ObjectiveScholars have debated the COVID-19's full and partial lockdowns' effectivity to control the transmission of the new case. They emphasized the provision of required economic and social resources worldwide. Past literature related to COVID-19 has contributed little evidence to examine the efficacy of full and partial lockdown measures with experimental perspectives at different intervals. This study bridges this literature gap and explores the full and smart lockdowns' impacts on Pakistani students' mental health, depression, quality of life, and anxiety symptoms, during the various waves of the COVID-19 pandemic.MethodThis pretest and posttest experimental designed web-based survey recruited 40 students from March 23 to August 23, 2020, and recorded their responses. The study incorporated four standardized psychological instruments to receive the desired datasets related to students' mental health, quality of life, anxiety, and depression. Researchers shared data links with the participants via social media, WhatsApp. The study applied one-way and multivariate ANOVA tests (analysis of variance) to draw the desired results.ResultsThis study's findings suggest that both full and partial COVID-19 lockdowns effectively improve students' mental health and quality of life. These measures help reduce anxiety and depressive symptoms among university students. The study results exhibit that partial lockdown (PL) is more effective in improving quality of life. Besides, PL helps reduce anxiety symptoms than complete lockdown among Pakistani students.ConclusionThe present study's findings suggest that students are vulnerable. They need particular interventions and preventive measures to protect and improve their mental health and quality of life during a global pandemic. As the stressful experience of the epidemic persists in Pakistan. It will also be interesting to examine the psychological impact of the successive waves of the COVID-19 pandemic.
Background
Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico.
Methods
We performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017.
Results
All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017.
Conclusions
Our subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.
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