Eastern Mediterranean Health Journal最新文献

Background: Asthma is a common chronic noncommunicable disease which can impair the health-related quality-of-life (HRQOL) of patients.

Aims: To investigate treatment-related experiences and HRQOL of asthma patients in Egypt during the COVID-19 pandemic.

Methods: A multicentre cross-sectional study was conducted from 21 July to 17 December 2020 in 3 teaching hospitals in Egypt among a convenience sample of asthma patients. We used socioeconomic and clinical variables, perceived threat level of COVID-19, experiences before and during COVID-19, the Asthma Control Questionnaire (ACQ), and the mini Asthma Quality of Life Questionnaire (mini-AQLQ) to collect data.

Results: Among the 200 respondents (66.0% male; mean age 40.2 years), 80.0% had uncontrolled asthma. The greatest impairment to HRQOL was due to limitation of activity. Females reported a higher level of perceived threat from COVID-19 (Chi squared = -2.33, P = 0.02). Before the pandemic, more patients visited the clinician when they had symptoms but did so more regularly during the pandemic. Over 75% could not differentiate between asthma and COVID-19 symptoms. Perceived uncontrolled asthma and poor compliance with treatment were significantly associated with impairment of HRQOL (P < 0.05) before COVID-19.

Conclusion: The COVID-19 pandemic improved some asthma-related health behaviours, but limitations in HRQOL were still evident. Uncontrolled asthma is a key factor for HRQOL and should remain a focus for all patients.

"Adaptation is surviving but resilience is for thriving."

In recent years, the multiple threats of COVID-19 and other disease outbreaks, intensified climate change and severe weather events, and increasing conflicts and humanitarian emergencies have highlighted the need to strengthen resilience in the different sectors, including social, economic, environment, and health. Resilience is the ability of a system, community or society exposed to hazards to resist, absorb, accommodate, adapt to, transform, and recover from the effects of a hazard in a timely and efficient manner, including through the preservation and restoration of its essential basic structures and functions through risk management.

Background: Skin problems associated with the use of personal protective equipment (PPE) have been reported during the COVID-19 pandemic.

Aims: To determine the skin problems experienced by healthcare workers in Türkiye who used PPE during COVID-19 and the effect of these problems on their quality-of-life.

Methods: This cross-sectional study was conducted from 30 November 2020 to 30 May 2021. Data were collected from 404 healthcare workers recruited via social media. Participants completed a skin problem evaluation form and Skindex-16, which measures the effects of skin disease on quality-of-life. The t test and ANOVA were used to analyse differences between the means.

Results: Most (85.1%) of the participants were nurses and 38.6% worked in COVID-19 intensive care units. All the participants wore gloves (53.2% wore double gloves), 99.3% wore surgical masks and 56.2% wore protective glasses. They washed their hands on average 31.94 [standard deviation (SD) 27.55] times a day. Skin problems developed were mostly around the forehead, hands, nose, and ears. The mean (SD) Skindex-16 score was 45.42 (26.31). Based on Skindex scores, respondents with chronic skin problems had a significantly lower quality-of-life than those without skin problems, as did those who developed skin problems during the COVID-19 pandemic than those who did not (P < 0.001).

Conclusion: Skin problems associated with the use of PPE increased during the COVID-19 pandemic and these affected the quality-of-life of healthcare workers. Further studies should evaluate how to minimize adverse reactions due to PPE use.

Background: The World Health Organization has often reiterated its recommendations for the prevention of COVID-19, however, the success of these measures largely depends on public knowledge and attitudes.

Aims: This study assessed the relationship between knowledge, attitude, behaviour and preventive measures for COVID-19 infection in a Lebanese population.

Methods: This cross-sectional study was conducted between September and October 2020 using the snowball sampling technique and an online self-administered questionnaire. The questionnaire had 4 parts targeting sociodemographic characteristics; medical history; knowledge, attitude and practices (preventive measures and behaviours related to COVID-19); and mental health variables such as psychological distress. Two models were derived using multivariable binomial logistic regression to optimize the picture of COVID-19 correlates.

Results: Our sample comprised 1119 adults. Being older, female, a regular alcohol consumer, waterpipe smoker, having low level of education, low family income, and having contact with a COVID-19 patient correlated with increased odds of ever having been diagnosed with COVID-19. Participants who had ever been diagnosed with COVID-19 had a significantly better knowledge and a higher risky practice scale [adjusted odds ratio (ORa) = 1.49; 95% CI 1.27-1.74; P < 0.001; and ORa = 1.04; 95% CI 1.01-1.08; P = 0.024, respectively].

Conclusion: The most important predictors of COVID-19 infection appear to be generally well-known among the general population, however, their knowledge and adherence to preventive measures should be continuously re-evaluated. This study highlights the need for greater awareness to improve precautionary behaviours among the public.

Background: Vaccine hesitancy re-emerged as a critical public health issue during the COVID-19 pandemic.

Aims: This study assessed the concerns of recovered COVID-19 patients about vaccination and the predictors of vaccine hesitancy.

Methods: This was a cross-sectional study of 319 adult patients who recovered from COVID-19 in Saudi Arabia. It was conducted during 1 May to 1 October 2020 at King Abdulaziz Medical City, Riyadh. Each participant was interviewed 6-12 months post-recovery using the vaccination attitude examination scale. Data were collected on COVID-19 illness severity, sociodemographic characteristics, history of chronic disease, and post-COVID-19 vaccination. Level of vaccination concern was assessed based on the percentage mean score (PMS).

Results: Most (85.3%) of the patients who recovered from COVID-19 expressed moderate overall concern (PMS = 68.96%) about vaccination. Concern was highest for mistrust in vaccine benefits (PMS = 90.28%), followed by natural immunity preference (PMS = 81.33%) and worries about the vaccine side-effects (PMS = 60.29%). Concern over commercial profiteering was low (PMS = 43.92%). The overall PMS for concern about vaccination was significantly higher among patients aged 45+ years (t = 3.12, P = 0.002) and among those who had experienced severe COVID-19 illness (t = 1.96, P = 0.05).

Conclusion: Overall concern about vaccination was high, and specific concerns were prevalent. Patient education on how the vaccine protects against reinfection should be targeted at COVID-19 patients before being discharged from hospital.

Background: This is one of the first studies exploring immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among blue-collar workers in Abu Dhabi.

Aims: This study estimated the seroprevalence of SARS-CoV-2 infection among workers living in a closed setting using qualitative analysis of the total SARS CoV-2 antibody immune response.

Methods: We conducted this monocentric, prospective, observational study in a labour compound for a cohort of workers between 28 March and 6 July 2020. We tested for SARS-CoV-2 (nasopharyngeal) (RT-PCR) and anti-SARS-CoV-2 T-Ab.

Results: Out of a total of 1600 workers, 1206 (75.0%) participated in the study - all were males, median age 35 years (19-63 years). We found 51% of the participants to be positive for SARS-CoV-2; the 49.0% who tested negative were considered as contacts. Anti-SARS-CoV-2 T-Ab was detected among 864 participants, showing an overall point prevalence of 71.6%. A relatively higher response was found among cases (89.0%) than among contacts (53.2%).

Conclusion: This study highlights the need to prioritize public health interventions in closed settings where disease transmission is higher due to greater overall exposure. A high seroprevalence of anti-SARS-CoV-2 T-Ab was found among the residents. A serial quantitative study applying time series and regression models is recommended to further evaluate the sustainability of the immune response among this and similar population groups.

Background: The B.1.1.7 SARS-CoV-2 variant results in spike gene target failure (SGTF) in reverse transcription-quantitative polymerase chain reaction (RT-PCR) assays. Few studies have been published on the clinical impact of B.1.1.7/SGTF.

Aims: To assess the incidence of B.1.1.7/SGTF and its associated clinical characteristics among hospitalized COVID-19 patients.

Methods: This observational, single-centre, cohort study was conducted between December 2020 and February 2021 and included 387 hospitalized COVID-19 patients. The Kaplan-Meier method was used for survival analysis, and logistic regression to identify risk factors associated with B.1.1.7/SGTF.

Results: By February 2021, B.1.1.7/SGTF (88%) dominated the SARS-CoV-2 PCR results in a Lebanese hospital. Of the 387 eligible COVID-19 patients confirmed by SARS-CoV-2 RT-PCR, 154 (40%) were non-SGTF and 233 (60%) were B.1.1.1.7/SGTF; this was associated with a higher mortality rate among female patients [22/51 (43%) vs 7/37 (19%); P = 0.0170]. Among patients in the B.1.1.7/SGTF group, most were aged ≥ 65 years [162/233 (70%) vs 74/154 (48%); P < 0.0001]. Independent predictors of B.1.1.7/SGTF infection were hypertension (OR = 0.415; CI: 0.242-0.711; P = 0.0010), age ≥ 65 years (OR = 0.379; CI: 0.231-0.622; P < 0.0001), smoking (OR = 1.698; CI: 1.023-2.819; P = 0.0410), and cardiovascular disease (OR = 3.812; CI: 2.215-6.389; P < 0.0001). Only non-SGTF patients experienced multi-organ failure [5/154 (4%) vs 0/233 (0%); P = 0.0096].

Conclusion: There was a clear difference between the clinical features associated with B.1.1.7/SGTF and non-SGTF lineages. Tracking viral evolution and its clinical impact is crucial for proper understanding and management of the COVID-19 pandemic.

Background: The COVID-19 pandemic caused people to stay indoors, resulting in social isolation and reluctance to access healthcare services in hospitals because of the fear of acquiring COVID-19. This fear caused a decrease in health service utilization during the pandemic.

Aims: To compare paediatric forensic cases admitted to an emergency department before and during the COVID-19 pandemic.

Methods: We retrospectively compared the age, sex, type, frequency, and distribution of forensic cases admitted to the Paediatric Emergency Department of Umraniye Training and Research Hospital, Istanbul, Türkiye, before the COVID-19 pandemic between 1 July 2019 and 8 March 2020, and during the pandemic between 9 March and 31 December 2020.

Results: There were 226 paediatric forensic cases among 147 624 emergency admissions before the COVID-19 pandemic, and 253 among 60 764 admissions during the pandemic. The proportion of forensic cases increased from 0.15% before the pandemic to 0.41% during the pandemic. Intoxication by accidental ingestion was the most common reason for forensic cases before and during the pandemic. There was a significant increase in ingestion of corrosive material during the pandemic compared to the pre-pandemic period.

Conclusion: Parental anxiety and depression caused by the COVID-19 pandemic and lockdown resulted in decreased attention to childcare, leading to increased accidental ingestion of harmful materials among paediatric forensic cases admitted to the emergency department.