scholarly journals A multinational e-survey on the delivery of cardiology services in Africa during the COVID-19 pandemic: what should we expect after this pandemic?

Author(s):  
Chris Nadege Nganou-Gnindjio ◽  
Mazou Ngou Temgoua ◽  
Liliane Mfeukeu Kuate ◽  
Clovis Nkoke ◽  
Joel Noutakdie Tochie ◽  
...  

Abstract Objective: To evaluate the impact of the COVID-19 pandemic on the delivery of cardiology services in Africa. Design: Cross-sectional e-survey study. Setting: African countries Participants: Cardiologists Primary and Secondary outcomes measures: The primary outcome was the change in service delivery in African cardiology units during the on-going COVID-19 pandemic. The secondary outcomes were the satisfaction of cardiologists with regards to the workload and factors associated with this satisfaction. Results: There was a significant reduction in working time and the number of patients consulted by week during this pandemic (p<0.001). In general, there was a decrease in the overall activities in cardiovascular care delivery. The majority of cardiology services (76.5%) and consulting programs (85%) were adjusted to the pandemic. Only half of the participants were satisfied with their workload. Reconfiguration of the consultation schedule was associated with a reduced satisfaction of participants (p=0.02). Conclusions: COVID-19 is associated with an overall reduction in cardiology services rendered in Africa. Since the cardiovascular burdens continue to increase in this part of the World and the risk of cardiovascular complications linked to SARS COV2 remains unchanged cardiology, departments in Africa should anticipate a significant surge of cardiology services demanded by patients after the COVID-19 pandemic.

2020 ◽  
Author(s):  
Chris Nadege Nganou-Gnindjio ◽  
Mazou Temgoua ◽  
Liliane Kuate ◽  
Clovis Nkoke ◽  
Joel Noutakdie Tochie ◽  
...  

Abstract BackgroundCOVID-19 is a global public health crisis that affects all sectors; studying the impact of this pandemic on the delivery of cardiology services in Africa is crucial as COVID-19-related cardiovascular complications may worsen the CVD burden in this already highly affected and resource-limited continentMethodsThis was a cross-sectional e-survey study conducted amongst cardiologists in African countries. The primary outcome was the change in service delivery in African cardiology units during the on-going COVID-19 pandemic. The secondary outcomes were the satisfaction of cardiologists with regards to the workload and factors associated with this satisfaction.ResultsThere was a significant reduction in working time and the number of patients consulted by week during this pandemic (p<0.001). In general, there was a decrease in the overall activities in cardiovascular care delivery. The majority of cardiology services (76.5%) and consulting programs (85%) were adjusted to the pandemic. Only half of the participants were satisfied with their workload. Reconfiguration of the consultation schedule was associated with a reduced satisfaction of participants (p=0.02).ConclusionsCOVID-19 is associated with an overall reduction in cardiology services rendered in Africa. Since the cardiovascular burdens continue to increase in this part of the World and the risk of cardiovascular complications linked to SARS COV2 remains unchanged cardiology, departments in Africa should anticipate a significant surge of cardiology services demanded by patients after the COVID-19 pandemic.


2020 ◽  
Author(s):  
Khanh Ngoc Cong Duong ◽  
Tien Nguyen Le Bao ◽  
Phuong Thi Lan Nguyen ◽  
Thanh Vo Van ◽  
Toi Phung Lam ◽  
...  

BACKGROUND The first nationwide lockdown due to the COVID-19 pandemic was implemented in Vietnam from April 1 to 15, 2020. Nevertheless, there has been limited information on the impact of COVID-19 on the psychological health of the public. OBJECTIVE This study aimed to estimate the prevalence of psychological issues and identify the factors associated with the psychological impact of COVID-19 during the first nationwide lockdown among the general population in Vietnam. METHODS We employed a cross-sectional study design with convenience sampling. A self-administered, online survey was used to collect data and assess psychological distress, depression, anxiety, and stress of participants from April 10 to 15, 2020. The Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) were utilized to assess psychological distress, depression, anxiety, and stress of participants during social distancing due to COVID-19. Associations across factors were explored using regression analysis. RESULTS A total of 1385 respondents completed the survey. Of this, 35.9% (n=497) experienced psychological distress, as well as depression (n=325, 23.5%), anxiety (n=195, 14.1%), and stress (n=309, 22.3%). Respondents who evaluated their physical health as average had a higher IES-R score (beta coefficient [B]=9.16, 95% CI 6.43 to 11.89), as well as higher depression (B=5.85, 95% CI 4.49 to 7.21), anxiety (B=3.64, 95% CI 2.64 to 4.63), and stress (B=5.19, 95% CI 3.83 to 6.56) scores for DASS-21 than those who rated their health as good or very good. Those who self-reported their health as bad or very bad experienced more severe depression (B=9.57, 95% CI 4.54 to 14.59), anxiety (B=7.24, 95% CI 3.55 to 10.9), and stress (B=10.60, 95% CI 5.56 to 15.65). Unemployment was more likely to be associated with depression (B=3.34, 95% CI 1.68 to 5.01) and stress (B=2.34, 95% CI 0.84 to 3.85). Regarding worries about COVID-19, more than half (n=755, 54.5%) expressed concern for their children aged &lt;18 years, which increased their IES-R score (B=7.81, 95% CI 4.98 to 10.64) and DASS-21 stress score (B=1.75, 95% CI 0.27 to 3.24). The majority of respondents (n=1335, 96.4%) were confident about their doctor’s expertise in terms of COVID-19 diagnosis and treatment, which was positively associated with less distress caused by the outbreak (B=–7.84, 95% CI –14.58 to –1.11). CONCLUSIONS The findings highlight the effect of COVID-19 on mental health during the nationwide lockdown among the general population in Vietnam. The study provides useful evidence for policy decision makers to develop and implement interventions to mitigate these impacts. CLINICALTRIAL


2020 ◽  
Author(s):  
Ke Zeng ◽  
Weiguo Zhu ◽  
Caiyou Wang ◽  
Liyan Zhu

BACKGROUND The rapid spread of COVID-19 has created a severe challenge to China’s healthcare system. Hospitals across the country reacted quickly under the leadership of the Chinese government and implemented a range of informatization measures to effectively respond to the COVID-19. OBJECTIVE To understand the impact of the pandemic on the medical business of Chinese hospitals and the difficulties faced by hospital informatization construction. To discuss the application of hospital informatization measures during the COVID-19 pandemic. To summarize the practical experience of hospitals using information technology to fight the pandemic. METHODS Performing a cross-sectional on-line questionnaire survey in Chinese hospitals, of which the participants are invited including hospital information staff, hospital administrators, medical staff, etc. Statistical analyzing the collected data by using SPSS version 24. RESULTS A total of 804 valid questionnaires (88.45%) are collected in this study from 30 provinces in mainland China, of which 731 (90.92%) were filled out by hospital information staff. 473 (58.83%) hospitals are tertiary hospitals while the remaining 331 (41.17%) are secondary hospitals. The majority hospitals (82.46%) had a drop in their business volume during the pandemic and a more substantial drop is found in tertiary hospitals. 70.40% (n=566) of hospitals have upgraded or modified their information systems in response to the epidemic. The proportion of tertiary hospitals that upgraded or modified systems is significantly higher than that of secondary hospitals. Internet hospital consultation (70.52%), pre-check and triage (62.56%), telemedicine (60.32%), health QR code (57.71%), and telecommuting (50.87%) are the most used informatization anti-pandemic measures. There are obvious differences in the application of information measures between tertiary hospitals and secondary hospitals. Among these measures, most of them (41.17%) are aiming at serving patients and most of them (62.38%) are universal which continue to be used after pandemic. The informatization measures are mostly used to control the source of infection (48.19%), such as health QR Code, etc. During the pandemic, the main difficulties faced by the hospital information department are “information construction projects are hindered” (58.96%) and “increased difficulty in ensuring network information security” (58.58%). There are significant differences in this issue between tertiary hospitals and secondary hospitals. The shortcomings of hospital informatization that should be made up for are “shorten patient consultation time and optimize consultation process” (72.51%), “Ensure network information security” (72.14%) and “build internet hospital consultations platform” (59.95%). CONCLUSIONS A significant number of innovative medical information technology have been used and played a significant role in all phases of COVID-19 prevention and control in China. Since the COVID-19 brought many challenges and difficulties for informatization work, hospitals need to constantly improve their own information technology skills to respond to public health emergencies that arise at any moment.


2021 ◽  
pp. 135910532098558
Author(s):  
Carmina Castellano-Tejedor ◽  
María Torres-Serrano ◽  
Andrés Cencerrado

The transformation that COVID-19 has brought upon the world is unparalleled. The impact on mental health is equally unprecedented and yet unexplored in depth. An online-based survey was administered to 413 community-based adults during COVID-19 confinement to explore psychological impact and identify high risk profiles. Young females concerned about the future, expressing high COVID-related distress, already following psychological therapy and suffering from pre-existing chronic conditions, were those at highest risk of psychological impact due to the COVID-19 situation. Findings could be employed to design tailored psychological interventions in the early stages of the outbreak to avoid the onset/exacerbation of psychopathology.


2021 ◽  
Vol 8 ◽  
pp. 237437352110076
Author(s):  
Hyllore Imeri ◽  
Erin Holmes ◽  
Shane Desselle ◽  
Meagen Rosenthal ◽  
Marie Barnard

Chronic conditions (CCs) management during the COVID-19 pandemic and the impact of the pandemic on patient activation (PA) and health locus of control (HLOC) remain unknown. This cross-sectional online survey study examined the role of COVID-19 pandemic-related worry or fear in PA and HLOC among patients with CCs. Individuals with CCs (n = 300) were recruited through MTurk Amazon. The questionnaire included sociodemographic questions, the Patient Activation Measure, and the Multidimensional Health Locus of Control–Form B. Out of the 300 participants, 9.7% were diagnosed with COVID-19, and 7.3% were hospitalized. Patients with cancer, chronic kidney disease, chronic obstructive pulmonary disease, drug abuse/substance abuse, and stroke reported significant difficulties in managing their CCs due to worry or fear because of COVID-19. More than half of the sample (45.7%) reported COVID-19-related worry or fear about managing their CCs, and these patients had lower PA and lower external HLOC compared to patients not affected by COVID-19-related worry or fear. Health professionals should provide more support for patients facing difficulties in managing their CCs during the COVID-19 pandemic.


2021 ◽  
pp. 229255032110300
Author(s):  
Caroline F. Illmann ◽  
Christopher Doherty ◽  
Margaret Wheelock ◽  
Joshua Vorstenbosch ◽  
Joan E. Lipa ◽  
...  

Background: The COVID-19 pandemic has led to unprecedented challenges and restrictions in surgical access across Canada, including for breast reconstructive services which are an integral component of comprehensive breast cancer care. We sought to determine how breast reconstructive services are being restricted, and what strategies may be employed to optimize the provision of breast reconstruction through a pan-Canadian evaluation from the providers’ perspective. Methods: This was a cross-sectional survey of Canadian plastic and reconstructive surgeons who perform breast reconstruction. The 33-item web-based questionnaire was developed by a pan-Canadian working group of breast reconstruction experts and disseminated via email to members of the Canadian Society of Plastic Surgery. The questionnaire queried respondents on the impact of the COVID-19 pandemic and associated restrictions on surgeons’ breast reconstruction practice patterns and opinions on strategies for resource utilization. Results: Responses were received from 49 surgeons, who reported practicing in 8 of 10 Canadian provinces. Restrictions on the provision of breast reconstructive procedures were most limited during the First Wave of the COVID-19 pandemic, where all respondents reported at least some reduction in capacity and more than a quarter reporting complete cessation. Average reported reduction in capacity ranged from 31% to 78% across all 3 waves. Autologous, delayed, and prophylactic reconstructions were most commonly restricted. Conclusion: This study provides a pan-Canadian impact assessment on breast reconstructive services during the COVID-19 pandemic from the providers’ perspective. To uphold the standards of patient-centred care, a unified approach to strategically reorganize health care delivery now and in the future is needed.


Author(s):  
Adithya Pradyumna ◽  
Mirko S. Winkler ◽  
Jürg Utzinger ◽  
Andrea Farnham

Studies from India and several eastern African countries found that the impact of dairy animal ownership on household nutrition varied greatly, depending on the socio-geographic context. The purpose of this study was to examine the association between livestock ownership and household dietary quality in rural Kolar district, India. We collected data from a household survey in four study villages (n = all 195 households of the four villages) of Kolar district, applying a cross-sectional design. Kendall’s rank correlation coefficient was employed to determine the correlation between milk consumption and other dietary variables. Multivariable logistic regression was used to describe the relationship between dairy animal ownership and household milk consumption. Households owning dairy animals more often had access to irrigation (58.3% vs. 25.2%) and were less often woman-headed (2.4% vs. 22.5%). Household milk consumption was significantly correlated with consumption of vegetable variety, egg, and meat (all p-values < 0.05). After adjusting for multiple confounders, the odds ratio of milk consumption between dairy animal-owning households as compared to other households was 2.11 (95% confidence interval 0.85, 5.45). While dairy animal ownership was found to be associated with improved dietary quality, larger households were in a better position to adopt dairy animals, which, in turn, might contribute to better household nutrition.


2021 ◽  
pp. 002190962110544
Author(s):  
Gizachew Tiruneh

The main objective of this paper is to test the influence of Africa’s founding fathers and the impact of British colonial legacy on the political stability of Africa. We relied on a sample of 50 African countries and employed cross-sectional research designs, which covered two separate periods (1960–1989 and 1990–2018). Using logistic regression and OLS estimators and controlling for French colonial legacy, economic development, regime type, ethnic heterogeneity, and ethnic polarization, we found that the founding fathers were conducive to Africa’s political stability between 1960 and 2018. We also found that British colonial legacy had some impact on former British colonies’ stability between 1960 and 2018. In addition, GDP per capita had a significant impact on Africa’s political stability over the two periods.


2021 ◽  
Author(s):  
Min Yi Sum ◽  
Sherry Kit Wa Chan ◽  
Gloria Hoi Yan Wong

BACKGROUND Adolescence and young adulthood is a period of heightened risk of mental disorders onset. The Covid-19 pandemic may have impacted the daily lives and learning of students, exposing them to risks of emotional distress. Understanding factors associated with individual differences in distress can inform remedial strategies for schools. OBJECTIVE To investigate the impact of Covid-19 on undergraduate students’ lifestyle and learning, and explore relationship between depressive symptoms, resilience, and optimism/pessimism bias in undergraduate students in Hong Kong. METHODS Cross-sectional online survey of undergraduate students in a university (n=1020) before and during the third wave of Covid-19 outbreak in Hong Kong between May and August 2020. Changes in habits and family conflicts, depressive symptoms (measured using Patient Health Questionnaire-9), resilience (measured using Connor-Davidson Resilience Scale), optimism/pessimism towards Covid-19 risks, and knowledge about Covid-19 were recorded. Multivariable linear regression and mediation analyses were used to explore relationships with depressive symptoms. RESULTS 61.7% of respondents have mild to severe depressive symptoms. The regression model found that 18.5% of the variance in depressive symptoms was explained by resilience, pessimism bias, changes in sleep, decrease in study at home, and increase in family conflict. Mediation analysis showed that resilience is indirectly related to depressive symptoms through its relationship with pessimism (ab = -0.042, CI = -0.057 to -0.013). Higher resilience was associated with lower depressive symptoms even after accounting for resilience’s indirect effect through pessimism (c’ = 0.311, P < .001). CONCLUSIONS The findings highlight the mental health vulnerability of undergraduate students. Measures to reduce family conflict, maintain healthy daily habits, adjust optimism/pessimism bias, and enhance resilience may be useful for improving the mental wellbeing of undergraduate students during the pandemic.


2017 ◽  
Vol 16 (8) ◽  
pp. 742-752 ◽  
Author(s):  
Joanna Sweeting ◽  
Kylie Ball ◽  
Julie McGaughran ◽  
John Atherton ◽  
Christopher Semsarian ◽  
...  

Background: Physical activity is associated with improved quality of life. Patients with an implantable cardioverter defibrillator (ICD) face unique clinical and psychological challenges. Factors such as fear of ICD shock may negatively impact on physical activity, while a sense of protection gained from the ICD may instil confidence to be active. Aim: We aimed to examine the impact of an ICD on physical activity levels and factors associated with amount of activity. Methods: Two cross-sectional studies were conducted. Accelerometer data (seven-day) was collected in March–November 2015 for 63 consecutively recruited hypertrophic cardiomyopathy patients, with or without an ICD, aged ⩾18 years. A survey study was conducted in July–August 2016 of 155 individuals aged ⩾18 years with an inherited heart disease and an ICD in situ. Results: Based on the International Physical Activity Questionnaire, mean leisure time physical activity was 239 ± 300 min/week with 51% meeting physical activity guidelines. Accelerometry showed that mean moderate–vigorous physical activity was the same for patients with and without an ICD (254 ± 139 min/week versus 300 ± 150 min/week, p=0.23). Nearly half of survey participants ( n=73) said their device made them more confident to exercise. Being anxious about ICD shocks was the only factor associated with not meeting physical activity guidelines. Conclusions: Patients with inherited heart disease adjust differently to their ICD device, and for many it has no impact on physical activity. Discussion regarding the appropriate level of physical activity and potential barriers will ensure best possible outcomes in this unique patient group.


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