ABSTRACT
BACKGROUND: The emergence of non-communicable diseases (NCDs) has been well documented in recent literature which constitute a significant global burden of disease. Qatar which has a significantly high prevalence of NCDs with early on set. Epidemiological and health service utilization information plays a central role in facilitating informed decision making and application of the fundamental principles of PHC in planning and delivery of healthcare with aim to prevent and control NCDs. To enable this, the Department of Clinical Research at Primary Health Care Corporation (PHCC), Qatar's publicly funded and largest primary care provider designed the Health Assessment Linking Trends in Health Status, Risks, and Healthcare Utilization (HEALTHSIGHT) study. This paper describes the HEALTHSIGHT study protocol. METHODS: The proposed study will use a cross sectional study design involving a random sample of participants enrolled across all 31 PHCC health centers. Individuals aged 18 and above years old registered with PHCC and hold a valid health card and contact information on PHCC's electronic medical records (EMR) will be eligible for inclusion. A stratified random sample not proportional to size sampling technique will be employed to obtain a representative sample size of the PHCC population (N = 6000). Participants will be scheduled for an appointment at a PHCC health centre where a data collector will obtain informed consent, collect vital sign information and administer a questionnaire. A phlebotomist will collect a blood sample. Health service utilization data will be extracted from PHCC's EMR. DISCUSSION: Epidemiological and health service utilization information is essential to plan and monitor primary care and public health services. The HEALTHSIGHT study, with the help of a randomly selected representative sample from Qatar's primary healthcare settings, provides a unique opportunity to capture this information. This study design will closely represent a real-world understanding of the health risk, status and utilisation and is likely to provide important data to guide primary care planning and delivery in Qatar. The proposed protocol provides an example of a robust nationwide study that be undertaken in short duration using limited resource which can be undertaken in other similar settings.
Subject(s)
Primary Health Care , Humans , Qatar/epidemiology , Primary Health Care/statistics & numerical data , Adult , Cross-Sectional Studies , Risk Factors , Female , Male , Patient Acceptance of Health Care/statistics & numerical data , Noncommunicable Diseases/epidemiology , Health Status , Middle Aged , Adolescent , Young AdultABSTRACT
BACKGROUND: Covid-19 related studies report psychological impacts during home isolation and social distancing. Despite that, children and adolescents were able to adopt coping strategies that assisted in lowering severe levels of psychological disorders. This study aims to report on the psychosocial implications of social distancing and isolation on children of different nationalities who reside in Qatar, and to reveal their coping ways. METHODS: This is a cross sectional study with qualitative component at its end. The study is a part of a larger study that reported the results of a national screening for psychological disorders experienced by children and adolescents in Qatar. A bilingual online questionnaire included close-ended and one open-ended question to screen for psychological changes and identify coping strategies practiced by children and adolescents (7-18 years) during home-isolation and social distancing. The quantitative questionnaire had five main sections as follows: the sociodemographic characteristics, Spence Children's Anxiety Scale, Kutcher Adolescent Depression Scale, and Clinical Anger Scale). The last section screened for eight different coping strategies. The summative content analysis was used to analyze the open-ended question "What practices do you do at home that make you happy?". First, open coding was used (for identification), followed by the axial coding (for comparison), and lasted by sorting of coping strategies inductively. RESULTS: Six thousand six hundred and eight (6608) subjects participated between June 23 and July 18, 2020. The clinical outcomes of the study had varying prevalence and levels of severity, which ranged from mild to severe. Higher prevalence was noted for adjustment disorder 66.5% (n = 4396), and generalized anxiety 60% (n = 3858), in comparison to depression 40% (n = 2588). Additionally, participants reported using cognitive, spiritual, social, and physical coping strategies. Eight higher order themes were identified to reflect the coping strategies: playing with siblings or pets, gardening, cooking, practicing arts and crafts, and doing chores. Furthermore, Sociodemographic factors such as ethnicity, religion and family status played a considerable role in choosing the type of coping strategy. CONCLUSION: The uniqueness of the study is bringing the psychosocial implications of social distancing through the voices of children and adolescents, and coping strategies from their perspective. These results are of importance for educational and healthcare systems that are recommended to collaborate even in "normal" times to prepare these age categories for any future crises. The importance of daily lifestyle and family is highlighted as protectors, and crucial factors in emotional management.
Subject(s)
COVID-19 , Humans , Adolescent , Child , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Physical Distancing , Patient Isolation , Qatar , Adaptation, PsychologicalABSTRACT
BACKGROUND: Globally, countries are rolling out Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) quarantine policies and vaccination programs. Research studies are needed in helping understand the likelihood of acquired immunity to reinfection and identify priority groups for vaccination to inform them. This study aimed to assess period prevalence and longitudinal changes in antibody levels after SARS-CoV-2 infection in Qatari primary care settings. METHODS: A cohort study design with 2 data collection phases was undertaken-Phase 1 (conducted in July 2020) and Phase 2 (conducted in October 2020). A stratified random sampling technique by age, gender and nationality was utilized to identify the study sample. The total sample size required for the study was estimated to be 2102. Participants were invited to an appointment where they were administered a questionnaire and provided samples for polymerase chain reaction and Immunoglobulin G immunoassay tests. RESULTS: A total of 943 individuals participated in both Phase 1 and Phase 2. In this cohort, seroprevalence of SARS-CoV-2 was found to be 12% (N = 113) in Phase 1 and 17.2% (N = 162) in Phase 2. Of the 113 participants who were seropositive in Phase 1, 38.1% (CI 29.5-47.2%, N = 43) had a reduction, 54.9% (CI 45.7-63.8%, N = 62) had no change, and 7.1% (CI 3.4-12.9%, N = 8) had an increase in IgG titer in Phase 2. All (N = 18) participants aged 10 to 17 years retained their antibodies. The proportion of men who retained their antibodies was slightly higher compared to women-92.5% (N = 74) and 87.9% (N = 29) respectively. Similarly, symptomatic individuals (97.8%; N = 45) had a higher antibody retention compared with asymptomatic individuals (86.4%; N = 57). CONCLUSIONS: This study provides preliminary information on the longitudinal changes in antibody levels after SARS-CoV-2 infection. These findings will help inform quarantine policies and vaccination programs.
Subject(s)
COVID-19 , SARS-CoV-2 , Antibody Formation , Cohort Studies , Female , Humans , Male , Primary Health Care , Qatar , Seroepidemiologic StudiesABSTRACT
BACKGROUND: Globally, non-communicable diseases (NCDs) are recognised as a leading cause of morbidity and mortality. Medications and medicines optimisation play an important role in the management of modifiable physiological risk factors and NCDs. The importance of lifestyle interventions in prevention of modifiable risk factors is also well established. The aim of this paper was to describe the quantity of type 2 diabetes mellitus (T2DM), hypertension and dyslipidaemia prescribing in Qatari primary care settings. Its findings will provide necessary information to inform pharmaceutical policy and practice. METHODS: The study was undertaken in Qatar's publicly funded primary health care centres. Data sources for this study comprised electronic medical records. The Anatomical Therapeutic Chemical (ATC) drug classification system was used to classify the medications prescribed. The number and proportion of medications by age, sex, nationality and diagnosis (T2DM, hypertension and dyslipidaemia) were reported. RESULTS: A total 81,569 individuals were included (18-29 years 2.4%; 30-39 years 11.7%; 40-49 years 25.4%; 50-59 years 31.9% and ≥ 60 years 28.6%). 55.6% participants were male. On average 10.2 medications were prescribed per person and 2.3 medications were included in each prescription. T2DM medications were most prescribed (N = 361,87780,799; 43.2%) followed by hypertension (N = 303,086; 36.2%) and dyslipidaemia (N = 172,163; 20.5%). Of the total medications prescribed, 72% (N = 605,488) were prescribed in individuals aged 50 years and above. Men were prescribed 62% (N = 515,043) medications while women were prescribed 38% (N = 322,083) medications. Southern Asians (N = 330,338; 39%) were prescribed most medication followed by Qataris (N = 181,328; 22%) and Northern African (N = 145,577; 17%). CONCLUSIONS: In Qatar's primary care settings, average medications prescribed per patients were found to be higher compared to other populations. While medications were actively prescribed for the 3 conditions, the study found variations by medication type, age, gender and nationality. Rational guidelines for the utilisation of medications need to be established with the support of real-world evidence.
ABSTRACT
BACKGROUND: There is an urgent need to elucidate the epidemiology of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) and characterize its potential impact. Investing in characterising the SARS-CoV2 will help plan and improve the response to the pandemic. Furthermore, it will help identify the most efficient ways of managing the pandemic, avoiding public health policies and interventions that may be unduly restrictive of normal activity or unnecessarily costly. This paper describes the design and reports findings of a population based epidemiological study undertaken to characterise SARS-CoV2 in Qatar using limited resources in a timely manner. METHODS: Asymptomatic individuals ≥10 years registered with Qatar's publicly funded primary health provider were eligible. A stratified random sampling technique was utilized to identify the study sample. Participants were invited to an appointment where they completed a questionnaire and provided samples for polymerase chain reaction and Immunoglobulin M and G immunoassay tests. Data collected were analyzed to calculate point and period prevalence by sociodemographic, lifestyle and clinical characteristics. RESULTS: Of 18,918 individuals invited for the study, 2084 participated (response rate 10.8%). The overall point prevalence and period prevalence were estimated to be 1.6% (95% CI 1.1-2.2) and 14.6% (95% CI 13.1-16.2) respectively. Period prevalence of SARS-CoV2 infection was not considerably different across age groups (9.7-19.8%). It was higher in males compared to females (16.2 and 12.7% respectively). A significant variation was observed by nationality (7.1 to 22.2%) and municipalities (6.9-35.3%). CONCLUSIONS: The study provides an example of a methodologically robust approach that can be undertaken in a timely manner with limited resources. It reports much-needed epidemiological data about the spread of SARS-CoV2. Given the low prevalence rates, majority of the population in Qatar remains susceptible. Enhanced surveillance must continue to be in place, particularly due to the large number of asymptomatic cases observed. Robust contact tracing and social distancing measures are key to prevent future outbreaks.
Subject(s)
COVID-19/epidemiology , SARS-CoV-2 , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Prevalence , Primary Health Care , Qatar/epidemiology , Young AdultABSTRACT
SARS-CoV2 a new emerging Corona Virus Disease in humans, which called for containment measures by many countries. The current paper aims to discuss the impact of two different sampling methodologies when executing a drive through COVID-19 survey on the quality of estimated disease burden measures. Secondary data analysis of a pilot cross-sectional survey targeting Qatar's primary health care registered population was done. Two groups with different sampling methods were compared for estimating COVID-19 point prevalence using molecular testing for nasopharyngeal swabs. The first group is a stratified random sample non-proportional to size (N = 260). A total of 16 population strata based on age group, gender, and nationality were sampled. The second group is the Open invitation group (N = 841). The results showed that the two groups were obviously and significantly different in age and nationality. Besides, reporting of COVID-19 symptoms was more frequent in the open invitation group (28.2%) than the random sample (16.2%). The open invitation group overestimated the symptomatic COVID-19 prevalence rate by more than four times, while it overestimated the asymptomatic COVID-19 cases by a small margin. The overall prevalence rate of active COVID-19 cases in the open invitation sample (13.3%) was almost double that of the random sample (6.9%). Furthermore, using population sampling weights reduced the prevalence rate to 0.8%. The lesson learned here is that it is wise to consider the magnitude of bias introduced in a surveillance system when relying on convenient sampling approaches in response to time constraints.
Subject(s)
COVID-19 , Cross-Sectional Studies , Humans , Primary Health Care , Qatar/epidemiology , RNA, Viral , SARS-CoV-2ABSTRACT
BACKGROUND: In December 2019, a novel coronavirus called SARS-CoV-2 was identified as the cause of a cluster of pneumonia cases in Wuhan, China. It rapidly spread due to human-to-human transmission, resulting in a global pandemic. Nearly every country, including Qatar, has established guidelines and regulations to limit the spread of the virus and to preserve public health. However, these procedures have been associated with negative effects on the psychological and intellectual well-being of individuals, including children and adolescents. OBJECTIVE: The objective of this study was to determine the psychological influence of home isolation and social distancing on children and adolescents during the COVID-19 pandemic in Qatar, and the strategies used to cope with these measures. METHODS: This cross-sectional study was undertaken using an online questionnaire administered through SMS text messaging. All home-isolated children and adolescents registered at the Primary Health Care Corporation aged 7-18 years were invited to participate in the study. Children and adolescents with intellectual disadvantages were excluded. A P value of .05 (two-tailed) was considered statistically significant. RESULTS: Data were collected from 6608 participants from June 23 to July 18, 2020. Nearly all participants adhered to the official regulations during the period of home isolation and social distancing; however, 69.1% (n=4568) of parents believed their children were vulnerable to the virus compared to 25% (n=1652) who expressed they were not vulnerable at all. Higher levels of anger, depression, and general anxiety were prevalent among 1.3% (n=84), 3.9% (n=260), and 1.6% (n=104) of participants, respectively. The mean score for the emotional constructs anger and depression decreased with increased compliance with regulations (P=.04 and P=.11, respectively). The differences in mean score for all psychological and coping strategies used among participants across the 3 levels of vulnerability to SARS-CoV-2 were statistically significant. The mean score varied little with increasing reported vulnerability to the virus. This mild variation can make a difference when the sample size is large, as is the case in this study. CONCLUSIONS: Screening for psychological and social disruptions is important for the development of strategies by schools and health care providers to assess and monitor behavioral changes and negative psychological impact during post-COVID-19 reintegration. Participants experiencing higher levels of anxiety should be given more attention during reintegration and transitional phases in schools. Although electronic devices and social media platforms may have lowered anxiety levels in some cases, it is important to address how they are used and how content is tailored to children and adolescents. It is also important to maintain an active lifestyle for children and young persons, and encourage them not to neglect their physical health, as this promotes a better psychological state of mind.