Quality of life (QoL) among COVID-19 recovered healthcare workers in Bangladesh.

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) caused by the SARS-CoV-2 virus has taken the lives of more than 100,000 healthcare workers (HCWs) so far. Those who survived continuously work under immense physical and psychological pressure, and their quality of life (QoL) is impacted. The study aimed to assess the QoL among HCWs in Bangladesh who recovered from COVID-19. METHODS: This cross-sectional, telephonic interview-based study was conducted among 322 randomly selected HCWs from Bangladesh who were positive for COVID-19 and recovered from the infection before the interview. Data were collected from June to November 2020. We examined the impact of COVID on the QoL of the participants using the validated Bangladesh version of the World Health Organization (WHO) Quality of life questionnaire brief (WHOQOL-BREF). All analyses were done by STATA (Version 16.1). RESULTS: More than half of the health care professionals were male (56.0%), aged between 26-35 years (51%), and completed graduation (49%). The majority of the study participants in the four domains were married (n = 263, 81%) and living in Dhaka. The average score of the participants was 70.91 ± 13.07, 62.68 ± 14.99, 66.93 ± 15.14, and 63.56 ± 12.11 in physical, psychological, social relationship and environmental domains, respectively. HCWs in urban areas enjoyed 2.4 times better socially stable lives (OR: 2.42, 95% CI: 1.18-4.96) but 72% less psychologically satisfactory lives. CONCLUSION: HCWs' post-COVID quality of life depended on variable interaction of demographic socioeconomic, including old age, female sex, graduation, and higher monthly income. The findings indicate the issues which should be addressed to improve the quality of life of frontline workers who fight against the pandemic.

Factors affecting intention to take COVID-19 vaccine among Pakistani University Students.

BACKGROUND: Widespread vaccination coverage is essential for reducing the COVID-19 havoc and regarded as a crucial tool in restoring normal life on university campuses. Therefore, our research aimed to understand the intention to be vaccinated for COVID-19 among Pakistani university students. METHODS: This cross-sectional study was conducted in five administrative units of Pakistan, i.e., Punjab, Sindh, Balochistan, Azad Jammu and Kashmir, and Khyber Pakhtunkhwa. We obtained data from 2,865 university students between 17th January and 2nd February, 2021, using a semi-structured and self-administered questionnaire. We used Stata (version 16.1, StataCorp LLC) for data management and analysis. RESULTS: The majority (72.5%) of our respondents were willing to take COVID-19 vaccine. The current level of education had a statistically significant relationship with the intention to be vaccinated (p < 0.05). Respondents answered 11 questions encompassing five different domains of the Health Belief Model (HBM). All the items of HBM were significantly associated with the positive intention towards receiving the vaccine (p < 0.05). We conducted a multivariable logistic regression analysis to assess the relative contribution of different factors towards the intention to receive COVID-19 vaccine. Multiple factors such as belief that vaccination should be mandatory for everyone (AOR: 3.99, 95% CI: 3.20-4.98) and willingness to take vaccine even if it is not free (AOR: 3.91, 95% CI: 3.18-4.81) were observed to be associated with high odds of showing willingness to be vaccinated against COVID-19. CONCLUSION: Most of our study participants intended to take vaccines based on their belief regarding the high effectiveness of COVID-19 vaccine. But as rumor-mongers are generating and spreading conspiracy theories daily, the health department and policymakers need to undertake evidence-based campaigns through electronic and social media to ensure expected countrywide vaccination coverage. In this case, our study findings can serve as a foundation for them to ensure mass vaccination coverage among university students, which is crucial now to reopen the dormitories and restore everyday life on campuses.

Psychological impact of COVID-19 pandemic: A cross-sectional study of hospitalized COVID-19 patients in an urban setting, Bangladesh.

Aim: The deleterious impact of the COVID-19 pandemic on mental health has been reported by earlier studies globally. However, such studies are limited in Bangladesh; therefore, we performed a cross-sectional study to explore the psychological effects of COVID-19 among hospitalized patients. Methodology: The cross-sectional study was performed from 1st June to 31st October, 2020, and included a total of 503 real time RT-PCR confirmed stable hospitalized adult (aged ≥18 years) COVID-19 patients using the convenience sampling approach. However, patients with prior mental illness, unstable vital signs, severely ill, oxygen saturation <92%, impaired consciousness were excluded from the study. We collected data by using a semi-structured questionnaire including Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Insomnia Severity Index (ISI-7), and Perceived Stress Scale (PSS-10). Descriptive analysis and multivariable logistic regression were carried out to determine the mental health outcomes. Results: The study found that about 42.5 %, 30.7%, 46.7%, and 28.5% of patients suffered from moderate to severe depression, anxiety, stress, and insomnia. The physical symptoms, fever, fatigue, loss of taste or smell, blurred vision, chest pain, and diarrhoea were significantly associated with augmented mental distress among the hospitalized patients. Furthermore, depression, anxiety, stress and insomnia were strongly linked with patients' education, occupation, infected family members, exposure to COVID-19 patients, smoking, comorbidities, infection among the neighbors or acquaintances, and preexisting stress. Conclusion: The negative psychological impact of the COVID-19 pandemic comprising depression, anxiety, insomnia and stress worsened the physical condition of hospitalized COVID-19 patients. These patients' poor mental health status needed to be addressed by devising an integrated approach towards improving patients' wellbeing at the post-COVID period.

Mental health status of married women during COVID-19 pandemic in Bangladesh: A cross-sectional study.

AIM: The uncontrolled spread of COVID-19 has demanded unparalleled measures, from the imposition of quarantine to the declaration as a public health emergency of international concern. COVID-19 poses a severe threat to our day-to-day life as well as physical and mental health. This study explores mental health status among married women that remain understudied in Bangladesh during the COVID-19 pandemic. METHODOLOGY: A cross-sectional study was conducted among 597 married women via face-to-face interview, maintaining all safety protocols. A semi-structured questionnaire was assembled that included socio-demographics and the DASS-21 scale. Descriptive analysis and logistic regression were performed to examine the associations between variables. RESULT: Almost 35% of the respondents had stress, 20% had anxiety, and 44% had depression ranging from mild to extremely severe. Metropolitan city inhabitants, being housewives, higher educational status, number of children, financial condition, comorbidities, family members assistance in household activities, relocation during COVID-19, social media use, concern about family, infected family members, tendency to get COVID-19 updates had been found significant in multivariable and univariate regression analysis with depression, anxiety, and stress. CONCLUSION: In this study, we found high rates of stress, anxiety, and depression among the study participants. These findings provide us with an epidemiological picture of the mental health status of our target population that could be a key benchmark for identifying high-risk groups and developing policies as well. Results could also be used to formulate psychological interventions that might be helpful during the COVID-19 period and later.

Evaluation of recombinase-based isothermal amplification assays for point-of-need detection of SARS-CoV-2 in resource-limited settings.

OBJECTIVES: The democratization of diagnostics is one of the key challenges towards containing the transmission of coronavirus disease 2019 (COVID-19) around the globe. The operational complexities of existing PCR-based methods, including sample transfer to advanced central laboratories with expensive equipment, limit their use in resource-limited settings. However, with the advent of isothermal technologies, the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is possible at decentralized facilities. METHODS: In this study, two recombinase-based isothermal techniques, reverse transcription recombinase polymerase amplification (RT-RPA) and reverse transcription recombinase-aided amplification (RT-RAA), were evaluated for the detection of SARS-CoV-2 in clinical samples. A total of 76 real-time reverse transcription PCR (real-time RT-PCR) confirmed COVID-19 cases and 100 negative controls were evaluated to determine the diagnostic performance of the isothermal methods. RESULTS: This investigation revealed equally promising diagnostic accuracy of the two methods, with a sensitivity of 76.32% (95% confidence interval 65.18-85.32%) when the target genes were RdRP and ORF1ab for RT-RPA and RT-RAA, respectively; the combination of N and RdRP in RT-RPA augmented the accuracy of the assay at a sensitivity of 85.53% (95% confidence interval 75.58-92.55%). Furthermore, high specificity was observed for each of the methods, ranging from 94.00% to 98.00% (95% confidence interval 87.40-9.76%). CONCLUSIONS: Considering the diagnostic accuracies, both RT-RPA and RT-RAA appear to be suitable assays for point-of-need deployment for the detection of the pathogen, understanding its epidemiology, case management, and curbing transmission.

COVID-19 vaccine acceptance in South Asia: a multi-country study.

OBJECTIVES: With COVID-19 vaccination underway, this study aimed to understand belief, attitude and intention of the people in the South Asia region towards the vaccine. METHODS: We conducted a cross-sectional study using semi-structured questionnaires among 18201 individuals in four South Asian countries; Bangladesh, India, Pakistan, and Nepal between January 17 and February 2, 2021. We used the Health Belief Model (HBM) to identify the predictors related to vaccine acceptance. STATA (v16.1) was used for all analyses. RESULTS: The percentage of respondents willing to be vaccinated against COVID-19 was 65%, 66%, 72% and 74% for Bangladesh, India, Pakistan and Nepal, respectively. Perceived destructive impact of COVID-19, positive perception of vaccines and concern about possible side effects were significant in modifying respondents' intentions.. In multivariable logistic regression, age, sex, marital status, education, comorbidities, worry about getting infected, perceived COVID-19 impact, belief regarding vaccine efficacy, positive attitude towards mandatory measures, and vaccine availability were found to be associated with vaccine acceptance across countries. CONCLUSION: Nearabout two-third of the respondants were willing to take COVID-19 vaccine in the four South Asia countries.

A case of acute encephalopathy and non-ST segment elevation myocardial infarction following mRNA-1273 vaccination: possible adverse effect?

A 77-year-old man with a past medical history of type 2 diabetes mellitus, peripheral neuropathy, and chronic obstructive pulmonary disease was admitted to the intensive care unit of Bangladesh Medical College Hospital with acute encephalopathy and non-ST segment elevation myocardial infarction (NSTEMI). The patient was on antidiabetic medicine along with H2 blocker and multivitamins for his existing diseases. The patient's attendant reported that the patient had received his first dose of the Moderna coronavirus disease 2019 (COVID-19) vaccine just 2 days ago. Physical examination revealed that he had a Glasgow Coma Scale of 8/15; a pulse of 106 beats/min; a respiratory rate of 30 breaths/min; oxygen saturation of 80% on room air, which became with 10 L of oxygen and blood pressure of 90/60 mm Hg at the time of admission. During the hospital stay, the patient was treated conservatively with intravenous antibiotics and other necessary medication. Although we have observed the onset of encephalopathy and NSTEMI following COVID vaccination for this patient, we, as healthcare professionals, cannot directly attribute the cause of the complications to the Moderna vaccine without further epidemiological studies with large samples.

Quality of life of COVID-19 recovered patients in Bangladesh.

Coronavirus Disease-2019 (COVID-19) quickly surged the whole world and affected people's physical, mental, and social health thereby upsetting their quality of life. Therefore, we aimed to investigate the quality of life (QoL) of COVID-19 positive patients after recovery in Bangladesh. This was a study of adult (aged ≥18 years) COVID-19 individuals from eight divisions of Bangladesh diagnosed and confirmed by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) from June 2020 to November 2020. Given a response rate of 60% in a pilot study, a random list of 6400 COVID-19 patients was generated to recruit approximately 3200 patients from eight divisions of Bangladesh and finally a total of 3244 participants could be recruited for the current study. The validated Bangla version of the World Health Organization Quality of Life Brief (WHOQOL-BREF) questionnaire was used to assess the QoL. Data were analyzed by STATA (Version 16.1) and R (Version 4.0.0). All the procedures were conducted following ethical approval and in accordance with the Declaration of Helsinki. The mean scores of QoL were highest for the physical domain (68.25±14.45) followed by social (65.10±15.78), psychological (63.28±15.48), and environmental domain (62.77±13.07). Psychological and physical domain scores among females were significantly lower than the males (p<0.001). The overall quality of life was lower in persons having a chronic disease. Participants over 45 years of age were 52% less likely to enjoy good physical health than the participants aged below 26 years (AOR: 0.48, CI: 0.28-0.82). The quality of life of employed participants was found 1.8 times higher than the unemployed (AOR: 1.80, CI: 1.11-2.91). Those who were admitted to hospitals during infection had a low QoL score in physical, psychological, and socials domains. However, QoL improved in all aspect except the psychological domain for each day passed after the diagnosis. These findings call for a focus on the quality of life of the COVID-19 affected population, with special emphasis given to females, older adults, unemployed, and people with comorbidities.

Acceptance of COVID-19 vaccine and its determinants: evidence from a large sample study in Bangladesh.

AIM: Our study aimed to understand the acceptance level of the COVID-19 vaccine and its determinants among the adult Bangladeshi population. METHODOLOGY: This cross-sectional study was conducted in all eight divisions of Bangladesh. Data from 7,357 adult respondents were collected between January 17 and February 2, 2021, using a self-administered semi-structured questionnaire. Statistical software STATA (Version 16.1) was used for all analyses. RESULTS: The majority of study participants were from the Dhaka division (34.24%). The most common age group was ≤30 years (46.18%). Almost two-thirds of respondents were male (65.50%) and married (67.76%). A large portion (79.85%) of people who had positive vaccine intentions believed that vaccination should be made mandatory for everyone. The majority of the respondents thought that the vaccine would work against COVID-19 infection (67%). In the binary logistic regression analysis, participants who had the education level of graduation or above (AOR = 1.80), age ≥50 years (AOR = 1.97), students (AOR = 2.98), monthly income ≥41,000 BDT (AOR = 2.22), being resident of rural area (AOR = 2.24), respondents from Khulna division (AOR = 6.43) were more likely to receive a COVID-19 vaccine. Those who had family members diagnosed with COVID-19 (AOR = 1.24), presence of chronic disease (AOR = 0.72), and those who were vaccinated in the last few years (AOR = 1.32) were also more likely to accept the COVID-19 vaccine. CONCLUSION: Most of the respondents were willing to be vaccinated based on the belief that the vaccine will work against COVID-19. As rumors are generating daily, there is a need for policy-level initiative and evidence-based mass media promotion to keep inspired the general Bangladeshi people to accept the COVID-19 vaccine whenever it will be available at the individual level.

Healthcare Workers' Knowledge, Attitude, and Practice Regarding Personal Protective Equipment for the Prevention of COVID-19.

PURPOSE: Adequate knowledge, positive attitude, and proper practice of personal protective equipment by healthcare workers are necessary to get protection from COVID-19 infection. But this area is yet to be explored. Hence, we aimed to assess the knowledge, attitude, and practice (KAP) regarding personal protective equipment (PPE) among healthcare workers, along with a survey of the possible determinants. SUBJECTS AND METHODS: For this cross-sectional study, online and offline surveys were conducted among a sample of 393 healthcare workers from five different districts of Bangladesh. A validated self-administered questionnaire comprising five sections (socio-demography, work-related information, knowledge, attitude, and practice) was used for data collection. Multivariate stepwise forward logistic regression was applied to find significant factors associated with good attitude, and practice using SPSS version 25. RESULTS: The average age of the 393 participants was 28.9±5.2 years with a male-female ratio of one. Of them, 99.5% (n=391) had good knowledge, 88.8% (n=349) had positive attitude and 51.7% (n=203) had good practice regarding PPE. Results revealed that being a physician and living at home were significantly associated with a positive attitude. While being a non-physician, having lower education, working in private hospitals, and using office transport were associated with good practice regarding PPE. CONCLUSION: The findings demonstrated that the healthcare workers had an overall good knowledge and a positive attitude but a poor practice regarding PPE. This study also highlighted the factors influencing KAP towards PPE that must be addressed in future education, awareness, and counseling programs.