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1.
International Journal of Stroke ; 17(1):14, 2022.
Article in English | EMBASE | ID: covidwho-2064665

ABSTRACT

Background: Access to rehabilitation services for Aboriginal people following acquired brain injury (ABI) is frequently hindered by challenges navigating: i) complex medical systems, ii) geographical distances from services and iii) culturally insecure service delivery. Healing Right Way is the first randomised control trial (RCT) to address these issues in partnership with multiple health service providers across Western Australia (WA). Aims: To outline the multicomponent Healing Right Way intervention by providing case studies, and describing challenges, facilitators and implications for rehabilitation services. Method: This stepped-wedge cluster RCT involved four metropolitan and four regional sites across WA. Aboriginal adults hospitalised for ABI were recruited from 2018-2021. Intervention components comprised ABI-related cultural security training (CST) for hospital staff, and employment of Aboriginal Brain Injury Coordinators (ABICs) to support ABI survivors for six months post-injury. The primary outcome was quality of life (measured with Euro QOL-5D-3L VAS) at 26 weeks. Secondary outcomes included participants' overall function and disability, anxiety and depression, carer strain, and changes to service delivery across the 26-week follow-up period. Detailed process and cost evaluations were also undertaken. Results: 108 participants were recruited from the participating sites. The CST was delivered across all eight participating hospitals with 250 hospital staff trained. ABICs supported 61 participants, 70% residing in regional, rural or remote areas. Challenges to implementation of the intervention included impacts from COVID-19 responses, hospital staff turnover and availability, recruitment of people with traumatic brain injury and methods for maintaining contact with participants and next-of-kin across locations. Collaboration with Aboriginal health providers and community networks were invaluable to maintaining contact with participants during follow-up, as was telehealth and research partnerships. Discussion/Conclusions: This landmark trial provides a novel multicomponent intervention in an underserviced population to inform muchneeded service improvements for Aboriginal people with ABI across metropolitan and rural settings.

2.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-344259

ABSTRACT

Background: We estimated the coverage and effectiveness of Covid-19 vaccines against laboratory-confirmed Covid-19 cases among indigenous people in Brazil. Methods: We linked nationwide immunization data with symptomatic and Severe Acute Respiratory Infection records and studied a cohort of vaccinated indigenous people aged ≥5 years between 18th Jan 2021 and 1st Mar 2022. We estimated the Covid-19 vaccination coverage and used Poisson regression to calculate the vaccine effectiveness (VE) of CoronaVac, ChAdOx1, and BNT162b2 against Covid-19 laboratory-confirmed symptomatic and severe cases (i.e., mortality, hospitalisation, and hospital-progression to Intensive Care Unit (ICU) or death). VE was estimated as (1-RR)*100, comparing unexposed (<14 days after the 1st dose), to partially (≥14 days after 1st dose to <14 days after 2nd dose), or fully vaccinated (≥14 days after 2nd dose). Findings: By 1st Mar 2022, 48·7% (35·0-62·3) of eligible indigenous people vs 74·8% (57·9-91·8) overall Brazilians had been fully vaccinated for Covid-19. Among the 370,092 indigenous subjects studied, we detected 1951 Covid-19 cases, of which 105 were hospitalised and 35 died. VE for the three Covid-19 vaccines combined was 53% (95%CI:44-60%) for symptomatic cases, 53% (95%CI:-56-86%) for mortality and 41% (95%CI:-35-75%) for hospitalisation. Among hospitalised patients, VE was 87% (95%CI:27-98%) for progression to ICU and 96% (95%CI: 90-99%) for death. Interpretation: Lower coverage but similar Covid-19 vaccine effectiveness among indigenous people than overall Brazilians suggest the need to expand access, timely vaccination, especially among children and adolescents, and urgently offer booster doses to achieve a great level of protection among this group.

3.
Australian Journal of Primary Health. Conference: Australasian Association for Academic Primary Care Annual Research Conference, AAAPC ; 28(4), 2022.
Article in English | EMBASE | ID: covidwho-2057498

ABSTRACT

The proceedings contain 101 papers. The topics discussed include: exploring the health seeking narratives of Assyrian refugee women living with chronic pain;can introducing a 'COIL program' enhance medical students' awareness regarding the relevance of cross-cultural communication skills in healthcare?;diagnosing doctor Google: investigating the relationship between cognitive bias and information behavior in older Australians accessing vaccine-related online information;patterns of multimorbidity show strong association between many chronic condition pairs;adult obesity management in Australia: how can we bridge the gap between guidelines and current general practice?;adaptive research practices in a pandemic: what have we learned during COVID-19?;culturally safe ways of working with Aboriginal and Torres Strait islander peoples in focus groups on sensitive topics;and supporting resilience and recovery: understanding general practitioners' perspectives on trauma-informed care for survivors of domestic and family violence.

4.
Psychology and rural contexts: Psychosocial dialogues from Latin America ; : 131-142, 2021.
Article in English | APA PsycInfo | ID: covidwho-2047983

ABSTRACT

This chapter describes how indigenous people face the SARS-CoV-2 pandemic from a community approach. Through a documentary research, we advance in analyzing the living conditions of indigenous people in the pandemic, the ways of facing it, and the "new normalities" based on the psychosocial and community resources that these social actors have. A substantial finding is that the sense of "us" functions as a psychosocial and community strength to face the pandemic. The sense of "us" implies feeling, vocalizing, living, and having a conscience that brings people together at a time when the social and health conditions resulting from the pandemic have exposed inequality, inequity, the system of injustice, and poverty as a framework of capitalism that urges individualism over the commitment to the common good and the community. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

5.
Journal of Tourism Futures ; 8(3):375-379, 2022.
Article in English | ProQuest Central | ID: covidwho-2037772

ABSTRACT

Purpose>This paper display how “objectifying” forms of tourism can be converted into a more gender-equal regenerative tourism.Design/methodology/approach>The methodology generates shared understandings about the opportunities and challenges of implementing regenerative tourism by stimulating gender equality. The research design is based on qualitative research methods. Using a transformative tourism development process of the Karenni village Huay Pu Keng in Thailand, which is the first and only village that made this transition, the results of a process to stimulate the empowerment of women have been described.Findings>The desk research and conversations reported in the findings of this paper provide important insights in the social impacts in relation to gender equality and women empowerment. The community has become a role model for transformative tourism in relation to gender equality. Findings included that women are more involved in tourism activities, which has created a positive shift towards a gender balance. However, there is still a difference in education and participation between men and women. The study further reveals how tourism contributes to enliven the indigenous traditions and cultures and be a model for future developments in creating life-long meaningful experiences.Originality/value>Insights of the first and only Karenni village that made a transition to community-based tourism demonstrate how the community has been empowered. It improved the gender balance to make strategic decisions towards transforming their futures. Exploring this process is therefore valuable, as it contains knowledge that can be advantageous for other communities and research.

6.
Disease Surveillance ; 37(4):427-429, 2022.
Article in Chinese | GIM | ID: covidwho-1994244

ABSTRACT

Objective To assess the risk of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in April 2022. Methods An internet based expert counsel was conducted to analyze the surveillance data of public health emergencies and priority communicable diseases in China reported through different channels, and the experts in all provincial centers for disease control and prevention attended this video conference. Results It is expected that number of domestically reported public health emergency events other than COVID-19 in April would remain unchanged from March. The risk of domestic COVID-19 outbreaks caused by the indigenous transmission and the foreign importation is high, making it more difficult to prevent and control the epidemic. Local governments need to strengthen epidemic prevention and control in accordance with national requirements and hold the bottom line of no large-scale rebound of the epidemic. The number of pertussis cases will maintain rising trend due to the improvement of laboratory testing technology, the weakening of vaccine protection and the strengthening of surveillance in some districts. Conclusion Special attention should be paid to COVID-19. General attentions should be paid to pertussis.

7.
Dissertation Abstracts International Section A: Humanities and Social Sciences ; 83(10-A):No Pagination Specified, 2022.
Article in English | APA PsycInfo | ID: covidwho-1989412

ABSTRACT

The coronavirus (COVID-19) created unprecedented changes for teachers and students worldwide. K-12 institution were forced into action, requiring a shift in their respective teaching, and learning modalities. The global pandemic caused all institutions to re-imagine educational opportunities, equity, and access relative to middle-skills options, combined with ensuring curriculum and learning outcomes remain relevant with rigorous [faculty to student, and student to business partner] engagement. In Houston Independent School District (Houston ISD), the pandemic provided an opportunity to examine the STEM Engineering program of study within the Career and Technical Education (CTE) Department, to determine if equity and access have been, and continues to be a reality for BIPOC girls. This research will quantitatively analyze CTE-STEM disaggregated data for the 2018-2019 cohort. Specifically, the study will explore the intersectional experiences of BIPOC girls as they relate to placement in the non-traditional CTE-STEM engineering program of study, and the designation of concentrator or completer to determine if gaps of equity and access exist. Further inquiry will consider the likely effects to [future earnings and widening of middle-skills gap]. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

8.
Russian Open Medical Journal ; 11(2), 2022.
Article in English | EMBASE | ID: covidwho-1988615

ABSTRACT

Rationale - The goal of the study was to investigate gender characteristics of functional somatic disorders in adolescents of the indigenous population of Khakassia (using the case study of the Abakan city). Material and methods - The object of the study was 215 (46.8%) boys and 244 (53.2%) girls of four secondary schools in Abakan. Their average age was 14.5±1.3 years. Data collection was conducted by means of an original screening questionnaire developed by Professor S.Yu. Tereshchenko. Results - The incidence of recurrent pain in the total sample of the surveyed youths was 184 (40.1%) for cephalalgia, 225 (49.0%) for abdominal pain, and 269 (58.7%) for back pain. The prevalence and structure of functional somatic disorders in Khakas adolescents depended on their gender. Asthenic syndrome was more common among girls - 42 (17.2%) vs. 14 (6.5%) in boys. In girls, the percentage of frequent headaches was higher than in boys: 22 (9.0%) vs. 8 (3.7%), respectively. Similar trend was observed in case of rare headaches: 100 (41.0%) vs. 54 (25.1%). Also, girls, compared with boys, were characterized by a higher incidence of both frequent and rare abdominal pains: 38 (15.6%) vs. 9 (4.2%) and 106 (43.4%) vs. 72 (33.5%), correspondingly. Conclusion - The case study of surveyed ethnic sample of Abakan school students revealed a high prevalence of recurrent pain syndromes in the indigenous youths of Khakassia. We have also established that incidence, structure and severity of recurrent pain, as well as its negative impact on well-being and daily activities, were associated with gender.

9.
Journal of Agriculture, Food Systems and Community Development ; 11(3):121-137, 2022.
Article in English | CAB Abstracts | ID: covidwho-1964348

ABSTRACT

The COVID-19 pandemic has unveiled deep and systemic weaknesses and gross inequalities in U.S. food and farming systems, compounding the effects of an already unjust food and agricultural system. Emergent studies reveal disproportionate effects of the pandemic on minority farmers and vulnerable communities, as well as inequitable access to critical relief programs. Less is understood about the experiences and responses of Native American producers, tribal governments, and tribal-led organizations to the COVID-19 crisis. As the nation's primary Native American agriculture and natural resources organization, serving 574 Federally Recognized Tribal communities throughout the United States, the Intertribal Agriculture Council (IAC) received a resounding increase in inquiries during the pandemic pertaining to a number of challenges that tribal producers and governments face. In response, IAC launched a series of national surveys to assess the impacts and needs of Native American producers, tribal governments, and grocery stores in and near tribal communities, with the goal of identifying effective strategies to address tribal priorities in policy and programming. As we continue to learn about the causes and consequences of food system ruptures during the COVID-19 pandemic, it has become abundantly clear that increased investment in and sovereignty over decentralized regional food and farming systems' infrastructure and markets are needed to strengthen the economic viability and resilience of Native American agriculture and food systems.

10.
4th ACM SIGCAS/SIGCHI Conference on Computing and Sustainable Societies, COMPASS 2022 ; Par F180472:596-602, 2022.
Article in English | Scopus | ID: covidwho-1950305

ABSTRACT

Indigenous communities in Bangladesh are comparatively disadvantaged and face several barriers regarding rights. Access to technology and ICT can help indigenous communities open new economic, political, and social dimensions. The recent COVID-19 pandemic necessitated technology adoption for routine use, which is equally important for indigenous communities, but their technology adoption scenario remains unexplored in HCI research. Considering the research gap, we interviewed n=36 (Female 26 and Male 10) indigenous people from six different indigenous communities in Chattogarm and Sylhet divisions in Bangladesh. We found that they are strongly connected in communities, have independent technology access, and have no gender differences. They have a strong interest and eagerness to learn available technologies that help them in their professions, enrich their technical skills, communication, social participation, and expand the business. The study also revealed some challenges while using technology, but that did not negatively impact their usage. The study also discussed the community-centric strengths that helped them fight against the COVID-19 crisis and work for their development. This research impacts HCI literature, revealing the technology adoption scenarios of Indigenous communities in Bangladesh. © 2022 ACM.

11.
Investigacion Clinica ; 62(Suplemento 3):148-158, 2021.
Article in Spanish | CAB Abstracts | ID: covidwho-1929329

ABSTRACT

In December 2019, an outbreak of pneumonia cases emerged in Wuhan, China, which evolved into the COVID-19 pandemic. The purpose of the work is to design a community prevention strategy in the indigenous population of zone 3 at the starting point of the epidemiological characterization carried out. A longitudinal and prospective experimental explanatory study was conducted with deliberate intervention, descriptive and inferential statistical methods were used. It was identified that the age of 60 years or more pre- dominated in the subjects surveyed, which represented 9,7%, and the other risk group located at ages under 18 years, were located 17 for 4,5% of the sample, although the figure of both age groups of risk is not high, it is necessary to work with the indigenous population at the community level, ischemic heart disease, high blood pressure, diabetes mellitus and bronchial asthma were also identified as a risk. As social factors, extreme poverty, living alone, overcrowding and poor accessibility to health services. The community prevention strategy of Covid-19 in the indigenous population will favor the epidemiological control of the pandemic with probable economic and social impact added, which will guarantee a rational use of resources focused on the most vulnerable population.

12.
Investigacion Clinica ; 62(Suplemento 3):385-398, 2021.
Article in Spanish | GIM | ID: covidwho-1929193

ABSTRACT

Covid 19, was first reported in Wuhan, China, declared by the World Health Organization (WHO) as an international health emergency in January 2020 and classified as a pandemic in March of the same year, Covid-19, is without doubt the topic of greatest clinical and investigative interest world-wide, national and local, the purpose of this research work is to design a rele-vant community prevention strategy with the needs of these population groups, from a medical and scientific bibliographic base, As a theoretical foundation, a strategy for the prevention of infections by Covid-19 in indigenous communities of the Ambato canton in Ecuador was designed, which consists of seven phases that include data analysis and mapping of the population at risk;characteriza-tion of the group;needs assessment;initial evaluation of the state of health;execution and implementation of prevention and promotion activities;final evaluation and socialization of the results.

13.
Prehosp Disaster Med ; 37(4): 429-430, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1931264

ABSTRACT

Extreme heat and wildfires have health implications for everyone; however, minority and low-income populations are disproportionately negatively affected due to generations of social inequities and discriminatory practices. Indigenous people in Canada are at a higher risk of many chronic respiratory diseases, as well as other non-communicable diseases and hospitalization, compared to the general population. These wildfires occurring during the COVID-19 pandemic have demonstrated how disruptive compounding disasters can be, putting minority populations such as First Nations, Metis, and Inuit tribes at increased risk and decreased priority. Going forward, if the necessarily proactive mitigation and preparedness steps are not undertaken, the ability to attenuate health inequity in the indigenous community by building resiliency to wildfire disasters will be significantly hampered.


Subject(s)
Wildfires , Canada/epidemiology , Humans
14.
Saude e Sociedade ; 31(2), 2022.
Article in English | EMBASE | ID: covidwho-1917072

ABSTRACT

This case-control study paired by gender and age analyzes factors associated with the death of indigenous people from COVID-19 in the state of Amapá, Brazil. Data were collected from a public secondary database produced by the Amapá State Department of Health. Cases (n=29) were deaths of indigenous people from COVID-19 and controls were cures of the disease (n=87), recorded between April 2020 and January 2021. Data from individuals with active disease were excluded. Univariate analysis followed by multiple logistic regression were performed to study the independent variables associated with death. Most cases of death were women (51.7%), without comorbidities (62.1%), residing in cities of the Metropolitan Region of Macapá (RMM) (65.5%) and in urban areas (89.7%). Median age of the death group was 72 years (interquartile range=21.5). The final multiple model showed that indigenous individuals with cardiovascular comorbidity had a 4.01 times greater chance (95% confidence interval – 95% CI=1.05-15.36) of death by COVID-19 when compared with indigenous people without comorbidities. And that indigenous people residing in the RMM had a 2.90 times greater chance (95%CI = 1.10-7.67) of death when compared with indigenous residing in the countryside.

15.
Australian and New Zealand Journal of Psychiatry ; 56(SUPPL 1):142-143, 2022.
Article in English | EMBASE | ID: covidwho-1916661

ABSTRACT

Background: Self-harm presentations in young people have increased internationally over the last decade. The COVID-19 pandemic has the potential to worsen these trends. Objectives: To describe trends in Emergency Department (ED) self-harm presentation for young people in New South Wales (NSW) before and since the COVID-19 pandemic. Methods: We studied presentations to NSW EDs by 10- to 24-year-olds for self-harm or suicidal ideation. Interrupted time series compared annualised growth before COVID-19 (2015-20) and since (March 2020-June 2021). Subgroup analyses compared age group, gender, triage category, rurality and disadvantage. Time series decomposition identified long-term, seasonal and shortterm trends. Findings: Self-harm presentations by young people in NSW increased by 8.9% per annum (pa) pre-COVID. Growth accelerated to 19.9% pa post-COVID, specifically due to increased presentations by females aged 13-17 (up 47.1% pa, from 290 per 10,000 in 2019 to 466 per 10,000 in 2021). Self-harm presentations in males aged 10-24 did not increase post-COVID (105.4 per 10,000 in 2019, 109.8 per 10,000 in 2021) despite growing 9.9% pa before COVID. Presentation rates accelerated significantly in socially advantaged areas and in non-aboriginal youth. Conclusion: ED self-harm presentations by NSW young people grew steadily before COVID. Growth has increased since COVID specifically for adolescent girls, but not among adolescent males. Surprisingly, the largest post-COVID increases in annual growth occurred in socio-economically advantaged and urban regions and non- Aboriginal young people. The COVID-19 pandemic appears to have added new challenges, particularly in females in the developmentally critical early adolescent and teenage years.

16.
Australian and New Zealand Journal of Psychiatry ; 56(SUPPL 1):136, 2022.
Article in English | EMBASE | ID: covidwho-1916657

ABSTRACT

Objectives: To identify: (1) which population groups are most vulnerable to climate change health and mental health (MH) impacts? (2) In strengths rather than deficit framing, which should be the highest priority populations for MH and well-being prevention, clinical amelioration and community mobilisation? (3) What factors contribute to the highest-level priority due to vulnerability to climate change MH impacts? We suggest the populations with the highest social determinants gaps, health comorbidities and over-incarceration. Findings: The extremes are often found in both the most urban and the most remote settings. Why are culturally strong, proud and resilient Indigenous communities still so prone to climate change-related events? Especially as Aboriginal and Torres Strait Islander communities have achieved so much, leading Australia and the world, for the first 16 months of COVID-19 outcomes in Indigenous communities? Conclusion: In terms of the approach taken to improving the MH and well-being of most Indigenous and other priority populations most vulnerable to climate changerelated events, we need a better balance between traditional cultural-healing approaches, communitycontrolled and clinically determined solutions. Indigenous communities can contribute considerably to MH and well-being solutions for themselves and for the wider community.

17.
Australian and New Zealand Journal of Psychiatry ; 56(SUPPL 1):219, 2022.
Article in English | EMBASE | ID: covidwho-1916632

ABSTRACT

Background: Iwi Maori (Maori people) are the Indigenous people of Aotearoa. Some estimates predict that Maori have been occupying the lands of Aotearoa for more than 1000 years. After claiming sovereignty in 1835 with He Whakaputanga (Declaration of Independence) following annexing international interests, Maori signed the Treaty of Waitangi (Te Tiriti o Waitangi) 5 years later to ensure independence, protection, ongoing prosperity and justice. Maori were prosperous, trading, had a strong economy and thriving in all areas of life. Maori knowledge systems and language were mainstream and many Pakeha who settled embraced all aspects of Maori culture including te reo Maori. Our history tells us that Te Tiriti was not honoured and this had catastrophic effects on Maori existence. By the late 1890s the Maori population had nearly been wiped out by infectious illnesses, loss of lands and the encroaching effects of assimilation, colonial shift in power and the disempowerment of Maori. Access to health care is a human right and was protected under treaty rights but successive governments have failed to address inequities. Moving forward to 2021, the Ministry of Health recently announced a new health structure and the establishment of a Maori Health Authority (MHA) to independently advise, commission health services for iwi Maori. Many see this change as transformative and a true act of Tino Rangatiratanga (self-determination). The act of re-Indigenising our health systems landscape may find the solutions to restoring equity. Objectives: To provide a personal reflection of the proposed new health care system reforms with a particular focus of the historical socio-cultural context of Aotearoa and illustrate why these reforms are important and transformative. I want to demystify the ideas and rationale for de-colonisation. I also want to consider the implications for Maori health and the enormous expectations others may have towards Maori solutions and the anticipated critics of the new system. Methods: I will briefly review the historical context of Maori in Aotearoa, the causes of poor mental health (MH) outcomes, why equity is important and why things need to change. I will discuss the most recent independent health reviews, which provides the basis of the new health reforms. Understanding Indigenous concepts like Tino Rangatiratanga and Mana Motuhake will be articulated. Understanding the concept of health and wellness from a Maori perspective will be discussed. Findings: Maori MH incidence and prevalence rates for most health conditions continue to be disproportionately higher than the dominant culture. Like Indigenous Australians, youth suicide rates for Maori remain the highest in the modern world, and other health crises such as COVID-19 can perpetuate these outcomes. Healthcare systems (in Australia and New Zealand), health structures and those in the positions of influence continue to underperform. The new proposed health reforms put Maori health leaders in the frontline in decision-backing processes and delivery: 'Ma Maori, mo Maori - By Maori, for Maori'. Conclusion: The enduring effects of colonisation continue to create inequitable health outcomes for Maori in Aotearoa. The new health reforms proposed may generate needed ideological, philosophical and culturally mandated shifts which align with the intent of Te Tiriti o Waitangi and the achievement of Tino Rangatiratanga and Mana Motuhake. There is now a process to re-empower Maori to find their own solutions to poor health outcomes, to rediscover lost knowledge and indigenise our healthcare system. The effects of the new system should be given time to make a difference.

18.
Journal of Management, Spirituality & Religion ; 18(5):462-481, 2021.
Article in English | APA PsycInfo | ID: covidwho-1893761

ABSTRACT

Indigenous knowledge and practices suffer marginalisation when it comes to seeking solutions to social problems. The world misses out on the richness of this knowledge and practices and role that they can play. This qualitative existential phenomenological study explored experiences of African indigenous knowledge holders and practitioners on their views regarding solutions towards COVID-19 pandemic. Interviews were conducted through WhatsApp and face-to-face with ten participants and data were analysed thematically. The findings show African knowledge and practices that could combat COVID-19 in terms of restrictions, heat related remedies and plant related remedies, and how these knowledge and practices can be applied through ancestral, environmental, metaphysical and generational modes. Africa and the world could benefit from how indigenous people respond to diseases such as COVID-19 and adopt/adapt some of these knowledge and practices;indigenous knowledge and practices have a role to play by contributing solutions to the world's problems. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

19.
Topics in Antiviral Medicine ; 30(1 SUPPL):358, 2022.
Article in English | EMBASE | ID: covidwho-1879921

ABSTRACT

Background: For newly diagnosed persons with HIV (PWH), early initiation of ART is essential in reducing morbidity and mortality and decreasing the risk of transmitting HIV. We have previously reported the trends in linkage to HIV medical care within one month of HIV diagnosis (LC-1Mo) and viral suppression within three months of HIV diagnosis (VS-3Mo) among PWH in Spain from 2004 to 2018. We herein update this information up to 2020. Methods: Longitudinal study based on the Cohort of the Spanish AIDS Research Network (CoRIS). VS was defined as ever having an HIV-RNA <200 copies/mL. We used logistic regression to assess differences by sex, age, country of birth, transmission category, and baseline CD4+ cell count. Results: A total of 13,632 PWH were enrolled in CoRIS in the study period: males 85%, men having sex with men (MSM) 62%, median age 35 (IQR: 28-43) years. LC-1Mo increased from 41% (95% CI, 37%-45%) in 2004 to 83% (79%-87%) in 2020 (P trend <0.001) (Figure). Median CD4+ cell counts at ART initiation increased from < 250/mm3 in 2004-2005 to > 350/mm3 since 2012 (P for trend <0.001). The percentage of initial ART regimens based on integrase strand transfer inhibitors (InSTI) increased from 3% in 2004 to > 70% from 2016 onwards (P trend <0.001). VS-3Mo increased from 6% (4%-8%) in 2004 to 43% (40%-47%) in 2019 with a small decrease to 41% (36%-46%) in 2020 (P trend [for the entire period] <0.001) (Figure). The odds of achieving VS-3Mo was higher among females (aOR, 95% CI: 1.30, 1.12-1.51), among non-Spanish Europeans and Latin Americans compared to native-born Spaniards (1.26, 1.11-1.44 and 1.36, 1.21-1.52, respectively), and among those older than 50 years (1.20, 1.03-1.41). Opposite, the odds of achieving VS-3Mo was lower among IDU compared to MSM (0.53, 0.40-0.70) and those with CD4 counts between 200-500 cells/uL (0.78, 0.69-0.89) and CD4 counts >500 cells/uL (0.51, 0.44-0.60) compared to those with CD4 < 200 cells/uL. Conclusion: Indicators of care have improved among newly diagnosed PWH in Spain over the last 16 years. Elimination of CD4 cell count restrictions for ART initiation and increasing use of InSTI-based regimens was decisive for progress. A slight decrease in VS-3Mo in 2020 compared with 2019 was observed, perhaps because of the COVID-19 pandemic.

20.
J Public Health (Oxf) ; 44(3): e359-e365, 2022 08 25.
Article in English | MEDLINE | ID: covidwho-1873990

ABSTRACT

BACKGROUND: Few studies have described the clinical characteristics of patients with COVID-19 from ethnic minority groups. Our objective was to evaluate the mortality and incidence rates, clinical characteristics and factors associated with mortality in cases with COVID-19 belonging to the Amazonian indigenous ethnic group in Peru. METHODS: We performed a retrospective cohort study including all cases from COVID-19 among Peruvian people identified as Amazonian indigenous from 07 March to 31 October 2020. We calculated the standardized mortality and incidence ratios using the indirect age-adjusted method to determine the differences between Amazonian Indigenous and the general population. In addition, we used multivariable logistic regression to determine the risk factors for death. RESULTS: A total of 19 018 laboratory confirmed COVID-19 cases were analyzed. Indigenous people had 3.18 (95% CI, 3.13-3.23) times the risk of infection and 0.34 (0.31-0.37) times the mortality risk of the general Peruvian population. Males had 1.29 (1.04-1.61) times the odds of death compared with females and for each year of age, the odds of mortality increased 1.03 (1.03-1.04) times. Cases with respiratory distress had 2.47 (1.96-3.10) times more likely to die. Having an immunodeficiency was 18.7 (6.12-57.00) times more likely to die. DISCUSSION: The Amazonian indigenous population in Peru was strongly affected by COVID-19 compared with the general Peruvian population.


Subject(s)
COVID-19 , Ethnicity , COVID-19/epidemiology , Female , Humans , Incidence , Male , Minority Groups , Peru/epidemiology , Retrospective Studies
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