Resource loss, positive religious coping, and suffering during the COVID-19 pandemic: a prospective cohort study of US adults with chronic illness

Micronutrient levels and their effect on the prognosis of visceral leishmaniasis treatment; a prospective cohort study.

10.21203/rs.3.rs-33284/v2 ◽

2020 ◽

Author(s):

berhanu elfu feleke ◽

Teferi Elfu Feleke

Keyword(s):

Vitamin D ◽

Cohort Study ◽

Chronic Illness ◽

Visceral Leishmaniasis ◽

Family Size ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Serum Vitamin ◽

Serum Selenium ◽

Serum Vitamin D

Abstract Background: Micronutrients are minerals and vitamins required in small amounts, and they are essential for normal physiological activities. The objectives of the study were to describe the progress and determinants of micronutrients level and to assess the effect of micronutrients in the treatment outcomes. Methods: A prospective cohort study was implemented. The data were collected using interviews, measuring anthropometric indicators, collecting blood, urine, and stool samples from each patient. The blood samples were collected five times: before starting anti-leishmaniasis treatments, in the first week, in the second week, in the third week, and in the 4th week of anti-leishmaniasis treatments. Descriptive statistics were used to describe the profile of patients and to compare the treatment success rate of visceral leishmaniasis patients. The generalized estimating equation was used to identify the determinants of serum micronutrients.Results: The serum zinc level of visceral leishmaniasis patients was affected by alcohol, DDS, family size, HIV, and sex. The serum iron level of visceral leishmaniasis patients were affected by alcohol, family size, malaria, hookworm, chronic diseases, and HIV. The serum selenium level of visceral leishmaniasis patients was affected by HIV and family size. The iodine level of visceral leishmaniasis patients was affected by HIV, DDS, smoking, chronic illness, and regular physical exercise. The serum vitamin D level of visceral leishmaniasis patients was affected by HIV, alcohol, chronic illness, DDS, malaria, family size, age, residence, and MUAC. The serum vitamin D level of visceral leishmaniasis patients was affected by BMI, DDS, malaria, hookworm, family size, HIV, and age. Conclusion: The Micronutrient levels of visceral leishmaniasis patients were significantly low. Anti-leishmaniasis treatment did not increase the serum micronutrient levels of the patients.

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Multi-purpose cash transfers and health among vulnerable Syrian refugees in Lebanon: a prospective cohort study

BMC Public Health ◽

10.1186/s12889-021-11196-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Emily Lyles ◽

Jakob Arhem ◽

Ghada El Khoury ◽

Antonio Trujillo ◽

Paul Spiegel ◽

...

Keyword(s):

Cohort Study ◽

Chronic Illness ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Cash Transfers ◽

Care Seeking ◽

Syrian Refugees ◽

Positive Effects ◽

Syrian Refugee ◽

The Impact

Abstract Background Multipurpose cash transfers (MPCs) are used on a widespread basis in the Syrian refugee response; however, there is little to no evidence as to how they affect health in humanitarian crises. Methods A prospective cohort study was conducted from May 2018 through July 2019 to evaluate the impact of MPCs on health care-seeking and expenditures for child, adult acute, and adult chronic illness by Syrian refugees in Lebanon. Households receiving MPCs from UNHCR were compared to control households not receiving UNHCR MPCs. Results Care-seeking for childhood illness was consistently high in both MPC and non-MPC households. An increased proportion of households did not receive all recommended care due to cost; this increase was 19.3% greater among MPC recipients than controls (P = 0.002). Increases in child hospitalizations were significantly smaller among MPC recipients than controls (DiD -6.1%; P = 0.037). For adult acute illnesses, care-seeking increased among MPC recipients but decreased in controls (adjusted DiD 11.3%; P = 0.057); differences in change for other utilization outcomes were not significant. The adjusted difference in change in the proportion of MPC households not receiving recommended chronic illness care due to cost compared to controls was − 28.2% (P = 0.073). Access to medication for adult chronic illness also marginally significantly improved for MPC households relative to controls. The proportion of MPC recipients reporting expenses for the most recent child and adult acute illness increased significantly, as did the [log] total visit cost. Both MPC and control households reported significant increases in borrowing to pay for health expenses over the year study period, but differences in change in borrowing or asset sales were not significant, indicating that MPC was not protective against for household financial risks associated with health. Conclusions While MPC may have shown some positive effects, findings were mixed and MPC appears insufficient on its own to address health utilization and expenditures. A broader strategy addressing Syrian refugee health in Lebanon is needed of which MPC should be incorporated, with additional support such as additional conditional cash transfers for health.

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