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1.
Talanta ; 236: 122832, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34635222

RESUMO

The objective of this research was to evaluate the application of an electronic nose and chemometric analysis to discriminate volatile organic compounds between patients with COVID-19, post-COVID syndrome and controls in exhaled breath samples. A cross-sectional study was performed on 102 exhaled breath samples, 42 with COVID-19, 30 with the post-COVID syndrome and 30 control subjects. Breath-print analysis was performed by the Cyranose 320 electronic nose with 32 sensors. Group data were evaluated by Principal Component Analysis (PCA), Canonical Discriminant Analysis (CDA), and Support Vector Machine (SVM), and the test's diagnostic power was evaluated through a Receiver Operaring Characteristic curve(ROC curve). The results of the chemometric analysis indicate in the PCA a 97.6% (PC1 = 95.9%, PC2 = 1.0%, PC3 = 0.7%) of explanation of the variability between the groups by means of 3 PCs, the CDA presents a 100% of correct classification of the study groups, SVM a 99.4% of correct classification, finally the PLS-DA indicates an observable separation between the groups and the 12 sensors that were related. The sensitivity, specificity of post-COVID vs. controls value reached 97.6% (87.4%-99.9%) and 100% (88.4%-100%) respectively, according to the ROC curve. As a perspective, we consider that this technology, due to its simplicity, low cost and portability, can support strategies for the identification and follow-up of post-COVID patients. The proposed classification model provides the basis for evaluating post-COVID patients; therefore, further studies are required to enable the implementation of this technology to support clinical management and mitigation of effects.


Assuntos
COVID-19 , Compostos Orgânicos Voláteis , Estudos Transversais , Voluntários Saudáveis , Humanos , SARS-CoV-2
2.
J Med Virol ; 94(1): 327-334, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34524690

RESUMO

Genomic surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) plays an important role in COVID-19 pandemic control and elimination efforts, especially by elucidating its global transmission network and illustrating its viral evolution. The deployment of multiplex PCR assays that target SARS-CoV-2 followed by either massively parallel or nanopore sequencing is a widely-used strategy to obtain genome sequences from primary samples. However, multiplex PCR-based sequencing carries an inherent bias of sequencing depth among different amplicons, which may cause uneven coverage. Here we developed a two-pool, long-amplicon 36-plex PCR primer panel with ~1000-bp amplicon lengths for full-genome sequencing of SARS-CoV-2. We validated the panel by assessing nasopharyngeal swab samples with a <30 quantitative reverse transcription PCR cycle threshold value and found that ≥90% of viral genomes could be covered with high sequencing depths (≥20% mean depth). In comparison, the widely-used ARTIC panel yielded 79%-88% high-depth genome regions. We estimated that ~5 Mbp nanopore sequencing data may ensure a >95% viral genome coverage with a ≥10-fold depth and may generate reliable genomes at consensus sequence levels. Nanopore sequencing yielded false-positive variations with frequencies of supporting reads <0.8, and the sequencing errors mostly occurred on the 5' or 3' ends of reads. Thus, nanopore sequencing could not elucidate intra-host viral diversity.


Assuntos
Genoma Viral/genética , Reação em Cadeia da Polimerase Multiplex/métodos , Sequenciamento por Nanoporos/métodos , SARS-CoV-2/genética , Sequenciamento Completo do Genoma/métodos , COVID-19 , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Nasofaringe/virologia , RNA Viral/genética , Análise de Sequência de RNA/métodos
3.
Sci Total Environ ; 802: 149585, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34454149

RESUMO

The impacts of COVID-19 lockdowns on air quality around the world have received wide attention. In comparison, assessments of the implications for water quality are relatively rare. As the first country impacted by COVID-19, China implemented local and national lockdowns that shut down industries and businesses between January and May 2020. Based on monthly field measurements (N = 1693) and daily automonitoring (N = 65), this study analyzed the influence of the COVID-19 lockdown on river water quality in China. The results showed significant improvements in river water quality during the lockdown period but out-of-step improvements for different indicators. Reductions in ammonia nitrogen (NH4+-N) began relatively soon after the lockdown; chemical oxygen demand (COD) and dissolved oxygen (DO) showed improvements beginning in late January/early February and mid-March, respectively, while increases in pH were more temporally concentrated in the period from mid-March to early May. Compared to April 2019, the Water Quality Index increased at 67.4% of the stations in April 2020, with 75.9% of increases being significant. Changes in water quality parameters also varied spatially for different sites and were mainly determined by the locations and levels of economic development. After the lifting of the lockdown in June, all water quality parameters returned to pre-COVID-19 lockdown conditions. Our results clearly demonstrate the impacts of human activities on water quality and the potential for reversing ecosystem degradation by better management of wastewater discharges to replicate the beneficial impacts of the COVID-19 lockdown. CAPSULE SUMMARY: River water quality improved during China's COVID-19 lockdown, but returned to normal conditions after the lockdown.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Poluentes Atmosféricos/análise , Poluição do Ar/análise , China , Controle de Doenças Transmissíveis , Ecossistema , Monitoramento Ambiental , Humanos , Material Particulado/análise , Rios , SARS-CoV-2 , Qualidade da Água
4.
Clin Imaging ; 81: 60-61, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34619565

RESUMO

From the more than 700,000 deaths from COVID-19 in the US and the nearly 5 million worldwide, there emerge even more stories than match the statistics when one considers all of the patients' relations. While the numbers are staggering, when we humanize the stories, we are left with even greater devastation, of course. One of the stories among so many that seemed particularly salient and poignant to us was the death of Dr. Susan Moore. Her plaintive Facebook post, which went viral in December 2020, was made a few weeks before she died at the age of 52 from COVID-19 and claimed that she was a victim of racially biased treatment at a hospital in Indiana. It was Dr. Moore's mentioning of CT scans that led us to reflect on the biases of some health care workers and the role of radiologists. Our initial interface with our patients is actually not with their faces, but with their films. This dynamic does not eliminate any biases we may harbor but shields practitioners and patients from potential glaring racial biases in this first and sometimes only stage of the relationship.


Assuntos
Atitude do Pessoal de Saúde , COVID-19 , Viés , Feminino , Humanos , Radiologistas , SARS-CoV-2
5.
Med Gas Res ; 12(2): 60-66, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34677154

RESUMO

The coronavirus disease 2019 (COVID-19) epidemic went down in history as a pandemic caused by corona-viruses that emerged in 2019 and spread rapidly around the world. The different symptoms of COVID-19 made it difficult to understand which variables were more influential on the diagnosis, course and mortality of the disease. Machine learning models can accurately assess hidden patterns among risk factors by analyzing large-datasets to quickly predict diagnosis, prognosis and mortality of diseases. Because of this advantage, the use of machine learning models as decision support systems in health services is increasing. The aim of this study is to determine the diagnosis and prognosis of COVID-19 disease with blood-gas data using the Chi-squared Automatic Interaction Detector (CHAID) decision-tree-model, one of the machine learning methods, which is a subfield of artificial intelligence. This study was carried out on a total of 686 patients with COVID-19 (n = 343) and non-COVID-19 (n = 343) treated at Erzincan-Mengücek-Gazi-Training and Research-Hospital between April 1, 2020 and March 1, 2021. Arterial blood gas values of all patients were obtained from the hospital registry system. While the total-accuracyratio of the decision-tree-model was 65.0% in predicting the prognosis of the disease, it was 68.2% in the diagnosis of the disease. According to the results obtained, the low ionized-calcium value (< 1.10 mM) significantly predicted the need for intensive care of COVID-19 patients. At admission, low-carboxyhemoglobin (< 1.00%), high-pH (> 7.43), low-sodium (< 135.0 mM), hematocrit (< 40.0%), and methemoglobin (< 1.30%) values are important biomarkers in the diagnosis of COVID-19 and the results were promising. The findings in the study may aid in the early-diagnosis of the disease and the intensive-care treatment of patients who are severe. The study was approved by the Ministry of Health and Erzincan University Faculty of Medicine Clinical Research Ethics Committee.


Assuntos
Inteligência Artificial , COVID-19 , Árvores de Decisões , Humanos , Aprendizado de Máquina , Prognóstico , SARS-CoV-2
6.
J. Health NPEPS ; 6(2): 1-23, dez. 2021.
Artigo em Inglês | LILACS, BDENF, ColecionaSUS | ID: biblio-1291053

RESUMO

Objective: to analyze epidemic curves based on mathematical models for the state of Mato Grosso do Sul and the impacts of population density on COVID-19 transmission. Method: the linear, polynomial and exponential regression model was used to make the numerical adjustment of the respective curves empirical. Result: it was found that the models used describe very well the empirical curves in which they were tested. In particular, the polynomial model is able to identify with reasonable reliability the appearance of the inflection point in the accumulated curves, which corresponds to the maximum point of the respective daily curves. The analysis indicates a weak positive correlation between infection, mortality, lethality and deaths from COVID-19 with population density, as revealed by the correlation and analysis of R2 . Conclusion: the models are very effective in describing the COVID-19 and epidemic curves in the estimation of important epidemiological parameters, such as peak case curves and daily deaths, allowing practical and efficient monitoring of the evolution of the epidemic.


Objetivo: analizar curvas epidémicas basadas en modelos matemáticos para el estado de Mato Grosso do Sul y los impactos de la densidad de población en la transmisión de COVID-19. Método: se utilizó el modelo de regresión lineal, polinomial y exponencial para hacer el ajuste numérico valor de las respectivas curvas empíricas. Resultados: se encontró que los modelos utilizados describen muy bien las curvas empíricas en las que fueron probados. En particular, el modelo polinomial es capaz de identificar con razonable fiabilidad la aparición del punto de inflexión en las curvas acumuladas, que corresponde al punto máximo de las respectivas curvas diarias. El análisis indica una correlación positiva débil entre la infección, la mortalidad, la letalidad y las muertes por COVID-19 con la densidad de población, según lo revelado por la correlación y el análisis de R2 .Conclusión: los modelos son muy efectivos para describir el COVID-19 y curvas epidémicas en la estimación de parámetros epidemiológicos importantes, como las curvas de casos máximos y las muertes diarias, lo que permite un seguimiento práctico y eficaz de la evolución de la epidemia.


Objetivo: analisar as curvas epidêmicas com base em modelos matemáticos para o estado de Mato Grosso do Sul e os impactos da densidade populacional na transmissão da COVID-19. Método: o modelo de regressão linear, polinomial e exponencial foi utilizado para fazer o ajuste numérico das respectivas curvas empíricas. Resultados: verificou-se que os modelos utilizados descrevem muito bem as curvas empíricas nas quais foram testados. Em particular, o modelo polinomial é capaz de identificar com razoável confiabilidade o aparecimento do ponto de inflexão nas curvas acumuladas, que corresponde ao ponto máximo das respectivas curvas diárias. A análise indica uma correlação positiva fraca entre infecção, mortalidade, letalidade e mortes por COVID-19 com a densidade populacional, conforme revelado pela correlação e análise de R 2. Conclusão: os modelos são muito eficazes na descrição das curvas epidêmicas de COVID19 e na estimativa de parâmetros epidemiológicos importantes, como curvas de casos de pico e óbitos diários, permitindo um monitoramento prático e eficiente da evolução da epidemia


Assuntos
Modelos Epidemiológicos , COVID-19 , Política de Saúde
7.
J Emerg Manag ; 18(7): 161-176, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34723360

RESUMO

The coronavirus COVID-19 pandemic is the worst health crisis of our time and the greatest challenge we are facing since World War II. It has caused a negative impact on engineering and construction industry, and huge uncertainty about the ability to anticipate a planned recovery for the industry. Waiting for an effective recovery that may take a long time, science has to provide solutions to coexist with this virus and resume the work on construction sites. In fact, it is not the first time that health and safety science deals with such a risk of infection, as many guidelines treat the manner to reduce the risk of infection to at-risk employees in construction, renovation, installation, and maintenance activities. This article aims to perform an infection risk analysis, taking into consideration COVID-19 particularities, and to identify control measures to ensure COVID-19 infection prevention and management on site. The study will be based on a probabilistic approach using the Fault Tree Analysis method.


Assuntos
COVID-19 , Indústria da Construção , Humanos , Pandemias , Gestão de Riscos , SARS-CoV-2
8.
Front Public Health ; 9: 738184, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34722447

RESUMO

The outbreak and persistence of COVID-19 have posed a great threat to global public health and economic development. The continuous economic deterioration has been intensified due to the continuous prevention and control measures, such as closed management. Insisting on the prevention of the epidemic or economic restart has become a dilemma for all countries. Epidemic prevention is not only the main behavior of a single country but also a common problem faced by all countries in the region. Continuous prevention measures will affect economic development, but an early restart of the economy is faced with the recurrence of the epidemic. To avoid the emergence of prisoner's dilemma in the governance of the epidemic, each country cannot make decisions with its optimization, and so it is necessary to build a regional cooperation mechanism to achieve the overall optimization of the economy and prevent the epidemic. Based on the game theory, we analyzed the behavior of countries when carrying out regional cooperation to govern the epidemic and put forward specific cooperative income distribution schemes according to the different attributes of the countries. Our results showed that in the presence of population mobility, regional cooperation to govern the epidemic can minimize the total number of infected people and maximize the overall utility of the region, which was significantly better than the overall benefits of the region in the case of non-cooperation. However, in detail, the smaller the difference of preference for preventing and controlling the epidemic between the two, the more likely it is to lead to a win-win situation. Otherwise, there will be one with damaged interests. When damaged interests appear, the appropriate distribution of cooperative income to the country with a small economic scale and low preference in preventing the epidemic is more conducive to the achievement of cooperative mechanisms and the realization of a win-win situation in the region.


Assuntos
COVID-19 , Epidemias , Comportamento Cooperativo , Teoria do Jogo , Humanos , SARS-CoV-2
9.
Front Public Health ; 9: 743520, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34722449

RESUMO

Background: As the world is still being ravaged by the coronavirus disease 2019 (COVID-19) pandemic, the first line of prevention lies in understanding the causative and preventive factors of the disease. However, given varied socioeconomic circumstances, there may be some inequality in the level of proper knowledge of COVID-19. Despite a proliferation of studies on COVID-19, the extent and prevalence of inequalities in knowledge about COVID-19 in Saudi Arabia are not known. Most related studies have only focused on understanding the determinants of COVID-19 knowledge. Therefore, the aim of this study was to assess the socioeconomic inequalities in knowledge regarding COVID-19 in Saudi Arabia. Methods: Data were extracted from an online cross-sectional self-reported questionnaire conducted on the knowledge about COVID-19 from 3,388 participants. Frequencies and graphs were used to identify the level and distribution of inequality in knowledge about COVID-19. Concentration curves and concentration indices were further used to assess and quantify the income- and education-related inequality in knowledge about COVID-19. Results: The level of COVID-19 knowledge was high among the surveyed sample, although the extent of knowledge varied. The findings further suggest the existence of socioeconomic inequality in obtaining proper knowledge about COVID-19, indicating that inequality in comprehensive knowledge is disproportionately concentrated among the wealthy (concentration index = 0.016; P < 0.001) and highly educated individuals (concentration index = 0.003; P = 0.029) in Saudi Arabia. Conclusions: There is inequality in the level of knowledge about COVID-19 among the more socioeconomically privileged population of Saudi Arabia. Given that COVID-19 cases ebb and flow in different waves, it is important that proper policies be put in place that will help in improving knowledge among the lower income and less educated individuals, leading to behavior that can help reduce transmission.


Assuntos
COVID-19 , Estudos Transversais , Humanos , Renda , SARS-CoV-2 , Arábia Saudita/epidemiologia
10.
Hist Philos Life Sci ; 43(4): 116, 2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34762181

RESUMO

It has been claimed that the global pandemic is a 'great equaliser' that creates a sense of cohesion, however, this is problematic since COVID-19 has revealed the stark divisions in our societies. For instance, in the UK COVID-19 has hit northern cities particularly hard. Therefore, by focusing on the north of England, and Bradford especially, this paper offers suggestions which may help us see clearly through COVID-19, creating a future that is more equitable.


Assuntos
COVID-19 , Humanos , Pandemias , SARS-CoV-2 , Fatores Socioeconômicos , Reino Unido
11.
Sch Psychol ; 36(6): 546-554, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34766816

RESUMO

As schools physically closed across the country to protect against the spread of the COVID-19 pandemic, it became clear early on that the burden on students will not be equally shared. Structural racism patterns the lives of people of color that, in turn, increases their exposure to the effects of the pandemic further impacting the quality of education the students of color have access to. It is critical to examine the ways in which racial disparities in social emotional and educational outcomes have the potential to increase as a result of the pandemic. To that end, using a content analysis of an open-ended survey, this study examines (a) how teachers and school staff experienced the pandemic, (b) their perception of student experiences during the transition to remote learning, and (c) school staff's perceptions of how racial inequities may be increased as a result of the pandemic. Our findings highlight the deep, but unequal impact of the pandemic on school staff, students, and their families. Teachers are overwhelmed and overworked, struggling to manage multiple roles while working at home. They also have tremendous empathy for the weight of the losses that students have experienced, and concern for the well-being of students in difficult living or family situations. However, most school staff maintained a colorblind analysis of the way the pandemic is affecting their students and did not recognize the role of systemic racism or potential for racial disparities to be increased. Implications and limitations are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
COVID-19 , Pandemias , Humanos , Percepção , SARS-CoV-2 , Instituições Acadêmicas
12.
Lancet Planet Health ; 5(11): e827-e839, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34774123

RESUMO

COVID-19 is disrupting and transforming the world. We argue that transformations catalysed by this pandemic should be used to improve human and planetary health and wellbeing. This paradigm shift requires decision makers and policy makers to go beyond building back better, by nesting the economic domain of sustainable development within social and environmental domains. Drawing on the engage, assess, align, accelerate, and account (E4As) approach to implementing the 2030 Agenda for Sustainable Development, we explore the implications of this kind of radical transformative change, focusing particularly on the role of the health sector. We conclude that a recovery and transition from the COVID-19 pandemic that delivers the future humanity wants and needs requires more than a technical understanding of the transformation at hand. It also requires commitment and courage from leaders and policy makers to challenge dominant constructs and to work towards a truly thriving, equitable, and sustainable future to create a world where economic development is not an end goal itself, but a means to secure the health and wellbeing of people and the planet.


Assuntos
COVID-19 , Saúde Global , Pandemias , COVID-19/epidemiologia , Previsões , Saúde Global/tendências , Humanos , Desenvolvimento Sustentável
13.
Nutr J ; 20(1): 89, 2021 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-34719404

RESUMO

BACKGROUND: The associations between vitamin D and coronavirus disease 2019 (COVID-19) infection and clinical outcomes are controversial. The efficacy of vitamin D supplementation in COVID-19 is also not clear. METHODS: We identified relevant cohort studies that assessed the relationship between vitamin D, COVID-19 infection and associated death and randomized controlled trials (RCTs) that reported vitamin D supplementation on the outcomes in patients with COVID-19 by searching the PubMed, EMBASE, and medRxiv databases up to June 5th, 2021. Evidence quality levels and recommendations were assessed using the GRADE system. RESULTS: Eleven cohort studies with 536,105 patients and two RCTs were identified. Vitamin D deficiency (< 20 ng/ml) or insufficiency (< 30 ng/ml) was not associated with an significant increased risk of COVID-19 infection (OR for < 20 ng/ml: 1.61, 95% CI: 0.92-2.80, I2 = 92%) or in-hospital death (OR for < 20 ng/ml: 2.18, 95% CI: 0.91-5.26, I2 = 72%; OR for < 30 ng/ml: 3.07, 95% CI: 0.64-14.78, I2 = 66%). Each 10 ng/ml increase in serum vitamin D was not associated with a significant decreased risk of COVID-19 infection (OR: 0.92, 95% CI: 0.79-1.08, I2 = 98%) or death (OR: 0.65, 95% CI: 0.40-1.06, I2 = 79%). The overall quality of evidence (GRADE) for COVID-19 infection and associated death was very low. Vitamin D supplements did not significantly decrease death (OR: 0.57, I2 = 64%) or ICU admission (OR: 0.14, I2 = 90%) in patients with COVID-19. The level of evidence as qualified using GRADE was low. CONCLUSIONS: Current evidence suggested that vitamin D deficiency or insufficiency was not significantly linked to susceptibility to COVID-19 infection or its associated death. Vitamin D supplements did not significantly improve clinical outcomes in patients with COVID-19. The overall GRADE evidence quality was low, we suggest that vitamin D supplementation was not recommended for patients with COVID-19.


Assuntos
COVID-19 , Abordagem GRADE , Estudos de Coortes , Suplementos Nutricionais , Humanos , SARS-CoV-2 , Vitamina D
14.
Health Aff (Millwood) ; 40(11): 1722-1730, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34724431

RESUMO

In 2020 the COVID-19 pandemic caused millions to lose their jobs and, consequently, their employer-sponsored health insurance. Enacted in 2010, the Affordable Care Act (ACA) created safeguards for such events by expanding Medicaid coverage and establishing Marketplaces through which people could purchase health insurance. Using a novel national data set with information on ACA-compliant individual insurance plans, we found large increases in Marketplace enrollment in 2020 compared with 2019 but with varying percentage increases and spending risk implications across states. States that did not expand Medicaid had enrollment and spending risk increases. States that expanded Medicaid but did not relax 2020 Marketplace enrollment criteria also had spending risk increases. In contrast, states that expanded Medicaid and relaxed 2020 enrollment criteria experienced enrollment increases without spending risk changes. The findings are reassuring with respect to the ability of Marketplaces to buffer employment shocks, but they also provide cautionary signals that risks and premiums could begin to rise either in the absence of Medicaid expansion or when Marketplace enrollment is constrained.


Assuntos
COVID-19 , Trocas de Seguro de Saúde , Humanos , Cobertura do Seguro , Seguro Saúde , Medicaid , Pandemias , Patient Protection and Affordable Care Act , SARS-CoV-2 , Estados Unidos
15.
BMJ Open ; 11(11): e052971, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725080

RESUMO

INTRODUCTION: Asthma is a common long-term disorder and strategies to improve asthma control are still a challenge. Integrated delivery of health systems is critical for effective asthma care: there is limited information on experiences of care coordination for asthma from Latin America, especially on perspectives of health personnel and in the context of the COVID-19 pandemic. METHODS AND ANALYSIS: This protocol details a qualitative approach to analyse health workers' perspectives of healthcare coordination for asthma control during COVID-19 pandemic in Ecuador and Brazil, at primary and specialised levels, through in-depth semistructured interviews using a video communications platform. The analysis will identify knowledge and perspectives based on coordination of clinical information, clinical management and administrative coordination. Theoretical sampling will be used to obtain approximately equal numbers of women and men within each level of healthcare; data saturation will be used to determine sample size. Transcripts will be analysed using content-coding procedures to mark quotations related to major topics and subthemes included in the interview guide, and narrative analysis will be based on a theoretical framework for healthcare coordination to identify new themes and subthemes. ETHICS AND DISSEMINATION: Ethical approval was obtained from the ethics committees of Hospital General Docente Calderón, Quito, Ecuador; and Universidade Federal da Bahia, Salvador, Brazil. The findings of this study will be disseminated through peer-reviewed articles, conference presentations and condensed summaries for key stakeholders and partners.


Assuntos
Asma , COVID-19 , Asma/epidemiologia , Asma/terapia , Brasil/epidemiologia , Atenção à Saúde , Equador/epidemiologia , Feminino , Pessoal de Saúde , Humanos , Masculino , Pandemias , Pesquisa Qualitativa , SARS-CoV-2
16.
Pan Afr Med J ; 40: 12, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34733380

RESUMO

The severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is a new virus that is responsible for COVID-19, a disease that complicate health conditions and results in death. The total diversion of attention of government and health care workers (HCWs) to prevent the escalation of the pandemic disease has placed a great barrier to diagnosis and treatment of other illnesses that share common symptoms with COVID-19, and that has consequently enabled the endemic practice of self-antimicrobial medication to increase in Nigeria. Development of secondary infections in COVID-19 and in other conditions, caused by antibiotic resistant pathogens could make them more deadly now or in the future. The mitigation strategies adopted in Nigeria and its States, which include enforcing social distancing, partial or total lockdown, and restricting access to health care facilities for non COVID-19 patients, have further increased the demand of antimicrobial agents from unauthorized outlets in communities for inappropriate use. A cross-sectional survey of 162 randomly selected individuals that visited medical stores and 170 medical store owners to evaluates the level of self-medication with five oral broad spectrum antibiotics and antimalaria during the lockdown revealed an increase (68.5%) in practice of self-medication with at least one of the antimicrobial and emergence of new abusers. Blind treatment of symptoms of malaria and common cold without diagnosis and health care consultation was nearly 100%. Irrational use of sanitizers, disinfectants and other cidal agents that can fuel antimicrobial resistance has drastically increased in communities. Exposure of microorganisms in the environment without caution to large volume of fumigants is increasing on daily basis. We strongly recommend that while mitigating SARS-CoV-2 virus spread, efficacious and feasible technological, social, economic and behavioral interventions that will also control the evolution and spread antimicrobial resistant microorganisms should be applied.


Assuntos
Antibacterianos/uso terapêutico , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Resistência Microbiana a Medicamentos , Pandemias/prevenção & controle , Automedicação , COVID-19/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Nigéria/epidemiologia , Distanciamento Físico , SARS-CoV-2 , Automedicação/efeitos adversos
17.
Pan Afr Med J ; 40: 26, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34733394

RESUMO

Introduction: the COVID-19 pandemic since its emergence has posed a great danger to the health of the general populace while impacting the Nigerian healthcare delivery significantly. Since its emergence, the health system has been stretched with overwhelming responsibilities. The study assessed health providers´ perceived impact of coronavirus pandemic on the uptake of health care services in South West Nigeria. Methods: a descriptive cross-sectional design using an online structured survey was used to elicit responses from 385 Nigerian health workers selected by convenience sampling technique. Data analysis was done with the Statistical Package for Social Sciences (SPSS) version 26. Comparison of the uptake of healthcare before and during the COVID-19 pandemic was performed using the Chi-square test. Results: findings revealed a significant difference between the uptake of health care prior and during the COVID-19 pandemic (χ2= 92.77, p=0.000) as 253 respondents (65.7%) reported that the hospital recorded a low turn-out of patients during the pandemic and 184 (47.8%) indicated that some of the facility units/departments were temporarily closed due to COVID-19 pandemic. Similarly, there was a significant difference between health-related conditions requiring hospital admission before and during COVID-19 pandemic (χ2=3.334 p=0.046). Factors influencing uptake of health services during the COVID-19 pandemic are: fear of nosocomial infection, fear of stigmatization, and misconception/misinformation on COVID-19 diseases and care. Conclusion: the Nigerian health system in the past months has been remarkably impacted by the pandemic. This calls for immediate restructuring to maintain an equitable distribution of care, while minimizing risk to patients and health providers.


Assuntos
COVID-19/psicologia , Atenção à Saúde/estatística & dados numéricos , Serviços de Saúde/estatística & dados numéricos , Pandemias/prevenção & controle , Adulto , Ansiedade , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Transversais , Medo , Feminino , Pessoal de Saúde , Acesso aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , SARS-CoV-2 , Inquéritos e Questionários
19.
Front Public Health ; 9: 732539, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34746080

RESUMO

The COVID-19 pandemic has revealed significant gaps in mental health in terms of unrecognized and unmet needs. The goal was to accurately assess the needs and identify gaps in this area during the epidemiological crisis. A Delphi study to identify the needs was conducted with a group of decision-makers, experts, and users of mental health services. A starting point of the Delphi study was prepared in two working groups, based on recognizable international recommendations and experiences of the practitioners from the field situation. This initial set of emergency measures was supplemented through the first Delphi round, and consensus about the importance was reached in the second round. A total of 41 activities were derived, the vast majority of which were rated with a score of 4 or more. Mental health activities, which should be addressed in terms of needs, can be divided into systemic measures and service measures. This study recognizes a need to reorganize services in the direction of improving local accessibility and strengthening the network of services for immediate responses to the psychological, health, and social needs of individuals, including those arising from crisis situations, such as COVID-19 pandemic. The results of this study are in line with the international recommendations and also influenced the formulation of the Action Plan of the National Mental Health Program, while some of the measures were already implemented during the publication of the research results.


Assuntos
COVID-19 , Pandemias , Consenso , Técnica Delfos , Humanos , Saúde Mental , Determinação de Necessidades de Cuidados de Saúde , SARS-CoV-2
20.
Front Public Health ; 9: 628931, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34746068

RESUMO

Background: To develop an effective countermeasure and determine our susceptibilities to the outbreak of COVID-19 is challenging for a densely populated developing country like Bangladesh and a systematic review of the disease on a continuous basis is necessary. Methods: Publicly available and globally acclaimed datasets (4 March 2020-30 September 2020) from IEDCR, Bangladesh, JHU, and ECDC database are used for this study. Visual exploratory data analysis is used and we fitted a polynomial model for the number of deaths. A comparison of Bangladesh scenario over different time points as well as with global perspectives is made. Results: In Bangladesh, the number of active cases had decreased, after reaching a peak, with a constant pattern of death rate at from July to the end of September, 2020. Seventy-one percent of the cases and 77% of the deceased were males. People aged between 21 and 40 years were most vulnerable to the coronavirus and most of the fatalities (51.49%) were in the 60+ population. A strong positive correlation (0.93) between the number of tests and confirmed cases and a constant incidence rate (around 21%) from June 1 to August 31, 2020 was observed. The case fatality ratio was between 1 and 2. The number of cases and the number of deaths in Bangladesh were much lower compared to other countries. Conclusions: This study will help to understand the patterns of spread and transition in Bangladesh, possible measures, effectiveness of the preparedness, implementation gaps, and their consequences to gather vital information and prevent future pandemics.


Assuntos
COVID-19 , Pandemias , Adulto , Bangladesh/epidemiologia , Surtos de Doenças/prevenção & controle , Humanos , Masculino , Pandemias/prevenção & controle , SARS-CoV-2 , Adulto Jovem
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