scholarly journals Clinical Characteristics of Vulnerable Populations Hospitalized and Diagnosed with COVID‑19 during Second Wave in Buenos Aires, Argentina.

2022 ◽  
Author(s):  
Silvia Kochen ◽  
Alejandro Yacobitti ◽  
Lisandro Otero ◽  
Valeria Doldan Arruabarrena ◽  
Florencia del Marmol ◽  
...  
Keyword(s):  
Vulnerable Populations ◽  
Rural Areas ◽  
Buenos Aires ◽  
Medical Condition ◽  
Intensive Therapy ◽  
Health Centers ◽  
Levels Of Care ◽  
Number Of Patients ◽  
Urban And Rural Areas ◽  
Second Wave

Abstract There are a few in Argentina publications regarding the presentation of patients with COVID-19 requiring hospitalized and emergency care in vulnerable populations that compares the first and second wave, and it has few reports in developing countries. The objective is to determine whether in the care of vulnerable patients, to succeed against COVID-19, multiple public health tools and interventions necessary to minimize morbidity and mortality. The study is a prospective cohort investigation of 3028 patients during second wave with lab-confirmed COVID-19, who required any of the Health Centers response from April 1, 2021, to June 30, 2021. In a previous publication, our group analyzed the situation of hospitalized patients during the first wave in the same region, "Southeast Network" (SN), Buenos Aires Metropolitan Area (AMBA). SN with 1.8 million inhabitants residing in urban and rural areas. A total of 14 health centers with different levels of care complexity provide care to patients in the region. The information of each patient with COVID-19 evaluated by SN, was incorporated in an Epidemiological Dashboard. The investigation was designed and reported with consideration of observational studies in epidemiology. A total of 57.9% patients were men, and the mean age (SD) was 52.1 (13.5) years. Sixty four percent patients with pre-existing diseases, most frequent hypertension and diabetes, but diabetes, obesity, and cardiovascular disease presented higher risk. A total of 24.7% were hospitalized in Intensive Therapy Unit. The mortality of the cohort was 22.9%. Mortality was higher for patients aged 65 or more, and for those had some pre-existing disease. But, it was a slightly more than double that in the first wave, it is possible mainly due to the fact that more than doubled of patients in Second wave required hospitalization in ITU, compared to First wave. The patients presented greater severity of their medical condition at the time of their hospitalization. These findings were similar to those reported by other authors. Another possible cause of the high number of patients in the period studied is due to the fact that most of the hospitalized population had not been vaccinated. The health system was able to respond to the demand.

scholarly journals SARS-CoV-2 exposure in Malawian blood donors: an analysis of seroprevalence and variant dynamics between January 2020 and July 2021

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jonathan Mandolo ◽  
Jacquline Msefula ◽  
Marc Y. R. Henrion ◽  
Comfort Brown ◽  
Brewster Moyo ◽  
...  
Keyword(s):  
Rural Areas ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Cross Sectional ◽  
Sub Saharan ◽  
Urban And Rural Areas ◽  
Second Wave ◽  
Adequate Sample Size ◽  
Pandemic Wave

Abstract Background By August 2021, the COVID-19 pandemic has been less severe in sub-Saharan Africa than elsewhere. In Malawi, there have been three subsequent epidemic waves. We therefore aimed to describe the dynamics of SARS-CoV-2 exposure in Malawi. Methods We measured the seroprevalence of anti-SARS-CoV-2 antibodies amongst randomly selected blood transfusion donor sera in Malawi from January 2020 to July 2021 using a cross-sectional study design. In a subset, we also assessed in vitro neutralisation against the original variant (D614G WT) and the Beta variant. Results A total of 5085 samples were selected from the blood donor database, of which 4075 (80.1%) were aged 20–49 years. Of the total, 1401 were seropositive. After adjustment for assay characteristics and applying population weights, seropositivity reached peaks in October 2020 (18.5%) and May 2021 (64.9%) reflecting the first two epidemic waves. Unlike the first wave, both urban and rural areas had high seropositivity in the second wave, Balaka (rural, 66.2%, April 2021), Blantyre (urban, 75.6%, May 2021), Lilongwe (urban, 78.0%, May 2021), and Mzuzu (urban, 74.6%, April 2021). Blantyre and Mzuzu also show indications of the start of a third pandemic wave with seroprevalence picking up again in July 2021 (Blantyre, 81.7%; Mzuzu, 71.0%). More first wave sera showed in vitro neutralisation activity against the original variant (78% [7/9]) than the beta variant (22% [2/9]), while more second wave sera showed neutralisation activity against the beta variant (75% [12/16]) than the original variant (63% [10/16]). Conclusion The findings confirm extensive SARS-CoV-2 exposure in Malawi over two epidemic waves with likely poor cross-protection to reinfection from the first on the second wave. The dynamics of SARS-CoV-2 exposure will therefore need to be taken into account in the formulation of the COVID-19 vaccination policy in Malawi and across the region. Future studies should use an adequate sample size for the assessment of neutralisation activity across a panel of SARS-CoV-2 variants of concern/interest to estimate community immunity.

scholarly journals A clinicopathological study of vernal conjunctivitis in urban and rural areas of Eastern India: A hospital based study

2018 ◽  
Vol 6 (3) ◽  
pp. 966
Author(s):  
Suman Adhikari ◽  
Asok Kumar Naskar ◽  
Samarendra Kabasi ◽  
Sujata Deb ◽  
R. K. Deb ◽  
...  
Keyword(s):  
Rural Areas ◽  
Vernal Keratoconjunctivitis ◽  
Treatment Groups ◽  
Medical College ◽  
Biopsy Specimens ◽  
Number Of Patients ◽  
Department Of Ophthalmology ◽  
Conjunctival Biopsy ◽  
Urban And Rural Areas ◽  
Vernal Conjunctivitis

Background: Vernal keratoconjunctivitis (VKC) is a relatively rare, chronic form of ocular allergy that can potentially cause severe visual complications.Methods: The present study was carried out amongst the patients suffering from vernal conjunctivitis and attending the Outpatient Department of Ophthalmology of Mata Gujri Memorial Medical College & Lions Seva Kendra Hospital, Kishanganj (Bihar). The conjunctiva and cornea were examined for any complication of the disease. The patients were categorized into two treatment groups, each group treated with one topical drug. As the total number of patients in the study was 100, each treatment group consisted of 50 patients, one group of patients was treated with 0.05% azelastine eye drop and the other group treated with 2% sodium cromoglycate eye drop.Results: Greater incidence during the period from March to June (59%) and the highest number in the month of May (18%). Of the 100 patients in the study group, the largest group of 89 patients presented with limbal vernal conjunctivitis; 7 patients presented with palpebral vernal conjunctivitis and 4 patients suffered from a mixed type (both limbal and palpebral) type of the disease.Conclusions: Examination of the conjunctival biopsy specimens of the patients showed chronic nonspecific inflammatory reaction, mostly confined to the subepithelial region. Patients in both groups showed dramatic results of the treatment proving the efficacy of steroids. 

scholarly journals Assessment of the Anemic Conditions among the Females with Pregnancy at Tertiary Care Hospitals of Sindh Pakistan

2021 ◽  
pp. 87-92
Author(s):  
Nusrat Fozia Pathan ◽  
Bushra Noor ◽  
Fozia Unar ◽  
Sadaf Chandio ◽  
Fareeda Wagan ◽  
...  
Keyword(s):  
Secondary Education ◽  
Rural Areas ◽  
Medical Condition ◽  
Tertiary Care ◽  
Intravenous Iron ◽  
Major Theme ◽  
Cross Sectional ◽  
Feminine Gender ◽  
Number Of Patients ◽  
Tertiary Care Hospitals

Anemia is pathological disorder usually caused by mal nutrition and it was very common among feminine gender during gestational period, number of disease and death are also associated with this type of disorder during pregnancy. The major theme of the study is to evaluate the anemic condition along with prescribed medication among females during the period of pregnancy. Descriptive cross-sectional study was carried out for the period of 9 months at various tertiary care hospitals situated in rural areas of Sindh province. Total 273 females with pregnancy along with anemic condition, were selected by purposive sampling method. From total number of study subjects 71% females were diagnosed as anemic, that were further categorized as mild, moderate and severe, depend on their medical condition. It was observed that anemic condition was more common among infancy pregnant females with ages 20-29 years, the number of patients were 209 (76.5%). females with primary or secondary education had more problem of anemia as compared to females with intermediate or graduation. Anemic females with primary education (126), secondary education (73) whereas anemic female with intermediate (46) and with graduation anemic females were only (28). Females with multipara had severe anemic condition as females with primigravida. Anemic condition becomes more severe among females with second or third trimester. Anemic condition among females with 1st trimester was 37, in second trimester 109 whereas in 3rd trimester 127 anemic females were reported. For management of anemia among females with pregnancy depends upon the medication taking by them, number of females was 142, which were taking 3 or 4 medicine, while females with mono pharmacy were 95 and only 36 females were taking various multi vitamin, intravenous Iron supplement and it was concluded that anemia was more common among females resident of rural area due to unawareness regarding anemia and its associated complication. Another major cause was observed was mal nutrition.

scholarly journals Preparedness of non-hospital health centers to manage patients with life-threatening emergency conditions: findings from a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Homayoun Sadeghi-Bazargani ◽  
Mehrdad Amir-Behghadami ◽  
Masoumeh Gholizadeh ◽  
Ali Janati ◽  
Farzad Rahmani
Keyword(s):  
Rural Areas ◽  
Work Experience ◽  
Healthcare Providers ◽  
Geographic Area ◽  
Health Centers ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Life Threatening ◽  
New Perspective ◽  
Urban And Rural Areas

Abstract Background Management of Life-threatening Emergency (LTE) patients in urban and rural areas is an important challenge, which can affect pre-hospital mortality rate. Therefore, Non-hospital Health Center (NHHC) must be prepared to manage such emergency cases that may occur in the geographic area where these centers act. The aim of this study was to explore domains related to the preparedness of NHHCs to manage LTE patients through resorting to healthcare providers’ and experts’ perspectives. Methods A qualitative exploratory study was applied using Semi-Structured Interviews (SSIs) and Focus Group Discussions (FGDs). Prior to beginning data collection, the study and its objectives were explained to the participants and their informed consents were obtained. Then, SSIs and FGDs were conducted by two trained researchers using an interview guide, which was developed through literature review and consulting experts. In total, 12 SSIs were done with the providers at different NHHCs in Tabriz. In addition, 2 FGDs were conducted with the specialists in Emergency Medicine (EM) and Primary Health Care (PHC), and the executives of health centers, with over 5 years of work experience, and Emergency Medical Services (EMS) experts. Purposive sampling method was used in this study. All SSIs and FGDs were audio recorded and subsequently transcribed. Framework Analysis was employed to manually analyze the interview transcripts from all the SSIs and FGDs. Results The interview transcripts analysis resulted in the emergence of 3 themes and 11 sub-themes, categorized according to Donabedian’s triple model. 5 sub-themes were related to input, including medical equipment and supplies, environmental infrastructures of the centers, emergency medicines, human resource, and protocols, guidelines and policies. 4 sub-themes were related to process, including providing clinical services, medicine storage capacity, maintenance of equipment, and management process. Finally, 2 sub-themes were related to outcome, which were patients’ satisfaction with the quality of care and improved survival of LTE patients. Conclusions The results of this study can provide a new perspective for health managers and policy makers on how to evaluate the preparedness of NHHCs in managing LTE patients. In addition, it will be used to develop instruments to measure the preparedness of these centers.

scholarly journals Study of proportion and pattern of adverse drug events among patients coming to health centers in urban and rural areas

2018 ◽  
Vol 5 (8) ◽  
pp. 3423
Author(s):  
P. B. Tarun Teja ◽  
Balaji Ramraj
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Adverse Drug Events ◽  
Educational Interventions ◽  
Cross Sectional Study ◽  
Health Centers ◽  
Cross Sectional ◽  
Urban And Rural Areas ◽  
Study Type ◽  
All Diseases

Background: Adverse drug events (ADE) are rated as the fifth leading cause of death among all diseases. Approximately 5-8% of all hospitalization worldwide is due to ADE. The present study was conducted with the aim of analyzing the pattern of Adverse Drug events in patients coming to urban and rural health care centres, their manifestations and severity.Methods: The study type useful in this study was cross sectional study. This method is helpful to find the exact duration of occurrence of ADE after administration of drug and to know what kind of adverse event patient is suffering from.Results: There are many studies done in peripheral health care centres regarding ADE in India. In our study, out of 250 patients, 125 were from urban and 125 were from rural. Among the 125 patients from urban 3.2% (4 cases) adverse drug events- reported. Among the 125 patients from rural 4% (5 cases)adverse drug events- reported.Conclusions: This study provides a baseline idea about the knowledge and perception toward ADEs among patients visiting an outpatient department at urban and rural hospital in India. Respondents were unaware about the process of reporting ADEs, reporting by the consumers, and the possible benefits to them by doing so. There is a strong need to do the work to make consumers aware about the same. Educational interventions are needed to improve awareness among patients regarding importance of ADE reporting. 

scholarly journals Dynamics of SARS-CoV-2 exposure in Malawian blood donors: a retrospective seroprevalence analysis between January 2020 and February 2021

2021 ◽  
Author(s):  
Jonathan Mandolo ◽  
Jacquline Msefula ◽  
Marc YR Henrion ◽  
Comfort Brown ◽  
Brewster Moyo ◽  
...  
Keyword(s):  
Blood Donor ◽  
Rural Areas ◽  
Blood Donors ◽  
Cross Protection ◽  
Prior Exposure ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
Urban And Rural Areas ◽  
Second Wave

Background: As at end of July 2021, the COVID-19 pandemic has been less severe in sub-Saharan Africa than elsewhere. In Malawi, there have been two subsequent epidemic waves. We therefore aimed to describe the dynamics of SARS-CoV-2 exposure in Malawi. Methods: We measured the seroprevalence of anti-SARS-CoV-2 antibodies among randomly selected blood donor sera in Malawi from January 2020 to February 2021. In a subset, we also assesed in vitro neutralisation against the original variant (D614G WT) and the Beta variant. Findings: A total of 3586 samples were selected from the blood donor database, of which 2685 (74.9%) were male and 3132 (87.3%) were aged 20-49 years. Of the total, 469 (13.1%) were seropositive. Seropositivity was highest in October 2020 (15.7%) and February 2021 (49.7%) reflecting the two epidemic waves. Unlike the first wave, both urban and rural areas had high seropositivity by February 2021, Balaka (rural, 37.5%), Blantyre (urban, 54.8%), Lilongwe (urban, 54.5%) and Mzuzu (urban, 57.5%). First wave sera showed potent in vitro neutralisation activity against the original variant (78%[7/9]) but not the Beta variant (22% [2/9]). Second wave sera potently neutralised the Beta variant (73% [8/11]). Interpretation: The findings confirm extensive SARS-CoV-2 exposure in Malawi over two epidemic waves with likely poor cross-protection to reinfection from the first on the second wave. Since prior exposure augments COVID-19 vaccine immunity, prioritising administration of the first dose in high SARS-CoV-2 exposure settings could maximise the benefit of the limited available vaccines in Malawi and the region.

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