COVID-19-related research in Africa: a cross-sectional review of the International Clinical Trial Registration Platform (ICTRP)

Abstract Objective The declaration of the coronavirus disease (COVID-19), a pandemic in early 2020, has seen an upsurge in research globally to fill gaps in the epidemiology of the SARS-CoV-2 virus impact on health care and clinical management, as well as possible prevention and treatment modalities. Published literature on the different types of COVID-19 research conducted globally is varied and is particularly limited in Africa. This study sets out to describe the COVID-19-related research registered and conducted on the African continent. Methods This is a cross-sectional study of all COVID-19-related studies available in the WHO’s International Clinical Trials Registry Platform (ICTRP) repository. We extracted studies registered from March 1, 2020, to July 15, 2021. A descriptive analysis of the extracted data was performed, and the findings were presented. Results At extraction, a total of 12,533 COVID-19-related studies were listed on the ICTRP portal. We included 9803 studies, after excluding 2060 duplicate records and 686 records without a site/country. While 9347 studies (96%) were conducted outside of Africa, only 456 studies (4%) were conducted in the African continent, of which 270 (59.2%) were interventional studies, and 184 (40.4%) were observational studies. About 80% of the studies were conducted in Egypt and South Africa, and most of these involved testing of drugs and biologicals. Conclusion The African continent hosts considerably fewer COVID-19-related research compared to other parts of the world. This may have implications on scientific evidence available for implementing COVID-19 control efforts. There is, therefore, a need for local funding and ownership of research projects and north-south collaboration in research.

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Frequency of Neck and Upper Extremity Musculoskeletal Disorders in Dentists

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v9i3.404 ◽

2020 ◽

Vol 9 (3) ◽

pp. 207-211

Author(s):

Sidra Sarwar ◽

Sara Khalid ◽

Tahir Mahmood ◽

Hadeeqa Jabeen ◽

Shahid Imran

Keyword(s):

Upper Extremity ◽

Musculoskeletal Disorders ◽

Health Care Professionals ◽

Descriptive Analysis ◽

Sampling Technique ◽

Cross Sectional Study ◽

Cross Sectional ◽

Dental Hospital ◽

Upper Extremity Musculoskeletal Disorders ◽

And Performance

Background: Musculoskeletal disorders are not only becoming prevalent among health care professionals in our country but are affecting their health and performance adversely. They are caused by poor ergonomics and awkward posture during work activities. The purpose of this study was to determine the frequency of neck and upper limb musculoskeletal disorders in dentists of Lahore, Pakistan. Material and Methods: This cross-sectional study was conducted during October 2017 to March 2018. The data was collected using convenient sampling technique from 162 Dentists including 52 males and 110 females of Children hospital Lahore, Punjab Dental hospital and Fatima Memorial Hospital, Lahore. Data was collected by using Mangalore Questionnaire for identification of musculoskeletal disorders. Descriptive analysis of the data was done using SPSS version 22.0. Results: Of 162 dentists, 115 (71%) suffered from musculoskeletal disorders. Shoulder was the most commonly affected region (30.9%) followed by neck (25.9%), arm (6.2%), wrist (4.3%), elbow (3.1%) and forearm (0.6%). Pain (45.7%) was found to be the most common complaint followed by muscle weakness (20.4%), paraesthesia (3.7%) and swelling (1.2%). Conclusions: It was concluded that majority of the dentists were suffering from musculoskeletal disorders with shoulder as the most affected region and pain as the most frequent complaint. Key words: Dentists, Musculoskeletal disorders, Neck pain, Upper extremity

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SAT0082 FRAX AND DAS IN MOROCCAN RHEUMATOID ARTHRITIS PATIENTS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4467 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 975.1-975

Author(s):

H. Azzouzi ◽

O. Lamkhanat ◽

I. Linda

Keyword(s):

Rheumatoid Arthritis ◽

Fracture Risk ◽

Disease Activity ◽

Descriptive Analysis ◽

Cross Sectional Study ◽

Fracture Probability ◽

Mineral Density ◽

Cross Sectional ◽

Risk Probability ◽

Fracture Assessment

Background:Rheumatoid Arthritis (RA) is one of the risk factors for the calculation of the 10 years fracture probability assessed by the FRAX tool.Objectives:The aim was to study the association of disease activity and the 10 year fracture risk probability by the FRAX tool in our RA patients and their impact on fracture prevalence.Methods:Cross-sectional study of the association FRAX and disease activity score (DAS 28 CRP) was designed. Patients with RA were included. Mean DAS was calculated for each patient adjusted on his follow-up duration. Data about patients (demographic, disease characteristics and fracture assessment) were collected. The 10 year fracture risk probability for major osteoporotic fracture was calculated with and without BMD (bone mineral density) using the FRAX tool for Morocco. Descriptive analysis and regressions were performed with SPSS.20. p<0.05 was considered significant.Results:One hundred and ninety nine RA patients were included with mean age of 55.5±12 years. Women represented 91% and 40.1% had osteoporosis. Remission was observed in 86.4% with 95.5% taking methotrexate. 17.1% had vertebral fractures. FRAX and DAS were associated (p=0.03), and both explained vertebral fracture (VF) prevalence. When adjusted on disease parameters, FRAX with and without BMD explained the vertebral prevalence (p=0.02, OR=1.09[1.01-1.19]). However, age remains the only predictor of VF when adjusted on osteoporosis factors (DAS28CRP, menopause, BMI, smoking, diabetes, gender, steroid use, HAQ) and FRAX BMD.Conclusion:Persistent disease activity was associated to high 10 year fracture risk probability calculated by the FRAX tool in RA.Disclosure of Interests:None declared

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Thyroid cancer overdiagnosis and overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador

BMC Cancer ◽

10.1186/s12885-020-07735-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Paola Solis-Pazmino ◽

Jorge Salazar-Vega ◽

Eddy Lincango-Naranjo ◽

Cristhian Garcia ◽

Gabriela Jaramillo Koupermann ◽

...

Keyword(s):

Thyroid Cancer ◽

Cancer Mortality ◽

Incidental Finding ◽

Cross Sectional Study ◽

Anaplastic Carcinoma ◽

Treatment Modalities ◽

Sectional Study ◽

Cross Sectional ◽

Referral Center ◽

Clinical Records

Abstract Background In contrast to the rapid increase in thyroid cancer incidence, the mortality has remained low and stable over the last decades. In Ecuador, however, thyroid cancer mortality has increased. The objective of this study is to determine possible drivers of high rates of thyroid cancer mortality, through a cross-sectional analysis of all patients attending a thyroid cancer referral center in Ecuador. Methods From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo, a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. Results Among 452 patients, 74.8% were young adults and 94.2% (426) were female. 13.7% had a family history of thyroid cancer, and patients’ median tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15–5.95) with 76.2% of the thyroid cancer patients having MACIS score less than or equal to 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma, 86% (375) received radioactive iodine. Conclusion Thyroid cancer histological characteristics and method of diagnosis are like those described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.

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Empty shelves: selected essential medicines stockouts in South Africa

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.490 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L Wolvaardt ◽

R Nemuntandani ◽

I Kamungoma-Dada

Keyword(s):

South Africa ◽

Urban Areas ◽

Descriptive Analysis ◽

Secondary Data ◽

Treatment Interruption ◽

Cross Sectional Study ◽

Essential Medicines ◽

Chi Square ◽

Cross Sectional ◽

Antiretroviral Medication

Abstract Background Access to essential medicines in South Africa has been compromised by stockouts in health facilities. This study describes the occurrence of stockouts for a selection of essential medicines. Methods This cross-sectional study used secondary data retrieved from the Stop Stock Outs Project (SSP). A descriptive analysis was conducted on data from the 2013-2015 SSP case management database of routinely reported stockouts. Chi square tests of independence was conducted on data from the SSP 2015 annual telephonic survey to investigate associations between the occurrence of stockouts, the level of health facility and the type of health professional. Results 231 facilities reported 609 stockouts. Antiretroviral medication had the most stockout reports (78%; n = 475/609), followed by anti-infectives (17.1%; n = 104/609) and tuberculosis medication (4.9%; n = 30/609). The highest number of stockout reports were received from Gauteng province and the majority (71.09%; n = 150/211) of facilities reporting stockouts were in urban areas. There were more stockouts at ambulatory, rather than inpatient care, facilities however, this was not statistically significant. Conclusions This study confirms that South Africa experiences medicine stockouts for many of the essential medicines, with antiretroviral medication being the category most affected. The stockouts vary between provinces and the urban-rural divide but are an equal threat to both ambulatory and inpatient facilities. Key messages The pattern of stockouts experienced over a three-year period suggest that stockouts are ‘normal’ despite the substantive effects of treatment interruption – especially patients with HIV and/or TB. Antiretroviral therapy is at risk as a result of stockouts.

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POS1274 THERAPEUTIC MANAGEMENT OF RHEUMATOLOGISTS VERSUS OTORHINOLARYNGOLOGISTS OF CERVICOGENIC DIZZINESS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2230 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 921.2-922

Author(s):

M. Yasmine ◽

K. Maatallah ◽

H. Ferjani ◽

W. Triki ◽

D. Ben Nsib ◽

...

Keyword(s):

Physical Therapy ◽

Treatment Approach ◽

Cross Sectional Study ◽

Treatment Modalities ◽

Sectional Study ◽

Cross Sectional ◽

Standard Assessment ◽

Number Of Patients ◽

Cervicogenic Dizziness ◽

No Gold Standard

Background:The treatment of patients presenting with cervicogenic dizziness (CGD) may be challenging. Indeed, there is no consensual treatment approach for CGD, nor is there no gold-standard assessment for diagnosis.Objectives:Our study aimed to assess the management of CGD by rheumatologists versus otorhinolaryngologists.Methods:We conducted a cross-sectional study including Tunisian doctors dealing with CGD. Rheumatologists (RTO) and otorhinolaryngologists (ORL) were invited to answer a questionnaire via google form about CGD daily management. Outcomes of interest were treatment modalities.Results:The study included 30 RTO and 32 ORL. Most of the doctors (RTO, vs ORL) were females (88.3%, vs 56.3%), aged between 35 and 45 (43.3%, vs 62.5%), and worked at a private practice (33.3%, vs 59.4%). The number of patients diagnosed with CGD by RTO was as follows: 1-2 per year (33.3%), 1-2 per month (18.8%), 1-2 per week (20%), less than one patient a year (10%) and none in 3.3% of cases. The number of patients diagnosed with CGD by ORL was as follows: 1-2 per year (50%), 1-2 per month (33.3%), 1-2 per week (6.2%), less than one patient a year (15.7%) and none (9.4%). Most patients presenting with CGD were females in both groups (93.1%, vs 82.8% respectively) with a mean age between 36 and 65 (79.3%, vs 82.1%). Most of the respondents declared treating patients with CGD (93.1%, vs 79.1%). Regarding treatment modalities, physical therapy was the most prescribed in both specialties (81.5% and 48.3%, respectively). Only RTO (18.5%) prescribed manual therapy. Concerning medical treatment, anti-inflammatory were the most prescribed drugs in both groups (92.6, and 34.5%, respectively). Sixty-seven percent of RTO prescribed anti-vertigo medication. Interestingly, it was the least prescribed drug by ORL (6.9%). Only RTO (59.3%) prescribed Muscle relaxants.Conclusion:Despite the disparities in the management of CGD, physical therapy remains the first prescribed treatment by Tunisian doctors. Further studies are needed to establish a consensus to treat CGD.Disclosure of Interests:None declared

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Domestic violence and coping strategies among married adults during lockdown due to Coronavirus disease (COVID-19) pandemic in India: a cross-sectional study

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.59 ◽

2021 ◽

pp. 1-29

Author(s):

Priyanka Sharma ◽

Anita Khokhar

Keyword(s):

Domestic Violence ◽

Coping Strategies ◽

Descriptive Analysis ◽

Cross Sectional Study ◽

Systematic Research ◽

Sectional Study ◽

Cross Sectional ◽

Frontline Workers ◽

And Coping ◽

Study Participants

Abstract Background: There has been a reported increase in cases of domestic violence during the coronavirus disease (COVID-19) pandemic, however systematic research data is still unavailable. This study was conducted to find out domestic violence prevalence and coping strategies among married adults during lockdown due to COVID-19 in India. Methodology: A cross-sectional study was conducted among married men and women in the month of April 2020. Data regarding socio-demographic profile, domestic violence and coping strategies employed during lockdown was collected thorough google forms. 97.9% forms were completely filled by the respondents. Descriptive analysis was done. Results: Out of 94 study participants, about 7.4% (n=7) had faced domestic violence during lockdown. Out of these 7 participants, about 85.7% (n=6) reported increased frequency of domestic violence during lockdown. About half of the victims chose to ignore it (57.1%, n=4) or used yoga/meditation (42.9%, n=3) to cope. Conclusion: With about 7.4% study participants facing domestic violence during lockdown, it is necessary to study its detailed epidemiology in pandemics so that interventions like helpline numbers, screening of patients during tele-consultation, etc. which can be delivered even during lockdown with the help of healthcare and frontline workers could be devised to address this problem.

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High prevalence of peripheral neuropathy in multiple myeloma patients and the impact of vitamin D levels, a cross-sectional study

Supportive Care in Cancer ◽

10.1007/s00520-021-06414-3 ◽

2021 ◽

Author(s):

B. E. Oortgiesen ◽

J. A. Kroes ◽

P. Scholtens ◽

J. Hoogland ◽

P. Dannenberg - de Keijzer ◽

...

Keyword(s):

Multiple Myeloma ◽

Vitamin D ◽

Peripheral Neuropathy ◽

Hypovitaminosis D ◽

Cross Sectional Study ◽

Clinical Trial Registration ◽

Cross Sectional ◽

Validated Questionnaire ◽

Vitamin D Levels ◽

The Impact

Abstract Purpose Peripheral neuropathy (PN) is common in patients with multiple myeloma (MM). We hypothesized that the relationship between hypovitaminosis D and PN described in diabetes mellitus patients may also be present in MM patients. Methods To study this potential association, we assessed the incidence of hypovitaminosis D (vitamin D < 75 nmol/L [= 30 ng/mL]) in smouldering and active MM patients in two Dutch hospitals. Furthermore, a validated questionnaire was used to distinguish different PN grades. Results Of the 120 patients included between January 2017 and August 2018, 84% had an inadequate vitamin D level (median vitamin D level 49.5 nmol/L [IQR 34–65 nmol/L]; mean age: 68 years [SD ± 7.7]; males: 58%). PN was reported by 69% of patients (n = 83); however, of these 83 patients, PN was not documented in the medical records of 52%. An association was found between lower vitamin D levels and higher incidence of PN in the total population (P = 0.035), and in the active MM patients (P = 0.016). Conclusion This multi-centre cohort study showed that PN and hypovitaminosis D are common in MM patients, and addressing low vitamin D levels in the treatment of MM patients might be beneficial in reducing the risk of PN. More attention for PN is warranted, as PN is underreported by clinicians. Further research is needed to fully understand the implications of vitamin D in the development of PN in patients with MM. Clinical trial registration Netherland Trial Register NL5835, date of registration July 28, 2016

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A year of hepatocellular carcinoma at a glance. Demographics, biochemical and radiological characteristics and treatment modalities from a specialized facility of Pakistan

Journal of the Pakistan Medical Association ◽

10.47391/jpma.826 ◽

2021 ◽

pp. 1-6

Author(s):

Laima Alam

Keyword(s):

Hepatocellular Carcinoma ◽

Cross Sectional Study ◽

Treatment Modalities ◽

Fisher Exact Test ◽

Tumour Staging ◽

Chi Square ◽

Cross Sectional ◽

Exact Test ◽

Team Meetings ◽

Contrast Enhanced Ct

Objectives:Relation of demographics of hepatocellular-carcinoma with the aetiology.Tumour characteristics in relation to anti-viral therapy and presence of viral-DNA/RNATreatment modalities offeredMethods: This cross-sectional study enrolled all the patients aged 18-70 years with diagnosed hepatocellular carcinoma either through Triphasic Contrast-Enhanced-CT scan and/or Magnetic Resonance Imaging or biopsy presenting to the Outpatient-Department or multi-disciplinary-team meetings for the year 2019. Demographic variables, biochemical analysis including liver profile and stage of cirrhosis, viral-status, tumour staging and the treatment modalities offered were all noted. ANOVA (normal) and Kruskal-Wallis (non-normal) tests were used to compare quantitative data whereas chi-square-test and fisher-exact-test were used to compare qualitative-data.Results: Out of 195 patients with hepatocellular carcinoma, 76% were males in their fifth to sixth decades of life, 96% had cirrhosis, 94% corresponded to viral hepatocellular-carcinoma (82% Hepatitis-C-Virus, 9% Hepatitis-B-Virus and 3% coinfection), 60% of the cirrhotics landed in Child-Pugh A category with tumour staging BCLC-B being the predominant one (43.6%) and single and multiple bilateral nodules were the commonest lesions encountered. Platelets and Alanine-Transaminase had a significant relation across aetiological groups. Lymph-nodes were the most common extra-hepatic organs for metastasis and the presence of viral PCR had a significant impact on the tumour aggressiveness. Thirty-two percent of the patients were amenable to curative treatment.Conclusion: Viral infection is the main cause of rising prevalence of this tumour in Pakistan. Treatment modalities are expensive and expertise are lacking. A nationwide cancer registry is required for the exact disease burden and tumour behaviour for our population. Continuous....

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Use of simulation based technology in pre-clinical years improves confidence and satisfaction among medical students

Journal of the Pakistan Medical Association ◽

10.47391/jpma.1152 ◽

2021 ◽

pp. 1-19

Author(s):

Muhammad Bilal Mirza ◽

Anjiya Sulaiman ◽

Satwat Hashmi ◽

Samar Zaki ◽

Rehana Rehman ◽

...

Keyword(s):

Medical Students ◽

Medical Curriculum ◽

Teaching Method ◽

Clinical Skills ◽

Descriptive Analysis ◽

Group Discussion ◽

Cross Sectional Study ◽

Learning Objectives ◽

Student Interest ◽

Cross Sectional

Abstract Objective: To determine perception of medical students about learning from integrated simulated clinical skills sessions in Respiration and Circulation module of Year 1 undergraduate medical curriculum at Aga Khan University. Subjects & Methods: This cross-sectional study was conducted at the Centre for Innovation in Medical Education, Aga Khan University (AKU) from July 2018 to February 2019. Integrated clinical skills session involves use of a combination of live simulated patient and mechanical simulator to teach clinical skills. These sessions were conducted in Respiration and Circulation Module of MBBS Year I curriculum after which quantitative data was collected by a questionnaire that assessed usefulness of integrated clinical skills teaching method and confidence gained by students. The responses acquired were assessed on a Likert scale ranging from 1-5, (strongly agree -strongly disagree). Descriptive analysis was performed. A focused group discussion (FGD) with students and an in-depth interview with a facilitator conducting the clinical skills sessions was arranged. Simple verbatim transcription of FGD recordings and thematic analyses was executed. Results: Quantitative analysis showed that more than 90% of the students believed integrated sessions were effective in acquiring the learning objectives and found them enjoyable and motivating. 80% expressed confidence that they had accomplished learning objectives and felt they have learned practical clinical skills. Qualitative analysis revealed that these sessions enhanced understanding of subject matter and student engagement during sessions. Conclusion: Integrated clinical skills sessions improved student interest, engagement and promoted student confidence. It should be implemented in undergraduate medical teaching curriculum. Continuous...

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Factors Associated With Informational Support in Transitional Care for Older Adults With Chronic Diseases: A Cross-Sectional Study

Clinical Nursing Research ◽

10.1177/10547738211051881 ◽

2021 ◽

pp. 105477382110518

Author(s):

Gui-Ling Geng ◽

Wen-Wen Yang ◽

Xiao-Liu Shi ◽

Jia-Ning Hua ◽

Min Cui ◽

...

Keyword(s):

Older Adults ◽

Chronic Diseases ◽

Transitional Care ◽

Descriptive Analysis ◽

Cross Sectional Study ◽

Informational Support ◽

Cross Sectional ◽

Care Survey ◽

Strobe Statement ◽

Care Study

To evaluate the current situation and associated factors of informational support for older adults with chronic diseases in transitional care. Study was conducted in five hospitals of five different cities in Jiangsu Province, China. A random cluster sample of 800 older adults with chronic diseases responded to the informational support questionnaire of transitional care survey. Descriptive analysis, t-tests, variance analysis, and stepwise multiple linear regression were used to analyze data. The STROBE statement for observational studies was applied. Total score of ISQTC for older adults with chronic diseases was (44.05 ± 17.21). Marital status, educational level, past occupation, close friends, medical insurance, complications, and exercise habits were significantly correlated with informational support. The level of informational support in transitional care for older adults with chronic diseases was low. Clinical staff should periodically and primarily assess their informational support, help find information resources for those who have low initial informational support, and identify which information they preferred to carry out accurate transitional care.

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