Knowledge, attitudes, and practices toward coronavirus and associated anxiety symptoms among university students : a cross-sectional study during the early stages of the COVID-19 pandemic in Bangladesh

Background: University students’ knowledge, attitude, and practice (KAP) toward COVID-19 are vital to prevent the spread of the virus, especially in the context of developing countries. Consequently, the present study aimed to determine the KAP levels of university students and associated anxiety during the earlier stage of the pandemic in Bangladesh. Methods: A cross-sectional, online study with 544 university students was conducted during April 17–May 1, 2020. The questionnaire incorporated several KAP-related test items aligned with the World Health Organization (WHO) guidelines. Anxiety was measured with the 2-item Generalized Anxiety Disorder scale (GAD-2). Multivariable logistic regression analysis was performed to determine the association between KAP levels and anxiety adjusting for sociodemographic variables. Subgroup analyses included rerunning models stratified by gender and quarantine status. Results: Approximately 50% of students showed high levels of knowledge about COVID-19 guidelines, 59% reported behavioral practices that aligned with COVID-19 guidelines, and 39% had negative attitudes toward COVID-19 guidelines. Attitudes differed by anxiety (χ2 = 23.55, p < 0.001); specifically, negative attitudes were associated with higher anxiety (OR: 2.40, 95% CI = 1.66–3.46, p < 0.001). Associations were significant for male (OR = 2.36; 95% CI = 1.45–3.84, p < 0.001) and female (OR = 2.45; 95% CI = 1.3–4.34; p < 0.001) students. Stratified analyses found non-quarantined students with negative attitudes had three times the chance of experiencing anxiety (OR = 3.14, 95% CI: 1.98–4.98, p < 0.001). Non-quarantined students with low levels of knowledge had half the chance of developing anxiety (OR = 0.49, 95% CI: 0.31–0.78, p < 0.01). Conclusion: Based on these findings, it is recommended that university authorities continue to prioritize proactive and effective measures to develop higher levels of knowledge, more positive attitudes and better behavioral practices regarding COVID-19 for the mental health of their students

COVID-19 Vaccine Acceptance among Low- and Lower-Middle-Income Countries: A Rapid Systematic Review and Meta-Analysis

Widespread vaccination against COVID-19 is critical for controlling the pandemic. Despite the development of safe and efficacious vaccinations, low-and lower-middle income countries (LMICs) continue to encounter barriers to care owing to inequitable access and vaccine apprehension. This study aimed to summarize the available data on COVID-19 vaccine acceptance rates and factors associated with acceptance in LMICs. A comprehensive search was performed in PubMed, Scopus, and Web of Science from inception through August 2021. Quality assessments of the included studies were carried out using the eight-item Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies. We performed a meta-analysis to estimate pooled acceptance rates with 95% confidence intervals (CI). A total of 36 studies met the inclusion criteria and were included in the review. A total of 83,867 respondents from 33 countries were studied. Most of the studies were conducted in India (n = 9), Egypt (n = 6), Bangladesh (n = 4), or Nigeria (n = 4). The pooled-effect size of the COVID-19 vaccine acceptance rate was 58.5% (95% CI: 46.9, 69.7, I2 = 100%, 33 studies) and the pooled vaccine hesitancy rate was 38.2% (95% CI: 27.2–49.7, I2 = 100%, 32 studies). In country-specific sub-group analyses, India showed the highest rates of vaccine acceptancy (76.7%, 95% CI: 65.8–84.9%, I2= 98%), while Egypt showed the lowest rates of vaccine acceptancy (42.6%, 95% CI: 16.6–73.5%, I2= 98%). Being male and perceiving risk of COVID-19 infection were predictors for willingness to accept the vaccine. Increasing vaccine acceptance rates in the global south should be prioritized to advance global vaccination coverage

Subjective Mortality Hazard Shocks and the Adjustment of Consumption Expenditures

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Mental Health Status of University Students and Working Professionals during the Early Stage of COVID-19 in Bangladesh

A novel coronavirus disease known as COVID-19 has spread globally and brought a public health emergency to all nations. To respond to the pandemic, the Bangladesh Government imposed a nationwide lockdown that may have degraded mental health among residents, in particular, university students and working professionals. We examined clinically significant anxiety levels with the Generalized Anxiety Disorder (GAD-7) scale and perceived stress levels with the Perceived Stress Scale (PSS-4) in an online cross-sectional study with 744 adults. Approximately 70% of respondents were afflicted with clinically significant anxiety levels, and more than 43.82% were afflicted with moderate or high perceived stress levels. Multivariate logistic regression models showed that postgraduates (OR = 2.78, 95% confidence interval [CI] = 1.03–8.75, p &lt; 0.05) were more likely to experience anxiety than their student counterparts. No such differences emerged for working professionals, however. Living with family members compared to living alone was a risk factor for perceived stress among working professionals (OR = 4.05, 95% CI = 1.45–11.32, p &lt; 0.05). COVID-19 stressors such as financial hardship (OR = 1.84, 95% CI = 1.11–3.05, p &lt; 0.05) and worries of family members’ health (OR = 1.84, 95% CI = 1.12–2.99) were risk factors for anxiety among students. Questionable social media news exposure (OR = 2.99, 95% CI = 1.13–7.92, p &lt; 0.05) contributed to the development of mental stress among working professionals. These findings confirm that effective initiatives and proactive efforts from concerned authorities are necessary to cope with the mental health correlates of the COVID-19 pandemic, including in developing contexts such as Bangladesh

Who should be prioritized for renal transplantation?: Analysis of key stakeholder preferences using discrete choice experiments

Background Policies for allocating deceased donor kidneys have recently shifted from allocation based on Human Leucocyte Antigen (HLA) tissue matching in the UK and USA. Newer allocation algorithms incorporate waiting time as a primary factor, and in the UK, young adults are also favoured. However, there is little contemporary UK research on the views of stakeholders in the transplant process to inform future allocation policy. This research project aimed to address this issue. Methods Discrete Choice Experiment (DCE) questionnaires were used to establish priorities for kidney transplantation among different stakeholder groups in the UK. Questionnaires were targeted at patients, carers, donors / relatives of deceased donors, and healthcare professionals. Attributes considered included: waiting time; donor-recipient HLA match; whether a recipient had dependents; diseases affecting life expectancy; and diseases affecting quality of life. Results Responses were obtained from 908 patients (including 98 ethnic minorities); 41 carers; 48 donors / relatives of deceased donors; and 113 healthcare professionals. The patient group demonstrated statistically different preferences for every attribute (i.e. significantly different from zero) so implying that changes in given attributes affected preferences, except when prioritizing those with no rather than moderate diseases affecting quality of life. The attributes valued highly related to waiting time, tissue match, prioritizing those with dependents, and prioritizing those with moderate rather than severe diseases affecting life expectancy. Some preferences differed between healthcare professionals and patients, and ethnic minority and non-ethnic minority patients. Only non-ethnic minority patients and healthcare professionals clearly prioritized those with better tissue matches. Conclusions Our econometric results are broadly supportive of the 2006 shift in UK transplant policy which emphasized prioritizing the young and long waiters. However, our findings suggest the need for a further review in the light of observed differences in preferences amongst ethnic minorities, and also because those with dependents may be a further priority.</p