Introduction: The primary healthcare workers (PHCWs) face a higher risk of infection associated with their occupation, due to inadequate supplies of personal protective equipment (PPE), inappropriate use of PPEs, and insu cient knowledge on infection prevention and control. Therefore, this study aimed to assess the preparedness for COVID-19 by PHCWs in Rivers State, Nigeria. Method: A cross-sectional survey was conducted involving the healthcare workers at the public primary healthcare facilities across the 23 local government areas (LGAs) of Rivers State, Nigeria. The descriptive statistics of mean ± standard deviation and percentage were used to present quantitative and categorical variables respectively. The preparedness for COVID-19 was measured by knowledge, attitude and preventive practices (KAP) towards the disease. The association between the KAP and demographic characteristics was tested with the Chi-square test, while the associations existing among the KAP constituents were evaluated with the Pearson correlation coe cient. Statistical signi cance was evaluated at P<0.05. Results: Out of 460 questionnaires distributed, 412 respondents participated in the survey, indicating a response rate of 89.6%. The proportion of respondents with good scores in knowledge, attitude, and COVID-19 related practices was 86.4% (10.66 ± 2.40), 85.0% (8.28 ± 1.94), and 97.3% (8.34 ± 1.39) respectively. Gender, occupation, and years of experience were associated with knowledge, while years of experience and marital status were associated with attitude and preventive practices. Knowledge score also had signi cant positive linear associations with both attitudes and practices (scores toward COVID-19. Conclusion: Our ndings revealed the level of PHCWs preparedness to ght COVID-19 in Rivers State. We suggest that public health education programs on infection prevention and control should be sustained. Furthermore, training should be tailored to meet the peculiarities of the different categories of healthcare workers and years of practice.

The coronavirus disease 2019 (COVID-19) originated from Wuhan (Hubei state, China), carrying similar DNA structure to SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) has spread throughout the world creating massive panic to the human life. 1,2 The disease has the worst feature to transmit from person to person, 3 considering this feature and its lofty infection rate on January 30, 2020, the World Health Organization (WHO) declared COVID-19 as a global emergency.To date, it has infected more than 13.9 million people and over 5 lakh have died. The outbreak has hit the USA, Brazil and India very badly. This three-country together holds over 6.7 million total identified cases and over 41% of the total death because of As no proven treatment/medicine or vaccine is available to date 5 the harm of COVID-19 has already overtaken SARS and MARS. 6 Although the infection rate is very high, all the patients getting infected by this disease don't always die. The global recovery rate is about 59.4% and the death rate is about 4. 25% until July 17, 2020. 4 This information suggests that there may be some factors that influence the risk of death or critical medical states of the patients.That's why it is important to identify and estimate such risk factors to predict the severe complication of the patients for avoiding or to minimise the severity. 7 Researchers are trying to identify risk factors that deteriorate the health state of the COVID-19 patients mostly by using meta-analysis and systematic review. Some earlier investigations reported that males are more likely to die or to go through the critical states of COVID-19. 8,9 There is an ongoing debate on whether smoking is a risk factor for COVID-19 severity. Although some regard it as a

The study aimed to identify the factors influencing the utilization of antenatal care (ANC) services among pregnant women to fulfill the Sustainable Development Goals (SDG) for maternal mortality ratio (MMR) by 2030; we also investigated the consistency of these factors. We have used the Demographic and Health Survey (DHS) data from 29 developing countries for analysis. A binary logistic regression model was run using Demographic and Health Survey data from Bangladesh to determine the factors influencing ANC utilization in Bangladesh. In addition, a random-effects model estimation for meta-analysis was performed using DHS data from 29 developing to investigate the overall effects and consistency between covariates and the utilization of ANC services. Logistic regression revealed that residence (odds ratio [OR] 1.436; 95% confidence interval [CI] 1.238, 1.666), respondent’s education (OR 3.153; 95% CI 2.204, 4.509), husband’s education (OR 2.507; 95% CI 1.922, 3.271) wealth index (OR 1.485; 95% CI 1.256, 1.756), birth order (OR 0.786; 95% CI 0.684, 0.904), working status (OR 1.292; 95% CI 1.136, 1.470), and media access (OR 1.649; 95% CI 1.434, 1.896) were the main significant factors for Bangladesh. Meta-analysis showed that residence (OR 2.041; 95% CI 1.621, 2.570), respondent’s age (OR 1.260; 95% CI 1.106, 1.435), respondent’s education level (OR 2.808; 95% CI 2.353, 3.351), husband’s education (OR 2.267; 95% CI 1.911, 2.690), wealth index (OR 2.715; 95% CI 2.199, 3.352), birth order (OR 1.722; 95% CI 1.388, 2.137), and media access (OR 2.474; 95% CI 2.102, 2.913) were the most conclusive factors in a subjects decision to attend ANC. Our results support the augmentation of maternal education and media access in rural areas with ANC services. Particular focus is needed for women from Afghanistan since they have a lower level of ANC services.

The evolving pandemic of non-communicable diseases like hypertension, diabetes mellitus are globally on the rise, and the trend is also escalating in Bangladesh. We aimed to assess the prevalence trend and associated factors of hypertension (HTN), diabetes mellitus (DM), and hypertension- diabetes mellitus combined (HDC) among Bangladeshi adults from 2011 to 2018. Two nationally representative cross-sectional data from Bangladesh Demographic and Health Survey (BDHS): 2011 and 2017–18 were utilized. According to baseline characteristics, the average annual rate of change (AARC) was applied to quantify the annual rate of increase/decrease in HTN, DM, and HDC from 2011 to 2018. The prevalence ratios of HTN, DM, and HDC were assessed through modified Poisson regression with robust error variance (PR, 95% Confidence Interval (CI)). The data were prepared in SPSS version 23 and exported to Stata version 13 for further analysis. Among 11,686 participants, the overall mean age of the study participants was 52.79 years, Standard Deviation (SD)±12.99, and 42.28% were female. From 2011–2018, HTN, DM, and HDC prevalence in Bangladesh has increased by 13, 3.2, and 3.1 percentage points, respectively. The average annual rate of increase was observed in the HTN and HDC prevalence by all socio-economic and demographic categories during 2011–2018. The prevalence of HDC among Chittagong residents was approximately double in 2018: 3.95% (2011) versus 6.59% (2018). Increased age, inactive workers, overweight adults, and adults in wealthy families were common risk factors associated with HTN, DM, and HDC in Bangladesh. The prevalence of developing HTN and HDC was significantly higher among adults aged ≥ 70 years (PR: 2.70, 95% CI: 2.42–3.00; PR: 2.97, 95% CI: 2.08–4.24, respectively). A comprehensive approach of different stakeholders is required to develop appropriate strategies, including appropriate weight management, adequate physical activity, and healthier food habits. Health agencies should take initiatives to spread awareness among people at an early age, but special attention is needed for older people and those at risk for NCDs.

Caesarean delivery (C-section) has been increasing worldwide; however, many women from developing countries in Sub-Saharan Africa are deprived of these lifesaving services. This study aimed to explore the impact of certain socioeconomic factors, including respondent’s education, husband’s education, place of residence, and wealth index, on C-section delivery for women in Sub-Saharan Africa. We used pooled data from 36 demographic and health surveys (DHS) in Sub-Saharan Africa. Married women aged 15–49 years who have at least one child in the last five years were considered in this survey. After inclusion and excluding criteria, 234,660 participants were eligible for final analysis. Binary logistic regression was executed to determine the effects of selected socioeconomic factors. The countries were assembled into four sub-regions (Southern Africa, West Africa, East Africa, and Central Africa), and a meta-analysis was conducted. We performed random-effects model estimation for meta-analysis to assess the overall effects and consistency between covariates and utilization of C-section delivery as substantial heterogeneity was identified (I2 > 50%). Furthermore, the meta-regression was carried out to explain the additional amount of heterogeneity by country levels. We performed a sensitivity analysis to examine the effects of outliers in this study. Findings suggest that less than 15% of women in many Sub-Saharan African countries had C-section delivery. Maternal education (OR 4.12; CI 3.75, 4.51), wealth index (OR 2.05; CI 1.94, 2.17), paternal education (OR 1.71; CI 1.57, 1.86), and place of residence (OR 1.51; CI 1.44, 1.58) were significantly associated with the utilization of C-section delivery. These results were also consistent in sub-regional meta-analyses. The meta-regression suggests that the total percentage of births attended by skilled health staff (TPBASHS) has a significant inverse association with C-section utilization regarding educational attainment (respondent & husband), place of residence, and wealth index. The data structure was restricted to define the distinction between elective and emergency c-sections. It is essential to provide an appropriate lifesaving mechanism, such as C-section delivery opportunities, through proper facilities for rural, uneducated, impoverished Sub-Saharan African women to minimize both maternal and infant mortality.