COVID-19 vaccination coverage in deprived populations living in segregated colonies: A nationwide cross-sectional study in Hungary

Sándor, János; Vincze, Ferenc; Shrikant, Maya Liza; Kőrösi, László; Ulicska, László; Kósa, Karolina; Ádány, Róza

doi:10.1371/journal.pone.0264363

Cited by 9 publications

(4 citation statements)

References 41 publications

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“…Similar findings were observed from the findings of the study done by Vincze et al. ( 2022 ) and Young‐Xu et al. ( 2021 ) on the coverage of vaccines among healthcare workers that indicated only a few healthcare workers received the COVID‐19 vaccine.…”

Section: Discussionsupporting

confidence: 89%

Knowledge, attitude, intentional practice and individualized determinants of COVID‐19 vaccine uptake among adults: A cross‐sectional study in Tanzania

Nassoro,

Millanzi,

Herman

2024

Nursing Open

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AimThe study assessed the knowledge, attitude, intentional practice and individualized factors of COVID‐19 vaccine uptake among adults in Tanzania.DesignHospital‐based analytical cross‐sectional study.MethodsQuantitative approaches were adopted to study 312 randomly selected adults using an interviewer‐administered structured questionnaire. Descriptive analysis established frequencies and percentages of variables at a 95% confidence interval and a 5% significance level.ResultsMean age was 24.66 ± 6.503 of which 61.5% were males. 86.9% of them were not vaccinated. 57.7% of respondents had inadequate knowledge about the COVID‐19 vaccine, and 61.5% had negative attitudes towards it. 63.8% of adults demonstrated an unwillingness to be vaccinated. Participants' sociodemographic characteristics profiles were significantly associated with COVID‐19 vaccine knowledge, attitude and willingness to uptake it (p < 0.05). Findings highlight the need for large‐scale interventions to address the low uptake vaccine. Adults' willingness to get a coronavirus vaccine was comparatively low. Sociodemographic profiles, knowledge and attitude were associated significantly with low uptake of the COVID‐19 vaccine among adults in Tanzania.

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Section: Discussionsupporting

confidence: 89%

Knowledge, attitude, intentional practice and individualized determinants of COVID‐19 vaccine uptake among adults: A cross‐sectional study in Tanzania

Nassoro,

Millanzi,

Herman

2024

Nursing Open

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“…Although a general vision of vaccine hesitancy was observed [ 43 ], usually due to the mobility of the group (emigrant/traveler status), their relative hard to reach locations, poor access to healthcare services, stereotypes, etc. [ 44 , 45 ], there are articles that also claim that a decent amount of Roma were interested in getting vaccinated and did so, as long as access was provided to their communities directly [ 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

Understanding the Impact of COVID-19 on Roma Vulnerable Communities in Western Romania: Insights and Predictive Factors from a Retrospective Study

Capraru,

Marian,

Vulcanescu

et al. 2024

Viruses

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Background: The COVID-19 pandemic disproportionately affected vulnerable populations like Roma patients in Western Romania due to marginalization and limited healthcare access. Methods: A retrospective study analyzed COVID-19 cases between March 2020 and August 2022 using data from the Directorate of Public Health in Timis county. Demographic, epidemiological, clinical, and laboratory data were assessed, along with risk factors and biomarkers for ICU admission and mortality prediction. The following biomarkers were assessed: C-reactive protein (CRP), ferritin (FER), IL-6, D-dimers, lactate dehydrogenase (LDH), high density lipoprotein cholesterol (HDL), and 25-OH vitamin D (25-OHD). Results: In comparison with the general population (GP), Roma patients were more overweight (p = 0.0292), came from rural areas (p = 0.0001), could not recall transmission source (p = 0.0215), were admitted to the intensive care unit (ICU, p = 0.0399) more frequently, had worse symptomatology (p = 0.0490), showed more elevated levels of CRP (p = 0.0245) and IL-6 (p < 0.0001) and lower levels of HDL (p = 0.0008) and 25-OHD (p = 0.0299). A stronger, significant correlation was observed between CRP and severity (rho = 0.791 vs. 0.433 in GP), and an inverse stronger significant one was observed between HDL and severity (rho = −0.850 vs. −0.734 in GP) in the Roma patients. The male sex continues to be an important risk factor for ICU admission (OR = 2.379) and death (OR = 1.975), while heavy smoking was more important in relation to ICU admission (OR = 1.768). Although the Roma ethnicity was 1.454 times more at risk of ICU admission than the GP, this did not prove statistically significant (p = 0.0751). CRP was the most important predictive factor in regards to admission to the ICU for both Roma (OR = 1.381) and the GP (OR = 1.110) and in regards to death (OR = 1.154 for Roma, OR = 1.104 for GP). A protective effect of normal values of HDL and 25-OHD was observed in the GP for both ICU admission (OR = 0.947, 0.853, respectively) and death (OR = 0.920, 0.921, respectively), while for the Roma group, normal 25-OHD values were only considered protective in regards to death (OR = 0.703). Cutoff values for ICU admission were 28.98 mg/L for Roma and 29.03 mg/L for GP patients, with high specificity for both groups (over 95). Conclusions: Higher rates of ICU admissions, severe symptomatology, and distinct laboratory biomarker profiles among Roma patients emphasize the critical importance of personalized care strategies and targeted interventions to mitigate the disproportionate burden of COVID-19 on vulnerable communities. CRP values at admission have had a clear impact as a risk assessment biomarker for Roma patients, while the significance of IL-6, HDL, and 25-OHD should also not be overlooked in these patients.

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“…Therefore, any differences between SAs and CAs in health care use or reimbursement should be minimized. Nevertheless, vaccination coverage was lower in SAs, suggesting that the COVID-19 epidemic contributed to some of the observed health care use and reimbursement inequalities ( 45 ). Altogether, the inequality pattern observed in our study should be further investigated in years not affected by the epidemic to substantiate the findings of our investigation.…”

Section: Discussionmentioning

confidence: 99%

Cross-sectional comparison of health care delivery and reimbursement between segregated and nonsegregated communities in Hungary

Kasabji,

Vincze,

Lakatos

et al. 2024

Front. Public Health

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IntroductionSpatially segregated, socio-economically deprived communities in Europe are at risk of being neglected in terms of health care. In Hungary, poor monitoring systems and poor knowledge on the health status of people in these segregated areas prevent the development of well-informed effective interventions for these vulnerable communities.AimsWe used data available from National Health Insurance Fund Management to better describe health care performance in segregated communities and to develop more robust monitoring systems.MethodsA cross-sectional study using 2020 health care data was conducted on each general medical practice (GMP) in Hungary providing care to both segregated and nonsegregated (complementary) adult patients. Segregated areas were mapped and ascertained by a governmental decree that defines them as within settlement clusters of adults with low level of education and income. Age, sex, and eligibility for exemption certificate standardized indicators for health care delivery, reimbursement, and premature mortality were computed for segregated and nonsegregated groups of adults and aggregated at the country level. The ratio of segregation and nonsegregation specific indicators (relative risk, RR) was computed with the corresponding 95% confidence intervals (95% CI).ResultsBroad variations between GMPs were detected for each indicator. Segregated groups had a significantly higher rate of health care service use than complementary groups (RR = 1.22, 95% CI: 1.219;1.223) while suffering from significantly reduced health care reimbursement (RR = 0.940, 95% CI: 0.929;0.951). The risk of premature mortality was significantly higher among segregated patients (RR = 1.184, 95% CI: 1.087;1.289). Altogether, living in a segregated area led to an increase in visits to health care services by 18.1% with 6.6% less health spending.ConclusionAdults living in segregated areas use health care services more frequently than those living in nonsegregated areas; however, the amount of health care reimbursement they receive is significantly lower, suggesting lower quality of care. The health status of segregated adults is remarkably lower, as evidenced by their higher premature mortality rate. These findings demonstrate the need for intervention in this vulnerable group. Because our study reveals serious variation across GMPs, segregation-specific monitoring is necessary to support programs sensitive to local issues and establish necessary benchmarks.

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COVID-19 vaccination coverage in deprived populations living in segregated colonies: A nationwide cross-sectional study in Hungary

Cited by 9 publications

References 41 publications

Knowledge, attitude, intentional practice and individualized determinants of COVID‐19 vaccine uptake among adults: A cross‐sectional study in Tanzania

Knowledge, attitude, intentional practice and individualized determinants of COVID‐19 vaccine uptake among adults: A cross‐sectional study in Tanzania

Understanding the Impact of COVID-19 on Roma Vulnerable Communities in Western Romania: Insights and Predictive Factors from a Retrospective Study

Cross-sectional comparison of health care delivery and reimbursement between segregated and nonsegregated communities in Hungary

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