Knowledge of mpox and its determinants among the healthcare personnel in Arabic regions: A multi-country cross-sectional study.

Background & aim: The monkeypox virus (MPXV), an Orthopoxvirus family member, is the zoonotic agent that causes mpox (formerly known as monkeypox). The ongoing mpox pandemic has caused cases across continents involving 110 countries. This study aimed to assess mpox knowledge and its determinants among healthcare personnel. Methods: This cross-sectional study was conducted from June 6 to June 25, 2022, among 17 Arab countries. The self-administered questionnaire consists of 53 questions assessing the knowledge about the monkeypox virus. Results: In total, 5874 medical students and clinical doctors from 17 Arab countries participated in this study. Only 13.8% (n = 812) of respondents have ever received information about mpox during their studies in medicine. The mean knowledge score was 13.84, and the median score was 15 (range 1-34). More than half (51.3%, n = 3012) have heard about mpox before. A low proportion of the participants had a good level of knowledge on mpox. Only 11.7% of respondents had correctly identified the natural host and the incubation period of mpox. More than half (58.9%) were aware of the signs and symptoms of mpox. Few respondents (28%) believed that mpox and smallpox have similar signs and symptoms. Specialist doctors had higher knowledge of mpox (AOR = 2.96, 95% CI = 2.24-3.92, p < 0.001) than other cadres. Conclusion: Mpox awareness among Arabic medical students and practitioners is low; hence immediate action in creating awareness among arab healthcare professionals is the need of the hour. This is crucial in the mpox early detection and prevention of its spread.

Oral manifestation of the monkeypox virus: a systematic review and meta-analysis.

Background: Mpox (formerly known as monkeypox) is a global public health concern, given the recent outbreaks in non-endemic countries where little scientific evidence exists on the disease epidemiology. Oral lesions among mpox cases have been poorly reported. Our aim was to estimate the overall prevalence of oral manifestations among patients with mpox globally. Methods: In this systematic review and meta-analysis, an extensive literature search in PubMed, Scopus, Web of Science, Embase, Cochrane, and preprint servers (medRxiv, arXiv, bioRxiv, BioRN, ChiRxiv, ChiRN, and SSRN) and assessment of all published articles, conducted across the world, until Nov 15 2022 as per the PROSPERO registration protocol (CRD42022371249), was undertaken. Primary studies (case series, cross-sectional, retrospective, prospective designs) that reported the oral/oropharyngeal symptoms among laboratory-confirmed mpox cases were included. The characteristics of the study, information on the number of cases, and symptomatic status were extracted from the included studies. The quality of the included studies was assessed for bias. Random-effects meta-regression with DerSimonian & Laird estimator, and subgroup analyses were conducted using STATA (v17.0). The degree of funnel plot asymmetry was assessed using Egger's test when at least 10 estimates were available. The heterogeneity between studies was assessed using the I2 statistic. The primary outcome was the pooled prevalence of oral manifestations in the examined population. Findings: 19 studies were included with 4042 laboratory-confirmed patients with mpox for qualitative and quantitative synthesis. The pooled prevalence of oral manifestations in the investigated population was 36.75% (95% confidence interval [CI]: 23.77-50.65). Heterogeneity was found to be high in the current meta-analysis (I2 = 98.24%; p < 0.001). Subgroup analysis revealed a pooled prevalence of 39.96% (95% CI: 21.42-59.91) of sore throat, 24.80% (95% CI: 8.14-46.32) of mouth sore, 18.24% (95% CI: 0.34-52.54) of tonsillitis and 17.99% (95% CI: 15.66-20.43) of mouth rash from the included studies. Interpretation: Oral manifestations are common in patients with mpox, with variations in prevalence across the sites within the oral cavity, and geography of the studies. Healthcare workers should be wary of the oral signs and symptoms of mpox in endemic and high-risk areas. Funding: None.

Rural community health workers' readiness for mobile-phone based telemedicine uptake in India.

Objective: Healthcare services using mobile-phone based telemedicine provide simple technology that does not require sophisticated equipment. This study assessed community health workers' knowledge, attitude, and practice (i.e., their readiness) at the village level for uptake of mobile-phone based telemedicine. Materials and Methods: This cross-sectional study was conducted among 80 community health workers, including Auxiliary Nurse Midwives, Multipurpose Health Workers and Accredited Social Health Activists working in a rural health block of India. A pre-tested, semi-structured, interviewer-assisted, self-administered questionnaire was used to assess their mobile-phone based telemedicine readiness. Results: Sixty (75.0%) health workers owned mobile phones. The median readiness score for mobile-phone based telemedicine was 109.0. The Accredited Social Health Activists showed a better attitude toward mobile-phone based telemedicine than others. There was a significant moderate positive correlation (r=0.67) between knowledge and practice domains. Community health workers who had smartphones showed a significantly better attitude than those who did not. Conclusion: Training programs on telemedicine service delivery, focused on Auxiliary Nurse Midwives/ Multipurpose Health Workers, can improve their attitudes towards telemedicine. A better attitude of the Accredited Social Health Activists must be leveraged to initiate mobile-phone based telemedicine services on a pilot basis initially and later scaled up in other settings.

Lockdowns, Community Mobility Patterns, and COVID-19: A Retrospective Analysis of Data from 16 Countries.

OBJECTIVES: During the coronavirus disease 2019 (COVID-19) pandemic, countries around the world framed specific laws and imposed varying degrees of lockdowns to ensure the maintenance of physical distancing. Understanding changes in temporal and spatial mobility patterns may provide insights into the dynamics of this infectious disease. Therefore, we assessed the efficacy of lockdown measures in 16 countries worldwide by analyzing the relationship between community mobility patterns and the doubling time of COVID-19. METHODS: We performed a retrospective record-based analysis of population-level data on the doubling time for COVID-19 and community mobility. The doubling time for COVID-19 was calculated based on the laboratory-confirmed cases reported daily over the study period (from February 15 to May 2, 2020). Principal component analysis (PCA) of six mobility pattern-related variables was conducted. To explain the magnitude of the effect of mobility on the doubling time, a finite linear distributed lag model was fitted. The k-means clustering approach was employed to identify countries with similar patterns in the significant co-efficient of the mobility index, with the optimal number of clusters derived using Elbow's method. RESULTS: The countries analyzed had reduced mobility in commercial and social places. Reduced mobility had a significant and favorable association with the doubling time of COVID-19-specifically, the greater the mobility reduction, the longer the time taken for the COVID-19 cases to double. CONCLUSIONS: COVID-19 lockdowns achieved the immediate objective of mobility reduction in countries with a high burden of cases.

Community Preparedness and Practices for Prevention and Control of COVID-19 (COP-COVID): An Assessment from Rural Northern India.

OBJECTIVES: The study assessed the community preparedness to manage the coronavirus disease 2019 (COVID-19) and access to health-care services during the lockdown of 2020 in a rural health block of northern India. METHODS: A cross-sectional study was conducted during June-July, 2020, in 25 villages and 5 wards of a rural administrative block of Haryana. A pretested, semi-structured investigator-administered checklist was used to assess the community preparedness and practices for COVID-19 prevention/control and health-care access through direct observations and interviewing community health workers and beneficiaries. RESULTS: Active surveillance for influenza-like illness was carried out in 86.7% of the study units, although the frequency was once a month. There was poor adherence (adherence: 0-3%) to COVID-19 infection prevention and control (IPC) measures such as physical distancing and use of face masks. Rural beneficiaries reported difficulty in accessing essential health-care services than their urban counterparts. CONCLUSIONS: A qualitative study to understand the facilitators and barriers for the non-adherence to IPC measures by the study population and formulating behavior change communication strategies for improving the IPC measures is needed. Repeat, cross-sectional surveys at regular intervals may be planned to gauge the change and effect of the interventions on the community preparedness and practices.

Prevalence of depression and the associated factors among the software professionals in Delhi: A cross-sectional study.

India is home to an estimated 57 million people (18% of the global estimate) affected by depression. We conducted a cross-sectional study to determine the prevalence of depression and associated factors among software professionals in Delhi National Capital Region, during 2017-2018 with a sample size of 310. Two-stage cluster sampling was used. A predesigned, pretested, semi-structured, English questionnaire was used. Patient Health Questionnaire 9, CAGE, CAGE Adapted to Include Drugs (CAGE-AID) questionnaire, Fagerstrom test for nicotine dependence questionnaire was used. Forty percent (124) of the participants were screened to have major depressive disorder. There was a statistically significant association between depression and marital status (P = 0.041), family type (P = 0.008), alcohol use (P < 0.001), substance use (P = 0.014), multiple roles in a project (P < 0.001), and shift of work (P < 0.008). Considering the high prevalence of depression, mental health screening program, sensitization, and promotion must be incorporated into the IT industry to prevent and detect depression early.