Primary care indicators for disease burden, monitoring and surveillance of COVID-19 in 31 European countries: Eurodata Study.

BACKGROUND: During the COVID-19 pandemic, the majority of patients received ambulatory treatment, highlighting the importance of primary health care (PHC). However, there is limited knowledge regarding PHC workload in Europe during this period. The utilization of COVID-19 PHC indicators could facilitate the efficient monitoring and coordination of the pandemic response. The objective of this study is to describe PHC indicators for disease surveillance and monitoring of COVID-19's impact in Europe. METHODS: Descriptive, cross-sectional study employing data obtained through a semi-structured ad hoc questionnaire, which was collectively agreed upon by all participants. The study encompasses PHC settings in 31 European countries from March 2020 to August 2021. Key-informants from each country answered the questionnaire. Main outcome: the identification of any indicator used to describe PHC COVID-19 activity. RESULTS: Out of the 31 countries surveyed, data on PHC information were obtained from 14. The principal indicators were: total number of cases within PHC (Belarus, Cyprus, Italy, Romania and Spain), number of follow-up cases (Croatia, Cyprus, Finland, Spain and Turkey), GP's COVID-19 tests referrals (Poland), proportion of COVID-19 cases among respiratory illnesses consultations (Norway and France), sick leaves issued by GPs (Romania and Spain) and examination and complementary tests (Cyprus). All COVID-19 cases were attended in PHC in Belarus and Italy. CONCLUSIONS: The COVID-19 pandemic exposes a crucial deficiency in preparedness for infectious diseases in European health systems highlighting the inconsistent recording of indicators within PHC organizations. PHC standardized indicators and public data accessibility are urgently needed, conforming the foundation for an effective European-level health services response framework against future pandemics.

Norwegian "dugnad" as a rhetorical device in public health communication during the COVID-19 pandemic. A qualitative study from immigrant's perspectives.

BACKGROUND: During the COVID-19 pandemic, the Norwegian government appealed to the term "national dugnad" in the communication of containment measures as a call for collective action to fight the spread of infection. "Dugnad" is traditionally associated with solidarity, social responsibility, and a communal spirit in the form of volunteer work carried out by a local community. Although the word "dugnad" is difficult to translate to other languages, it was used as a rhetorical device by the government to communicate health-related information during the pandemic. This study aims to explore how immigrants understood and related to the term "dugnad" as used in the context of the COVID-19 pandemic in Norway. METHODS: We conducted 55 semi-structured interviews in 2020 with immigrants from Poland (10), Syria (15), Somalia (10), Sri Lanka (10), and Chile (10). Interviews were conducted in participants' mother-tongues. We used systematic text condensation following Malterud's four steps to analyze the data. RESULTS: The results are organized into three themes corresponding to: (1) meaning making of the term "dugnad"; (2) attitudes towards the term "dugnad"; and (3) reactions to the use of "dugnad" in a public health context. Overall, participants were familiar with the term "dugnad" and positively associated it with volunteering, unity, and a sense of community. However, we found a variety of reactions towards using this term in a public health context, ranging from agreement to disagreement and irritation. CONCLUSION: Health communication during pandemics is crucial for maximizing compliance and gaining control of disease spread. In multicultural societies, governments and authorities should be aware of the linguistic and cultural barriers to public health communication if they are to effectively reach the entire population. The use of culturally specific concepts in this context, specially as rhetorical devices, may hinder effective health communication and increase health inequalities.

Utilización de servicios de salud por febriles en un área de transmisión de paludismo en México / Health services utilization by febrile patients in a malarial area of Mexico

Objetivo. Analizar la utilización de las unidades de atención primaria a la salud (UAPS) por pacientes febriles en áreas de transmisión de paludismo, en diferentes condiciones de organización de los servicios de salud. Material y métodos. Estudio transversal realizado en septiembre de 1993, en 32 localidades de los estados de Tabasco (con servicios de salud descetralizados) y Campeche ( no descentralizados). Se efectuó un análisis descriptivo y se identificaron variables predictoras de utilización de las UAPS mediante una regresión logística. Resultados. Se entrevistaron 817 febriles, de los cuales 55 por ciento se atendieron en casa; 16.4 por ciento utilizaron UAPS y 17 por ciento fueron atendidos por colaboradores voluntarios, sin diferencias entre ambos estados. Los febriles de localidades con UAPS las utilizaron 11 veces más (IC 95 por ciento 7.0-18.2) que aquéllos sin UAPS; los graves 2.8 veces más (IC 95 por ciento 1.7-4.6) que los leves-moderados y los <13 años (IC 95 por ciento 1.3-2.9) 1.9 veces más que los ò13 años. Sólo 2 por ciento de los febriles fueron casos de paludismo. Conclusiones. No hubo diferencias en la utilización de UAPS entre estado descentralizado y no descentralizado. Debe revalorarse la fiebre como indicador único para detección de paludismo

Objective. To analyze primary health care service (PHCS) utilization by febrile patients in a malarial area of Mexico. Material and Methods. A cross-sectional study was carried out in September, 1993, in 32 communities of Tabasco (decentralized health services) and Campeche (non-decentralized) states. Predictors of utilization were analyzed using descriptive statistics and logistic regression analysis. Results. 817 febrile patients were interviewed, 55% of all febrile patients received care at home (SELF), 16.5% by PHCS and 17% by volunteer collaborators, with no significant differences in health services utilization between states. Febrile patients living in communities where PHCS was available used these facilities 11 times more than those without PHCS (C.I. 95%: 7.0-18.2%). Severely febrile patients used PHCS 2.8 times more than mild-moderate cases (C.I. 95%: 1.7-4.6%). Febrile patients under 13 years of age used PHCS 1.9 times more than older patients. Two per cent of febrile patients consisted of malaria cases. Conclusions. There was no difference between decentralized and non-decentralized health services regarding the utilization of PHCS. Fever symptoms must be evaluated as a single screening indicator of malarial disease.