RESUMO
Background: The Nipah virus (NiV) is a zoonotic pathogen that belongs to the Paramyxoviridae family. It can cause severe respiratory and neurological diseases in humans, with varying clinical symptoms. Recognized as a critical public health concern by the World Health Organization, it requires concerted efforts in research and development to prevent outbreaks. Methodology: An analytical cross-sectional study was conducted on 455 healthcare workers across four major regions in Bangladesh from April 2022 to May 2023. Using multistage convenient sampling and face-to-face interviews with a semi-structured questionnaire, we have examined the level of knowledge, attitudes, and individual perceptions of the preparedness for NiV. Data analysis included univariate and bivariate analyses, followed by binary logistic regression to ascertain the association with demographic factors. Results: The study identified a gender disparity favoring female healthcare workers (HCWs). Approximately 46.15 % of participants demonstrated a good knowledge about NiV, with doctors showing significantly higher knowledge odds (OR = 5.197, p < 0.001). Interestingly, graduate and post-graduate education levels did not yield a statistically significant correlation with knowledge. Specific training received was positively associated with knowledge levels (OR = 1.832, p = 0.014), highlighting the gap in routine infection prevention education. Regional differences were notable, with participants from Chittagong having a lower level of knowledge compared to Dhaka (OR = 0.307, p = 0.004). Attitudes towards NiV were predominantly positive, although higher education inversely correlated with positive attitudes, suggesting a potential gap between theoretical knowledge and practical attitudes. Conclusion: While the attitude towards NiV is generally positive among Bangladeshi HCWs, there is a need to enhance knowledge levels, especially in primary care settings and certain regions. To effectively prepare for NiV outbreaks, it is crucial to prioritize continuous education and practical training. The study underscores the importance of implementing uniform educational strategies to equip HCWs across all categories and regions with adequate NiV knowledge and preparedness.
RESUMO
BACKGROUND: The COVID-19 pandemic posed a danger to global public health because of the unprecedented physical, mental, social, and environmental impact affecting quality of life (QoL). The study aimed to find the changes in QoL among COVID-19 recovered individuals and explore the determinants of change more than 1 year after recovery in low-resource settings. METHODS: COVID-19 patients from all eight divisions of Bangladesh who were confirmed positive by reverse transcription-polymerase chain reaction from June 2020 to November 2020 and who subsequently recovered were followed up twice, once immediately after recovery and again 1 year after the first follow-up. The follow-up study was conducted from November 2021 to January 2022 among 2438 individuals using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF). After excluding 48 deaths, 95 were rejected to participate, 618 were inaccessible, and there were 45 cases of incomplete data. Descriptive statistics, paired-sample analyses, generalized estimating equation (GEE) analysis, and multivariable logistic regression analyses were performed to test the mean difference in participants' QoL scores between the two interviews. RESULTS: Most participants (n = 1710, 70.1%) were male, and one-fourth (24.4%) were older than 46. The average physical domain score decreased significantly from baseline to follow-up, and the average scores in psychological, social, and environmental domains increased significantly at follow-up (P < 0.05). By the GEE equation approach, after adjusting for other factors, we found that older age groups (P < 0.001), being female (P < 0.001), having hospital admission during COVID-19 illness (P < 0.001), and having three or more chronic diseases (P < 0.001), were significantly associated with lower physical and psychological QoL scores. Higher age and female sex [adjusted odd ratio (aOR) = 1.3, 95% confidence interval (CI) 1.0-1.6] were associated with reduced social domain scores on multivariable logistic regression analysis. Urban or semi-urban people were 49% less likely (aOR = 0.5, 95% CI 0.4-0.7) and 32% less likely (aOR = 0.7, 95% CI 0.5-0.9) to have a reduced QoL score in the psychological domain and the social domain respectively, than rural people. Higher-income people were more likely to experience a decrease in QoL scores in physical, psychological, social, and environmental domains. Married people were 1.8 times more likely (aOR = 1.8, 95% CI 1.3-2.4) to have a decreased social QoL score. In the second interview, people admitted to hospitals during their COVID-19 infection showed a 1.3 times higher chance (aOR = 1.3, 95% CI 1.1-1.6) of a decreased environmental QoL score. Almost 13% of participants developed one or more chronic diseases between the first and second interviews. Moreover, 7.9% suffered from reinfection by COVID-19 during this 1-year time. CONCLUSIONS: The present study found that the QoL of COVID-19 recovered people improved 1 year after recovery, particularly in psychological, social, and environmental domains. However, age, sex, the severity of COVID-19, smoking habits, and comorbidities were significantly negatively associated with QoL. Events of reinfection and the emergence of chronic disease were independent determinants of the decline in QoL scores in psychological, social, and physical domains, respectively. Strong policies to prevent and minimize smoking must be implemented in Bangladesh, and we must monitor and manage chronic diseases in people who have recovered from COVID-19.