A Syndemic Perspective on the Management of Non-communicable Diseases Amid the COVID-19 Pandemic in Low- and Middle-Income Countries

Yadav, Uday Narayan; Rayamajhee, Binod; Mistry, Sabuj Kanti; Parsekar, Shradha S; Mishra, Shyam Kumar

doi:10.3389/fpubh.2020.00508

Cited by 137 publications

(158 citation statements)

References 42 publications

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“…Although the literature on fear of COVID-19 among the older population lacks from Nepal, experts opine that COVID-19 has heavily affected the mental health of older adults across the globe as they are more susceptible to fear and anxiety problems during the pandemic (18,19). Our ndings aligned with the recently published evidence that reported fear, psychosocial effects, and uncertainty due to COVID-19 (20,21). The ongoing fear among the general Nepali population is also corroborated by the media reports of residents protesting against the building of quarantine centers near their community settlement, evicting health workers from their rented units, non-attendance at the funerals, entry blockades to outsiders into their local areas, demonstrations and protests against the insu cient government's responses and so on.…”

Section: Discussionsupporting

confidence: 84%

Perceived Fear of COVID-19 and its Associated Factors Among Nepalese Older Adults in Eastern Nepal: Findings From a Cross-Sectional Study

Yadav

Singh

et al. 2020

Preprint

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BackgroundCoronavirus disease 2019 (COVID-19) has impacted all age groups, but older adults may have greater distress given their increased risk for severe illness and mortality. In Nepal, most stories of older adults are untold ̶ both in pre-COVID-19 and the COVID-19 era. In this study, we aimed to assess the perceived fear of COVID-19, and associated factors, among older adults in eastern Nepal.MethodsA cross-sectional study was conducted between July and September 2020 among 847 older adults (≥60 years) residing in three districts of eastern Nepal. Perceived fear of COVID-19 was measured using the seven-item Fear of COVID-19 Scale (FCV-19S). In order to examine the factors associated with the COVID 19 fear, a generalized estimating equation, adjusting the sampling design was used. STATA 15 and JASP 0.13.1 were used for data analyses.ResultsThe mean score of the FCV-19S was 18.1±5.2, and a sizeable proportion of participants, ranging between 12%-34%, agreed to the seven items of the fear scale. Increasing age, Dalit ethnicity remoteness to the health facility, and being concerned or overwhelmed with the COVID-19 were associated with greater fear of COVID-19. Surprisingly, pre-existing health conditions were inversely associated with fear of COVID-19.ConclusionGreater fear of the COVID-19 pandemic among the older population suggests that during unprecedented times such as the current pandemic, the psychological needs of most vulnerable groups should be prioritized. Fear among the most vulnerable groups could be reduced with the flow of adequate genuine information as well as better preparedness and psychosocial interventions.

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Section: Discussionsupporting

confidence: 84%

Perceived Fear of COVID-19 and its Associated Factors Among Nepalese Older Adults in Eastern Nepal: Findings From a Cross-Sectional Study

Yadav

Singh

et al. 2020

Preprint

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“…However, the observed higher magnitude of multimorbidity in a productive age group is a matter of concern. Furthermore, these individuals have to be socially and physically active owing to their functional role and livelihood activities, with potential increased risk of exposure and vulnerability ( 33 ). Moreover, especially the working adults with cardio-metabolic (hypertension + diabetes) dyad should stringently adhere to COVID-19 preventive measures, such as physical distancing, wearing mask and hand hygiene ( 34 – 36 ).…”

Section: Discussionmentioning

confidence: 99%

Managing Multimorbidity (Multiple Chronic Diseases) Amid COVID-19 Pandemic: A Community Based Study From Odisha, India

Pati

Mahapatra

Kanungo

et al. 2021

Front. Public Health

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While most of the studies to date demonstrate the deleterious effect of multiple chronic diseases on COVID-19 risk and outcome, there is sparse information available on the effect of the pandemic on multimorbidity management, with no reports yet from India. We sought to explore the effect of COVID-19 pandemic on routine and emergency care for multimorbidity among community-dwelling adults in Odisha, India. A community-based cross-sectional study was undertaken pandemic lockdown, in Khurda district of Odisha, India. Around 600 individuals having at least one chronic disease residing in rural, urban residential and slums were interviewed using a specifically developed questionnaire MAQ COVID-19. The association of socio-demographic characteristics and multimorbidity with pandemic-related care challenges was examined by multiple logistic regression. Principal Component Analysis was employed to minimize the dimensionality of factors related to multimorbidity care. Multimorbidity was highly prevalent in younger age group (46–60 years) with cardio-metabolic clusters being dominant. Individuals with multimorbidity experienced significantly higher care challenges than those with single condition (AOR = 1.48, 95% CI = 1.01–2.05) with notable disruption in treatment and routine check-up. Most frequently cited concerns were—physician consultation (43%), diagnostic-services (26%), transport (33%), and mobility restrictions (21%). Multivariate analysis revealed older adults living alone in urban residence to have higher challenges than their rural counterparts. Patient activation for self-care, multimorbidity literacy, and technology-enabled tele-consultation could be explored as potential interventions. Future studies should qualitatively explore the challenges of physicians as well as garner an in-depth understanding of multimorbidity management in the vulnerable subgroups.

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“…The Nepalese authorities need to develop a clear mechanism and system for managing both COVID-19 and other morbidities; compiling a list of operational COVID-19 and non-COVID-19 hospitals will enable people to receive health care services. Similarly, the government must strengthen primary health care services through regular supplies of essential medicines and extra staffing of human resources for health services; these efforts may reduce the patient burden on secondary and tertiary hospitals ( 41 ).…”

Section: Opportunities For the Government Of Nepalmentioning

confidence: 99%

How Well the Government of Nepal Is Responding to COVID-19? An Experience From a Resource-Limited Country to Confront Unprecedented Pandemic

Rayamajhee

Pokhrel

Syangtan

et al. 2021

Front. Public Health

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COVID-19, caused by SARS-CoV-2, was first reported in Wuhan, China and is now a pandemic affecting over 218 countries and territories around the world. Nepal has been severely affected by it, with an increasing number of confirmed cases and casualties in recent days, even after 8 months of the first case detected in China. As of 26 November 2020, there were over 227,600 confirmed cases of COVID in Nepal with 209,435 recovered cases and 1,412 deaths. This study aimed to compile public data available from the Ministry of Health and Population (MoHP), Government of Nepal (GoN) and analyse the data of 104 deceased COVID-19 patients using IBM SPSS (Version 25.0). Additionally, this study also aimed to provide critical insights on response of the GoN to COVID-19 and way forward to confront unprecedented pandemic. Figures and maps were created using the Origin Lab (Version 2018) and QGIS (Version 3.10.8). Most of the reported cases were from Bagmati Province, the location of Nepal's capital city, Kathmandu. Among deceased cases, >69% of the patients were male and patients ≥54 years accounted for 67.9% (n = 923). Preliminary findings showed respiratory illness, diabetes, and chronic kidney diseases were the most common comorbid conditions associated with COVID-19 deaths in Nepal. Despite some efforts in the 8 months since the first case was detected, the government's response so far has been insufficient. Since the government eased the lockdown in July 2020, Nepal is facing a flood of COVID-19 cases. If no aggressive actions are taken, the epidemic is likely to result in significant morbidity and mortality in Nepal. The best way to curb the effect of the ongoing pandemic in a resource-limited country like Nepal is to increase testing, tracing, and isolation capacity, and to set up quality quarantine centers throughout the nation. A comprehensive health literacy campaign, quality care of older adults and those with comorbidity will also result in the effective management of the ongoing pandemic.

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A Syndemic Perspective on the Management of Non-communicable Diseases Amid the COVID-19 Pandemic in Low- and Middle-Income Countries

Cited by 137 publications

References 42 publications

Perceived Fear of COVID-19 and its Associated Factors Among Nepalese Older Adults in Eastern Nepal: Findings From a Cross-Sectional Study

Perceived Fear of COVID-19 and its Associated Factors Among Nepalese Older Adults in Eastern Nepal: Findings From a Cross-Sectional Study

Managing Multimorbidity (Multiple Chronic Diseases) Amid COVID-19 Pandemic: A Community Based Study From Odisha, India

How Well the Government of Nepal Is Responding to COVID-19? An Experience From a Resource-Limited Country to Confront Unprecedented Pandemic

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