Abstract 047: Using Geospatial Data To Eliminate Disparities In Covid-19 Testing

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Gregory W Heath ◽  
Tim Moreland ◽  
Shannon Stephenson ◽  
Jesse A Houser ◽  
Colleen Schmitt
Keyword(s):  
Community Health Centers ◽  
Effective Means ◽  
Age Distribution ◽  
Healthcare Services ◽  
Health Concern ◽  
Behavioral Risk ◽  
Local Health ◽  
Social Vulnerability Index ◽  
First Case ◽  
Black Residents

Introduction: The first case of COVID-19 in Chattanooga/Hamilton County, Tennessee (CHC) was identified on March 13, 2020. By early April, 51 RT-PCR confirmed cases were identified, with white, non-Hispanic males and females representing 82% (41/51) of positive cases and remaining cases representing black residents (18%; 9/51). That few people from racial/ethnic minorities were being tested became a key public health concern. We hypothesized that local mapping of health-related data would identify regions where individuals at greater risk for COVID-19 live and work and have limited access to testing and healthcare services. Methods: The CDC 500 Cities data was used to generate layered maps of prevalence estimates for cardiovascular disease, type 2 diabetes mellitus, chronic lung disease, and the behavioral risk factors of physical inactivity and obesity. Layers also included the CDC Social Vulnerability Index, age distribution, gender, race, ethnicity, and zip codes. Maps were shared with intersectoral collaborators representing the black and Hispanic/Latinx communities who provided specific neighborhood information to the maps. Collaborators included hospital systems, the local health department, community health centers, the private sector, and non-profit organizations. Maps were used to identify geographic sites for mobile and strategic testing within communities at higher risk for the spread of the coronavirus. Specific diverse neighborhoods along with worksites were then provided with testing beginning in early May and ongoing. Results: Strategic and mobile testing beginning in early May increased three-fold the number of identified new cases of COVID-19. Seventy percent (652/932) of these positive tests were among ethnically Hispanic/Latinx and 16% (149/932) among black residents. Positive tests continued to increase at a greater rate among Hispanic/Latinx and black residents compared with white residents through the months of May-July (68/10K vs. 2.6/10K, OR = 4.85, 95% CI 2.66, 9.02). Conclusions: This example of inter-sectoral collaboration, data sharing, and data use through strategic mapping of vulnerable populations for COVID-19 was an effective means to enhance COVID-19 testing and identification of positive cases throughout CHC. This expanded partnering resulting in targeted testing may be a useful approach among similar communities and subsequent outbreaks.

scholarly journals Overcoming the Challenges Faced by Immigrant Populations While Accessing Primary Care: Potential Solution-oriented Actions Advocated by the Bangladeshi-Canadian Community

2021 ◽  
Vol 12 ◽  
pp. 215013272110101
Author(s):  
Tanvir C Turin ◽  
Sarika Haque ◽  
Nashit Chowdhury ◽  
Mahzabin Ferdous ◽  
Nahid Rumana ◽  
...  
Keyword(s):  
Focus Group ◽  
Community Health Centers ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Service Level ◽  
Local Health ◽  
Self Awareness ◽  
Community Members ◽  
Individual Level ◽  
Policy Level

Introduction: Immigrants continue to face significant challenges in accessing primary healthcare (PHC) that often negatively impact their health. The present research aims to capture the perspectives of immigrants to identify potential approaches to enhance PHC access for this group. Methods: Focus group discussions (FGDs) were conducted among a sample of first-generation Bangladeshi immigrants who had experience with PHC in Canada. A total of 13 FGDs (7 among women, 6 among men) were conducted with 80 participants (women = 42, men = 38) in their preferred language, Bangla. We collected demographic information prior to each focus group and used descriptive statistics to identify the socio-demographic characteristics of participants. We applied thematic analysis to examine qualitative data to generate a list of themes of possible approaches to improve PHC access. Results: The focus group findings identified different levels of approaches to improve PHC access: individual-, community-, service provider-, and policy-level. Individual-level approaches included increased self-awareness of health and wellness and personal knowledge of cultural differences in healthcare services and improved communication skills. At the community level, supports for community members to access care included health education workshops, information sessions, and different support programs (eg, carpool services for senior members). Suggested service-level approaches included providers taking necessary steps to ensure an effective doctor-patient relationship with immigrants (eg, strategies to promote cultural competencies, hiring multicultural staff). FGD participants also raised the importance of government- or policy-level solutions to ensure high quality of care (eg, increased after-hour clinics and lab/diagnostic services). Conclusions: Although barriers to immigrants accessing healthcare are well documented in the literature, solutions to address them are under-researched. To improve healthcare access, physicians, community health centers, local health agencies, and public health units should collaborate with members of immigrant communities to identify appropriate interventions.

Policy Review: Dubai Health Authority’s COVID-19 Rapid Response

2020 ◽  
Vol 5 (Special) ◽  
Keyword(s):  
United Arab Emirates ◽  
Well Being ◽  
Healthcare Services ◽  
Rapid Response ◽  
Policy Implications ◽  
World Health ◽  
Healthcare Sector ◽  
Services Delivery ◽  
First Case ◽  
The World

Dubai Health Authority (DHA) is the entity regulating the healthcare sector in the Emirate of Dubai, ensuring high quality and safe healthcare services delivery to the population. The World Health Organization (WHO) declared COVID-19 a pandemic on the 11th of March 2020, indicating to the world that further infection spread is very likely, and alerting countries that they should be ready for possible widespread community transmission. The first case of COVID-19 in the United Arab Emirates was confirmed on 29th of January 2020; since then, the number of cases has continued to grow exponentially. As of 8th of July 2020 (end of the day), 53,045 cases of coronavirus have been confirmed with a death toll of 327 cases. The UAE has conducted over 3,720,000 COVID-19 tests among UAE citizens and residents over the past four months, in line with the government’s plans to strengthen virus screening to contain the spread of COVID-19. There were vital UAE policies, laws, regulations, and decrees that have been announced for immediate implementation to limit the spread of COVID- 19, to prevent panic and to ensure the overall food, nutrition, and well-being are provided. The UAE is amongst the World’s Top 10 for COVID-19 Treatment Efficiency and in the World’s Top 20 for the implementation of COVID-19 Safety measures. The UAE’s mission is to work towards resuming life after COVID-19 and enter into the recovery phases. This policy research paper will discuss the Dubai Health Authority’s rapid response initiatives towards combating the control and spread of COVID-19 and future policy implications and recommendations. The underlying factors and policy options will be discussed in terms of governance, finance, and delivery.

scholarly journals Diagnosis and Management of Osteoporosis During COVID-19: Systematic Review and Practical Guidance

2021 ◽  
Author(s):  
G. Hampson ◽  
M. Stone ◽  
J. R. Lindsay ◽  
R. K. Crowley ◽  
S. H. Ralston
Keyword(s):  
Clinical Care ◽  
Fragility Fractures ◽  
Osteoporosis Treatment ◽  
Healthcare Services ◽  
Urgent Care ◽  
Health Concern ◽  
Care Pathways ◽  
Long Term Conditions ◽  
Treatment Pathways ◽  
Diagnosis And Management

AbstractIt is acknowledged that the COVID-19 pandemic has caused profound disruption to the delivery of healthcare services globally. This has affected the management of many long-term conditions including osteoporosis as resources are diverted to cover urgent care. Osteoporosis is a public health concern worldwide and treatment is required for the prevention of further bone loss, deterioration of skeletal micro-architecture, and fragility fractures. This review provides information on how the COVID-19 pandemic has impacted the diagnosis and management of osteoporosis. We also provide clinical recommendations on the adaptation of care pathways based on experience from five referral centres to ensure that patients with osteoporosis are still treated and to reduce the risk of fractures both for the individual patient and on a societal basis. We address the use of the FRAX tool for risk stratification and initiation of osteoporosis treatment and discuss the potential adaptations to treatment pathways in view of limitations on the availability of DXA. We focus on the issues surrounding initiation and maintenance of treatment for patients on parenteral therapies such as zoledronate, denosumab, teriparatide, and romosozumab during the pandemic. The design of these innovative care pathways for the management of patients with osteoporosis may also provide a platform for future improvement to osteoporosis services when routine clinical care resumes.

scholarly journals Why has COVID-19 not hit the countries like Nepal yet?

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Krishna Prasad Pathak ◽  
Tara Gaire ◽  
Mu-Hsing Ho ◽  
Hui chen (Rita) Chang
Keyword(s):  
Health Services ◽  
Social Distance ◽  
Scientific Evidence ◽  
Local Health ◽  
First Case ◽  
Populations At Risk ◽  
Test Kit ◽  
Health Services Need ◽  
The Government ◽  
Google Search

AbstractNoble CORONA Virus (COVID-19) is an infectious disease similar form of pneumonia/ SARS-CoV-2- impacting globally. The fear of coronavirus looks pandemic, but its severity is uncertain. Nepal was one of the first nine countries outside of China to report a COVID-19 case. Also, its unpredictability of mode or range of surface, the lifespan of the virus, objects of transmission (a distance of air/air currents, living duration in air, humidity, duration on objects, surface). The first case was found in Wuhan in December 2019 in China. The purpose is to summarize the current information about COVID-19 and to explore in terms of why Nepal is not hitting severely, while other countries are on death toll? We summarized the published articles form the web sources and news, Academic Journals, Ministry of health and population Nepal, WHO/CDC update reports/guidelines, Google search engine. Thematic analysis is made to explore the situation. Although, Nepal has a lack of health services, testing kits, advance lab and protecting equipment (PPE), why COVID-19 does not hit Nepal than China, Europe and North America, it still tremendous uncertainty. Is lockdown, isolation, social distance and quarantine the best ways of prevention? The hypothesis is floating globally – do BCG vaccinated countries are safer than non-user OR due to not having enough kits to screen populations at risk for the virus – while lack of testing a big cause for missing case OR Nepalese have better immune systems? It has attracted global attention. We believe that the COVID-19 is still evolving and it is too early to predict of an outbreak in Nepal. The government needs to increase funding for local health departments, begin planning for future epidemics and be prepared to bolster the economy by supporting consumer spending the midst of a serious outbreak. COVID-19 is a serious health challenge for Nepal, but so far the number of death has been lower than was foretell. It is, therefore essential to carry out more scientific evidence to explore results. Nepalese health services need to maintain up than today and follow lockdown, isolation, social distance and an advance screening test kit through the country.

scholarly journals Malaria patterns across altitudinal zones of Mount Elgon following intensified control and prevention programs in Uganda

2020 ◽  
Author(s):  
Siya Aggrey ◽  
Egeru Anthony ◽  
Kalule Bosco John ◽  
Lukwa Tafadzwa Akim ◽  
Ssentongo Benard
Keyword(s):  
High Altitude ◽  
Arima Model ◽  
Sub Saharan Africa ◽  
Eastern Africa ◽  
Health Concern ◽  
Series Data ◽  
Trend Test ◽  
Local Health ◽  
Control And Prevention ◽  
Mount Elgon

Abstract Background Malaria remains a major tropical vector-borne disease of immense public health concern owing to its debilitating effects in sub-Saharan Africa. In the recent past, the high altitude areas in Eastern Africa have been reported to experience dramatic cases of malaria. However, its patterns following intensified control and prevention interventions remains and the changing climate remains widely unexplored in these regions. This study thus analyzed malaria patterns across altitudinal zones of Mount Elgon, Uganda. Methods Times-series data on malaria cases (2011 - 2017) from five level III local health centers occurring across three altitudinal zones; low, mid and high altitude was utilized. Inverse Distance Weighted (IDW) interpolation regression and Mann Kendall trend test were used to analyze malaria patterns. Autoregressive Integrated Moving Average (ARIMA) model was used to project malaria patterns for a seven year period. Results On average, 66±69/1000 individuals suffered from malaria on a monthly basis. This was most pronounced in the months of May-August 89±88/1000 compared to the months of November-February (40±33/1000). Malaria patterns varied with season and altitude and declined over time across the three altitudinal zones. Observed cases, revealed an annual average of 587±750/1000; 345±321/1000 and 338±351/1000 cases in lower, mid and high altitudes respectively. Conclusions Despite observed decline in malaria cases across the three altitudinal zones, the high altitude zone became a malaria hotspot as cases variably occurred in the zone. The projections of malaria revealed declining patterns of malaria cases in all the altitudinal zones. Malaria control interventions thus ought to be strengthened and strategically designed to achieve no malaria cases across all the altitudinal zones. Integration of climate information within malaria interventions can also strengthen eradication strategies of malaria in such differentiated altitudinal zones.

scholarly journals Level of Practice of Safety Precautions against COVID 19 among Pregnant Women Attending Antenatal clinics in Central Hospital Benin, Benin City in Nigeria

2021 ◽  
Vol 24 (11) ◽  
pp. 1925-1931
Author(s):  
ES Omozuwa ◽  
NE Uwaibi ◽  
JO Erhabor
Keyword(s):  
Health Education ◽  
Pregnant Women ◽  
Good Practice ◽  
Antenatal Clinic ◽  
Health Concern ◽  
Central Hospital ◽  
Benin City ◽  
First Case ◽  
Safety Precaution ◽  
Antenatal Clinics

Coronavirus disease 2019 (COVID‐19) has assumed a global health concern since the first case was recorded in Wuhan community China in December 2019. The objective of this paper is to report the level of practice of safety precautions against COVID 19 among pregnant women attending Antenatal Clinics in Central Hospital Benin, Benin City in Nigeria. A self- administered questionnaire on the level of practice of safety precautions against covid19 infection was administered to a total of 420 pregnant women attending antenatal clinics in central Hospital Benin City for Data collection. The results showed that two hundred and four (48.6%) of the respondents reported that they have recently avoided crowded places. Three hundred and seventy two (88.6%) reported recently wearing mask whenever they left home. Three hundred and twenty four (77.1%) of the respondents had good practice of safety precautions against COVID19. The study showed a good practice of safety precautions against COVID19 and this was influenced by the women’s level of education, occupation and knowledge of COVID-19. However, there is still the need to improve the knowledge of the women attending antenatal clinic regarding COVID-19 through health education seminars. Also up scaling the practice of safety precautions could be done through such health education seminars. Keywords: Pregnant women, Practice, Safety precaution, covid-19

Spontaneous Reporting of Adverse Drug Reaction Among Health Professionals In Kpone-Katamanso District, Ghana

2021 ◽  
Author(s):  
Morrison Asiamah ◽  
Kwadwo Owusu Akuffo ◽  
Pricillia Nortey ◽  
Nina Donkor ◽  
Anthony Danso-Appiah
Keyword(s):  
Health Professionals ◽  
Spontaneous Reporting ◽  
Effective Means ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Pharmacovigilance System ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Adequate Knowledge ◽  
Statistical Adjustment

Abstract Background: Spontaneous reporting of adverse drug reactions (ADR) is an effective means of ensuring postmarketing surveillance of drugs, and health professionals play a cardinal role through voluntary reporting of ADR. However, the pharmacovigilance system in Ghana is plagued with under-reporting issues, which is of public health concern. Method: A questionnaire-based cross-sectional study involving 268 health professionals at Kpone-Katamanso District was carried out. Data on spontaneous reporting of ADR, demographics of participants, knowledge, and attitudes of professionals towards reporting and factors that may influence ADR reporting were collected. Logistic regression models were used to examine the association of the independent variables with spontaneous reporting of ADR.Result: Overall, 77.6% (208) of the 268 respondents had witnessed ADR; however, only 17.3% of the respondents have ever reported an ADR to the FDA. Health professionals who had adequate knowledge on spontaneous reporting of ADR were 51.9%, while 30.3% had very good knowledge of spontaneous reporting of ADR. After statistical adjustment, Age (AOR=2.26, 95%CI= 1.25–4.10), Fear of Legal Consequences (AOR=0.15, 95%CI=0.41–0.51), Time Constraint (AOR=0.3, 95%CI=0.10–0.91), Pharmacovigilance training (AOR= 18.78, 95%CI= 5.46–64.59) and Unavailability of Reporting form (AOR=0.28, 95%CI=0.09– 0.88) were found to be significantly associated spontaneous reporting of ADR. Conclusion: The proportion of health professionals in the Kpone-Katamanso District who spontaneously report observed ADR is low. Our findings underscore the need for the FDA to intensify awareness through media sensitization and engage all relevant stakeholders on the need for the entire population to report ADR.

Exploring the Role of Service Quality and Knowledge for Mobile Health Services

2020 ◽  
pp. 1632-1653
Author(s):  
Nabila Nisha ◽  
Mehree Iqbal ◽  
Afrin Rifat ◽  
Sherina Idrish
Keyword(s):  
Health Services ◽  
Service Quality ◽  
Mobile Health ◽  
Information Quality ◽  
Effective Means ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Future Research ◽  
Facilitating Conditions

The use of mobile technology-based services has made healthcare delivery more accessible and affordable in recent times. In fact, mobile health services today act as an effective means of providing healthcare knowledge to users directly from providers. However, the cynical behavior of users regarding this medium of healthcare services often encircles around the quality of such services. The aim of this paper is to examine the role of service quality and knowledge among other underlying factors that can influence future use intentions of m-Health services in the context of Bangladesh. The conceptual model of the study identifies that certain aspects of service qualities like reliability, privacy, responsiveness, empathy and information quality along with facilitating conditions, effort expectancy, performance expectancy and social influence plays an important role in capturing users' overall perceptions of mobile health services. Finally, the study highlights managerial implications, future research directions and limitations from the Bangladesh perspective.

scholarly journals Utilization of healthcare services among Chinese migrants in Kenya: a qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jialing Qiu ◽  
Duo Song ◽  
Juan Nie ◽  
Mengyi Su ◽  
Chun Hao ◽  
...  
Keyword(s):  
Health Services ◽  
Language Translation ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Local Health ◽  
Quality Healthcare ◽  
Healthcare Facilities ◽  
Chinese Migrants ◽  
Sub Saharan ◽  
Local Healthcare

Abstract Background The number of Chinese migrants in Sub-Saharan Africa (SSA) is increasing, which is part of the south-south migration. The healthcare seeking challenges for Chinese migrants in Africa are different from local people and other global migrants. The aim of this study is to explore utilization of local health services and barriers to health services access among Chinese migrants in Kenya. Methods Thirteen in-depth interviews (IDIs) and six focus group discussions (FGDs) were conducted among Chinese migrants (n = 32) and healthcare-related stakeholders (n = 3) in Nairobi and Kisumu, Kenya. Data was collected, transcribed, translated, and analyzed for themes. Results Chinese migrants in Kenya preferred self-treatment by taking medicines from China. When ailments did not improve, they then sought care at clinics providing Traditional Chinese Medicine (TCM) or received treatment at Kenyan private healthcare facilities. Returning to China for care was also an option depending on the perceived severity of disease. The main supply-side barriers to local healthcare utilization by Chinese migrants were language and lack of health insurance. The main demand-side barriers included ignorance of available healthcare services and distrust of local medical care. Conclusions Providing information on quality healthcare services in Kenya, which includes Chinese language translation assistance, may improve utilization of local healthcare facilities by Chinese migrants in the country.

scholarly journals Evaluation of antibody detection against the NDO-BSA, LID-1 and NDO-LID antigens as confirmatory tests to support the diagnosis of leprosy in Yunnan province, southwest China

2019 ◽  
Vol 114 (3) ◽  
pp. 193-199
Author(s):  
Liu Jian ◽  
Shang Xiujian ◽  
You Yuangang ◽  
Xing Yan ◽  
Yuan Lianchao ◽  
...  
Keyword(s):  
Yunnan Province ◽  
Southwest China ◽  
Professional Staff ◽  
Health Concern ◽  
Antibody Detection ◽  
Diagnostic Tools ◽  
Local Health ◽  
Operating Characteristics ◽  
Leprosy Patients ◽  
Better Than

Abstract Although multidrug therapy (MDT) has been widely used for the treatment of leprosy for nearly 40 y, the disease remains a public health concern in some areas. The early detection of leprosy cases is vital to interrupt Mycobacterium leprae transmission, but currently diagnosis is typically achieved during the recognition of clinical symptoms by professional staff performing physical examinations in conjunction with microbiological assessment of slit skin smears (SSSs) and histopathology. In the last 10 y, serum antibody detection tests have emerged to aid leprosy diagnosis. Here we evaluated the ability of antigens NDO-BSA and LID-1 (ML0405 and ML2331) and the conjugate of these, NDO-LID, to detect antibodies in the sera of 113 leprosy patients and 166 control individuals in Yunnan province in southwest China. We found that each antigen was readily detected by sera from multibacillary (MB) patients, with sensitivities of 97.3%, 97.3% and 98.6% for NDO-BSA, LID-1 and NDO-LID, respectively. Even among paucibacillary (PB) patients the antigens detected antibodies in 74.4%, 56.4% and 69.2% of serum samples, respectively. Receiver operating characteristics (ROC) curve analysis indicated that, irrespective of the leprosy case classification as MB or PB, the detection efficiency obtained with NDO-LID was better than that obtained with the other two antigens (with LID-1 being a slightly better than NDO-BSA). Our results indicate the utility of NDO-LID in assisting in the diagnosis of PB and MB leprosy patients and that these antibody detection assays represent powerful diagnostic tools. We suggest that could be implemented into the procedures of local health centres in leprosy-endemic regions to assist in earlier diagnosis.

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