Estimating Case Fatality and Case Recovery Rates of COVID-19: is this the right thing to do?

Introduction: Case fatality rates (CFRs) and case recovery rates (CRRs) are frequently used to define health consequences related to specific disease epidemics, including the COVID-19 pandemic. This study aimed to compare various methods and models for calculating CFR and CRR related to COVID-19 based on the global and national data available as of April 2020.Methods: This analytical epidemiologic study was conducted based on detailed data from 210 countries and territories worldwide in April 2020. We used three different formulas to measure CFR and CRR, considering all possible scenarios.Results: We included information for 72 countries with more than 1,000 cases of COVID-19. Overall, using first, second, and third estimation models, the CFR were 6.22%, 21.20%, and 8.67%, respectively; similarly, the CRR was estimated as 23.21%, 78.86%, 32.23%, respectively. We have shown that CFRs vary so much spatially and depend on the estimation method and timing of case reports, likely resulting in overestimation.Conclusion: Even with the more precise method of CFRs estimation, the value is overestimated. Case fatality and recovery rates should not be the only measures used to evaluate disease severity, and the better assessment measures need to be developed as indicators of countries’ performance during COVID-19 pandemic.

Online Game Addiction and the Level of Depression Among Adolescents in Manila, Philippines

Introduction: World Health Organization recognizes online game addiction as a mental health condition. The rise of excessive online gaming is emerging in the Philippines, with 29.9 million gamers recorded in the country. The incidence of depression is also increasing in the country. The current correlational analysis evaluated the association between online game addiction and depression in Filipino adolescents. Methods: A paper-and-pencil self-administered questionnaire assessing depression and online game addiction was distributed from August to November, 2018. The questionnaire included socio-demographic profiles of the respondents, and the 14-item Video Game Addiction Test (VAT) (Cronbach's α=0.91) and the Patient Health Questionnaire-9 (Cronbach's α=0.88) to determine levels of online game addiction and depression, respectively. Multiple regression analyses were used to test the association between depression and online game addiction. Results: Three hundred adolescents (59% males, 41% females) participated in the study. Fifty-three out of 300 respondents (12.0% males, 5.7% females) had high level of online game addiction as reflected in their high VAT scores. In this study, 37 respondents (6.7% males, 5.7% females) had moderately severe depression and 6 (2.0%) females had severe depression. Online game addiction was positively correlated with depression in this study (r=0.31; p<0.001). When multiple regression analysis was computed, depression was found to be a predictor of online game addiction (Coefficient=0.0121; 95% CI-8.1924 - 0.0242; p=0.05). Conclusion: Depression, as associated with online game addiction, is a serious threat that needs to be addressed. High level of online game addiction, as positively correlated to the rate of depression among adolescents in Manila, could potentially be attributed to the booming internet industry and lack of suffiicent mental health interventions in the country. Recommended interventions include strengthening depression management among adolescents and improving mental health services for this vulnerable population groups in schools and within the communities.

Poisoning Cases Reported to Poison Information Centre, Ahmedabad, India: A Three Year Observational Study

Introduction: Morbidity and mortality associated with pesticide poisoning is a major public health issue, especially in lower and middle income countries, including India. Timely understanding of poisoning trends is required for improved prevention. The objective of the present study was to analyze the trend of poisoning cases in Ahmedabad, India in the period of 2015-2017.Methods: Detailed history, including demographic data, risk factors, poisoning history, agents involved, and occupational influence were collected for poisoning cases reported to the Poison Information Centre in Ahmedabad. Cholinesterase activity and HPTLC method for detection of sanguinarine in urine were used to investigate the agents of poisoning. Non-parametric tests, such as Chi-square test and Mann-Whitney U Test were applied to test statistical significance between the groups. All statistical analysis was carried out using IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.Results: A total 1373 poisoning cases were investigated. The incidence and fatality rate was found to be higher in males compared to females (M/F ratio 1.89:1). About 91.62% of the poisoning were through the oral route. Erythrocyte cholinesterase activity assay results indicated that 41.29% of the cases were due to organophosphorus/carbamate poisoning. Insecticides were found to be the agent of poisoning in 26.29% cases, and 11.07% of all the cases were agricultural workers. Poisoning with medications, household pesticides and chemicals were also reported. Few cases of food poisoning with sanguinarine were detected.Conclusion: The data presented here suggest that pesticides used for agriculture are the major source of poisonings. Implementation of usage guidelines, educating farmers and vulnerable population, and finding novel alternatives for highly toxic chemicals may be helpful in decreasing the number of poisoning cases.

Sociodemographic Factors Associated with Bottle Feeding Practices in Infants Under Two Years of Age: A hospital-based study in Woldia, Ethiopia

Introduction: Bottle feeding should be avoided when possible in infants under the age of two to improve health outcomes. The magnitude of bottle feeding practice is currently increasing in Ethiopia, however factors associated with bottle feeding usage are rarely addressed in research. We aimed to fill this gap and assess the magnitude of bottle feeding and its association with sociodemographic factors among infants in Woldia, Ethiopia in 2019.Methods: A hospital-based cross-sectional study was conducted in Woldia General Hospital at the Immunization Clinic. A total of 255 mothers who had infants were selected by systematic random sampling method. Data was collected through face-to-face interview using a structured standardized questionnaire. The data was entered to EpiData version 3.1 and analyzed using SPSS version 20. Binary logistic regression analysis models were used to assess the association between dependent and independent variables. Variables with p-value < 0.2 in bivariable logistic regression analysis were entered to multivariable logistic regression analysis. Finally, variables with p-value < 0.05 with 95% CI in multivariable logistic regression were taken as independent predictors. COR and AOR were used to show the strength of association between the dependent and independent variables.Results: The rate of bottle feeding practice in this study was 42.7% (95%CI: 35.8,48.2). Being an infant age 0-5 months old [AOR=0.16; 95%CI: 0.06,0.4], being a mother age 35-50 years old [AOR=0.43; 95%CI: 0.22, 0.85], having 2-5 children [AOR=6.37; 95%CI: 1.33, 30.44], and being a farmer as reported mother’s occupation [AOR=2.72; 95%CI: 1.30, 5.67] showed significant association with bottle feeding practice.Conclusion: The magnitude of bottle feeding practice was significantly higher in the current study as compared to national prevalence. Several sociodemographic factors showed significant association with bottle feeding practice which need to be explored further in the future research.

Need for Couple’s Awareness About Sexual Health in COVID-19 Pandemic

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Family Planning in the Republic of Tajikistan: A narrative review from Soviet times to 2017

Introduction: Tajikistan’s dramatic shift from a high to a low fertility society has taken place over a little more than two decades. While some fertility beliefs remained the same throughout the rapid economic and political transitions of Tajikistan, other beliefs may have changed to respond to the financial realities of the newly independent and Central Asian republic, such as having fewer children. The objective of this review was to describe and analyze the state of family planning in the Republic of Tajikistan from Soviet period (1929-1991) until 2017.Methods: The review is based on materials obtained from various sources including Google Scholar and PubMed, relevant to family planning in Tajikistan, including government policies, open-access nationally representative data, journal articles, and program reports, identified through a selective search of Google Scholar and PubMed databases, and the grey literature. Conclusion: This narrative review presents the history of family planning in Tajikistan, outlines an understanding of the health system context as it relates to family planning, and analyzes the latest national family planning policy (2017). The authors suggest further research is required to (a) understand the beliefs and practices related to family planning; and (b) define strategies to address the issue of unmet need of family planning services.

Erratum to: A Systematic Review of the Effects of Aromatherapy with Lavender Essential Oil on Depression

The editors of the Central Asian Journal of Global Health regretfully published the article “A Systematic Review of the Effects of Aromatherapy with Lavender Essential Oil on Depression” with a misspelled word in the title. This mistake has been corrected. The original article has been updated to reflect this change.Jafar-Koulaee A, Elyasi F, Taraghi Z, Ilali ES, Moosazadeh M. A systematic review of the effects of aromatherapy with lavender essential oil on depression. Cent Asian J Glob Health. 2020;9(1) doi:10.5195/cajgh.2020.442.

Clinical Data, Comorbidities, and Mortality of COVID-19 in the State of Guanajuato, Mexico until May 20, 2020

Introduction: In December 2019, cases of pneumonia of unknown cause arose in Wuhan, China. The causative agent was subsequently identified as 2019-nCoV and later called SARS-CoV-2. In Mexico, since January 2020 when the first cases were reported, the spread of the infection has occurred throughout the country. The state of Guanajuato, which is located in the center of the country, has taken isolation measures and closed public places in March 2020. The objective of this study was to analyze the evolution, symptoms, co-morbidities and deaths due to confirmed cases of COVID-19.Methods: An ecological study was designed from the database of confirmed cases of COVID-19 in the state of Guanajuato. Odds ratios and 95% confidence intervals were calculated for symptoms and co-morbidities in deaths of confirmed cases. Logistic regression models were generated adjusting for age group and gender.Results: Among the 838 confirmed cases in the state, cases with dyspnea and cyanosis showed more significant effect on death. Age group and gender had little involvement as confounders. For practically all comorbidities (including diabetes, hypertension, cardiovascular disease, chronic kidney disease, and immunosuppression), there was a significant effect (odds ratio greater than 2) on mortality from COVID-19. Age group showed a confounding effect on comorbidities and death, but not gender.Conclusion: The confirmed cases had more than twice the possibility of having comorbidities, compared with those who did not die.

Work Preferences in Rural Health Job Posting Among Medical Interns in a Lower Middle-Income Country— a Discrete Choice Experiment

Introduction: Timely empirical evidence is important in the success of health systems, and such evidence is necessary for informed policy making to address inequity in the health workforce. Literature is ripe with incentives that affect recruitment and retention of physicians in rural and remote areas, but such data in still lacking in the Philippine setting. Discrete choice experiment is one methodology utilized by the World Health Organization which provides both qualitative and quantitative information to aid policy makers in health human resource management.Methods: The study utilized a discrete choice experiment involving three phases: 1) identification of incentives and levels using key informant interviews and focus group discussions, 2) selection of scenarios utilizing an experimental design, and 3) administration of survey based on WHO guidelines. Conditional logistic regression, point estimates, and correlational analyses were done using Stata.Results: There is significant association between type of background and considerations for rural practice among the respondents based on Pearson’s correlation (p < 0.01). The respondents put more value into non-wage rural job posting incentives than small to modest base salary increases. The high willingness to pay for the presence of supervision, relative location of work areas from families, and status of workplace infrastructure/equipment or supplies suggest the importance of workplace conditions to attract rural health physicians. Combinations of wage and non-wage incentives may be necessary to provide for the most cost-efficient increases in rural job post uptake rates based on post-estimate calculations.Conclusion: Philippine medical interns and young doctors value non-wage incentives in considering rural health job postings. Rural health job postings with these incentives are predicted to significantly increase recruitment in rural health job posts, particularly when combinations of wage and high-impact non-wage incentives are considered.

Community Readiness for Increasing Older Adult Physical Activity Levels in Kazakhstan

Introduction: Physical activity is proven to be a significant element of successful aging, but many seniors worldwide fail to achieve the recommended levels. This study aimed to assess the readiness of the community in Nur-Sultan, Kazakhstan, to act on the issue of physical inactivity among older adults.Methods: In order to achieve this purpose, we conducted qualitative interviews with key informants in the community and applied a validated community readiness tool.Results: The results suggest that the local community is at early stages of readiness to act on the issue of older adult physical inactivity. We identified a number of barriers that prevented seniors from leading active lifestyles, which included community misconceptions about older adult physical activity, family centeredness in older adulthood, scarcity of resources, passive support from the leadership, and lack of efforts in the community. Research findings also highlighted the importance of conducting in-depth analysis of key informant responses in addition to calculating readiness scores, when using the community readiness tool.Conclusion: Community-specific strategies for enhancing the level of physical activity among seniors are required to offset the disease burden associated with aging and to prolong life expectancy in Kazakhstan, and it is of paramount importance to tailor potential efforts as to address the current readiness of the community and its needs.