Depression and its associated factors among COVID-19 survivors in a middle income country

IntroductionCOVID-19 survivors who have mental health issues are more likely to have a lower quality of life, reduced work productivity, social troubles, and other health issues. However, information on the mental health of COVID-19 survivors is scarce. Therefore, we aimed to determine the COVID-19 survivors mental health status in the form of depression and its associated factors. MethodsThis was a cross-sectional study conducted in Malaysia, from July to September 2021, during a nationwide lockdown. Data was collected using an online questionnaire shared on social and news media. Socio-demographic variables, comorbidities, self-perception of health, information on the persons acute condition during COVID-19 infection, symptoms and duration of symptoms post-COVID, and state of depression were gathered. The Patient Health Questionnaire 9 was used to assess depression. Factors associated with mild to severe depression were analysed using both univariable and multivariable logistic regression analyses. ResultsA total of 732 COVID-19 survivors responded to the survey. The respondents were mainly females and of younger age (in their 20s and 30s). Two-thirds perceived themselves to be in good health. One in five reported to have experienced Long COVID. Slightly less than half (47.3%) of the respondents had mild to severe depression (total PHQ-9 score of 5 -27). In the multivariable analysis, being female (aOR: 1.68; 95% CI: 1.08,2.62), of younger age (20s - aOR: 3.26; 95% CI: 1.47, 7.25; 30s - aOR: 2.08; 95% CI: 1.05, 4.15; and 40s - aOR: 2.43; 95% CI: 1.20, 4.90; compared to those in the 50s and above), being overweight/obese (aOR: 1.83; 95% CI: 1.18, 2.83), having Long COVID (aOR: 2.45; 95% CI: 1.45, 4.16) and perceiving to have poorer health (aOR: 4.54; 95% CI: 2.89, 7.13) were associated with mild to severe depression. ConclusionFemales, younger age groups, being overweight/obese, having Long COVID and perceiving to be in poor health were factors associated with higher odds for mild to severe depression.

Long COVID and its associated factors among COVID survivors in the community from a middle-income country: an online cross-sectional study

IntroductionPatients with COVID-19 usually recover and return to normal health, however some patients may have symptoms that last for weeks or even months after recovery. This persistent state of ill health is known as Long COVID if it continues for more than 12 weeks and are not explained by an alternative diagnosis. Long Covid has been overlooked in low and middle income countries. Therefore, we conducted an online survey among the COVID-19 survivors in the community to explore their Long COVID symptoms, factors associated with Long COVID and how Long COVID affected their work. MethodsThis was a cross sectional study conducted from July to September 2021, during the implementation of a nationwide movement control order (MCO). Data was collected using the REDCap electronic data capture tool. The questionnaire was distributed in social and news media. The questionnaire covers information such as socio-demographic characteristics, existing comorbidities, self-perception on health, information on the acute COVID-19 condition and treatment received, symptoms and duration of post-COVID condition and effects on occupation. Results: A total of 732 COVID-19 survivors responded. There were slightly more females (58.7%), younger and more highly educated respondents. More than half of them were overweight or obese and about two third were free of comorbidities. Among these respondents, about 56% were without or with mild symptoms during their acute COVID-19 conditions. A total of 21.1% of the respondents reported to experience Long COVID. The most commonly reported symptoms for Long COVID were fatigue, brain fog, depression, anxiety, insomnia, arthralgia or myalgia. Females had 58% higher odds (95% CI: 1.02, 2.45) of experiencing Long COVID. Patients with moderate and severe levels of acute COVID-19 symptoms had OR of 3.01 (95% CI: 1.21, 7.47) and 3.62 (95% CI: 1.31, 10.03) respectively for Long COVID. ConclusionThis study provides additional insight on the symptoms and duration of post-COVID symptoms as well as the associated factors with Long COVID among COVID-19 survivors in Malaysia. Recognition of Long COVID and its associated factors is important in planning prevention, rehabilitation, clinical management to improve recovery and long-term COVID-19 outcomes.

Towards Precision Health in Weight Reduction: Thematic Content Analysis of an Open-Ended Survey on Reasons Why Morbidly Obese Patients Want to Lose Weight

@#Introduction: Addressing motivation to lose weight among morbidly obese patients increases successful weight management outcomes. We aimed to understand the motivations and reasons why morbidly obese patients attending hospital-based weight management programmes wanted to lose weight. Methods: A qualitative thematic content analysis was used to analyse responses from a self-administered open-ended question, “What is the main factor why you want to lose your weight?”. A total of 225 new patients attending obesity clinics program run by endocrinologists, dietitians and occupational therapists in two tertiary hospitals in Klang Valley responded to the questionnaire. Results: Patients’ mean BMI was 45.6±8.05 kg/m2 . Four themes emerged and they are health, function, appearance and perceived stigma. Health, the most commonly inferred theme (84%), highlighted concerns over obesity complications and concomitant morbidities, which include infertility, impact on surgical procedures as well as general physical and psychological well-being. Patients regard being functional to care for themselves, family members, religious and career needs as the next most crucial theme (25.8%). They relate to the theme appearance (12.9%) by wanting to look and feel beautiful. The theme perceived stigmatization recount the time when they were mocked and laughed at for their appearance (3.1%). Conclusion: Patients with morbid obesity in this study had expressed their main personal motivational reasons to lose weight. Identifying and addressing these unique personal motivations in a focused approach is vital for health care professionals to manage the complexity of the health, social and psychological needs among patients with morbid obesity.

Seroprevalence report on tick-borne encephalitis virus and Crimean-Congo hemorrhagic fever virus among Malaysian's farm workers.

BACKGROUND: Tick-borne encephalitis virus (TBEV) and Crimean-Congo haemorrhagic fever virus (CCHFV) are important tick-borne viruses. Despite their wide geographical distribution and ease of acquisition, the prevalence of both viruses in Malaysia is still unknown. This study was conducted to determine the seroprevalence for TBEV and CCHFV among Malaysian farm workers as a high-risk group within the population. METHODS: We gave questionnaires to 209 farm workers and invited them to participate in the study. Eighty-five agreed to do so. We then collected and tested sera for the presence of anti-TBEV IgG (immunoglobulin G) and anti-CCHFV IgG using a commercial enzyme-linked immunosorbent assay (ELISA) kit. We also tested seroreactive samples against three other related flaviviruses: dengue virus (DENV), West Nile virus (WNV) and Japanese encephalitis virus (JEV) using the ELISA method. RESULTS: The preliminary results showed the presence of anti-TBEV IgG in 31 (36.5%) of 85 sera. However, when testing all the anti-TBEV IgG positive sera against the other three antigenically related flaviviruses to exclude possible cross reactivity, only five (4.2%) sera did not show any cross reactivity. Interestingly, most (70.97%) seropositives subjects mentioned tick-bite experience. However, there was no seroreactive sample for CCHFV. CONCLUSIONS: These viruses migrate to neighbouring countries so they should be considered threats for the future, despite the low seroprevalence for TBEV and no serological evidence for CCHFV in this study. Therefore, further investigation involving a large number of human, animal and tick samples that might reveal the viruses' true prevalence is highly recommended.

Salivary biomarkers of stress among teachers in an urban setting.

The aim of this study was to determine the prevalence of job stress among secondary school teachers using Karasek Job Content Questionnaire (JCQ), the association between salivary cortisol, salivary IgA, and sociodemographic characteristics, and the association between log cortisol, IgA levels, and job strain categories. A cross-sectional study was undertaken using JCQ and salivary cortisol and IgA samples. Cluster sampling was done yielding 302 respondents. The prevalence of stress among all teachers was 20.2%. Being a Malay, teaching experience of 5 to 10 years, and those without a supervisor's support had higher prevalence of high job strain. Teachers in the 31 to 40 years age bracket, educating handicapped children with the absence of supervisor support exhibited higher stress levels with lower log salivary IgA levels. Further studies must be conducted using salivary biomarkers to study the in-depth relationship of stress, extending into other occupational groups.

Hand-arm vibration syndrome among a group of construction workers in Malaysia.

OBJECTIVES: To determine the extent of hand transmitted vibration exposure problems, particularly hand-arm vibration syndrome (HAVS), among construction workers in Malaysia. METHODS: A cross-sectional study was conducted on a construction site in Kuala Lumpur, Malaysia. 243 workers were recruited. Questionnaire interviews and hand examinations were administered to 194 respondents. Vibration magnitudes for concrete breakers, drills and grinders were measured using a 3-axis accelerometer. Clinical outcomes were compared and analysed according to vibration exposure status. RESULTS: Vibration total values for concrete breakers, impact drills and grinders were 10.02 ms(-2), 7.72 ms(-2) and 5.29ms(-2), respectively. The mean 8 h time-weighted hand transmitted vibration exposure, A(8), among subjects on current and previous construction sites was 7.52 (SD 2.68) ms(-2) and 9.21 (SD 2.48) ms(-2), respectively. Finger tingling, finger numbness, musculoskeletal problems of the neck, finger coldness, abnormal Phalen's test and abnormal light touch sensation were significantly more common in the high vibration exposure group (n=139) than the low-moderate vibration exposure group (n=54). Mean total lifetime vibration dose among exposed subjects was 15.2 (SD 3.2) m(2) h(3) s(-4) (ln scale). HAVS prevalence was 18% and the prevalence ratio of stage 1 and higher disease in the high vibration exposure group versus the low-moderate vibration exposure group was 4.86 (95% CI 1.19 to 19.80). CONCLUSIONS: Hand transmitted vibration is a recognisable problem in tropical countries including Malaysia. The current study has identified clinical symptoms and signs suggesting HAVS among construction workers exposed to hand transmitted vibration in a warm environment.