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JMIR Research Protocols ; 9(12):e22996, 2020.
Article | WHO COVID | ID: covidwho-961550


BACKGROUND: The immunization uptake rates in Pakistan are much lower than desired Major reasons include lack of awareness, parental forgetfulness regarding schedules, and misinformation regarding vaccines In light of the COVID-19 pandemic and distancing measures, routine childhood immunization (RCI) coverage has been adversely affected, as caregivers avoid tertiary care hospitals or primary health centers Innovative and cost-effective measures must be taken to understand and deal with the issue of low immunization rates However, only a few smartphone-based interventions have been carried out in low- and middle-income countries (LMICs) to improve RCI OBJECTIVE: The primary objectives of this study are to evaluate whether a personalized mobile app can improve children's on-time visits at 10 and 14 weeks of age for RCI as compared with standard care and to determine whether an artificial intelligence model can be incorporated into the app Secondary objectives are to determine the perceptions and attitudes of caregivers regarding childhood vaccinations and to understand the factors that might influence the effect of a mobile phone-based app on vaccination improvement METHODS: A mixed methods randomized controlled trial was designed with intervention and control arms The study will be conducted at the Aga Khan University Hospital vaccination center Caregivers of newborns or infants visiting the center for their children's 6-week vaccination will be recruited The intervention arm will have access to a smartphone app with text, voice, video, and pictorial messages regarding RCI This app will be developed based on the findings of the pretrial qualitative component of the study, in addition to no-show study findings, which will explore caregivers' perceptions about RCI and a mobile phone-based app in improving RCI coverage RESULTS: Pretrial qualitative in-depth interviews were conducted in February 2020 Enrollment of study participants for the randomized controlled trial is in process Study exit interviews will be conducted at the 14-week immunization visits, provided the caregivers visit the immunization facility at that time, or over the phone when the children are 18 weeks of age CONCLUSIONS: This study will generate useful insights into the feasibility, acceptability, and usability of an Android-based smartphone app for improving RCI in Pakistan and in LMICs TRIAL REGISTRATION: ClinicalTrials gov NCT04449107;https://clinicaltrials gov/ct2/show/NCT04449107 International registered report identifier (irrid): Derr1-10 2196/22996

Shiraz E Medical Journal ; 21(12):1-2, 2020.
Article | WHO COVID | ID: covidwho-937665
Chest ; 158(4):A2493-A2494, 2020.
Article | WHO COVID | ID: covidwho-871908


SESSION TITLE: Late-breaking Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: There is pandemic of Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection RT-PCR is done for the diagnosis of COVID-19 Purpose of this study to follow the dynamics of RT-PCR in patients with COVID-19 and determine average time taken by them to become RT-PCR SARS-CoV2 negative METHODS: A retrospective study 60 confirmed COVID-19 patients hospitalized at Kulsum Internationl Hospital were included Demographic characteristics of the patients were collected like age and gender Clinical characteristics such as date of onset (defined as the first date when the clinical symptoms were reported), date of admission and date of discharge were recorded SARS-CoV-2 RT-PCR characteristics: Nasal swabs were collected for the SARS-CoV-2 viral nucleic acid detection in sequential time-points Positive SARS-CoV-2 RT-PCR assay is defined as the period from the date of onset of the symptoms to the date of last positive RT-PCR test result Effective negative SARS-CoV-2 RT-PCR assay is defined as the period from the date of onset of symptoms to the date of first negative RT-PCR test Confirmed case: patient who had Nasal swab positive SARS-CoV-2 RT-PCR Upper respiratory specimens (throat and/or nasal swabs) were obtained and analyzed by realtime RT-PCR for SARS-CoV-2 infection Period of viral infection and the contagious stage were analyzed RESULTS: A total 68 patients were enrolled Median age was 55 5 years (IQR 50 – 65 range: 21 – 85) Among them 56 were male (82 4%) and 12(17 6%) were female The total number of SARS CoV-2 RT-PCR assay from 68 patients was 162, with 2 4 tests per patient The median duration from onset of symptoms to first RT-PCR assay was 7 days (IQR: 5 5 – 9;range: 3 – 5 days) All patients presenting at 0-7 days of symptoms were tested positive Whereas positive rate of RT-PCR assay was 64 3 %, 20 9% and 12 5 % at day 8-14, day 15-21 and >21 days respectively We studied the dynamic profile of SARS-CoV-2 by RT-PCR that shows a comparatively longer duration for onset of symptoms to a negative PCR in positive patients of age > 65 years They had longer duration of illness;however, the difference was not statistically significant Also, male patients had a significantly longer median duration from onset to negative test results as compared to female patients (Median 16 days, IQR: 14 75 – 20 days, Range: 12 – 21 days, p value: 0 03) CONCLUSIONS: This study showed that average contagious period of SARS-CoV-2 infected patients was 16 days This period was prolonged in patients with age more than 65 years so longer followups are required in this age group CLINICAL IMPLICATIONS: In older population a prolong period of isolation may be required DISCLOSURES: no disclosure on file for Muhammad Sajid Abbasi;No relevant relationships by Nadir Ali, source=Web Response No relevant relationships by Shazli Manzoor, source=Web Response No relevant relationships by rukhsana Manzoor, source=Web Response

Chaos Solitons Fractals ; (140)20201101.
Article in English | ELSEVIER | ID: covidwho-639221


Recent quantitative approaches for studying several aspects of urban life and infrastructure have shown that scale properties allow the understanding of many features of urban infrastructure and of human activity in cities. In this paper, we show that COVID-19 virus contamination follows a similar pattern in different regions of the world. The superlinear power-law behavior for the number of contamination cases as a function of the city population, with exponent β of the order of 1.15 is always obtained. Due to the strong indication that scaling is a determinant feature of covid-19 spread, we propose an epidemiological model that embodies a fractal structure, allowing a more detailed description of the observed data about the virus spread in different countries and regions. The hypothesis that fractal structures can be formed in cities as well as in larger networks is tested, indicating that indeed self-similarity may be found in networks connecting several cities.