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1.
PLoS One ; 17(3): e0264534, 2022.
Article in English | MEDLINE | ID: covidwho-1793513

ABSTRACT

The lessening of food wastage, specifically among nations where about half of its worldwide quantity is produced, has turned to be a mammoth challenge for environmental, social and economic sustainability, and represents one of the seventeen Sustainable Development Goals (SDG) within the Agenda 2030. The quantity of food being thrown away in spite of being in an edible condition has become alarming in middle and high income countries. The COVID-19 lockdown strategy, both at local and international levels, has expressively altered work, life and food consumption behaviors globally, directing to food wastage as a multi sectoral issue. Pakistan has no exception to such manifestations. The main objective of this study is to analyze the perceptions of rural people of Pakistan regarding food wastage during the COVID-19 pandemic. To evaluate whether behavior about food wastage among rural households varied or not during the pandemic, a descriptive survey was carried out using a self-administered questionnaire and 963 responses were selected for further empirical investigations. The findings of the study reveal that food waste actually decreased in spite of an increased amount of purchased food during the lockdown. Our results highlight that the effect of the pandemic has led to reduction in food wastage among rural respondents, an increased consciousness for the morals of food waste, and awareness of environmental impacts of food wastage. The conclusions of this study highlight that rural consumers of Pakistan are emerging with a new level of responsiveness about food wastage with possible positive impact on the environment in terms of decreased greenhouse gas (GHG) emission and other pollutants. The study findings imply that this pandemic time provides a suitable window to raise awareness about food wastage among rural as well as urban households while contemplating effective strategies to overcome the issue of food wastage in the country.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control , Consumer Behavior , Food Security , Refuse Disposal , Adult , Consumer Behavior/statistics & numerical data , Female , Food/statistics & numerical data , Food Security/statistics & numerical data , Food Supply/statistics & numerical data , History, 21st Century , Humans , Male , Pakistan/epidemiology , Pandemics , Perception/physiology , Refuse Disposal/statistics & numerical data , Rural Population/statistics & numerical data , Surveys and Questionnaires
2.
Nutr J ; 21(1): 17, 2022 03 20.
Article in English | MEDLINE | ID: covidwho-1745452

ABSTRACT

BACKGROUND: The COVID-19 pandemic has impacted the Australian food supply through changed consumer purchasing patterns, and potentially, household food security. The aim of this study was to determine the impact of COVID-19 on the prevalence of food insecurity and food supply issues, and perspectives of food supply stakeholders in regional Australia. METHODS: A mixed-methods consumer survey and in-depth interviews with food supply stakeholders were conducted in regional Australia, more specifically South West Western Australia between May and July 2020, immediately after the 1st wave of the pandemic. RESULTS: The prevalence of food insecurity was 21% among consumers, and significantly more prevalent for those aged less than 30 years and living with a disability. Most consumers (73%) agreed that the COVID-19 pandemic had impacted the food supply. Food insecure respondents were more likely to report that food was more expensive, resulting in changes to the types and quantities of food bought. Food supply stakeholders perceived that consumers increased their intention to buy locally grown produce. Panic buying temporarily reduced the availability of food for both food suppliers and consumers, regardless of their food security status. CONCLUSIONS: This study provided novel insights from South West Australian consumer and food supply stakeholder perceptions. Food insecure consumers provided insights about the high cost of food and the subsequent adaptation of their shopping habits, namely type and amount of food purchased. Stakeholder perceptions largely focused on supply chain issues and corroborated consumer reports.


Subject(s)
COVID-19 , Adult , Australia/epidemiology , COVID-19/epidemiology , Food Security , Food Supply , Humans , Pandemics
3.
Int J Environ Res Public Health ; 19(6)2022 03 09.
Article in English | MEDLINE | ID: covidwho-1732059

ABSTRACT

Prior to the COVID-19 pandemic, rural-dwelling people in high-income countries were known to have greater challenges accessing healthy food than their urban counterparts. The COVID-19 pandemic has impacted food supplies across the world, and public health restrictions have changed the way people shop for food, potentially exacerbating food insecurity. This systematic literature review aimed to synthesize the available evidence on the impact of the COVID-19 pandemic on aspects of food insecurity in rural populations residing in high-income countries. Five electronic databases were searched, identifying 22 articles that assessed food insecurity prevalence or data on food availability, access, utilization and the stability of the food supply in rural populations during the COVID-19 pandemic. Ten studies examined the prevalence of food insecurity in rural populations, with the reported prevalence ranging from 15% to 95%. Where rural/urban comparisons were presented, most studies (n = 5; 71%) reported that food insecurity was significantly higher in rural regions. Five studies examined the availability of food and eight studies examined access to food, identifying that rural populations often had lower food availability and access to food during the pandemic. In contrast, two studies identified positive effects such as more gardening and increased online access to food. Rural populations experienced multiple changes to food utilization, such as reduced diet quality and food safety observed in eight studies, but this was not shown to be different from urban populations. Additionally, the food supply in rural regions was perceived to be affected in two studies. The results of this review may be used to inform region-specific mitigation strategies to decrease the impact of the current COVID-19 pandemic and future global events on food security. However, the lack of consistency in study outcomes in research on rural populations limits the identification of priority areas for intervention at a global-scale.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Developed Countries , Food Security , Humans , Rural Population
4.
PLoS One ; 17(2): e0264315, 2022.
Article in English | MEDLINE | ID: covidwho-1714777

ABSTRACT

About 2 billion people worldwide suffer moderate or severe forms of food insecurity, calling for correctional measures involving economic strengthening interventions. This study assessed the impact of household economic strengthening (HES) intervention on food security among caregivers of orphans and vulnerable children (OVC) in Tanzania. The study was longitudinal in design, based on OVC caregivers' baseline (2017-2018) and midline (2019) data from the USAID Kizazi Kipya project. Food security, the outcome, was measured using the Household Hunger Scale (HHS) in three categories: little to no hunger (food secure), moderate hunger, and severe hunger. Membership in the USAID Kizazi Kipya-supported economic strengthening intervention (i.e. WORTH Yetu) was the main independent variable. Data analysis involved generalized estimating equation (GEE) for multivariate analysis. With mean age of 50.3 years at baseline, the study analyzed 132,583 caregivers, 72.2% of whom were female. At midline, 7.6% of all caregivers enrolled at baseline were members in WORTH Yetu. Membership in WORTH Yetu was significantly effective in reducing household hunger among the caregivers: severe hunger dropped from 9.4% at baseline to 4.1% at midline; moderate hunger dropped from 65.9% at baseline to 62.8% at midline; and food security (i.e., little to no hunger households) increased from 25.2% at baseline to 33.1% at midline. In the multivariate analysis, membership in WORTH Yetu reduced the likelihood of severe hunger by 47% (OR = 0.53, 95% CI 0.48-0.59), and moderate hunger by 21% (OR = 0.79, 95% CI 0.76-0.83), but increased the likelihood of food security by 45% (OR = 1.45, 95% CI 1.39-1.51). The USAID Kizazi Kipya's model of household economic strengthening for OVC caregivers was effective in improving food security and reducing household hunger in Tanzania. This underscores the need to expand WORTH Yetu coverage. Meanwhile, these results indicate a potential of applying the intervention in similar settings to address household hunger.


Subject(s)
Caregivers , Child, Orphaned , Food Security , Hunger , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Tanzania
5.
Nutr Diet ; 79(1): 28-47, 2022 02.
Article in English | MEDLINE | ID: covidwho-1714093

ABSTRACT

AIM: The COVID-19 pandemic has disrupted the Australian food supply with potential ramifications on food security. This scoping review aimed to synthesise current evidence on the prevalence of food insecurity and changes to factors related to food insecurity during the COVID-19 pandemic in Australia. METHODS: A comprehensive search strategy was used to search seven databases (MEDLINE, CINAHL, Embase, Global Health, Cochrane Database of Systematic Reviews, PsycINFO, Informit Online) and Google Scholar. Included studies were written in English, published in 2020-2021 and examined food security status in Australia during the COVID-19 pandemic and/or factors associated with food insecurity in free-living Australian residents. Articles with participants residing in institutional settings, where meals were supplied, were excluded. RESULTS: A total of 700 records were identified from database, grey literature and hand searching, and nine articles were included. All studies indicated that the prevalence of food insecurity had increased due to negative changes to food availability, accessibility, usability and stability. The downturn in employment and economic circumstances following the onset of the COVID-19 pandemic appeared to create a new group of food-insecure Australians consisting of newly unemployed, and international students. CONCLUSION: COVID-19 has exacerbated vulnerabilities in the Australian food supply and food security. Suggested actions include ongoing data collection on the long-term impact of COVID-19 on food supply and security in addition to coordinated national and community responses that improve the stability of the local food supply and address underlying determinants of food insecurity.


Subject(s)
COVID-19 , Australia/epidemiology , COVID-19/epidemiology , Cross-Sectional Studies , Food Security , Humans , Pandemics , SARS-CoV-2
6.
J Health Popul Nutr ; 41(1): 4, 2022 02 21.
Article in English | MEDLINE | ID: covidwho-1700597

ABSTRACT

BACKGROUND: One of the impacts of the COVID-19 pandemic was the weakening of the community's economic condition. The weak economy of the community will have an impact on household food security. This study aims to determine food security in the COVID-19 pandemic situation and the impact of the pandemic on food security in urban and semi-urban areas. METHODS: A cross-sectional study with a total sample of 517 people who live in urban (Jakarta) and semi-urban (Depok) areas. The research data was collected online and purposively through Posyandu cadres who have access to family/community. Food security was measured using HFIAS (Household Food Insecurity Access Scale) method, while impact of COVID-19 pandemic was categorized into two categories: impacted (reduced income and laid off) and less impacted (not reduced income and laid off). Data analysis used the Chi-square test and multiple logistic regression. RESULTS: There were 65.0% of households with various level of food insecurity during the COVID-19 pandemic. The results of the multivariate analysis showed that family income during the COVID-19 pandemic (AOR = 4.2; CI = 2.7-6.7), the type of impact of the COVID-19 pandemic, i.e., reduced income and stopped working (AOR = 2.6; CI = 1.6-4.1), and the age of the respondent (AOR = 1.7; CI = 1.1-2.5) were significantly related to household food security during the pandemic after being controlled by husband's work status. Households with lower income had 4 times higher risk to experience food insecurity compared to those with higher income. Heavily impacted households (through reduced income and stopped working) had 3 times higher risk to experience food insecurity compared to those who did not. Additionally, we found that households with younger respondent (< 31 years old) had 2 times higher risk to experience food insecurity compared to those older counterparts. CONCLUSIONS: The COVID-19 pandemic impacted household food security in both urban and semi-urban areas through worsening employment status and income condition.


Subject(s)
COVID-19 , Pandemics , Adult , Cross-Sectional Studies , Food Security , Food Supply , Humans , Indonesia/epidemiology , SARS-CoV-2
8.
Clin Cardiol ; 45(2): 180-188, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1664403

ABSTRACT

BACKGROUND: The impact of the novel coronavirus disease 2019 (COVID-19) pandemic on diet and nutrition among older adults with chronic medical conditions have not been well-described. METHODS: We conducted a survey addressing (1) food access, (2) diet quality and composition, (3) nutritional understanding, and (4) attitudes towards research among adults with heart failure (HF) within an integrated health system. Adults (≥18 years) with diagnosed HF and at least one prior hospitalization for HF within the last 12 months were approached to complete the survey electronically or by mail. Outcomes included all-cause and HF-specific hospitalizations and all-cause death was ascertained via the electronic health record. RESULTS: Among 1212 survey respondents (32.5% of eligible patients) between May 18, 2020 and September 30, 2020, mean ± SD age was 77.9 ± 11.4 years, 50.1% were women, and median (25th-75th) left ventricular ejection fraction was 55% (40%-60%). Overall, 15.1% of respondents were food insecure, and only 65% of participants answered correctly more than half of the items assessing nutritional knowledge. Although most respondents were willing to participate in future research, that number largely declined for studies requiring blood draws (32.2%), study medication (14.4%), and/or behavior change (27.1%). Food security, diet quality, and nutritional knowledge were not independently associated with outcomes at 90 or 180 days. CONCLUSION: In a cohort of older adults with HF and multiple comorbidities, a significant proportion reported issues with food access, diet quality, and nutritional knowledge during the COVID-19 pandemic. Future research should evaluate interventions targeting these domains in at-risk individuals.


Subject(s)
COVID-19 , Heart Failure , Aged , Aged, 80 and over , Attitude , Diet , Female , Food Security , Heart Failure/epidemiology , Heart Failure/therapy , Humans , Nutritive Value , Pandemics , SARS-CoV-2 , Stroke Volume , Ventricular Function, Left
10.
PLoS One ; 16(12): e0261118, 2021.
Article in English | MEDLINE | ID: covidwho-1597647

ABSTRACT

Rice market efficiency is important for food security in countries where rice is a staple. We assess the impact of rice quality on rice prices, food security, and environmental sustainability in Bangladesh. We find that while price varies as expected for most quality attributes, it is unaffected by a broken percentage below 24.9 percent. This reveals a potential inefficiency, considering the average 5 percent broken rate observed in the market. An increase in the broken rate of milled rice within the limits supported by our findings can, ceteris paribus, increase rice rations by 4.66 million a year, or conversely, yield the current number of rice rations using 170.79 thousand fewer hectares and cutting emissions by 1.48 million metric tons of CO2 equivalent. Thus, producing rice based on quality assessment can improve food security and its sustainability.


Subject(s)
Food Security , Oryza/physiology , Sustainable Development , Bangladesh , Commerce , Food Security/economics , Models, Economic , Statistics as Topic
11.
Nutrients ; 14(1)2021 Dec 30.
Article in English | MEDLINE | ID: covidwho-1580546

ABSTRACT

COVID-19 has negatively impacted many households' financial well-being, food security, and mental health status. This paper investigates the role financial resources play in understanding the relationship between food security and mental health among U.S. households using data from a survey in June 2020. Results show job loss and savings draw down to pay for household bills had a significant relationship with both lower food security and greater numbers of poor mental health days during the pandemic.


Subject(s)
COVID-19/economics , COVID-19/psychology , Food Security/statistics & numerical data , Income/statistics & numerical data , Mental Health/statistics & numerical data , Adult , Female , Food Security/economics , Humans , Male , Mental Health/economics , Middle Aged , Pandemics , SARS-CoV-2 , United States
12.
Trop Anim Health Prod ; 54(1): 12, 2021 Dec 11.
Article in English | MEDLINE | ID: covidwho-1565445

ABSTRACT

The world population exceeded 7.8 billion people in 2020 and is predicted to reach 9.9 billion by 2050 as per the current increasing rate of 25%. In view of this, ensuring human health and food security has become an issue of key importance to countries with different degrees of economic development. At the same time, the livestock sector plays a strategic role in improving the economic, environmental, and sociocultural stewardship of any nation. The cow (Bos indicus) has held a distinctive role in human history ever since its domestication because of its valued harvests like dairy products (milk, clarified butter, yogurt, curd, and buttermilk) excreta like dung and urine. These products, except dung, provide all the necessary energy and nutrients to ensure the proper growth and development of the human. They are the source of many bioactive substances, which possess immense pharmacotherapeutic action against various physiological, metabolic and infectious disorders, including COVID-19. The use of urine and dung can be considered a low-cost agricultural practice for farmers and has been extensively used in modern agriculture practices to ensure food security via soil fertility, plant pathogens, and pests. Cow urine mediated synthesized nanomaterial also display distinctive characteristics and novel applications in various fields of science and technology. Thus, this paper aims to provide a comprehensive overview of cow products, describing their biochemical constituents, bioactivities, and their utilization in the area ranging from human welfare to agriculture sustainability. An attempt is also made to present possible applications in bioenergy production and pollution reduction.


Subject(s)
COVID-19 , Cattle Diseases , Agriculture , Animals , COVID-19/veterinary , Cattle , Female , Food Security , Humans , SARS-CoV-2 , Soil
13.
J Food Prot ; 85(3): 518-526, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1560770

ABSTRACT

ABSTRACT: There is limited examination about coronavirus disease 19 (COVID-19)-related food handling concerns and practices that cause chemical or microbial contamination and illness, particularly among those with food insecurity. We investigated consumer food handling concerns and practices during the COVID-19 pandemic and whether they differed by food insecurity status. An online survey was distributed among Chicago, IL, residents between 15 July and 21 August 2020 (n = 437). Independent t tests and Fisher's exact tests were used to identify differences in food handling concerns and practices between those with and without food insecurity (alpha = 0.05). Survey items included questions about food handling practices that were considered safe or neutral (i.e., washing hands and produce with water, sanitizing food packaging) and unsafe (i.e., using cleaning agents to wash foods, leaving perishable foods outside) by using 5-point Likert-style scales or categorical responses (i.e., yes, no). Participant responses fell between "slightly" and "somewhat" concerned about contracting COVID-19 from food and food packaging (mean ± standard error [SE]: 2.7 ± 0.1). Although participants reported washing their hands before eating and before preparing foods at least "most of the time" (mean ± SE: 4.4 ± 0.0 and 4.5 ± 0.0, respectively), only one-third engaged in unsafe practices. The majority of participants (68%) indicated that they altered food handling practices due to the COVID-19 pandemic and received information about food safety from social media (61%). When investigating differences in concerns and practices by food insecurity status, food insecure participants were more concerned about COVID-19 foodborne transmission for all food items (all P < 0.001) and more frequently performed unsafe food handling practices than those with food security (all P < 0.001). Results from this study suggest more investigation is needed to understand barriers to safe food handling knowledge and practices, particularly among those with food insecurity.


Subject(s)
COVID-19 , Food Handling , Food Security , Humans , Pandemics , SARS-CoV-2
14.
Public Health Nutr ; 24(16): 5524-5533, 2021 11.
Article in English | MEDLINE | ID: covidwho-1557148

ABSTRACT

OBJECTIVE: The aim of this study was to explore and analyse the actions implemented by civil society to contribute to food security in the context of the COVID-19 outbreak in Uruguay, a high-income country in South America. DESIGN: An exploratory systematic approach was used to identify the contributions of civil society to food security through reports in news websites and Facebook posts. Data were analysed based on content analysis following a deductive-inductive approach. SETTING: Uruguay, Latin America. RESULTS: A total of 1220 civil society organisations were identified, which developed two main actions to increase access to food among the Uruguayan population: food baskets and 'community pots' (also known as 'common pots'). Most of the initiatives targeted citizens under socioeconomic vulnerability in the face of COVID-19, without specifying any specific requirement or population segment. Actions were mainly led by spontaneously organised community groups, and, to a lesser extent, by consolidated organisations. Interactions between organisations were identified. The foods provided by the organisations were mostly aligned with national dietary guidelines. Social media posts evidenced that the main challenge faced by organisations was related to the lack of funds or supplies. CONCLUSIONS: Results from this work suggest that the lack of funds or supplies poses challenges to the medium- and long-term contributions of civil society to food security and stresses the need for comprehensive governmental measures to guarantee food security amongst Uruguayan citizens.


Subject(s)
COVID-19 , Food Security , Humans , Income , SARS-CoV-2 , Uruguay
15.
Glob Health Res Policy ; 6(1): 45, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1546803

ABSTRACT

BACKGROUND: Agricultural food production and distribution industries may play a vital role in determining the current conditions of any country's food security and sustainable development goals. This paper examined the determinants of food security within three distinct aspects (effective utilization of food, food availability, and food access) within the COVID-19 epidemic situation. METHODS: The qualitative set-up of the study comprised with the identification of drivers by critical analysis of published papers and discussion held with some practitioners. The quantitative data used in this research were collected from a survey covering the agricultural food supply industry in China (Shaanxi Province). The survey was conducted from November to December 2020 and we mainly focus on three aspects of food security (effective utilization of food, food availability, and food access). The core analytical assumptions were made by employing exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and structural equation modeling (SEM). RESULTS: After analyzing the data collected from 257 agricultural food productions and distribution personnel along with the hypothesis testing, it found that the determinants of the effective utilization of food were positively related to the determinants of food access (ß = 0.291, p = 0.029) and food availability (ß = 0.298, p = 0.011), and the determinants of food availability were positively related to the food access determinants (ß = 0.128, p = 0.002). The association and variance values between food availability and food access were 0.659 and 0.407; the association and variance values between for effective utilization of food and food availability aspects were 0.465 and 0.298, and between effective utilization of food and economy were 0.508 and 0.475. CONCLUSION: The study critically evaluated the interconnection among the crucial determinants within the banner of three dimensions, which will act as a major contribution to existing literature. This research will help the government and industry to develop policies and strategies for the successful implementation of all the associated determinants of food security in terms of the epidemic situation.


Subject(s)
COVID-19 , China/epidemiology , Food Security , Humans , Pandemics , SARS-CoV-2
16.
PLoS Med ; 18(11): e1003869, 2021 11.
Article in English | MEDLINE | ID: covidwho-1542164

ABSTRACT

Salim Abdool Karim, Segenet Kelemu and Cheryl Baxter discuss COVID-19 impacts and adaptations in Africa.


Subject(s)
COVID-19/epidemiology , Sustainable Development , Africa/epidemiology , Food Security , Food Supply , Health Resources , Humans
17.
Clin Infect Dis ; 73(10): 1901-1905, 2021 11 16.
Article in English | MEDLINE | ID: covidwho-1522150

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic and associated public health responses have disrupted daily living activities with economic and health consequences globally. We observed transient decreases in human immunodeficiency virus (HIV) clinic visit adherence and food security among persons living with HIV early in the pandemic, and an increase in viral suppression later in the pandemic.


Subject(s)
COVID-19 , HIV Infections , Food Security , HIV , HIV Infections/epidemiology , Humans , Pandemics , SARS-CoV-2
18.
Am J Trop Med Hyg ; 106(1): 21-24, 2021 11 10.
Article in English | MEDLINE | ID: covidwho-1512903

ABSTRACT

Afghanistan, a country challenged by war and conflicts, has been in a state of turmoil for several years. The prolonged suffering has brought many challenges to the country's inhabitants. Among these, food security is one important cause for concern. Food security occurs when people continuously have physical and economic access to adequate, safe, and nutritious food to meet their dietary requirements and food preferences for a functional and healthy life. Amid the pandemic, Afghanistan has witnessed a large increase in food shortages due to its dependence on neighboring countries. In light of current circumstances, food insecurity, coupled with political instability and the third wave of the COVID-19, have made it extremely hard for people to access daily provisions. Hence, people are left to navigate the COVID-19 pandemic with economic recession and poverty as the backdrop of the other health crises. To mitigate food security, international attempts are the required at this critical juncture. The aim of this article is to understand the causes leading to food insecurity and its implications in Afghanistan and to propose solutions that will improve the overall food security at the policy and implementation levels.


Subject(s)
COVID-19/economics , Economic Recession , Food Security , Afghanistan , Armed Conflicts/economics , Food Assistance , Food Security/economics , Humans , Socioeconomic Factors , Unemployment , United Nations
20.
J Infect Dis ; 224(Supplement_7): S901-S909, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1475801

ABSTRACT

BACKGROUND: Bangladesh has experienced remarkable transformation in demographic, health, and nutritional status of the population. The changes have exposed the population to a number of challenges, the detrimental effect of which on health and nutrition is likely to be increased by the coronavirus disease 2019 (COVID-19) pandemic. We provide an overview of health and nutritional challenges in Bangladesh in relation to demographic transition and the COVID-19 pandemic. METHODS: We identified and reviewed recent reports, published articles, and pertinent gray literature on nutrition and food security in Bangladesh to provide historical and contextual information. RESULTS: The review identifies the progress as well as existing burden regarding nutrition and food security in Bangladesh and highlights the challenges in the coming days in regard to population growth and the COVID-19 pandemic. The country is on track to reduce all forms of childhood undernutrition, while the proportion of nutrition-related noncommunicable diseases is rising owing to changes in dietary intake, low physical activity, and sedentary lifestyle. CONCLUSIONS: Despite remarkable progress, health and nutritional status of the population in Bangladesh faces challenges, particularly in relation to demographic transition and compounded by the COVID-19 pandemic, which require concerted attention from policymakers as well as stakeholders.


Subject(s)
COVID-19 , Food Security , Food Supply/statistics & numerical data , Pandemics , Bangladesh/epidemiology , Humans , Nutritional Status , SARS-CoV-2
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