Is self-reported depression, HIV status, COVID-19 health risk profile and SARS-CoV-2 exposure associated with difficulty in adhering to COVID-19 prevention measures among residents in West Africa?

Background: The aim of this study was to determine whether self-reported depression, coronavirus disease of 2019 (COVID-19) health risk profile, HIV status, and SARS-CoV-2 exposure were associated with the use of COVID-19 prevention measures.Methods: This survey collected data electronically between June 29 and December 31, 2020 from a convenient sample of 5050 adults 18 years and above living in 12 West African countries. The dependent variables were: social distancing, working remotely, difficulty obtaining face masks and difficulty washing hands often. The independent variables were self-reported depression, having a health risk for COVID-19 (high, moderate and little/no risk), living with HIV and COVID-19 status (SARS-CoV-2 positive tests, having COVID-19 symptoms but not getting tested, having a close friend who tested positive for SARS-CoV-2 and knowing someone who died from COVID-19). Four binary logistic regression models were developed to model the associations between the dependent and independent variables, adjusting for socio-demographic variables (age, gender, educational status, employment status and living status).Results: There were 2412 (47.8%) male participants and the mean (standard deviation) age was 36.94 (11.47) years. Respondents who reported depression had higher odds of working remotely (AOR: 1.341), and having difficulty obtaining face masks (AOR: 1.923;) and washing hands often (AOR: 1.263). People living with HIV had significantly lower odds of having difficulty washing hands often (AOR: 0.483). Respondents with moderate health risk for COVID-19 had significantly higher odds of social distancing (AOR: 1.144) and those with high health risk had difficulty obtaining face masks (AOR: 1.910). Respondents who had a close friend who tested positive for SARS-CoV-2 (AOR: 1.132) and knew someone who died of COVID-19 (AOR: 1.094) had significantly higher odds of social distancing. Those who tested positive for SARS-CoV-2 had significantly lower odds of social distancing (AOR: 0.629) and working remotely (AOR: 0.713). Those who had symptoms of COVID-19 but did not get tested had significantly lower odds of social distancing (AOR: 0.783) but significantly higher odds of working remotely (AOR: 1.277).Conclusions: The study signifies a disparity in the access to and use of COVID-19 preventative measures that is allied to the health and COVID-19 status of residents in West Africa. Present findings point to risk compensation behaviours in explaining this outcome.</p

Associations between COVID-19 testing status, non-communicable diseases and HIV status among residents of sub-Saharan Africa during the first wave of the pandemic

Background: This study determined if non-communicable disease status, HIV status, COVID-19 status and co-habiting were associated with COVID-19 test status in sub-Saharan Africa.Methods: Data of 5945 respondents age 18-years-old and above from 31 countries in sub-Saharan Africa collected through an online survey conducted between June and December 2020, were extracted. The dependent variable was COVID-19 status (testing positive for COVID-19 and having symptoms of COVID-19 but not getting tested). The independent variables were non-communicable disease status (hypertension, diabetes, cancer, heart conditions, respiratory conditions, depression), HIV positive status, COVID-19 status (knowing a close friend who tested positive for COVID-19 and someone who died from COVID-19) and co-habiting (yes/no). Two binary logistic regression models developed to determine associations between the dependent and independent variables were adjusted for age, sex, employment, sub region and educational status.Results: Having a close friend who tested positive for COVID-19 (AOR:6.747), knowing someone who died from COVID-19 infection (AOR:1.732), and living with other people (AOR:1.512) were significantly associated with higher odds of testing positive for COVID-19 infection, while living with HIV was associated with significantly lower odds of testing positive for COVID-19 infection (AOR:0.284). Also, respondents with respiratory conditions (AOR:2.487), self-reported depression (AOR:1.901), those who had a close friend who tested positive for COVID-19 infection (AOR:2.562) and who knew someone who died from COVID-19 infection (AOR:1.811) had significantly higher odds of having symptoms of COVID-19 infection but not getting tested.Conclusion: Non-communicable diseases seem not to increase the risk for COVID-19 positive test while cohabiting seems to reduce this risk. The likelihood that those who know someone who tested positive to or who died from COVID-19 not getting tested when symptomatic suggests there is poor contact tracing in the region. People with respiratory conditions and depression need support to get tested for COVID-19.</p

Associations between Emotional Distress, Sleep Changes, Decreased Tooth Brushing Frequency, Self-Reported Oral Ulcers and SARS-Cov-2 Infection during the First Wave of the COVID-19 Pandemic: A Global Survey

This study assessed the association between emotional distress, sleep changes, decreased frequency of tooth brushing, and self-reported oral ulcers, and the association between COVID-19 status and decreased frequency of tooth brushing. Using a cross-sectional online survey, data were collected from adults in 152 countries between July and December 2020. Binary logistic regression analyses were conducted to determine the associations between dependent (decreased frequency of tooth brushing, oral ulcers, change in sleep pattern) and independent (tested positive for COVID-19, depression, anxiety, frustration/boredom, loneliness, anger, and grief/feeling of loss) variables after adjusting for confounders (age, sex, level of education, employment status). Of the 14,970 participants data analyzed, 1856 (12.4%) tested positive for COVID-19. Respondents who reported feeling depressed (AoR: 1.375), lonely (AoR: 1.185), angry (AoR: 1.299), and experienced sleep changes (AoR:1.466) had significantly higher odds of decreased tooth brushing frequency. Respondents who felt anxious (AoR: 1.255), angry (AoR: 1.510), grief/sense of loss (AoR: 1.236), and sleep changes (AoR: 1.262) had significantly higher odds of oral ulcers. Respondents who tested positive for COVID-19 had significantly higher odds of decreased tooth brushing frequency (AoR: 1.237) and oral ulcers (AoR: 2.780). These findings highlight that the relationship between emotional distress and oral health may intensify during a pandemic.</p

Prácticas de lactancia y alimentación complementaria en menores de 6 meses en Argentina. Estimaciones a partir de una Encuesta Multipropósito

Se realizó un análisis de base de datos secundaria para estimar indicadores de lactancia materna y alimentación complementaria en menores de 6 meses en Argentina, a partir de la Encuesta Nacional de Salud Sexual y Reproductiva 2013, la cual utilizó un muestreo polietápico abarcando todas las regiones estadísticas del país. Se realizaron análisis descriptivos y multivariados sobre 3.137 mujeres que respondieron el bloque de lactancia materna de la encuesta en relación al último hijo nacido vivo. Los resultados indican que el 65,9% de los lactantes fue amamantado hasta los seis meses de vida o más; el 43% recibió fórmula para lactantes antes de los 6 meses, el 58,5% recibió agua antes de los 6 meses, y el 33,5% recibió alimentos semisólidos antes de los 6 meses. Se puede concluir que el hecho de identificar factores asociados a determinadas prácticas de alimentación en lactantes puede orientar para la promoción de una lactancia materna adecuada

Análisis de los indicadores de salud infantil en Argentina, en relación a los objetivos de desarrollo del Milenio trazados por Naciones Unidas

Objetivos: A la luz del 4° Objetivo de Desarrollo del Milenio trazado por Naciones Unidas, este trabajo tuvo como objetivos analizar la epidemiología de la mortalidad de menores de 1 año y menores de 5 años en la Argentina entre los años 1990 y 2011, y describir la cobertura de vacunación antisarampionosa en niños de 1 año entre 1990 y 2009. Método: Se midieron indicadores epidemiológicos con datos nacionales de fuentes secundarias: Tasa de mortalidad infantil y tasa de mortalidad en menores de 5 años; y porcentaje de cobertura de vacunación antisarampionosa en Argentina. Resultados: Los resultados muestran un descenso del 54,2% en la tasa de mortalidad infantil, y del 54,5% en la mortalidad de menores de 5 años. Las causas de muerte más frecuentes durante los primeros 5 años de vida están asociadas principalmente a las afecciones perinatales y anomalías congénitas. En relación a la cobertura de vacunación antisarampionosa, se observa una evolución positiva de ese indicador llegando en el año 2009 al 100% de cobertura. Conclusiones: La mortalidad infantil representa un indicador indiscutible de muertes evitables e innecesarias, que pueden prevenirse mediante acciones sanitarias y políticas sociales orientadas a influir sobre los determinantes sociales y económicos, en ese sentido se torna indispensable avanzar hacia la reducción prevista entre los compromisos que las Naciones Unidas establecieron en el marco de los Objetivos de Desarrollo del Milenio

Internal Displacement Due to Disasters in Latin America and the Caribbean

Environmental disasters have been identified as a significant cause of human mobility. Particularly in developing regions, climate change is responsible for rising the frequency and intensity of weather-related disasters in the last decades, thus increasing the number of people who migrate within their countries. This chapter examines the magnitude and duration of internal displacements due to disasters in 18 countries of Latin America and the Caribbean between 2013 and 2015, and analyzes the quality of the Global Internal Displacement Database. Overall, 505 events of disaster were identified, which led to the internal migration of 4,217,737 people. The mean of displaced persons per event was 8351 (SD = 69,755) and the mean duration of the displacement was 11.9 (SD = 40.5) days. The primary reason for internal displacement in the countries examined was hydro-meteorological disaster related to climate change (51%). Results conclude that the Global Internal Displacement Database accurately identifies the starting date of internal displacements, but presents limitations to measure the duration of the displacements during the reference period

Post-Traumatic Stress Disorder and other mental disorders in the general population after Lorca's earthquakes, 2011 (Murcia, Spain): A cross-sectional study

Aims: To describe the prevalence and severity of mental disorders and to examine differences in risk among those with and without a lifetime history prior to a moderate magnitude earthquake that took place in Lorca (Murcia, Spain) at roughly the mid-point (on May 11, 2011) of the time interval in which a regional epidemiological survey was already being carried out (June 2010 –May 2012). Methods: The PEGASUS-Murcia project is a cross-sectional face-to-face interview survey of a representative sample of non-institutionalized adults in Murcia. Main outcome measures are prevalence and severity of anxiety, mood, impulse and substance disorders in the 12 months previous to the survey, assessed using the Composite International Diagnostic Interview (CIDI 3.0). Sociodemographic variables, prior history of any mental disorder and earthquake-related stressors were entered as independent variables in a logistic regression analysis. Findings: A total number of 412 participants (response rate: 71%) were interviewed. Significant differences in 12-month prevalence of mental disorders were found in Lorca compared to the rest of Murcia for any (12.8% vs 16.8%), PTSD (3.6% vs 0.5%) and other anxiety disorders (5.3% vs 9.2%) (p≤ 0.05 for all). No differences were found for 12-month prevalence of any mood or any substance disorder. The two major predictors for developing a 12-month post-earthquake mental disorder were a prior mental disorder and the level of exposure. Other risk factors included female sex and low-average income. Conclusions: PTSD and other mental disorders are commonly associated with earthquake disasters. Prior mental disorders and the level of exposure to the earthquakes are the most important for the development of a consequent mental disorder and this recognition may help to identify those individuals that may most benefit from specific therapeutic intervention