Prevalence of Long COVID symptoms in Bangladesh: A Prospective Inception Cohort Study of COVID-19 survivors.

ObjectiveThe objective of this study was to identify the prevalence of Long COVID symptoms (LCS) in a large cohort of survivors and identify any potential associated risk factors. DesignA prospective survey was undertaken of an inception cohort of confirmed COVID-19 survivors (Aged 18 to 87 years). Participants and Setting14392 participants were recruited from 24 testing facilities across Bangladesh between June, and November 2020. All participants had a previously confirmed positive COVID-19 diagnosis, and reported persistent symptoms and difficulties in performing daily activities. Main Outcome MeasuresParticipants who consented, were contacted by face-to-face interview, and were interviewed regarding LCS, and restriction of activities of daily living using Post COVID-19 functional scale. Cardio-respiratory parameters were also measured. ResultsAmong 2198 participants, the prevalence of LCS at 12 weeks was 16.1%. Overall, eight LCS were identified and in descending order of prominence are: fatigue, pain, dyspnea, cough, anosmia, appetite loss, headache, and chest pain. COVID survivors experienced between 1 to 5 LCS with an overall duration period of 21.8 {+/-} 5.2 weeks. SEM predicted the length of LCS to be related to younger age, female gender, rural residence, prior functional limitation and smoking. ConclusionIn this cohort of survivors, at 31 weeks post diagnosis, the prevalence of LCS was 16.1%. The risk factors identified for presence and longer length of LCS warrant further research and consideration to support public health initiatives.

Coping with COVID-19 Pandemic: A Population-Based Study in Bangladesh

This study aims to investigate coping strategies used by Bangladeshi citizens during the COVID-19 pandemic. DesignProspective, cross-sectional survey of adults (N=2001) living in Bangladesh. MethodsParticipants were interviewed for socio-demographic data and completed the Bengali translated Brief-COPE Inventory. Statistical data analysis was conducted using SPSS (Version 20). ResultsParticipants (N=2001), aged 18 to 86 years, were recruited from eight administrative divisions within Bangladesh (mean age 31.85{+/-}14.2 years). Male to female participant ratio was 53.4% (n=1074) to 46.6% (n=927). Higher scores were reported for approach coping styles (29.83{+/-}8.9), with lower scores reported for avoidant coping styles (20.83 {+/-} 6.05). Humor coping scores were reported at 2.68{+/-}1.3 and religion coping scores at 5.64{+/-}1.8. Both men and women showed similar coping styles. Multivariate analysis found a significant relationship between male gender and both humor and avoidant coping (p <.01). Male gender was found to be inversely related to both religion and approach coping (p <.01). Marital status and education were significantly related to all coping style domains (p<.01). Occupation was significantly related to approach coping (p <.01). Rural and urban locations differed significantly in participant coping styles (p <.01). Factor analysis revealed two cluster groups (Factor 1 and 2) comprised of unique combinations from all coping style domains. ConclusionParticipants in this study coped with the COVID-19 pandemic by utilizing a combination of coping strategies. Factor 1 revealed both avoidant and approach coping strategies and Factor 2 revealed a combination of humor and avoidant coping strategies. Overall, a higher utilization of approach coping strategies was reported, which has previously been associated with better physical and mental health outcomes. Religion was found to be a coping strategy for all participants. Future research may focus on understanding resilience in vulnerable populations, including people with disability or with migrant or refugee status in Bangladesh.

Knowledge, Attitudes, and Practices of People living with SCI towards COVID-19 and their Psychological State during In-patient Rehabilitation in Bangladesh

Study DesignA prospective cross-sectional survey. ObjectiveThe study aimed to examine the Knowledge, Attitudes, and Practices (KAP) of people living with Spinal cord injury (SCI) towards COVID-19 and their psychological status during in-patient rehabilitation in Bangladesh. SettingThe Centre for the Rehabilitation of the Paralyzed (CRP) and the National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), two tertiary level hospitals in Dhaka, Bangladesh. MethodsFrom July to September 2020, a prospective, cross-sectional survey of SCI subjects, 13-78 years of age, carried out in two SCI rehab centers in Bangladesh. Data has been collected by face to face interview through a pretested, and language validated questionnaire on KAP and Depression, Anxiety, Stress (DASS). Ethical approval and trial registration obtained prospectively. As all the patients were previously living with Spinal cord injury (SCI), therefore, all the patients admitted/ attend SCI rehab centers were considered as SCI positive samples. ResultsA total of 207 people with SCI responded, 87%were male, and 13% were female with mean age34.18{+/-}12.9 years. 33.8% was tetraplegic and 66.2% was paraplegic and 63.8% of them were diagnosed ASIA-A, with motor score 45.38{+/-}19.5, sensory score 97.2{+/-}52, SpO2 95.07{+/-}3.3, and Vo2max 35.7{+/-}3.7mL/kg/min. 178 people had at least one health issue. Overall knowledge score was 8.59{+/-}2.3 out of 12, depression 11.18{+/-}8, anxiety 7.72{+/-}5.1, and stress was 9.32{+/-}6.7 from a total of 21 scores each. There was a correlation between Knowledge and DASS with age (P<.05); and Knowledge with gender (P<.05), and education (P<.01). Binary logistic regression found a higher association of Knowledge and DASS with gender (OR 6.6, 6.6, .95, 6.6; P<.01); and young age (OR.418, P<.01), illiterate (OR3.81, P<.01), and rural people (OR.48, P<.05) with knowledge. A linear relation was noted between depression and anxiety scores (r.45, P<.01) and stress scores (r.58, P<.01). A positive attitude was reported for the majority of subjects. SCI Persons reported they and the caregiver followed health advisory in consulting health professionals (65.7%), isolation (63.8%), droplet precaution (87.4%), and hygiene (90.3%). ConclusionsDuring in-patient rehabilitation in Bangladesh, the majority of SCI reported that they had communicated with health professionals and practiced behaviors that would reduce transmission and risk of COVID-19.

Knowledge, Attitudes, and Fear of COVID-19 during the Rapid Rise Period in Bangladesh

ObjectivesTo determine the level of Knowledge, Attitude, and Practice (KAP) related to COVID-19 preventive health habits and perception of Fear towards COVID-19 in subjects living in Bangladesh. DesignProspective, cross-sectional survey of (n= 2157) male and female subjects, 13-90 years of age, living in Bangladesh. MethodsEthical Approval and Trial registration were obtained prior to the commencement of the study. Subjects who volunteered to participate and signed the informed consent were enrolled in the study and completed the "Fear of COVID-19 Scale" (FCS). ResultsTwenty-eight percent (28.69%) of subjects reported one or more COVID-19 symptoms and 21.4% of subjects reported one or more comorbidities. Knowledge scores were slightly higher in males (8.75{+/-} 1.58) than females (8.66{+/-} 1.70). Knowledge was significantly correlated with age (p<.005), an education level (p<.001), Attitude (p<.001), and urban location (p=<.001). Knowledge scores showed an inverse correlation with Fear scores (p=<.001). Eighty-three percent (83.7%) of subjects with COVID-19 symptoms reported wearing a mask in public and 75.4% of subjects reported staying away from crowded places. Subjects with one or more symptoms reported higher Fear compared to subjects without (18.73{+/-} 4.6; 18.45{+/-} 5.1). ConclusionsOverall, Bangladeshis reported a high prevalence of self-isolation, positive preventive health behaviors related to COVID-19, and moderate to high fear levels. Higher Knowledge and Practice were found in males, higher education levels, older age, and urban location. "Fear" of COVID-19 was more prevalent in female and elderly subjects. Positive "Attitude" was reported for the majority of subjects, reflecting the belief that COVID-19 was controllable and containable. Ethical approvalEthical permission obtained from the Institutional review board (BPA-IPRR/IRB/29/03/2020/021) of Institute of Physiotherapy, Rehabilitation, and Research (IPRR), the academic organization of the Bangladesh Physiotherapy Association. WHO Trial registryThe trial registration obtained prospectively from a primary trial registry of WHO (CTRI/2020/04/024413). Data AvailabilityThe data are available regarding this study and can be viewed upon request

Knowledge, attitude, practice and fear of COVID-19: A cross-cultural study

BackgroundKnowledge, Attitude and Practice (KAP), and Fear toward COVID-19 are an important issue when designing public health approaches to control the spread of this highly contagious disease like COVID-19 during the global pandemic period. Studies with KAP and fear measures are limited only regional or country level, not yet with global or cross-cultural populations. The study is aimed to measure KAP and fear level towards COVID-19 and explore its cross-cultural variances in knowledge by socio-demographic factors among the general population of 8 different countries over 5 continents. MethodA cross-sectional online survey was conducted in April 2020 among 1296 participants using the Google form platform. Considering the social distancing formula and pandemic situation, we collect data using popular social media networks. Univariate and bivariate analyses were used to explore the collected data on KAP, fear, and sociodemographic factors. ResultOverall knowledge score was 9.7 (out of 12) and gender differences (female vs male: 9.8 vs 9.5) were significant (p=0.008) in the bivariate analysis. Knowledge score variances found significant in some regions by gender, marital status and education qualification. The highest and lowest mean knowledge scores were recorded in the Middle East (10.0) and Europe (9.3). Despite having a high fear score (22.5 out of 35), 78.35% of respondents were in a positive attitude and 81.7% in good practice level. Fear score rankings: Middle East (1st; 23.8), Europe (2nd; 23.2); Africa (3rd; 22.7); South Asia (4th; 22.1); Oceania (5th; 21.9); and North America (6th; 21.7). We didnt find a correlation between fear and knowledge. LimitationDue to the nature of the online survey, aged and rural populations are under-representing (e.g. more than half of the responders are 16-29 age group). ConclusionKAP and fear variation exist among geographical regions. Gender, marital status and education qualification are factors in knowledge variances for some regions. KAP and fear measures can assist health education programs considering some sociodemographic factors and regions during an outbreak of highly contagious disease and, which can uplift a positive attitude and good practice. HighlightsO_LICross-cultural KAP and fear toward COVID-19 are evaluated C_LIO_LIRespondents from Europe scored less knowledge on COVID 19 but had more good knowledge level C_LIO_LIAbout 80% participants had positive attitude and good practice behavior. C_LIO_LIInterestingly, Participants in Oceania avoided more crowded places whereas, in Europe worn more masks during outing as a measure of prevention C_LIO_LIParticipants in Middle East had the highest score in fear, and fear was independent of knowledge C_LI