Economic and social determinants of health care utilization during the first wave of COVID-19 pandemic among adults in Ghana: a population-based cross-sectional study.

BACKGROUND: The COVID-19 pandemic had socioeconomic effects in Africa. This study assessed the social and economic determinants of healthcare utilization during the first wave of COVID-19 among adults in Ghana. METHODS: Information about individuals residing in Ghana was derived from a survey conducted across multiple countries, aiming to evaluate the impact of the COVID-19 pandemic on the mental health and overall well-being of adults aged 18 and above. The dependent variable for the study was healthcare utilization (categorized as low or high). The independent variables were economic (such as financial loss, job loss, diminished wages, investment/retirement setbacks, and non-refunded travel cancellations) and social (including food scarcity, loss of financial support sources, housing instability, challenges affording food, clothing, shelter, electricity, utilities, and increased caregiving responsibilities for partners) determinants of health. A multinomial logistic regression was conducted to identify factors associated with healthcare utilization after adjusting for confounders (age, gender, access to medical insurance, COVID-19 status, educational background, employment, and marital status of the participants). RESULTS: The analysis included 364 responses. Individuals who encountered a loss of financial support (AOR: 9.58; 95% CI: 3.44-26.73; p < 0.001), a decrease or loss of wages (AOR: 7.44, 95% CI: 3.05-18.16, p < 0.001), experienced investment or retirement setbacks (AOR: 10.69, 95% CI: 2.60-43.88, p = 0.001), and expressed concerns about potential food shortages (AOR: 6.85, 95% CI: 2.49-18.84, p < 0.001) exhibited significantly higher odds of low healthcare utilization during the initial phase of the pandemic. Contrastingly, participants facing challenges in paying for basic needs demonstrated lower odds of low healthcare utilization compared to those who found it easy to cover basic expenses (AOR: 0.19, 95% CI: 0.06-0.67, p = 0.001). CONCLUSION: Economic and social factors were associated with low healthcare utilization in Ghana during the first wave of the pandemic. Investment or retirement loss and financial support loss during the pandemic had the largest effect on healthcare utilization. Further research is needed to understand the connection between concerns about food shortages, welfare losses during pandemics and healthcare utilization during pandemics in Ghana.

A multi-country study of the associations between HIV vulnerability status, perception of COVID-19 related stigma and post-traumatic stress symptoms during the first wave of the pandemic.

BACKGROUND: This study investigated the associations between COVID-19 related stigma and post-traumatic stress symptoms (PTSS); and the associations between PTSS and COVID-19 related stigma, HIV status, COVID-19 status and key HIV population status. METHODS: This was a secondary analysis of data of 12,355 study participants generated through an online survey that recruited adults from 152 countries between July and December 2020. The dependent variables were COVID-19-related stigma and PTSS. The independent variables were HIV status (positive/negative), transaction sex (yes/no), use of psychoactive drugs (yes/no), and vulnerability status (transaction sex workers, people who use psychoactive drugs, living with HIV, and COVID-19 status). The confounding variables were age, sex at birth (male/female), level of education, sexual minority individuals (yes/no) and country income level. Multivariable logistic regression analyses were conducted to determine associations between the dependent and independent variables after adjusting for confounders. RESULTS: There were 835 (6.8%) participants who experienced COVID-19 related stigma during the pandemic and 3,824 (31.0%) participants reported PTSS. Respondents who were living with HIV (AOR: 1.979; 95%CI: 1.522-2.573), tested positive for COVID-19 (AOR: 3.369; 95%CI: 2.692-4.217), engaged in transactional sex (AOR: 1.428; 95%CI: 1.060-1.922) and used psychoactive drugs (AOR: 1.364; 95%CI: 1.053-1.767) had significantly higher odds of experiencing COVID-19 related stigma. Individuals with vulnerability status (AOR:4.610; 95%CI: 1.590-13.368) and who experienced COVID-19 related stigma (AOR: 2.218; 95%CI: 1.920-2.561) had significantly higher odds of PTSS. CONCLUSION: Individuals with vulnerability status may be at increased risk for COVID-19 related stigma. Key and vulnerable populations who were living with HIV and who experienced stigma may be at a higher risk of experiencing PTSS. Populations at risk for PTSS should be routinely screened and provided adequate support when they contract COVID-19 to reduce the risk for poor mental health during COVID-19 outbreaks and during future health crisis with similar magnitude as the COVID-19 pandemic.

Associations between mental health challenges, sexual activity, alcohol consumption, use of other psychoactive substances and use of COVID-19 preventive measures during the first wave of the COVID-19 pandemic by adults in Nigeria.

BACKGROUND: The aims of this study were to assess: 1) the associations among sexual activity, alcohol consumption, use of other psychoactive substances and mental health during the COVID-19 pandemic; and 2) the associations between COVID-19 preventive measures, alcohol consumption and use of psychoactive substances. METHODS: This was a secondary analysis of data collected from adults in Nigeria between July and December 2020. The variables extracted included change in sexual activity, alcohol consumption and use of other psychoactive substances, COVID-19 preventive behaviors (wearing face masks, washing hands, physical distancing), anxiety, depression, post-traumatic stress disorder (PTSD) and sociodemographic variables (age, sex, education, HIV status, employment status). Multivariable logistic regressions were conducted. A model was run to regress depression, anxiety, PTSD, increased alcohol consumption, and increased use of other psychoactive substances, on increased sexual activity. In separate models, anxiety, depression, and PTSD were regressed on increased alcohol consumption and on increased use of other psychoactive substances. Finally, three models were constructed to determine the associations between increased alcohol consumption and increased use of other psychoactive substances on three separate COVID-19 preventive behaviors. All models were adjusted for sociodemographic variables. RESULTS: Increased alcohol consumption (AOR:2.19) and increased use of other psychoactive substances (AOR: 3.71) were significantly associated with higher odds of increased sexual activity. Depression was associated with significantly higher odds of increased alcohol consumption (AOR:1.71) and increased use of other psychoactive substances (AOR:3.21). Increased alcohol consumption was associated with significantly lower odds of physical distancing (AOR:0.59). CONCLUSION: There was a complex inter-relationship between mental health, sexual health, increased use of psychoactive substances. The consumption of alcohol also affected compliance with physical distancing. Further studies are needed to understand the observed relationships.

Risk indicators for oral ulcers among people living with HIV during the first wave of the pandemic: a cross sectional study.

BACKGROUND: Little is currently known about HIV-related parameters that may increase the risk for oral ulcers during the COVID-19 pandemic. This study aimed to overcome this gap in research by assessing the associations between HIV viral load, antiretroviral adherence profile, co-morbidity status, SARS-CoV-2 infection and oral ulcers among people living with HIV (PLHIV). METHODS: This was a secondary analysis of data generated from 21,206 to 18 years and above, recruited from 152 countries through an online survey between July and December 2020. Data were extracted for 874 people who reported living with HIV. The dependent variable was reporting having oral ulcer. The independent variables were the viral load, adherence to antiretroviral treatment and a history of SARS-CoV-2 infection. The confounding variables were age at last birthday and sex at birth. A multivariable logistic regression analysis was conducted to determine the associations between the dependent and independent variables after adjusting for the confounding variables. RESULTS: Of the 874 participants, 99 (11.3%) reported having oral ulcers during the first wave of the COVID-19 pandemic. The odds of PLHIV having oral ulcers during the first wave of the COVID-19 pandemic was significantly higher for people who did not know their viral load than those who had undetectable viral load (AOR: 2.036; 95% CI: 1.204-3.443; p = 0.008); and people who did not adhere to the use of antiretroviral treatment than those who adhered (AOR: 4.113; 95% CI: 2.567-6.589; p < 0.001). Also, PLHIV who had SARS-CoV-2 infection had significantly higher odds of having oral ulcers than those who did not have the infection (AOR: 14.556; 95% CI: 4.500-47.078; p < 0.001). PLHIV who had co-morbidities had non-significantly higher odds of having oral ulcers than those without co-morbidities (AOR: 1.170; 95% CI: 0.656-2.085; p = 0.595). CONCLUSION: Oral ulcers may be an indicator of poor adherence to antiretroviral therapy and unsuppressed viral load among PLHIV. It may also be an indicator of SARS-CoV-2 infection and a signal to take prompt and critical care of affected individuals because of the risk for severe COVID-19 for these individuals.

Sex differences in the experience of COVID-19 post-traumatic stress symptoms by adults in South Africa.

BACKGROUND: The COVID-19 pandemic has created multiple mental health challenges. Many residents in South Africa face pre-existing elevated levels of stress and the pandemic may have had varying impacts on sub-populations. The aims of this study were to determine: 1) the factors associated with post-traumatic stress symptoms (PTSS) and 2) sex differences in the factors associated with PTSS in adults residing in South Africa during the COVID-19 pandemic. METHODS: Study participants aged 18 years and above, were recruited for this cross-sectional study through an online survey implemented from June 29, 2020 to December 31, 2020. The outcome variable was PTSS; explanatory variables were sex at birth, COVID-19 status, social isolation and access to emotional support. Confounders considered were age, education level completed and current work status. Logistic regressions were used to determine the association between the outcome and explanatory variables after adjusting for confounders. OUTCOMES: There were 489 respondents. Among all respondents, those who were older (AOR: 0.97; 95% CI: 0.95 - 0.99) and had access to emotional support from family and relatives (AOR: 0.27; 95% CI: 0.14 - 0.53) had significantly lower odds of PTSS. Respondents who felt socially isolated had higher odds of PTSS (AOR: 1.17; 95% CI: 1.08 - 1.27). Females had higher PTSS scores and higher odds of PTSS compared to males (AOR: 2.18; 95% CI: 1.41-3.39). Females (AOR: 0.27; 95% CI: 0.08 - 0.95) and males (AOR: 0.26; 95% CI: 0.11, 0.59) who had access to emotional support had significantly lower odds of PTSS than those who had no support. Females (AOR: 1.15; 95% CI: 1.04 -1.27) and males (AOR: 1.19; 95% CI: 0.11, 0.59) who felt socially isolated had higher odds of PTSS compared to those who did not feel socially isolated. INTERPRETATION: Compared to males, females had higher scores and higher odds of reporting PTSS during the COVID-19 pandemic. Access to emotional support ameliorated the odds of having PTSS for both sexes, while feeling socially isolated worsened the odds for both sexes.

Fear of contagion, emotional stress and coping strategies used by adults during the first wave of the COVID-19 pandemic in Nigeria.

BACKGROUND: The COVID-19 pandemic has induced high levels of stress. The aim of the study was to assess the relationship between emotional stress (COVID-19 related fear, anger, frustration, and loneliness) and the use of coping strategies among adults in Nigeria during the COVID-19 pandemic. METHODS: Data from adults aged 18 years and above were collected through an online survey from July to December 2020. The dependent variables were COVID-19 related fear (fear of infection and infecting others with COVID-19), anger, frustration, and loneliness. The independent variables were coping strategies (use of phones to communicate with family and others, video conferencing, indoor exercises, outdoor exercises, meditation/mindfulness practices, engaging in creative activities, learning a new skill, following media coverage related to COVID-19) and alcohol consumption. Five logistic regression models were developed to identify the factors associated with each dependent variables. All models were adjusted for sociodemographic variables (age, sex at birth, and the highest level of education). RESULTS: Respondents who consumed alcohol, followed media coverage for COVID-19 related information, and who spoke with friends or family on the phone had higher odds of having fear of contracting COVID-19 or transmitting infection to others, and of feeling angry, frustrated, or lonely (p < 0.05). Respondents who exercised outdoors (AOR: 0.69) or learned a new skill (AOR: 0.79) had significantly lower odds of having fear of contracting COVID-19. Respondents who practiced meditation or mindfulness (AOR: 1.47) had significantly higher odds of feeling angry. Those who spoke with friends and family on the phone (AOR: 1.32) and exercised indoors (AOR: 1.23) had significantly higher odds of feeling frustrated. Those who did video conferencing (AOR: 1.41), exercised outdoors (AOR: 1.32) and engaged with creative activities (AOR: 1.25) had higher odds of feeling lonely. CONCLUSION: Despite the significant association between emotional stress and use of coping strategies among adults in Nigeria during the COVID-19 pandemic, it appears that coping strategies were used to ameliorate rather than prevent emotional stress. Learning new skills and exercising outdoors were used to ameliorate the fear of contracting COVID-19 in older respondents.

Factors associated with COVID-19 pandemic induced post-traumatic stress symptoms among adults living with and without HIV in Nigeria: a cross-sectional study.

BACKGROUND: Nigeria is a country with high risk for traumatic incidences, now aggravated by the COVID-19 pandemic. This study aimed to identify differences in COVID-19 related post-traumatic stress symptoms (PTSS) among people living and not living with HIV; to assess whether PTSS were associated with COVID-19 pandemic-related anger, loneliness, social isolation, and social support; and to determine the association between PTSS and use of COVID-19 prevention strategies. METHODS: The data of the 3761 respondents for this analysis was extracted from a cross-sectional online survey that collected information about mental health and wellness from a convenience sample of adults, 18 years and above, in Nigeria from July to December 2020. Information was collected on the study's dependent variable (PTSS), independent variables (self-reported COVID-19, HIV status, use of COVID-19 prevention strategies, perception of social isolation, access to emotional support, feelings of anger and loneliness), and potential confounder (age, sex at birth, employment status). A binary logistic regression model tested the associations between independent and dependent variables. RESULTS: Nearly half (47.5%) of the respondents had PTSS. People who had symptoms but were not tested (AOR = 2.20), felt socially isolated (AOR = 1.16), angry (AOR = 2.64), or lonely (AOR = 2.19) had significantly greater odds of reporting PTSS (p < 0.001). People living with HIV (AOR = 0.39), those who wore masks (AOR = 0.62) and those who had emotional support (AOR = 0.63), had lower odds of reporting PTSS (p < .05). CONCLUSION: The present study identified some multifaceted relationships between post-traumatic stress, HIV status, facemask use, anger, loneliness, social isolation, and access to emotional support during this protracted COVID-19 pandemic. These findings have implications for the future health of those affected, particularly for individuals living in Nigeria. Public health education should be incorporated in programs targeting prevention and prompt diagnosis and treatment for post-traumatic stress disorder at the community level.

[Disasters in Mexico, 1900-2016: Patterns of occurrence, population affected, and economic damagesDesastres no México de 1900 a 2016: padrão de ocorrência, população atingida e prejuízos econômicos]. / Desastres en México de 1900 a 2016: patrones de ocurrencia, población afectada y daños económicos.

OBJECTIVE: Characterize the patterns in the occurrence of disasters, associated deaths, population affected, and economic damages in Mexico over the period 1900-2016. METHODS: In a descriptive study approach, information was gathered on the frequency of disasters, associated deaths, persons affected, and economic damages in Mexico over the period indicated, using the International Disaster Database (EM-DAT) of the Center for Disaster Epidemiology Research (CRED) of the School of Public Health, Catholic University of Louvain, Belgium. RESULTS: In Mexico, an increase was observed in the frequency of disasters starting in the 1990s. According to the pattern of occurrence, the highest percentage were of hydrometeorological origin (storms, extreme temperatures, floods, avalanches, and storm surges), which accounted for half the reported disasters. In the series analyzed, disasters of hydrologic, meteorological, or climatological origin represented between 50% and 60% of the events and were the ones that caused the greatest damage. Geophysical events caused the most deaths, followed by hydrologic and then by meteorological events. The cost of damages increased with each decade. CONCLUSIONS: Of the 219 disasters analyzed over the period, 63.4% have occurred since 1990. The frequency of the disasters and the need for investment in their prevention and mitigation are increasing.

OBJETIVO: Caracterizar o padrão de ocorrência de desastres, mortes, população atingida e prejuízos econômicos no México no período 1900-2016. MÉTODOS: Foi realizado um estudo descritivo da frequência de desastres, mortes e população atingida no México sendo estimados os prejuízos económicos no período considerado. Foi usada a base de dados EM-DAT do International Disaster Database do Centro de Pesquisa Epidemiológica de Desastres da Escola de Saúde Pública da Université Catholique de Louvain, Bélgica. RESULTADOS: Foi observado um aumento da frequência de desastres a partir da década de 1990. Os padrões de ocorrência de desastres no México demonstram uma maior porcentagem de desastres de origem meteorológica e hidrológica (temporais, temperaturas extremas, enchentes, deslizamentos e ação das ondas), representando metade das ocorrências registradas. A porcentagem de desastres de origem meteorológica, hidrológica e climatológica variou entre 50% e 60% e foram os desastres que causaram maior prejuízo ao país na série analisada. Os desastres que causaram mais mortes foram os geofísicos, seguidos dos hidrológicos e meteorológicos. O montante do prejuízo económico aumentou ao longo dos anos. CONCLUSÕES: Dos 219 desastres analisados no período considerado, 63,4% foram registrados a partir de 1990. A frequência dos desastres está aumentando assim como a necessidade de investimento em prevenção e redução dos danos.

Socio-economic factors associated with post-traumatic stress symptoms among adolescents and young people during the first wave of the COVID-19 pandemic.

This study assessed the association between sociodemographic factors and post-traumatic stress symptoms (PTSS) among 18-24-year-olds during the first wave of the COVID-19 pandemic. This was a secondary analysis of data from 4508 individuals collected through an online survey conducted between June and January 2021. PTSS was measured as a dependent variable using the checklist for post-traumatic stress disorder in civilians. Age, birth sex, sexual, level of education, access to emotional and social support, and emotional distress were the independent variables. A multivariate logistic regression analysis was conducted to determine the associations between the dependent and independent variables while controlling for the country related confounding variables. Females (AOR:2.023), sexual minority individuals (AOR:1.868), those who did not disclose their sexual identify (AOR:1.476), those with poor access to emotional and social support (AOR:4.699) and individuals with no formal education (AOR:13.908), and only primary level education (AOR:4.521) had higher odds of PTSS. The study highlights the multifaceted nature of PTSS during the pandemic and suggests the importance of promoting access of young people, especially females, sexual minority individuals and those with low educational status, to emotional/social support to mitigate the probability of PTSS, especially among sexual minority individuals.

Psychosocial Factors Associated with Memory Complaints during the First Wave of the COVID-19 Pandemic: A Multi-Country Survey.

This study assessed the associations between psychosocial factors (social isolation, social support, financial support and emotional distress) and memory complaints during the COVID-19 pandemic. This was a secondary analysis of data extracted from the dataset of participants recruited from 151 countries for a COVID-19 related mental health and wellness study between June and December 2020. The dependent variable was memory complaint, measured using the Memory Complaint Questionnaire. The independent variables were perception of social isolation, social support, financial support, emotional distress and history of SARS-CoV-19 infection. Confounding variables were age, sex at birth, level of education, employment status, HIV status and country-income level. Multivariable logistic regression was used to determine the associations between the dependent and independent variables after adjusting for the confounders. Of the 14825 participants whose data was extracted, 2460 (16.6%) had memory complaints. Participants who felt socially isolated (AOR: 1.422; 95% CI: 1.286-1.571), emotionally distressed (AOR: 2.042; 95% CI: 1.850-2.253) and with history of SARS-CoV-19 infection (AOR: 1.369; 95% CI: 1.139-1.646) had significantly higher odds of memory complaints. Participants who perceived they had social and financial support had significantly lower odds of memory complaints (AOR: 0.655; 95% CI: 0.571-0.751). Future management of pandemics like the COVID-19 should promote access to social and financial support and reduce the risk of social isolation and emotional distress.

Social media information and its association with the adoption of COVID-19 preventive measures in four Latin American countries.

Objective: The study aimed to assess the association between adherence to COVID-19 preventive measures and access to media information related to COVID-19. Methods: A multi-country, cross-sectional study using an online survey was conducted from June to December 2020. The sample included 1,457 participants from Argentina, Brazil, Chile, and Mexico. The outcome variable was self-reported adherence to preventive measures (handwashing, social distancing, self-isolation, use of face masks, and working from home). The explanatory variable was self-report of following media information related to COVID-19 (watching or reading the news, following social media coverage). Multivariable logistic regression analyses were conducted to determine the associations. Results: Following information on social media was positively associated with higher odds of practicing social distancing (AOR=5.39; 95%CI: 3.93-7.30), self-isolation (AOR=1.44; 95%CI: 1.08-1.92), use of face masks (AOR=16.84; 95%CI: 10.03-28.27), handwashing (AOR=6.95; CI 95%: 4.98-9.71), and working from home (AOR=1.85; 95% CI: 1.43-2.41). Differences in the use of social media for COVID-19 information were observed among the four countries. Conclusion: Following social media was positively associated with adherence to COVID-19 preventive measures in Latin America. Social media may be effectively used for COVID-19 behaviour modification in Latin America.

Associations between Emotional Distress, Sleep Changes, Decreased Tooth Brushing Frequency, Self-Reported Oral Ulcers and SARS-Cov-2 Infection during the First Wave of the COVID-19 Pandemic: A Global Survey.

This study assessed the association between emotional distress, sleep changes, decreased frequency of tooth brushing, and self-reported oral ulcers, and the association between COVID-19 status and decreased frequency of tooth brushing. Using a cross-sectional online survey, data were collected from adults in 152 countries between July and December 2020. Binary logistic regression analyses were conducted to determine the associations between dependent (decreased frequency of tooth brushing, oral ulcers, change in sleep pattern) and independent (tested positive for COVID-19, depression, anxiety, frustration/boredom, loneliness, anger, and grief/feeling of loss) variables after adjusting for confounders (age, sex, level of education, employment status). Of the 14,970 participants data analyzed, 1856 (12.4%) tested positive for COVID-19. Respondents who reported feeling depressed (AoR: 1.375), lonely (AoR: 1.185), angry (AoR: 1.299), and experienced sleep changes (AoR:1.466) had significantly higher odds of decreased tooth brushing frequency. Respondents who felt anxious (AoR: 1.255), angry (AoR: 1.510), grief/sense of loss (AoR: 1.236), and sleep changes (AoR: 1.262) had significantly higher odds of oral ulcers. Respondents who tested positive for COVID-19 had significantly higher odds of decreased tooth brushing frequency (AoR: 1.237) and oral ulcers (AoR: 2.780). These findings highlight that the relationship between emotional distress and oral health may intensify during a pandemic.

Impact of the COVID-19 pandemic on student' sleep patterns, sexual activity, screen use, and food intake: A global survey.

BACKGROUND: The education sector experienced substantial impacts during the COVID-19 pandemic resulting from worldwide restrictions. PURPOSE: To examine differences in the sleep patterns, sexual activity, screen use, and food intake of students and non-students during the COVID-19 pandemic. METHODS: This was a global cross-sectional study conducted in the second half of 2020 using multiple social media platforms to recruit study participants globally. A close-ended questionnaire was administered anonymously in English, French, Spanish, Portuguese, and Arabic to adults ages 18 and older. The outcome variables considered in analyses were changes in sleep pattern, sexual activity, screen use, and food intake. The explanatory variable was student status categorized as students vs. non-student. T-test, chi-square, and Mann Whitney U tests were used to assess differences between student and non-student populations. One logistic regression model was built for each outcome variable. Country of residence and country income level were included in the adjusted models. RESULTS: There were 17,008 participants of which 3,793 (22.3%) were students. Of the total sample, 4,889 (28.7%) reported changes in sleep, 4,642 (31.8%) reported increases in sexual activity, 10,278 (70.7%) reported increases in screen use, and 5,662 (40.2%) reported increases in food intake during the pandemic. Compared to non-students, students had significantly higher odds of reporting changes in sleep (AOR = 1.52), increases in sexual activity (AOR = 1.79), and increases in screen use (AOR = 1.36) but lower odds of reporting increase in food intake (AOR = 0.87). CONCLUSION: Students displayed higher risk of experiencing changes in sleep, sexual behavior, and screen use during the COVID-19 pandemic. This has the potential to lead to broader adverse effects on students' overall wellbeing. The findings and implications raise further obligations on the education sector to put extra-curricular support systems in place that address COVID-19 related behavior changes that have the potential to adversely impact students' wellbeing.

Factors Associated With Experiences of Fear, Anxiety, Depression, and Changes in Sleep Pattern During the COVID-19 Pandemic Among Adults in Nigeria: A Cross-Sectional Study.

Background: Multiple facets of the pandemic can be a source of fear, depression, anxiety and can cause changes in sleep patterns. The aim of this study was to identify health profiles and the COVID-19 pandemic related factors associated with fear, depression, anxiety and changes in sleep pattern in adults in Nigeria. Methods: The data for this analysis was extracted from a cross-sectional online survey that collected information about mental health and well-ness from a convenience sample of adults 18 years and above resident in Nigeria from July to December 2020. Study participants were asked to complete an anonymous, closed-ended online questionnaire that solicited information on sociodemographic profile, health profiles (high, moderate and low COVID-19 infection risk profile) including HIV status, COVID-19 status, and self-reported experiences of fear, anxiety, depression and changes in sleep patterns. Results: In total, 4,439 participants with mean age of 38.3 (±11.6) years responded to the survey. Factors associated with higher odds of having COVID-19 related fear were health risk (p < 0.05); living with HIV (AOR: 3.88; 95% CI: 3.22-4.69); having COVID-19 symptoms but not tested (AOR: 1.61; 95% CI: 1.30-1.99); having a friend who tested positive to COVID-19 (AOR: 1.28; 95% CI: 1.07-1.53) and knowing someone who died from COVID-19 (AOR: 1.43; 95% CI: 1.24-1.65). The odds of feeling anxious was significantly higher for those with moderate or low health risk profile (p < 0.05); living with HIV (AOR: 1.64; 95% CI: 1.32-2.04); had a friend who tested positive for COVID-19 (AOR: 1.35; 95% CI: 1.08-1.68) or knew someone who died from COVID-19 (AOR: 1.53; 95% CI: 1.28-1.84). The odds of feeling depressed was significantly higher for those with health risk profile (p < 0.05); living with HIV (AOR: 2.49; 95% CI: 1.89-3.28); and respondents who had COVID-19 symptoms but had not taken a test (AOR: 1.41; 95% CI: 1.02-1.94). Factors associated with higher odds of having sleep pattern changes were having moderate and low health risk profiles (p < 0.05). Conclusion: The study findings suggest that the pandemic may cause fear, anxiety, depression and changes in sleep patterns differently for people with different health profile, HIV status and COVID-19 status.

Factors Associated with Financial Security, Food Security and Quality of Daily Lives of Residents in Nigeria during the First Wave of the COVID-19 Pandemic.

An online survey was conducted to identify factors associated with financial insecurity, food insecurity and poor quality of daily lives of adults in Nigeria during the first wave of the COVID-19 pandemic. The associations between the outcome (experience of financial loss, changes in food intake and impact of the pandemic on daily lives) and the explanatory (age, sex, education level, anxiety, depression, HIV status) variables were determined using logistic regression analysis. Of the 4439 respondents, 2487 (56.0%) were financially insecure, 907 (20.4%) decreased food intake and 4029 (90.8%) had their daily life negatively impacted. Males (AOR:0.84), people who felt depressed (AOR:0.62) and people living with HIV -PLHIV- (AOR:0.70) had significantly lower odds of financial insecurity. Older respondents (AOR:1.01) had significantly higher odds of financial insecurity. Those depressed (AOR:0.62) and PLHIV (AOR:0.55) had significantly lower odds of reporting decreased food intake. Respondents who felt anxious (AOR:0.07), depressed (AOR: 0.48) and who were PLHIV (AOR:0.68) had significantly lower odds of reporting a negative impact of the pandemic on their daily lives. We concluded the study findings may reflect a complex relationship between financial insecurity, food insecurity, poor quality of life, mental health, and socioeconomic status of adults living in Nigeria during the COVID-19 pandemic.

Posttraumatic stress symptoms in people exposed to the 2017 earthquakes in Mexico.

This is the first study to produce a reliable valid measure of the symptoms of Posttraumatic Stress Disorders (PTSD) in Mexico, which has a high incidence of disasters, and has not had a measurement of PTSD frequency in the population. The objective was to analyze the prevalence of PTSD symptoms in persons who experienced the 2017 earthquakes in Mexico. A probabilistic sample of 1539 participants from Mexico City, the State of Mexico, Chiapas, Puebla, Morelos and Oaxaca during November and December of 2017 was screened using the Davidson Trauma Scale (DTS) for symptoms of post-traumatic stress. The prevalence of PTSD symptoms was 34.6%, with greater effects on the inhabitants of Oaxaca, Morelos and Puebla, women, indigenous people and people who experienced damage to their homes (p = 0.001). The DTS had a moderate negative correlation with the RS-14 and a Cronbach's alpha coefficient of 0.957. The confirmatory factor analysis generated four factors that explain 50% of the variance, compatible with a Dysphoria model. We can conclude that one in three people exposed to earthquakes had symptoms of post-traumatic stress.

Complementary training in disasters for healthcare professionals: an analysis of the official offer in brazil and mexico / Formación complementaria en desastres para profesionales de la salud: un análisis de la oferta oficial en brasil y méxico / Formação complementar em desastres para profissionais da saúde: uma análise da oferta oficial no brasil e méxico

ABSTRACT Objective: to identify courses available online by national civil defense bodies in Brazil and Mexico to assist in the additional training of healthcare professionals for disasters. Method: an exploratory descriptive study, based on a qualitative approach, using technological prospecting methodology, carried out on the official Civil Defense websites in Brazil and Mexico. Results: ten courses offered by the Government of Mexico's National Center for Disaster Prevention were found, nine of which were short-term and one offered as vocational training. All of these courses were synchronous. In Brazil, 36 courses were located, all in asynchronous formats, with durations varying between 20 and 50 hours. Although the courses presented programmatic content that included activities inherent to healthcare professionals, none of them made specific mention of professionals in this area as the target audience. Conclusion: the prospective study reinforces that Information and Communication Technologies for distance education present themselves as an alternative present in both countries in terms of additional training for disasters, although not yet specifically aimed at healthcare professionals. The need to include this area of interdisciplinary and multi-professional content reflects gaps in sector integration.

RESUMEN Objetivo: identificar cursos disponibles en línea por los organismos nacionales de defensa civil en Brasil y México para ayudar en la capacitación adicional de profesionales de la salud para desastres. Método: estudio descriptivo exploratorio, de enfoque cualitativo, utilizando metodología de prospección tecnológica, realizado en los sitios web oficiales de la Defensa Civil de Brasil y México. Resultados: se encontraron 10 cursos ofrecidos por el Centro Nacional para la Prevención de Desastres del Gobierno de México, nueve de los cuales fueron de corta duración y uno se ofreció como formación vocacional. Todos estos cursos fueron sincrónicos. En Brasil se ubicaron 36 cursos, todos en formato asincrónico, con duraciones que variaron entre 20 y 50 horas. Aunque los cursos presentaron contenidos programáticos que incluyeron actividades inherentes a los profesionales de la salud, ninguno de ellos hizo mención específica a los profesionales de esa área como público objetivo. Conclusión: el estudio prospectivo refuerza que las Tecnologías de la Información y las Comunicaciones para la educación a distancia se presentan como una alternativa presente en ambos países en términos de capacitación adicional para desastres, aunque aún no dirigida específicamente a los profesionales de la salud. La necesidad de incluir esta área de contenidos interdisciplinarios y multiprofesionales refleja brechas en la integración del sector.

RESUMO Objetivo: identificar cursos disponíveis on-line pelos órgãos de defesa civil nacional do Brasil e do México visando auxiliar na formação complementar de profissionais de saúde para desastres. Método: estudo descritivo exploratório, a partir de uma abordagem qualitativa, utilizando a metodologia de prospecção tecnológica, realizada nos sites oficiais de Defesa Civil do Brasil e do México. Resultados: foram encontrados 10 cursos oferecidos pelo Centro Nacional de Prevenção de Desastres do Governo do México, sendo nove de curta duração e um oferecido como curso técnico. Todos esses cursos na modalidade síncrona. No Brasil, localizaram-se 36 cursos, todos em formatos assíncronos, com duração variável entre 20 e 50 horas. Embora os cursos apresentassem conteúdo programático que incluía atividades inerentes aos profissionais de saúde, nenhum deles fazia menção específica aos profissionais desta área como público-alvo. Conclusão: o estudo prospectivo reforça que as Tecnologias da Informação e da Comunicação para educação a distância se apresentam como uma alternativa presente em ambos os países quanto à formação complementar para desastres, porém, ainda não direcionados especificamente aos profissionais da saúde. A necessidade de inclusão desta área de conteúdos interdisciplinares e multiprofissionais reflete lacunas de integração de setores.

Desastres en México de 1900 a 2016: patrones de ocurrencia, población afectada y daños económicos / Disasters in Mexico, 1900-2016: Patterns of occurrence, population affected, and economic damages / Desastres no México de 1900 a 2016: padrão de ocorrência, população atingida e prejuízos econômicos

RESUMEN Objetivo Caracterizar los patrones de ocurrencia de desastres, defunciones, población afectada y daños económicos en México en el período 1900-2016. Métodos Se realizó un estudio descriptivo de las frecuencias de desastres, de defunciones y de personas afectadas y se estimaron los daños económicos para México en el período señalado. Se utilizó la base de datos EM-DAT del International Disaster Database, del Centre de Recherche sur l'Epidémiologie des Désastres de L'École de Santé Publique de l'Université Catholique de Louvain, Belgique. Resultados Se observó un aumento de la frecuencia de desastres a partir de la década de los noventa. Los patrones de ocurrencia de desastres en México indican que el porcentaje más alto es el de los de origen meteorológico e hidrológico (tormentas, temperaturas extremas, inundaciones, aludes y acción de los oleajes), que representan la mitad de los desastres registrados. El pocentaje de los desastres de origen meteorológico, hidrológico y climatológico oscila entre 50%-60% y son los que han provocado mayores daños a México en la serie analizada. Los que más defunciones han causado son los geofísicos, seguidos de los hidrológicos y los meteorológicos. El costo de los daños asciende con el paso de las décadas. Conclusiones De los 219 desastres analizados en el período mencionado, 63,4% se ha registrado a partir de 1990. La frecuencia de los desastres y las necesidades de inversión en su prevnción y mitigación van en aumento.

ABSTRACT Objective Characterize the patterns in the occurrence of disasters, associated deaths, population affected, and economic damages in Mexico over the period 1900-2016. Methods In a descriptive study approach, information was gathered on the frequency of disasters, associated deaths, persons affected, and economic damages in Mexico over the period indicated, using the International Disaster Database (EM-DAT) of the Center for Disaster Epidemiology Research (CRED) of the School of Public Health, Catholic University of Louvain, Belgium. Results In Mexico, an increase was observed in the frequency of disasters starting in the 1990s. According to the pattern of occurrence, the highest percentage were of hydrometeorological origin (storms, extreme temperatures, floods, avalanches, and storm surges), which accounted for half the reported disasters. In the series analyzed, disasters of hydrologic, meteorological, or climatological origin represented between 50% and 60% of the events and were the ones that caused the greatest damage. Geophysical events caused the most deaths, followed by hydrologic and then by meteorological events. The cost of damages increased with each decade. Conclusions Of the 219 disasters analyzed over the period, 63.4% have occurred since 1990. The frequency of the disasters and the need for investment in their prevention and mitigation are increasing.

RESUMO Objetivo Caracterizar o padrão de ocorrência de desastres, mortes, população atingida e prejuízos econômicos no México no período 1900-2016. Métodos Foi realizado um estudo descritivo da frequência de desastres, mortes e população atingida no México sendo estimados os prejuízos económicos no período considerado. Foi usada a base de dados EM-DAT do International Disaster Database do Centro de Pesquisa Epidemiológica de Desastres da Escola de Saúde Pública da Université Catholique de Louvain, Bélgica. Resultados Foi observado um aumento da frequência de desastres a partir da década de 1990. Os padrões de ocorrência de desastres no México demonstram uma maior porcentagem de desastres de origem meteorológica e hidrológica (temporais, temperaturas extremas, enchentes, deslizamentos e ação das ondas), representando metade das ocorrências registradas. A porcentagem de desastres de origem meteorológica, hidrológica e climatológica variou entre 50% e 60% e foram os desastres que causaram maior prejuízo ao país na série analisada. Os desastres que causaram mais mortes foram os geofísicos, seguidos dos hidrológicos e meteorológicos. O montante do prejuízo económico aumentou ao longo dos anos. Conclusões Dos 219 desastres analisados no período considerado, 63,4% foram registrados a partir de 1990. A frequência dos desastres está aumentando assim como a necessidade de investimento em prevenção e redução dos danos.