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2021 ◽  
Vol 21 (1) ◽  
Zofia Szczuka ◽  
Charles Abraham ◽  
Adriana Baban ◽  
Sydney Brooks ◽  
Sabrina Cipolletta ◽  

Abstract Background The COVID-19 pandemic has affected people’s engagement in health behaviors, especially those that protect individuals from SARS-CoV-2 transmission, such as handwashing/sanitizing. This study investigated whether adherence to the World Health Organization’s (WHO) handwashing guidelines (the outcome variable) was associated with the trajectory of the COVID-19 pandemic, as measured by the following 6 indicators: (i) the number of new cases of COVID-19 morbidity/mortality (a country-level mean calculated for the 14 days prior to data collection), (ii) total cases of COVID-19 morbidity/mortality accumulated since the onset of the pandemic, and (iii) changes in recent cases of COVID-19 morbidity/mortality (a difference between country-level COVID-19 morbidity/mortality in the previous 14 days compared to cases recorded 14–28 days earlier). Methods The observational study (#NCT04367337) enrolled 6064 adults residing in Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Data on handwashing adherence across 8 situations (indicated in the WHO guidelines) were collected via an online survey (March–July 2020). Individual-level handwashing data were matched with the date- and country-specific values of the 6 indices of the trajectory of COVID-19 pandemic, obtained from the WHO daily reports. Results Multilevel regression models indicated a negative association between both accumulation of the total cases of COVID-19 morbidity (B = −.041, SE = .013, p = .013) and mortality (B = −.036, SE = .014 p = .002) and handwashing. Higher levels of total COVID-related morbidity and mortality were related to lower handwashing adherence. However, increases in recent cases of COVID-19 morbidity (B = .014, SE = .007, p = .035) and mortality (B = .022, SE = .009, p = .015) were associated with higher levels of handwashing adherence. Analyses controlled for participants’ COVID-19-related situation (their exposure to information about handwashing, being a healthcare professional), sociodemographic characteristics (gender, age, marital status), and country-level variables (strictness of containment and health policies, human development index). The models explained 14–20% of the variance in handwashing adherence. Conclusions To better explain levels of protective behaviors such as handwashing, future research should account for indicators of the trajectory of the COVID-19 pandemic. Trial registration Clinical Trials.Gov, #NCT04367337

2021 ◽  
Omar S. Abdellatif ◽  
Ali Behbehani ◽  
Mauricio Landin

The International Health Regulations (2005) are legally binding on 196 States Parties, Including all WHO Member States. The IHR aims to keep the world informed about public health risks, through committing all signatories to cooperate together in combating any future “illness or medical condition, irrespective of origin or source, that presents or could present significant harm to humans.” Under IHR, countries agreed to strengthen their public health capacities and notify the WHO of any such illness in their populations. The WHO would be the centralized body for all countries facing a health threat, with the power to declare a “public health emergency of international concern,” issue recommendations, and work with countries to tackle a crisis. Although, with the sudden and rapid spread of COVID-19 in the world, many countries varied in implementing the WHO guidelines and health recommendations. While some countries followed the WHO guidelines, others imposed travel restrictions against the WHO’s recommendations. Some refused to share their data with the organization. Others banned the export of medical equipment, even in the face of global shortages. The UN Compliance Research group will focus during the current cycle on analyzing the compliance of the WHO member states to the organizations guidelines during the COVID-19 pandemic.

2021 ◽  
Vol 15 (9) ◽  
pp. 2202-2206
Maryam Khaled ◽  
Mahnoor Mohydin ◽  
Hamza Tahir ◽  
W. Haider Zaidi ◽  
M. H. U Rasheed ◽  

Aim: To assess the level of knowledge and awareness of undergraduate medical students in order to determine whether the undergraduate virology course is up to standard for preparation of the COVID-19 pandemic. Methodology: A cross-sectional study was conducted online by random-sampling method with a multi-central approach. Data was collected from 311 respondents for a time period of one month during May 2020. IRB approval was granted. Descriptive analysis was done on student demographics, their knowledge and opinions, using the research tool SPSS 24. Results: Majority of students had factually correct knowledge about Covid-19, according to the WHO guidelines. However, there was poor knowledge regarding animal reservoirs and other diseases caused by Coronaviruses. Most students had learned about Coronaviruses from sources apart from the syllabi or course material and 93% were in agreement for wanting an improved Coronavirus module in their undergraduate virology courses. Conclusion: Medical students have good knowledge about Coronavirus, but are lacking in some crucial topics such as sources of animal reservoir and types of diseases etc. More studies need to be conducted in order to assess whether undergraduate syllabi are sufficient for educating and training students about future possible pandemics. An efficient prospective course of action should be determined accordingly. Keywords: Medical students, Coronaviruses, Covid-19, Pandemic, Knowledge, Awareness.

Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1114
Cristiana Campa ◽  
Thierry Pronce ◽  
Marilena Paludi ◽  
Jos Weusten ◽  
Laura Conway ◽  

Stability assessment of pharmaceuticals in specific storage and shipment conditions is a key requirement to ensure that safe and efficacious products are administered to patients. This is particularly relevant for vaccines, with numerous vaccines strictly requiring cold storage to remain stable. When stability evaluation is exclusively based on real-time data, it may represent a bottleneck for rapid and effective vaccine access. Stability modeling for vaccines represents a key resource to predict stability based on accelerated stability studies; nevertheless, this approach is not fully exploited for these kinds of products. This is likely because of the complexity and diversity of vaccines, as well as the limited availability of dedicated guidelines or illustrative case studies. This article reports a cross-company perspective on stability modeling for vaccines. Several examples, based on the direct experience of the contributors, demonstrate that modeling approaches can be highly valuable to predict vaccines’ shelf life and behavior during shipment or manipulation. It is demonstrated that modeling methodologies need to be tailored to the nature of the vaccine, the available prior knowledge, and the monitored attributes. Considering that the well-established strategies reported in ICH or WHO guidelines are not always broadly applicable to vaccines, this article represents an important source of information for vaccine researchers and manufacturers, setting the grounds for further discussion within the vaccine industry and with regulators.

Ahmed Atia

Background and objective. Globally, disposing of unused medicines has become a source of concern, as pharmaceutical waste enters the ecosystem, posing a threat to human health and the environment. This study aimed to assess the disposal practice of unused medication among pharmacists in Libya. This study also seeks to determine if pharmacists plan to have their pharmacies serve as assembly points for potential take-back initiatives. Methods. A random sample of 150 pharmacists from various government and private pharmacies in Tripoli participated in a self-administered questionnaire about their disposal practices, and knowledge on pharmacies serving as collection points for ideal disposal of unused medicines. Descriptive statistics were used to interpret the data. Results. A total of 128 pharmacists completed the survey. The majority of respondents said that throwing discarded drugs in the trash bin was their preferred method of disposal (53.1%), followed by discarding via burn and drug wholesalers (17.2%, 14.8%, respectively). Only 2.1% of the respondents disposed unused medicines according to the WHO guidelines of drug disposal. Moreover, about 65.6% had poor knowledge about Take-Back program. Conclusion. Failure to follow the WHO guidelines for drug disposal raises the risk of contamination of our environment and the likelihood of humans and animals ingesting harmful pharmaceutical wastes.

Shahrizan Majid Binti Allapitchai

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, predominantly affecting the skin and peripheral nerves. Lucio phenomenon is a rare reactional state presenting in patient with lepromatous leprosy and described as acute cutaneous necrotising vasculitis. We discussed the case of a 38-year-old male patient presenting with oedematous and dusky discolouration of bilateral hands and feet associated with diffuse facial involvement. His skin condition gradually worsened to form multiple ulcers with bizarre shaped purpuric lesion over bilateral upper and lower limbs, trunk, and face. Histopathological examination of the skin biopsy showed multiple acid-fast bacilli and diagnosis of Lucio’s phenomenon was made in the background of lepromatous leprosy. He was treated with multi drug therapy (MDT) as recommended by the WHO guidelines. A better understanding of rarer manifestation of this illness is important for early diagnosis and to prevent significant morbidity associated with it.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S20

2021 ◽  
Vol 8 (10) ◽  
pp. 1499
Abdul Hassan Wahid ◽  
Vallish Shenoy ◽  
Ravi K.

Background: The objective of this study was to estimate the Interleukin-6 levels of COVID 19 patients and to find any associations between Interleukin-6 levels and age, gender, co-morbidities, symptoms, clinical outcomes and other biochemical parameters among COVID19 patients.Methods: It was a cross sectional observational study conducted on 150 patients admitted to Victoria Hospital, Bangalore medical college from May 2020 to September 2020. Case record form with follow up chart was used to record the relevant demographic details, clinical data including symptoms, co-morbid conditions and various laboratory data. COVID 19 infection was diagnosed by RTPCR technique and severity of COVID-19 disease was classified according to WHO guidelines and guidelines laid by Ministry of Health and Family Welfare, India. Interleukin-6 levels were correlated with the above parameters.Results: It was found that IL6 was elevated and found to be statistically significant with the presence of co-morbid conditions including Hypertension, with the presence of symptoms including fever, cough, breathlessness, with the severity of the disease, with the presence of intubation, with the mortality of the illness and strong association with neutrophil count, C-reactive protein, Ferritin and Neutrophil-Lymphocyte ratio.Conclusions: IL6 can be used as a viable biomarker for knowing the severity of COVID19, to predict the outcome and prognosis of the patient and associations with various presenting symptoms, co-morbid conditions and other laboratory values.

2021 ◽  
Vol 11 (3) ◽  
pp. 146-154
A. Almeida ◽  
M. Adjuntsov ◽  
W. Bushura ◽  
E. Delgado ◽  
M. Drasher ◽  

BACKGROUND: WHO drug-resistant TB (DR-TB) treatment recommendations now emphasize all-oral regimens, recommending against certain injectable agents and deprioritizing others due to inferior safety and efficacy. Despite increasing focus on patient-centered care, we are not aware of systematic attempts to qualitatively document patients’ perspectives on injectable agents. This may inform implementation of WHO guidelines, emphasizing the importance of consultation with affected communities.METHODS: Testimonies were provided by TB survivors who experienced hearing loss from treatment with injectable agents. Testimonies were submitted in writing in response to minimal, standardized, open-ended prompts. Participants provided a signed consent form (with options to participate anonymously or as a named co-author), and later gave input into the overall shape and recommendations of the article.RESULTS: Fourteen TB survivors in 12 countries contributed testimonies. The following common themes emerged: lack of access to appropriate testing, information, treatment, or a collaborative treatment environment; the power of supportive care and social environments; stigma and isolation from TB treatment itself and resultant disability; and inaccessibility of cochlear implants.CONCLUSIONS: Survivor testimonies indicate strong preferences for avoidance of injectable agents, supporting rapid implementation of revised WHO guidelines, as well as for quality and supportive care for both TB and disabilities.

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Bijun Wen ◽  
Daniella Brals ◽  
Celine Bourdon ◽  
Lauren Erdman ◽  
Moses Ngari ◽  

Abstract Background Despite adherence to WHO guidelines, inpatient mortality among sick children admitted to hospital with complicated severe acute malnutrition (SAM) remains unacceptably high. Several studies have examined risk factors present at admission for mortality. However, risks may evolve during admission with medical and nutritional treatment or deterioration. Currently, no specific guidance exists for assessing daily treatment response. This study aimed to determine the prognostic value of monitoring clinical signs on a daily basis for assessing mortality risk during hospitalization in children with SAM. Methods This is a secondary analysis of data from a randomized trial (NCT02246296) among 843 hospitalized children with SAM. Daily clinical signs were prospectively collected during ward rounds. Multivariable extended Cox regression using backward feature selection was performed to identify daily clinical warning signs (CWS) associated with time to death within the first 21 days of hospitalization. Predictive models were subsequently developed, and their prognostic performance evaluated using Harrell’s concordance index (C-index) and time-dependent area under the curve (tAUC). Results Inpatient case fatality ratio was 16.3% (n=127). The presence of the following CWS during daily assessment were found to be independent predictors of inpatient mortality: symptomatic hypoglycemia, reduced consciousness, chest indrawing, not able to complete feeds, nutritional edema, diarrhea, and fever. Daily risk scores computed using these 7 CWS together with MUAC<10.5cm at admission as additional CWS predict survival outcome of children with SAM with a C-index of 0.81 (95% CI 0.77–0.86). Moreover, counting signs among the top 5 CWS (reduced consciousness, symptomatic hypoglycemia, chest indrawing, not able to complete foods, and MUAC<10.5cm) provided a simpler tool with similar prognostic performance (C-index of 0.79; 95% CI 0.74–0.84). Having 1 or 2 of these CWS on any day during hospitalization was associated with a 3 or 11-fold increased mortality risk compared with no signs, respectively. Conclusions This study provides evidence for structured monitoring of daily CWS as recommended clinical practice as it improves prediction of inpatient mortality among sick children with complicated SAM. We propose a simple counting-tool to guide healthcare workers to assess treatment response for these children. Trial registration NCT02246296

Md. Abdul Wadood ◽  
Lai Lee Lee ◽  
Md. Monimul Huq ◽  
Asma Mamun ◽  
Suhaili Mohd ◽  

Background: The coronavirus disease 2019 (COVID-19) has continued to spread across the world with increasing numbers of confirmed cases and deaths. Due to outbreaks of new variants of the virus and limited treatment options, positive perception and good practice of preventive guidelines have remained essential measures for the prevention of the disease and slowing down its transmission. We aimed to study perception towards COVID-19 and the practice of guidelines for preventing the disease among Bangladeshi adults during the early stage of the rapid rise of the outbreak. Methods: Data was collected data from 320 participants. For measuring their level of practice, we asked a general question: “Are you properly following the WHO-recommended guidelines to avoid COVID-19?” The frequency distribution, Chi-square (χ2) test and binary logistic regression model were used in this study. Results: The average risk perception among the participants was 3.05±0.75 (median, 3.00) (95% CI of mean: 2.96-3.13) where the score ranges from 0 (no risk) to 4 (high risk). More than 27% of participants showed high-risk perceptions. Males (p<0.05), high educated (p<0.05), rich (p<0.01), service holders (p<0.05), and younger adults (p<0.05) had higher odds of high-risk perception. More than 71% of participants had a good practice of always following the WHO guidelines to prevent COVID-19 and living locations in urban areas (p<0.01), high education (p<0.01), rich (p<0.01), and joint family (p<0.01) had the most contributions to good practice. Conclusions: The study findings revealed that special attention should be given to rural areas, and individuals of low literacy, education and socioeconomic level to more effectively prevent COVID-19.

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