Immigrants, health, and the impact of COVID-19: A narrative review.

While the COVID-19 pandemic has gravely challenged health systems globally, countries that host a large number of refugees are finding themselves even more burdened as providing preventive and curative services to refugees, and, migrants has proved to be a challenging task. The aim of this narrative review is to discuss the impact COVID-19 pandemic on immigrants, and seek to understand how COVID-19 affects provision of health services, access to health care and the socioeconomic situation. Like any other health challenge, COVID-19 has also left migrants susceptible to adverse outcomes, both directly and indirectly. Several factors limit their ability to avoid infections, access healthcare, and cope with socio-psychological impacts. In addition, undocumented immigrants or people living on short-term visit visas do not have full access to healthcare services in most countries. It is evident that COVID-19 has also influenced these workers leaving them jobless or receiving low wages or no pay, hence, this has hugely impacted the remittance and economic situation in their country. Extending access to healthcare to the entire immigrant population, irrespective of their legal status, is the cornerstone of an effective response to counter the COVID-19 pandemic.

Are we seeing the unseen of human trafficking? A retrospective analysis of the CTDC k-anonymized global victim of trafficking data pool in the period 2010-2020.

BACKGROUND: Human trafficking is considered a hidden global crime with unsubstantiated numbers. Despite the challenges in counting or measuring this crime, reports revealed the presence of around 40.3 million victims worldwide. Human trafficking results in severe detrimental impacts on both mental and physical health. Given the sensitivity and negative consequences of human trafficking on the global system and victims, and considering the scarce research in this area, our current study aimed at describing the (i) Sociodemographic profiles of anonymized victims, (ii) Means of control, and (iii) Purpose of trafficking, utilizing the largest anonymized and publicly available dataset on victims of human trafficking. METHODS: This is a retrospective secondary analysis of the Counter-Trafficking Data Collaborative (CTDC) data pool in the period from 2010 to 2020. The utilized dataset is called the k-anonymized global victim of trafficking dataset, and it is considered the largest global dataset on victims of human trafficking. Data from the k-anonymized data pool were extracted and exported to Statistical Package for Social Sciences, SPSS® version 27.0 for Windows (IBM Corp. Version 27.0. Armonk, NY) for quality check and analysis using descriptive statistics. RESULTS: A total of 87003 victims of human trafficking were identified in the period from 2010 to 2020. The most age category encountered among victims was 9-17 years with 10326 victims (11.9%), followed by 30-38 years with 8562 victims (9.8%). Females comprised 70% of the sample with 60938 victims. The United States (n = 51611), Russia (n = 4570), and the Philippines (n = 1988) comprised the most countries of exploitation/trafficking. Additionally, the year 2019 witnessed the greatest number of victims registered for assistance by anti-trafficking agencies with around 21312 victims (24.5%). Concerning means of control, threats, psychological abuse, restriction of the victim's movement, taking the victim's earnings, and physical abuse were the most reported means. 42685 victims (49.1%) reported sexual exploitation as the purpose of their trafficking, followed by forced labor with 18176 victims (20.9%). CONCLUSION: Various means and methods can be used by traffickers to control the victims to be trafficked for many purposes, with sexual exploitation and forced labor being the most common ones. Global anti-trafficking efforts should be brought together in solidarity through utilizing the paradigm of protection of victims, prosecution of traffickers, prevention of trafficking, and inter-sectoral partnerships. Despite being a global concern with various reports that tried to capture the number of trafficked victims worldwide, human trafficking still has many unseen aspects that impose a significant challenge and adds to the global burden in combatting this threat.

The impact of social media on risk perceptions during COVID-19 in Saudi Arabia.

Background: Social media is considered a critical source for seeking health information, especially during outbreaks. During the Coronavirus disease 2019 (COVID-19) pandemic, social media played an important role in disseminating information. However, it has been a source of misinformation in many communities throughout the pandemic. Whether this disseminated information has a positive or negative impact, individuals' risk perceptions of disease are influenced. It is important to explore factors that build public behaviors and their adaptation of risk reduction measures during the COVID-19 pandemic. Therefore, the aim of this study is to determine the role of social media and its impact on the risk perceptions of the COVID-19 in Saudi Arabia. Methods: This was a cross-sectional study, and participants were recruited using different social media outlets between August to October 2020. The survey was delivered through Qualtrics platform targeting Saudi Arabian residents over the age of 18 years old. The questionnaire was delivered in English and Arabic. A convenience sampling was used to recruit participants to the study. The survey link was posted on several social media platforms. Results: A total of 2,680 respondents completed the online survey. The results showed that male gender, individuals earning 4,000-12,000 SAR, and employed had positive and significant relationships with risk perception compared to their counterparts (ß: 0.044, p-value: 0.035 and ß: 0.051, p-value: 0.041, ß: 0.108 p-value: < 0.001, ß: 0.119 p-value: < 0.001), respectively. In second block, individuals exposed to social media had higher risk perception (ß: 0.096, p-value < 0.001). In third block, self-efficacy was significantly but negatively associated with risk perception, indicating individuals who were self-efficient were less likely to perceive risk for the COVID-19 (ß: -0.096, p-value < 0.001). There was no interactive effect of social media and self-efficacy on risk perception. Conclusion: The current study results show that social media exposure to the COVID-19 information has a positive impact in shaping an individuals' risk perception. The study also suggests that there is a need for public officials and policymakers to develop effective communication strategies through risk communication campaigns targeted at women, individuals with lower socioeconomic status, and those who are single as they showed a negative relationship with risk perception.

Psychological Wellbeing of Diabetic Individuals, Prediabetics, and Non-diabetics: A Population-Based Study in Saudi Arabia.

Background: The increased burden of diabetes affects the quality of life, including psychosocial problems. The study aims to compare the psychological well-being of individuals who are prediabetic, diabetic, or non-diabetic. Methods: A cross-sectional exploratory study was conducted from January to June 2016 (n = 1,019) in Al Kharj, Saudi Arabia. After consent and questionnaires were filled out, trained staff took blood samples followed by anthropometry. Chi-squared tests, one-way ANOVA, and multiple linear regression analyses were conducted to examine the association between diabetes classes defined by HbA1c cut-off levels set by the American Diabetes Association (three categories), individual items, and total score in general health questionnaire (GHQ). An ROC curve was plotted for the total GHQ-12 score against HbA1c. Findings: The mean GHQ score for psychological distress was significantly higher (F = 6.569, P = 0.038) in the diabetics (mean = 14.7) and the prediabetics (12.4) than in the non-diabetics (10.71). Four out of six positive GHQ items and three out of six negative GHQ items significantly differed among the three classes of diabetes. The adjusted multivariate analysis revealed that people with diabetes were most likely to report psychological distress compared to non-diabetics (unstandardized beta = 2.414; P = 0.037). The AUC examining the relationship between HBA1c and GHQ scores showed a moderate but statistically insignificant sensitivity/specificity of 0.643 (P = 0.23). Conclusion: This study demonstrates that psychological wellbeing is substantially poorer among diabetic or prediabetic individuals than non-diabetic individuals. Future longitudinal studies are required to examine a plausible causal relationship between diabetes/prediabetes and psychological distress.

Combined' Neck/Back Pain and Psychological Distress/Morbidity Among the Saudi Population: A Cross-Sectional Study.

Background: Psychological distress/morbidity is amongst the primary reason for the cause of pain at multiple sites, its progression, and recovery. Though still not very clear if physical pain in the neck or the back may predict psychological morbidities or not. Thus, we investigated the association between combined neck or back pain and psychological distress/morbidity. Methods: A cross-sectional study was conducted in Al-Kharj, Saudi Arabia, including 1,003 individuals. The questionnaire comprised of General Health Questionnaire-12 (GHQ-12) and some questions about neck and back pain. Data analysis was done using statistical software SPSS version 26.0. Results: The results of the multivariate analysis revealed a significant positive association between neck/back pain status and total GHQ score (unstandardized Beta = 2.442, P ≤ 0.0001). Having neck/back pain had almost a 2.5 times greater risk of psychological distress/morbidity. Further, females were more likely to have a higher risk of psychological distress/morbidity (unstandardized Beta = 1.334, P = 0.007) than males while adjusting for sociodemographic and clinical characteristics. Conclusion: The combination of neck and back pain was significantly associated with the Saudi population's psychological problems. Therefore, the Saudi government needs to devise high-risk strategies and allocate adequate resources to the cause so that at-risk people can be shielded from the adverse complications arising from this condition in the long run.

Systematic Review of Setting-Based Interventions for Preventing Childhood Obesity.

INTRODUCTION: Child obesity is recognized as one of the major public health problems globally, which demands multicomponent and comprehensive interventions. The objective of this systematic review is to evaluate, synthesize, and combine the existing evidence of various setting-based interventions across developed and developing countries that aim to prevent childhood obesity. METHODS: An electronic and systematic search was conducted on setting-based interventions related to childhood obesity both in developed and developing countries. A study was considered eligible if it was a randomized controlled trial that focused on home-based, school-based, or community-based intervention for childhood obesity and published in English from 2010 to 2020. A wide range of electronic bibliographic databases, such as PubMed, Medline, Embase, and ERIC were searched. The various studies were carried out among children aged 4-18 years old. A total of 32 studies were identified; out of which 24 were school-based interventions, and the remaining were nonschool-based. RESULTS: The studies in this review highlighted important school and nonschool-based interventions to avoid obesity among children and adolescents. School-based interventions that had considered both physical activity (PA) and diet along with home elements showed great effectiveness. These findings reveal that the specific intervention components such as nutrition education curriculum, prolonged time for PA, and upgrading self-efficacy of study participants should be considered to prevent obesity across developed and developing countries. However, the findings from nonschool-based interventions were restricted by the scarcity of the studies. CONCLUSION: Multisetting and multipronged strategies are required to avoid or reduce childhood obesity across the globe. However, additional studies are needed with a large sample size. Further study designs based on theory should be conducted in nonschool settings for the creation of meaningful and detailed guidelines that can support the prevention of obesity in children.

Association between prehypertension and psychological distress among adults in Saudi Arabia: A population-based survey.

BACKGROUND: Prehypertension is a precursor to hypertension status. Psychological distress has been identified earlier among hypertensives; however, there is little evidence for the presumptive relationship between prehypertension and psychological distress. OBJECTIVE: The study aimed to assess the psychological wellbeing of the Al-Kharj, Saudi Arabia population, using the General Health Questionnaire (GHQ-12) and correlating it with prehypertensive patients in the same population. METHODS: A cross-sectional analysis of the population of Al-Kharj, Saudi Arabia, was carried out between January and June of 2016. With an 85 percent response rate, a total of 1016 participants participated in the study. A multiple linear regression analysis was performed to assess the relationship between prehypertension and psychological distress. RESULTS: The findings of the adjusted analysis demonstrated that, on average prehypertensive patients were more distressed psychologically than non-hypertensive patients (unstandardized Beta regression coefficient = 3.600; P-value 0.025). Similarly, on average women were found to be more psychologically distressed than men (unstandardized Beta = 1.511, P-value 0.002). Civil workers and unemployed individuals were more psychologically distressed than employed individuals (unstandardized Beta = 1.326, P-value 0.041) while adjusting for the sociodemographic and other variables such as BMI, diabetes status, cholesterol, and smoking status. CONCLUSION: The current study shows that as compared to normotensive patients, self-rated mental wellbeing and psychological wellbeing are all considerably poorer among prehypertensive patients. To prevent individuals from having negative psychological outcomes and their long-term complications, the Government of Saudi Arabia needs to concentrate on prehypertensive, female, and unemployed individuals. Well-designed longitudinal studies, primarily in Saudi Arabia, are needed in the future to research the cause and impact of poor mental health and prehypertension.

Coping during COVID-19 Pandemic in Saudi Community: Religious Attitudes, Practices and Associated Factors.

The COVID-19 pandemic has affected many societies' life aspects and activities including social and Islamic practices; more attention should be given to investigate the interaction between Islamic worships and the spread of the disease. Here, we performed a cross-sectional study using an online questionnaire to assess the preventive Islamic attitudes and practices during the COVID-19 lockdown period from the Saudi publics' perspectives. Mann-Whitney, Kruskal and logistic regression tests were used to analyze the data. The results revealed that most participants had positive Islamic attitudes and practices. However, elders and males were less obeyed to preventive measures during performing worship (p < 0.05). While younger, females and not married were less obeyed when dealing with COVID-19 related death (p < 0.05). Even though, elders were less likely to have poor social and Islamic practices concerning adherence to preventive measures during the pandemic (OR = 0.38; 95% CI: 0.176-0.816) than younger. Furthermore, males, Saudi participants, lower education level, lower Islamic attitudes scores were more likely to have poor social and Islamic practices concerning adherence to preventive measures during the pandemic (OR = 1.65; 95% CI: 1.126-2.421; OR = 1.57; 95% CI: 1.067-2.322; OR = 3.09; 95% CI: 1.721-5.563; and OR = 1.89; 95% CI: 1.309-2.753, respectively), than their corresponding targeted counterparts. Thus, despite the high preventative perceptions of Islamic attitudes and practices of the Saudi community, our study highlighted some risk groups with less preventative practices. Thus, targeted health education interventions are highly recommended for these risk groups to enhance the commitment to government instructions.

Acceptability of a COVID-19 Vaccine among the Saudi Population.

To investigate the associated factors underlying vaccination intentions for Coronavirus Disease 2019 (COVID-19), an online cross-sectional survey was conducted among adults 18 years or over in the Kingdom of Saudi Arabia. Data were collected between 8 and 14 December 2020. A logistic regression analysis was employed to examine and identify the variables associated with vaccination intentions for COVID-19, with the odds ratio (OR) and 95% confidence interval (CI) also calculated. A total of 2137 respondents completed the questionnaire. Overall, about 48% of Saudi adults were willing to receive the COVID-19 vaccine. Participants had stronger intentions to receive a vaccination if they resided in the southern region (OR: 1.95; 95% CI: 1.21-3.14), received the seasonal influenza vaccination in the past (OR: 1.52; 95% CI: 1.17-1.97), believed in mandatory COVID-19 vaccination (OR: 45.07; 95% CI: 31.91-63.65), or reported high levels of concern about contracting COVID-19 (OR: 1.91; 95% CI: 1.29-2.81). Participants were less likely to have an intention to be vaccinated if they had a history of vaccine refusal (OR: 0.28; 95% CI: 0.19-0.40). The low acceptance rate among the Saudi population should be targeted with multifaceted interventions aimed at raising awareness and emphasizing the safety and efficacy of the COVID-19 vaccine.

The Prevalence of Headache and Associated Factors in Al-Kharj, Saudi Arabia: A Cross-Sectional Study.

Background: Only few studies have investigated the prevalence and risk factors of headaches among the Saudi population. The study aimed to estimate the prevalence of headache and to explore its associated risk factors Al-Kharj, Saudi Arabia. Methods: The multistage sampling technique was used to enroll 1200 population-based participants who were asked to complete a self-administered questionnaire about headaches, demographics, and several other parameters such as smoking status and different chronic and psychological illnesses. The chi-square test and multivariate logistic regression analysis were used to test the association. Results: The overall prevalence of headaches in this study was 3%. The multiple logistic regression analysis showed that females were more likely to have headaches than males (odds ratio (OR) 0.735, 95% confidence interval (CI) = 0.612-1.341; P=0.024). Being a current smoker was also significantly associated with higher "odds" of having headache (OR = 1.319, 95% CI = 0.932-2.462; P=0.037). Participants who were overweight had a significantly higher risk of headache (OR = 1.631, 95% CI = 1.48-1.854; P=0.037). Nonmarried people were significantly more likely to have headache pain, compared to married individuals (OR = 0.875, 95% CI = 0.646-2.317; P=0.047). Conclusion: The prevalence of headaches was 3%, and four significant associated factors were identified: females, nonmarried, smoking, and overweight. The temporality of the relationship between these factors and headache cannot be confirmed in this cross-sectional study; so future longitudinal studies are needed to confirm these potential causal relationships.

Psychological Distress Amongst Health Workers and the General Public During the COVID-19 Pandemic in Saudi Arabia.

BACKGROUND: The rapid spread of COVID-19 worldwide has confined millions of people to their homes and has caused a substantial degree of psychological distress. This study aims to investigate the psychological distress impact of the COVID-19 pandemic among the Saudi population. METHODS: This is a cross-sectional study, using data collected from 3036 participants via an online self-reported questionnaire. The psychological distress was constructed using the COVID-19 Peritraumatic Distress Index to classify individuals in the sample as having normal, mild or severe distress levels. The study used descriptive analysis and multinomial logistic regressions to examine the sociodemographic factors associated with psychological distress levels during the COVID-19 pandemic. RESULTS: The evidence showed that 40% of the Saudi population are distressed due to COVID-19, of whom approximately 33% are mildly distressed, while 7% are severely distressed. The distress levels are particularly high amongst the young, females, private sector employees and health workers, especially those working on the frontline. CONCLUSION: The COVID-19 pandemic is associated with increased distress amongst people living in Saudi Arabia. In support of evidence found in other countries, the study has established that the distress levels vary across different sociodemographic characteristics. Therefore, limiting people's psychological damage demands both medium- and long-term policy strategies, which include mapping the rates of stress and anxiety for effective psychological treatment allocation and establishing innovative online methods of heightening people's mental wellbeing.

Knowledge, Attitude and Practice Toward COVID-19 Among the Public in the Kingdom of Saudi Arabia: A Cross-Sectional Study.

Background: Saudi Arabia has taken unprecedented and stringent preventive and precautionary measures against COVID-19 to control its spread, safeguard citizens and ensure their well-being. Public adherence to preventive measures is influenced by their knowledge and attitude toward COVID-19. This study investigated the knowledge, attitudes, and practices of the Saudi public, toward COVID-19, during the pandemic. Methods: This is a cross-sectional study, using data collected via an online self-reported questionnaire, from 3,388 participants. To assess the differences in mean scores, and identify factors associated with knowledge, attitudes, and practices toward COVID-19, the data were run through univariate and multivariable regression analyses, respectively. Results: The majority of the study participants were knowledgeable about COVID-19. The mean COVID-19 knowledge score was 17.96 (SD = 2.24, range: 3-22), indicating a high level of knowledge. The mean score for attitude was 28.23 (SD = 2.76, range: 6-30), indicating optimistic attitudes. The mean score for practices was 4.34 (SD = 0.87, range: 0-5), indicating good practices. However, the results showed that men have less knowledge, less optimistic attitudes, and less good practice toward COVID-19, than women. We also found that older adults are likely to have better knowledge and practices, than younger people. Conclusions: Our finding suggests that targeted health education interventions should be directed to this particular vulnerable population, who may be at increased risk of contracting COVID-19. For example, COVID-19 knowledge may increase significantly if health education programs are specifically targeted at men.