The Challenges in the Fight against COVID-19 Pandemic: A Qualitative Study

Background: COVID-19 pandemic has dominated the global space for more than a year, and the world faces a lot of challenges in the battle against the deadly virus. This study highlights funda­mental issues that undermine the fight against the COVID-19pandemic and informs on how government and health authorities might further the cause of pandemic control. This study aimed is to analyze challenges that hinder the battle against the COVID-19pandemic from the viewpoint of the Nigerian Twitter community. Subjects and Method: This was a qualitative study with phenomenological approach, conducted using an online survey through Google Forms with Nigerian Twitter community. A total of 128 informants were selected using a list-based sampling technique. The data was managed, cleaned, organized and analyzed in SPSS, Microsoft Excel Spreadsheet, Microsoft Word and Microsoft Notepad. Results: 40.6% of the informants are in the field of Education, 11.7% are Entrepreneurs, 10.9% are Students, 10.9% are Civil Servants, 9.4% are IT Specialists, while 7.0% are Engineers. Issues that undermines the fight against COVID-19pandemic according to the findings from this study were summarized and classified into five themes, included: 1) Fake News Distort Health Messages on Covid-19, 2) Conspiracy Theories on Covid-19, 3) Mismanagement of COVID-19pandemic, 4) Lack of Government Trust on Covid-19, 5) Lack of Adequate Information on Covid-19. Conclusion: Findings suggest that these five issues are key in fighting the COVID-19scourge and must be addressed in future pandemic mitigation efforts and control plans. Keywords: COVID-19, health communication, fake news, pandemic, health messages Correspondence: Sanni Shamsudeen Ademola. Department of Computer Science, Faculty of Science and Engineering, University of Eswatini. Private Bag 4, Matsapha Manzini, The Kingdom of Eswatini. Email: [email protected]. Mobile: +26876241155/ 79241155 Journal of Health Promotion and Behavior (2021), 06(02): 133-143 DOI: https://doi.org/10.26911/thejhpb.2021.06.02.0

Effect of COVID-19 Infodemic on Media Trust and Perceived Stress

Background: Health infodemic undermines public health response, results in poor observance of public health measures and costs lives. Health campaigns will not produce intended results without controlling misinformation. This study aimed to analyzed the correlation between infodemic, COVID-19 stress and media trust. Subjects and Method: This was a cross sectional study conducted using online structured questionnaire, from December 2020 to January 2021. A total of 470 participants among African twitter community were randomly selected for this study. The dependent variables were COVID-19 stress and media trust. The independent variable was while Infodemic serve. The data was analysed using Pearson’s product moment correlation coefficient test. Results: COVID-19 stress  (r= 0.369; p<0.001) and media trust (r= 0.301; p<0.001) were correlated with infodemic and it was statistically significant. Conclusion: infodemic is correlated with COVID-19 stress and media trust. Keywords: infodemic, health communication, media trust, stress, COVID-19 Correspondence: Sanni Shamsudeen Ademola. Department of Computer Science, Faculty of Science and Engineer­ing, University of Eswatini, Private Bag 4, Matsapha, manzana, Kingdom of Eswatini. Email: [email protected]. Mobile: +26876241155/79241155. Journal of Health Promotion and Behavior (2021), 06(02): 144-153 DOI: https://doi.org/10.26911/thejhpb.2021.06.02.0

Analysis of Twitter Conversation on COVID-19 Pandemic in Africa 2019-2020

Background: Communication about COVID-19 pandemic has a huge impact on coordination, control and mitigation efforts against the disease. Patterns and trends of COVID-19 pandemic conversations amongst African tweeps between the year 2019 and 2020 was studied. This study aimed to determine the impact of Twitter COVID-19 information dissemination on attitudes, behaviour and decision making during the pandemic. Subjects and Method: This was a cohort study with combined quantitative and qualitative approach. This study was conducted in Africa, from December 2019 to December 2020. The quantitative approach was founded on data mining and data analytics research approach, applying measurements in terms of counts, numbers and frequencies while qualitative approach was founded on Natural Language Processing (NPL) algorithm to extract themes/topics and further applying sentiment analysis to a body of large textual data. Results: A total number of 24,251 tweets was recorded, out of which 9, 016 (37.2%) of the tweets were positive, indicating positive attitude towards COVID-19 related information, control, treatment and regulations. A number of 7, 024 (29%) of tweets were considered neutral, indicating a neutral opinion on conversations related to COVID-19, while 8, 211 (33.9%) were considered negative tweets.  South Africa is the most frequently used word and frequently used hashtag followed by Nigeria. Result further revealed four clear topics of discussion which are: a) Africa coronavirus, b) First sub-Saharan pandemic variant, c) Total number of confirmed new deaths, and d) COVID-19 cases in Africa. Besides, it was observed that most health authorities and health partners in Africa are not actively participating on Twitter. Conclusion: Health information dissemination on social media must be moderated through censorship, otherwise fake news and misinformation would persist to aggravate the spread of diseases and cause deaths. In order to protect the public against false information, public health institutions, governments and partners in health should establish an active presence on social media to share factual information, and timely debunk misinformation.  Keywords: Africa, COVID-19, twitter Conversation, social media, sentiment Analysis Correspondence:  Sanni Shamsudeen Ademola. Department of Computer Science, Faculty of Science and Engineer­ing, University of Eswatini, Private Bag 4, Matsapha, Manzini, Kingdom of Eswatini. Email: [email protected]. Mobile: +26876241155/79241155 Journal of Health Promotion and Behavior (2021), 06(04): 272-283 DOI: https://doi.org/10.26911/thejhpb.2021.06.04.0

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Adoption of e-publishing amongst Malaysian journal publishers / Sanni Shamsudeen Ademola

The study investigates adoption of e-publishing amongst Malaysian journal publishers through the lenses of the Diffusion of Innovation Theory. The main objectives of the study are to: (i) Determine the relevance of organizational variables and publishers characteristics in the adoption of e-publishing amongst Malaysian journal publishers. (ii) Identify key attributes and factors that are most relevant in the adoption of e-publishing amongst Malaysian journal publishers. (iii) Evaluate the diffusion rate of e-publishing amongst Malaysian journal publishers. (iv) Examine the level of implementation of e-publishing amongst Malaysian journal publishers. Quantitative research method was adopted using survey questionnaire as the data collection tool and SPSS software for statistical analysis. The participants are Chief Editors or managers of journals published in Malaysia with a total of 156 respondents. The study adopts the Innovation Diffusion Model for the e-journal publishing research framework, by studying and explaining the effect of adopter characteristics variables : field of publishing, publishing experience, publication age, publication size; familiarity and innovativesness; the five attributes of innovation : relative advantage, compatibility, complexity, observability and trialability; two supporting variables: peer network influence and change agent influence as antecedents to the adoption of e-journal publishing amongst Malaysian journal publishers. The study indicates a statistically significant association between field of publishing and publication format X2 (1, n = 140) =.207, P = .050, phi = .207 with publishers in science/technology field adopting e-publishing earlier and in large proportion than their counterparts in social science/arts/humanities. The finding reports that organizational variables or publishers characteristics are not relevant in the familiarity with e-journal publishing and adoption of e-journal publishing. Innovativeness is significantly associated iii with familiarity with e-journal publishing but is not significantly associated with adoption. The most significant attributes in the adoption of e-journal publishing are: relative advantage, complexity, and compatibility, while observability and trialability are moderately significant compared to the first three. The study further indicates a significant but weak relationship between peer network influence and adoption and no relationship between change agent influence and adoption. Meanwhile, the study observed a difference in the relationship between the independent variables and adoption with respect to field of publishing, indicating that there is a field factor in the diffusion process. The findings show that diffusion of e-journal publishing is very low amongst Malaysian journal publishers. The average (mean) year of adoption is 2.33 years with a standard deviation of 3.00. It was observed that many of the publishers who have adopted e-publishing have failed to effectively implement it and the current state of e-journal publishing amongst Malaysian journal publishers is still at the persuasion stage in the innovation decision process. The study is relevant to research in journal publishing, innovation diffusion studies, technology adoption, social and behavioral studies

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was$216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with$195 for low FiO2 leading to a −$11 (95$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was$1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this

Use of Telemedicine for Post-discharge Assessment of the Surgical Wound: International Cohort Study, and Systematic Review with Meta-analysis

Objective: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardised assessment tools are needed. Summary background data: Surgical site infection is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery. Methods: The primary outcome of this study was surgical site infection reported up to 30-days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analysed primary data from an international cohort study of adult patients undergoing abdominal surgery who were discharged from hospital before 30-days after surgery. The second part combined this data with the results of a systematic review to perform a meta-analysis of all available data conducted in accordance with PRIMSA guidelines (PROSPERO:192596). Results: The cohort study included 15,358 patients from 66 countries (8069 high, 4448 middle, 1744 low income). Of these, 6907 (45.0%) were followed up using telemedicine. The SSI rate reported using telemedicine was slightly lower than with in-person follow-up (13.4% vs. 11.1%, P&lt;0.001), which persisted after risk adjustment in a mixed-effects model (adjusted odds ratio: 0.73, 95% confidence interval 0.63-0.84, P&lt;0.001). This association was consistent across sensitivity and subgroup analyses, including a propensity-score matched model. In nine eligible non-randomised studies identified, a pooled mean of 64% of patients underwent telemedicine follow-up. Upon meta-analysis, the SSI rate reported was lower with telemedicine (odds ratio: 0.67, 0.47-0.94) than in-person (reference) follow-up (I2=0.45, P=0.12), although there a high risk of bias in included studies. Conclusions: Use of telemedicine to assess the surgical wound post-discharge is feasible, but risks underreporting of SSI. Standardised tools for remote assessment of SSI must be evaluated and adopted as telemedicine is upscaled globally