COVID-19 Vaccination Status as Well as Factors Associated with COVID-19 Vaccine Acceptance and Hesitancy among Prisoners and the Implications.

Prisoners form a population who are highly vulnerable to COVID-19 due to overcrowding, limited movement, and a poor living environment. Consequently, there is a need to ascertain the status of COVID-19 vaccination and factors associated with hesitancy among prisoners. A cross-sectional questionnaire-based study was undertaken among prisoners at three district jails in Punjab Province, Pakistan. A total of 381 prisoners participated and none of the study participants had received an influenza vaccine this year. In total, 53% received at least one dose of a COVID-19 vaccine, with the majority having two doses. The top three reasons of vaccine acceptance were "fear of contracting SARS-CoV-2 infection" (56.9%), "desire to return to a pre-pandemic routine as soon as possible" (56.4%), and "having no doubts on the safety of COVID-19 vaccines" (39.6%). There was no statistically significant difference (p > 0.05) in any demographic variables between vaccinated and unvaccinated prisoners except for age, which was strongly association with COVID-19 vaccine uptake (χ2(3) = 76.645, p < 0.001, Cramer's V = 0.457). Among the unvaccinated prisoners (N = 179), only 16 subsequently showed willingness to receive a COVID-19 vaccine. The top three reasons for hesitancy were: COVID-19 is not a real problem/disease (60.1%), safety concerns (51.1%), and COVID-19 vaccine is a conspiracy (50.3%). Efforts are needed to address their concerns given this population's risks and high hesitancy rates, especially among younger prisoners.

Assessment of health-related quality of life in hypertensive hemodialysis patients.

BACKGROUND AND OBJECTIVES: Globally, the prevalence of hypertension (HTN) with the coexistence of chronic kidney disease (CKD) is increasing, resulting in poor quality of life. The main objective of the study was to measure the health-related quality of life (HRQoL) of hypertensive hemodialysis patients. METHODS: A multicenter follow-up study was carried out in six public and two private dialysis centers in Pakistan. A total of 517 hypertensive hemodialysis patients responded by completing the questionnaire at baseline and two subsequent phases. The quality of life of these patients was assessed using the EQ-5D-5L questionnaire (a standardized instrument for measuring generic health status). Statistical analysis was done using a multivariate linear regression model, Friedman test and Kruskal Wallis test. RESULTS: The majority of patients (58.2%) had normal body mass index and about 60.5% of the patients were taking less salt due to HTN. Friedman test gave the statistically significant results (p ≤ 0.001) in systolic blood pressure (BP), diastolic BP and EQ-5D visual analogue scale (VAS) score between three phases (initial visit, first follow-up and second follow-up). A significant improvement was observed in self-care and usual activities from initial visit to first follow-up (p < 0.05). The most problematic dimension among the hypertensive patients with CKD was pain/discomfort (86.5%). CONCLUSIONS: HTN with coexisting CKD in hemodialysis patients severely affected HRQoL. Pain/discomfort was the most problematic dimension among the participants.