 related enacted stigma among Tehran citizens from 27 to 30 September 2020. METHODS: A preliminary questionnaire with 18 items was developed. The total score ranged from 18 to 54; a higher score indicated a higher level of COVID-19 related stigma. An expert panel assessed the face and content validity. Of 1637 randomly recruited Tehran citizens without a history of COVID-19 infection, 1064 participants consented and were interviewed by trained interviewers by phone. RESULTS: Item content validity index (I-CVI), Item content validity ratio (I-CVR), and Item face validity index (I-FVI) were higher than 0.78 for all 18 items. The content and face validity were established with a scale content validity index (S-CVI) of 0.90 and a scale face validity index (S-CVI) of 93.9%, respectively. Internal consistency of the questionnaire with 18 items was confirmed with Cronbach's alpha of 0.625. Exploratory factor analysis revealed five latent variables, including "blaming", "social discrimination", "dishonor label", "interpersonal contact", and "retribution and requital attitude". The median of the stigma score was 24 [25th percentile: 22, 75the percentile: 28]. A large majority (86.8%) of participants reported a low level of stigma with a score below 31. None of the participants showed a high level of stigma with a score above 43. We found that the higher the educational level the lower the participant's stigma score. CONCLUSION: We found a low level of stigmatizing thoughts and behavior among the non-infected general population in Tehran, which may be due to the social desirability effect, to the widespread nature of COVID-19, or to the adaptation to sociocultural diversity of the large city.


Subject(s)
COVID-19 , COVID-19/epidemiology , Humans , Iran/epidemiology , Psychometrics , Reproducibility of Results , Social Stigma , Surveys and Questionnaires
17.
Indo Global Journal of Pharmaceutical Sciences ; 12:205-208, 2022.
Article in English | EMBASE | ID: covidwho-2006725

ABSTRACT

Since 2020, we are witnessing a COVID-19 pandemic that has ruled out all other pandemics ever happened in our history. Countries are still not be able to manage the COVID-19 threat properly, and while we are still dealing with it, here comes another deadly infectious disease, monkeypox. Rapid circulation of monkeypox infections worldwide has forced the WHO to declared it as PHEIC. As per the current reports available on WHO, though the monkeypox is alarmingly spreading, but this threat seems to be quite manageable if dealt properly with smallpox vaccine and other antibiotic regimens in proper place. Key challenge now is actually how to control misinformation and misleading news that flooded the social media and news outlets. We have gathered studies available on the PubMed search engine since the starting of 2022, and also collected relevant information from WHO and other reliable news sources. As on 27.07.2022, WHO reported 19,178 laboratory confirmed cases, and out of these, on the white paper, only for 31.8% cases, there was recorded information about the sexual orientation. But if we look at the scientific publications and social media, it is only men having sex with men (MSM) who are the main victims and having monkeypox infections. Same message is being circulated to the common public through such channels. It is thus becoming responsibility of WHO, government and public health agencies to properly guide the public and aware them about the misleading information. Further, the presence of monkeypox DNA in the urine and feces have again showcased the role of wastewater management and proper surveillance.

18.
Pediatrics ; 149, 2022.
Article in English | EMBASE | ID: covidwho-2003269

ABSTRACT

Background: The COVID-19 global pandemic has shed light on the importance of testing to stop the spread of disease. For a developing country with a large population of over 200 million inhabitants such as Pakistan, widespread testing can be difficult. To date, 957,371 cases have been confirmed and over 14 million tests have been performed in Pakistan, with only 1% of the population vaccinated. In a country already burdened by health disparities with little to no resources, the challenges became ever apparent as case numbers grew. According to the WHO, complacency among the population in cooperating with public protective measures is a rising challenge. Several violent incidents have occurred in hospital wards in Pakistan, prompting medical staff to fear for their lives and demand extra security not only from the virus, but from volatile patients and families. The incidents are thought to be rooted in a mix of anger at a lack of resources, and mistrust of the medical system. The objective of this study was to survey Pediatric emergency medicine (PEM) physicians in Pakistan on their ability to test for COVID-19 and their limitations experienced. Methods: An anonymous prospective survey was performed from February to March 2021 in association with the ChildLife Foundation, a nonprofit organization that operates and manages Pediatric EDs in 10 government teaching hospitals in the province of Sindh. 170 PEM providers were surveyed on their experiences with COVID-19 testing, reasoning for why testing was not performed when infection was suspected and reasoning for patient refusals. Results: 68% of respondents had COVID-19 on their differential for patients under their care in the week prior to survey. However, 49% of respondents did not order any COVID-19 testing. 37% of those providers had at least one patient in whom COVID-19 was on the differential. 81% of providers claimed to collect COVID-19 testing every time when suspected. When surveying reasoning for not acquiring COVID-19 testing, providers listed patient refusal as the top reason, followed by limited availability and cost, mild presentation of disease, patient leaving AMA, fear of violence against healthcare professionals, social stigma/fear from patients of being labelled as COVID-19 positive and denial of the diagnosis. Conclusion: According to this survey, PEM providers in Pakistan were not always able to send COVID-19 testing, when indicated, due to a variety of factors. Testing limitations despite suspicion for disease can be a major hurdle in identifying cases and limiting spread in unvaccinated populations.

19.
Journal of Hepatology ; 77:S553, 2022.
Article in English | EMBASE | ID: covidwho-1996643

ABSTRACT

Background and aims: Hepatitis C virus (HCV) is a major public health burden in Canada, with prevalence in Indigenous (First Nation, Metis and Inuit) communities 4–6 times higher than non-Indigenous population. Conventional care models have created barriers to curative DAA therapy in remote Indigenous communities. Innovative approaches are required to improve access to HCV services.Method: The ECHO+ telehealth program in Alberta aims to increase access to HCV treatment through a hub-and-spoke model led by a hepatologist (hub) working with Indigenous communities (spokes) designing a model of care tailored to local needs. We incorporated Indigenous ways of knowingl (see figure), including building a predominantly Indigenous team, and embedding the 5 R’s of Indigenous Research Methodology (Respect, Relationship, Relevance, Reciprocity, and Responsibility). ECHO+ builds relationships with Indigenous community healthcare teams while using a novel co-design approach to remove barriers while increasing awareness, screening for HCV, and providing telehealth access to specialist care. Results: Collaborative methods included developing information resources translated into local languages;building infrastructure and supporting community-directed implementation to include other health topics. Due to the COVID-19 pandemic, virtual awareness presentations (HCV awareness topics, community interaction and knowledge sharing, opportunity to follow up with mailed resources packages, and sharing lived experience stories from Indigenous youth and Elders) have been shared with every Indigenous community in Alberta. Practitioners were interviewed to identify barriers to care. Biweekly Zoom meetings with community healthcare teams have expanded during the pandemic to include pandemic topics, and other liver diseases. Collaboration between ECHO+ and Indigenous community leadership and healthcare teams has improved HCV screening, de-stigmatization, increased treatment access, and supported local community healthcare providers to effectively access DAA therapy. Thus, currently 92% of the 53 Indigenous communities in Alberta have engaged with ECHO+, compared to 23% before this approach. This reflects success of the 5R method.(Figure Presented) Conclusion: A culturally-sensitive framework combines Indigenous with western approaches to improve access to HCV awareness and care in remote Indigenous communities. This approach has increased community communication and involvement, facilitated engagement with every Indigenous community, and provided practical support throughout the pandemic.

20.
Journal of Korean Academy of Community Health Nursing ; 33(2):196-206, 2022.
Article in Korean | Scopus | ID: covidwho-1994526

ABSTRACT

Purpose: The purpose of this study is to identify health belief, subjective norms, social stigma, and sense of community affecting COVID-19 preventive behaviors among college students, and provide basic data for the development of preventive programs to improve COVID-19 preventive behaviors. Methods: This study used a cross-sectional study design. The study recruited a total of 170 college students, through an online survey from three online communities which are mostly used by college students. Data were collected from July 24 to August 9, 2021. The SPSS 21.0 program was used to analyze the data using simple multiple regression. Results: In simple multiple regression, the perceived susceptibility, perceived benefits and subjective norms were found to have a significant association with COVID-19 preventive behaviors of college students. These variables explained the 55.1% variance in COVID-19 preventive behaviors of college students (p<.001). Conclusion: The results of this study showed that the perceived susceptibility, perceived benefits, and subjective norms were significant factors affecting COVID-19 preventive behaviors of college students. Based on the results of this study, it is expected to develop COVID-19 preventive programs and strategies that increase perceived susceptibility, perceived benefits, and subjective norms to improve the COVID-19 preventive behaviors of college students. © 2022. Korean Academy of Community Health Nursing

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