Social contributors for the rise of COVID-19 infections in South Asia: A large cross-sectional survey

Background: The ongoing global coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was first reported in South Asia on 30th January 2020 in India. Ever since, certain countries have witnessed multiple waves of COVID-19, requiring attention by public health experts and strategists in the region. The objectives of this study are to assess social contributors to the recurrent waves of COVID-19 in South Asia including first demographic traits, second household characteristics and social measures, third workplace trends and personal protective equipment use, and fourth satisfaction and attitudes concerning public health measures and vaccination status. The study also aims to plan for control strategies focusing on India, Pakistan, Bangladesh, Sri Lanka, and Nepal, countries with the highest burden of COVID-19 in South Asia.Methods: A population-based large cross-sectional study was conducted from 1st July to August 10th, 2021 using online mediums. The survey consisted of 31 questions divided into sociodemographic and COVID-19 status information, household characteristics and social measures, workplace trends and personal protective measures, satisfaction and attitudes towards public health measures, and vaccination status. Bivariate, receiver operating characteristic (ROC) analysis, and the Kruskal Wallis test was conducted for factors associated to COVID-19 infection and positive vaccination status.Findings: We enrolled 1046 participants with 57.1% females and 41.8% males, comprising 48.9% healthcare workers. Statistically significant associations were found using ANOVA based on the Kruskal-Wallis test for differences between thoughts towards public health authorities implementing standard operating procedures (SOPs) and HCW status were statistically significant (P = 0.002). The most important social predictors for positive vaccination status based on the ROC analysis were gender (P \u3c 0.001), job role (P \u3c 0.001), income group (P \u3c 0.001), healthcare worker status (P \u3c 0.001), household member tested positive (P = 0.007), personal vehicle ownership (P \u3c 0.001), job requiring close contacts (P \u3c 0.001) and co-worker masking habits (P = 0.02).Conclusions: Public health experts and strategists are required to focus control strategies on political and religious gatherings, reopening offices, noncompliance of SOPs by the masses, and crowded commuting to limit the reemergence of COVID-19 infections in countries with the highest burden in the region

Rationalization of the Laboratory Diagnosis for Good Management of Malaria: Lessons from Transitional Methods

Introduction. Malaria is an endemic disease in sub-Saharan Africa. In clinical practice, the main concern is the overdiagnosis of malaria leading to inappropriate drug prescription without laboratory confirmation. Objective. This study aimed to evaluate clinical examination reliability compared with translational laboratory methods of malaria diagnosis. Methods. The study was conducted in Goundi Hospital among hospitalized patients over a seven-month period. Patients were interviewed, and malaria tests done included the Giemsa-stained thick and thin blood smears. Diagnostic accuracy was analysed by calculating sensitivity, specificity, and predictive values. Results. Among 1,874 participants, 674 (35.96%) patients had positive Giemsa-stained thick blood films. The rate of positivity is higher for patients under 5 years of age. The parasite densities were between 160 and 84.000 parasites/μL. The threshold pyrogen of the parasitic density was around 10.000 parasites/μL for patients between 0 and 11 months of age, between 1 and 4 years of age, and between 5 and 14 years of age. This threshold was lower for patients over 15 years of age. The study reported some issues in the findings: 60.88% (607/997) cases of fever without positivity of the blood thick smear and 40.13% (284/674) cases of positivity of the thick drop without fever. The positive predictive value of malaria was between 80 and 85% for patients under 5 years of age. This value is lower for patients between 5 and 14 years of age and patients over 15 years of age. Conclusion. A presumptive diagnosis of malaria should be confirmed by the laboratory in all suspected cases in all possible scenarios. Every parasitemia should be followed by the calculation of parasitic density. However, for the children under 5 years of age in areas of high transmission, the presumptive diagnosis of malaria in certain circumstances could be considered

Mid and Long Term Follow Up of 50 Pediatric Cardiac Chadians Operated in France from 2003 to 2012

Introduction Cardiac valvular diseases (CVDs) are the major cause of cardiovascular morbidity and mortality globally, with predominance of rheumatic heart disease (RHD) in developing countries. Congenital heart defects (CHD) diagnoses are delayed due to socioeconomic factors. This study aims to evaluate the post-operative surgical outcomes of CHD and valvular RHD. Methods This study is conducted with 50 patients from Chad, operated on between 2003 and 2012. Post-operative outcomes are evaluated from 2010 to 2012. Results With the follow-up of 19 RHD patients who underwent plasty, 8 (42.1%) had no complications, 4 (21%) presented with mild regurgitation, 7 (36.8%) required re-operation due to 6 mitral stenosis (MS) cases (mitral surface range from 0.7 to 1.2 cm2) and 1 severe mitral regurgitation (MR) case. While those patients with valve replacement, 2 (50%) had no complications, 1 (25%) had mild regurgitation and 1 (25%) patient died. Two patients with aortic regurgitation (AR) that underwent annuloplasty presented with severe regurgitation. Regarding AR with valve replacement, 3 (60%) had no complications, and 2 (40%) had mild regurgitation. Among the tricuspid regurgitation (TR) patients who had plasty, 6 (85.7%) had no complications, and 1 (14.3%) had severe regurgitation. The surgical repair was curative in all CHD patients. The loss to follow-up rate was 13/50 (26%). Conclusion The annuloplasty on rheumatic valve disease (MR and AR) has proven to be disappointing. Plasty is debated without justified indication for AR. The Outcomes of CHD, mitral and aortic valve replacement are successful

COVID-19 Pathophysiology and Clinical Effects on Multiple Organ Systems - A Narrative Review

Patients with comorbidities including Hypertension (HTN), Diabetes Mellitus (DM), Chronic Obstructive Pulmonary Disease (COPD), Asthma, Obesity, Cardiovascular Disease (CVD), Chronic Kidney Disease (CKD), and those who are immunocompromised are prone to more severe complications of COVID-19 and a higher rate of hospitalizations. In the United States, around 94% of COVID-19 deaths had an average of 2.6 additional conditions or causes per death. In a summary report published by the Chinese Centre for Disease Control and Prevention of 72,314 cases, case-fatality rate was elevated among those with preexisting comorbid conditions—10.5% for cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for HTN, and 5.6% for cancer. The COVID-19 pandemic continues to threaten people and healthcare systems globally and therefore the global economy. Currently, there is no cure or vaccine for COVID-19 and there is an urgent need to develop target therapies as we continue to learn more about this novel virus. Without therapeutic interventions, much of how we contain the viral spread is prevention through mitigation strategies (social distancing, face masks, supportive care). Early suspicion of COVID-19 symptoms with radiological and laboratory assessments may play a major role in preventing severity of the COVID-19. With this literature review we aim to provide review of pathophysiology of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and its clinical effects on multiple organ systems

COVID-19 Pathophysiology and Clinical Effects on Multiple Organ Systems: A Review

Patients with comorbidities including Hypertension (HTN), Diabetes Mellitus (DM), Chronic Obstructive Pulmonary Disease (COPD), Asthma, Obesity, Cardiovascular Disease (CVD), Chronic Kidney Disease (CKD), and those who are immunocompromised are prone to more severe complications of COVID-19 and a higher rate of hospitalizations. In the United States, around 94% of COVID-19 deaths had an average of 2.6 additional conditions or causes per death. In a summary report published by the Chinese Centre for Disease Control and Prevention of 72,314 cases, case-fatality rate was elevated among those with preexisting comorbid conditions—10.5% for cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for HTN, and 5.6% for cancer. The COVID-19 pandemic continues to threaten people and healthcare systems globally and therefore the global economy. Currently, there is no cure or vaccine for COVID-19 and there is an urgent need to develop target therapies as we continue to learn more about this novel virus. Without therapeutic interventions, much of how we contain the viral spread is prevention through mitigation strategies (social distancing, face masks, supportive care). Early suspicion of COVID-19 symptoms with radiological and laboratory assessments may play a major role in preventing severity of the COVID-19. With this literature review we aim to provide review of pathophysiology of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and its clinical effects on multiple organ systems