Global health Division

/Global health Division
Global health Division2022-06-21T09:00:40+00:00
2206, 2022

Mental Health of the COVID-19 Patients in Bangladesh

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Publication status: Published
Brief description: The mental health aspect of coronavirus disease-19 (COVID-19) patients in Bangladesh has remained less focused and has not been addressed properly. The objective of the study was to assess the levels of anxiety and depression in COVID-19 patients. We adopted a mixed online and telephone-based survey using Google Forms. Recruitment was performed through a snowball sampling approach. The Google Form was initially circulated in Facebook to identify interested participants. Then, three trained physicians interviewed the online responders over telephone for a period spanning from April 2020 to June 2020. Two well-known questionnaires, the Generalized Anxiety Disorder 7-item (GAD-7) scale and the Patient Health Questionnaire (PHQ-9), were used for the assessment of anxiety and depression, respectively. Here, the severity of anxiety was classified with the standard thresholds: minimal or none (0-4), mild (5-9), moderate (10-14) and severe (>15) for the GAD-7. Depression severity score: 0-4 was considered as none or no depression, 5-9: mild, 10-14: moderate, 15-19: moderately severe, 20-27 was for severe depression. A total of 237 patients were finally analyzed. The mean age ±SD of the patients was 41.59±13.73 years. Most of them were male (73%) and lived in urban areas (90.29%). Half of the patients were unemployed, and 17.7% admitted loss of job due to lockdown. The overall prevalence of anxiety and depression was 55.7% and 87.3%, respectively. The mean GAD-7 score was 5.79±4.95, and the mean PHQ-9 score was 5.64±5.15. Among the depressive patients, 3% had minimal depression, 38.4% had mild depression, 32.1% had moderate depression, 11.8% had moderate depression, and 2.1% had a severe depression. Similarly, 37.1%, 10.5% and 8% had mild, moderate and severe levels of anxiety, respectively. Nearly half of the study population (47.7%) was suffering from both depression and anxiety. Living in urban area was an independent predictor for depression (OR 3.882; CI: 1.249-12.069). Considering the high comorbid burden, the mental health issues of these patients need to be addressed and reinforced to the existing health system on a priority basis.

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2206, 2022

The impact of the COVID-19 pandemic on the mental health of Rohingya refugees with pre-existing health problems in Bangladesh

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Publication status: Published
Brief description: Mental disorders among refugees have been well explored in several studies. However, longitudinal studies on the impact of the pandemic on refugee populations are widely lacking. This study was designed to examine the impact of the current pandemic on the mental health of Rohingya refugees living in Bangladesh. This longitudinal study involved a convenience sample of 732 Rohingya people with pre-existing health problems who lived in the Kutupalong refugee camp in Cox’s Bazar, Bangladesh. The first recruitment was performed on 5 July 2019 (prepandemic visit) and assessed the health status of refugees using the Refugee Health Screener-15 (RHS-15). The follow-up survey was conducted on 10 November 2020, approximately 15 months later, during the pandemic. A total of 342 Rohingya refugees who completed the initial survey participated in the follow-up survey. A newly developed COVID-19 Impact on Quality of Life (COV19-QoL) scale was used alongside the RHS-15 scale during the second survey. Ethical measures were taken in compliance with the current Declaration of Helsinki. The analysis was performed using SPSS 26. A total of 342 Rohingya refugees completed this longitudinal survey. The average age of participants was 32.25 ± 14.01 years (SD), and the predominant age group was ≤ 30 years (n = 207, 60.5%). Most of the participants were female (n = 209, 61.1%). A significant increase in stress was noted from the prepandemic to pandemic periods, as determined by the RHS-15 scale (RHS-15 Part I: 22.96 ± 8.43 vs. 46.72 ± 1.87, p < 0.001; and RHS-15 Part II: 4.43 ± 1.59 vs. 6.91 ± 1.49, p < 0.001). The mean COV19-QoL score of the participants was 4.47 ± 0.15 (out of 5), indicating a perceived negative impact of the pandemic in their lives. In the multiple regression analysis, female sex (β = 0.604, p = 0.017) and COV19-QoL score (β = 2.537, p = 0.003) were significantly associated with higher perceived distress among participants. Rohingya refugees experienced a significant deterioration of mental health during the COVID-19 pandemic. Alongside other socioeconomic, environmental, and political factors, the pandemic itself might have been a crucial contributor to this negative trend.

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2106, 2022

Health problems among Forcibly Displaced Myanmar Nationals (FDMNs) admitted to the Medicine ward of Cox’s Bazar Medical College Hospital

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Publication status: Published
Brief description: Forcibly Displaced Myanmar Nationals (FDMNs) or Rohingya refugees are one of the vulnerable groups suffering from different kinds of health problems but have been less reported yet. Therefore, the study was designed to delineate the health problems among FDMNs admitted to Cox’s Bazar Medical College Hospital. This hospital-based cross-sectional study was conducted at the Medicine ward, Cox’s Bazar Medical College Hospital, for a six-month period following approval. Rohingya refugees who were admitted during the study period were approached for inclusion. Informed written consent was ensured prior to participation. A structured questionnaire was used during data collection. Collected information was recorded in case record form. A total of 290 subjects were interviewed. Analysis was performed using the statistical package for social science (SPSS) version 20.

The mean age of the participants was 48.76 ± 18.67 years (range: 16–91), with a clear male predominance (60.7%). Family size ranged 6–8. All of the participants reported at least one of the illnesses. Of all, 29.66% patients had disease of the respiratory system, and 26.9% had disease of the gastrointestinal and hepatobiliary system. Accidental injury or injury due to electrocution or thin falls or snake bites was present in 10.4% of the cases. Among the single most common diseases, COPD (20%) was the most frequently observed, and the rest of them were chronic liver disease (13.1%), pulmonary TB (5.5%), ischemic stroke (5.5%), CAP (4.1%), acute coronary syndrome (3.4%), thalassaemia (3.4%) and hepatocellular carcinoma (3.4%). Among the top 6 diagnosed diseases, PTB was more common in elderly individuals (p = 0.29). The disease pattern was similar across the sexes among the refugees except community acquisition pneumonia (CAP), which was commonly observed among males (p = .004). Considering different age groups, genitourinary problems were more common in males aged >60 years, and rheumatology and musculoskeletal problems were equally affected in females aged between 40 and 60 years. COPD, CLD and CAP were the most prevalent diseases in FDMN patients who attended the Medicine ward of Cox’s Bazar Medical College Hospital. Further exploration is warranted before any policy making and comprehensive plan.

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2106, 2022

Constraints and current practices of menstrual hygiene among Rohingya adolescent girls

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Publication status: Published
Brief description: Although half of Rohingya refugees are women and adolescent girls, the sexual and reproductive health issues of these vulnerable groups are still unexplored. The aim of this study was to review and describe menstrual hygiene management (MHM) along with the existing challenges of MHM among Rohingya adolescent girls. This concurrent mixed methods study was conducted among adolescents aged 13–18 years living in Kutupalong refugee camps in Ukhiya, Cox’s Bazar, Bangladesh. Camp-based surveys along with focus group discussions were performed for data collection. The findings of a total of 12 FGDs and 101 survey responses were included for data analysis. Descriptive statistics were used for quantitative data analysis, and thematic analysis was considered for the qualitative data. Approximately one-fourth of the adolescent girls (28.71%) had premenstrual knowledge. Only 8% had “Good” knowledge, and 12% had a basic understanding. Half of the women used cloths during menstruation, while others (20.79%) used homemade clean pads, disposable sanitary pads (17.82%), and used only underwear without absorbance (10.89%). The frequency of changing sanitary pads varied, but the majority of respondents (48.51%) changed padding at least once daily. Common disposal places were inside the toilet (30.69%), open spaces (17.82%), dustbins (6.93%) and water sources (3.96%). An inadequate and irregular supply of sanitary napkins or absorbents leads to poor MH practices. Limited cleaning and disposal facilities, lack of privacy in camps or informal settlements, confined and crowded places and nonsupportive environments in the camp were also factors affecting the use of pads and disposal. Family and cultural beliefs, stigma, restrictions, and fear of sexual violence were also noted within typical day-to-day activities during menstruation. The provision of adolescent-friendly wash facilities, appropriate information and adequate menstrual supplies is needed to improve the MH response in an emergency context. Despite some limitations, this study could lead to future changes relative to MH for women and adolescents in Rohingya.

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2106, 2022

Sociodemographic profile, clinical characteristics, anxiety, and depression of 74 patients infected with COVID-19: first report from Bangladesh

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Publication status: Published
Brief description: The pandemic of Corona Virus Disease 2019 (COVID-19) has cost a large number of lives and is causing substantial mental stress among people. We conducted a study to identify the sociodemographic and clinical characteristics and prevalence of anxiety and depression among confirmed COVID-19 cases in Bangladesh. Methods: An online cross-sectional survey using a preformed questionnaire adapted in Google form was conducted for data collection. The form was shared along with a brief introduction and rationale via Facebook, Twitter, Facebook Messenger, Viber, and What’s App. Formal ethical clearance was taken from the Biomedical Research Foundation, Bangladesh. Informed consent was ensured before participation. Results: Seventy-four patients with COVID-19 who had an average age of 42.59±14.43 years with male predominance (77%) were included. A total of 29.7% were doing health-care related jobs, and 14.9% lost their jobs due to COVID-19. Patients had a median income of BDT 30000. Of all, 87.8% of patients were symptomatic and presented with fever (77%), cough (58.8%), breathlessness (24.3%), myalgia (24.3%), sore throat (21.6%), fatigue (17.6%), nausea and/or vomiting (12.2%), headache (12.2%), runny nose (9.5%), chest pain (9.5%), diarrhea (8.1%), ARDS (2.7%), stuffy nose (2.7%), conjunctivitis (1.4%) and oral ulcer (1.4%). Overall, the prevalence of anxiety and depression was 60% and 52.9%, respectively. Among the participants, 11.4% had only anxiety, 4.3% had only depression and 48.6% had both. Conclusion: Patients were mostly middle aged, male and healthy workers. Typical presentations were fever and cough. Nearly two-thirds of the patients had either or both anxiety and depression.

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