Abstract
This study aimed to estimate the prevalence of depression, anxiety, post-traumatic stress disorder, and insomnia symptoms among frontline health workers during the corona virus disease 19 (COVID-19) pandemic in Bangladesh and to compare these between medical and allied health workers. We conducted a cross-sectional survey between June and August 2020. A total of 479 health care professionals participated in the study. Anxiety and depression were measured using Patient Health Questionnaire-4 (PHQ-4), post-traumatic stress disorder (PTSD) was measured by primary care post-traumatic stress disorder score (PC-PTSD score), and insomnia was measured by Insomnia Severity Index (ISI). We performed logistic regression to assess risk factors associated with psychological symptoms. Overall, prevalence of anxiety, depression, PTSD and insomnia symptoms were 17.6%, 15.5%, 7.6% and 5.9%, respectively. Compared to allied health workers, doctors had significantly higher prevalence of symptoms of anxiety: doctor versus allied health care worker; 21.1% vs 06%, (OR= 4.19; 95% CI= 1.88-9.35; p <0.001); depression: 18% vs 6.8%, (OR= 2.99; 95% CI= 1.40-6.42; p 0.005); PTSD: 9.4% vs 1.7%, (OR= 5.96; 95% CI= 1.41-25.11; p 0.015) and insomnia: 7.4% vs 0.9%, (OR= 9.22; 95% CI= 1.24-68.4; p 0.03),respectively. The logistic regression analysis showed pre-existing medical illness as a predictor of anxiety (OR= 2.85; 95% CI= 1.71-4.76; p <0.001) and depressive symptoms (OR= 2.29; 95% CI= 1.39-3.77; p 0.001). Working more than 6(six) weeks in COVID-19 dedicated hospitals was significantly associated with PSTD symptoms (OR= 2.83; 95% CI= 1.35-5.93; p 0.006) and insomnia (OR= 2.63; 95% CI= 1.15-6.02; p 0.022). Our study demonstrated a high prevalence of symptoms of depression, anxiety, PTSD, and insomnia among Bangladeshi frontline health workers during the COVID-19 pandemic.
 BSMMU J 2021; 14 (COVID -19 Supplement): 22-29
Highlights
The novel coronavirus disease 19 (COVID-19) outbreak started in early December 2019 in Wuhan, Hubei province, China.[1]
This study revealed the prevalence of anxiety (17.6%), depression (15.5%), and insomnia (5.9%) symptoms among health workers was higher compare to the pre-pandemic general population as reported in the most recent national mental health survey in Bangladesh conducted by National Institute of Mental Health in 2018-201915 where the lifetime prevalence for anxiety, depression, and insomnia was reported as 4.5%, 6.7% and 0.9% respectively
The prevalence of anxiety and depression reported in this study are largely similar with a pooled prevalence of anxiety (15.15%; 95% confidence interval (CI)= 12.29-18.54) and depression (15.97%; 95% CI= 13.24-19.13) reported in a meta-analysis of global studies during Covid[19] pandemic on general population; the prevalence of post-traumatic stress disorder (PTSD) and insomnia symptoms of this study appeared as far less compared with the same meta-analysis where prevalence rate for PTSD and insomnia were reported as 21.94% and 23.87% respectively.[17]
Summary
The novel coronavirus disease 19 (COVID-19) outbreak started in early December 2019 in Wuhan, Hubei province, China.[1] Since the cases have spread widely over the last year with a rapidly increasing number of deaths, affecting almost every country across the world World Health Organization (WHO) has declared a global pandemic.[2]. In addition to the chance of directly contracting infection due to close contact with patients, their careers, and/ or potentially infectious asymptomatic co-workers during the COVID-19 pandemic, healthcare professionals are under huge stress and mental health risks, as was the case reported during the previous SARS epidemic.3.4 Frontline health care workers who are providing services to the COVID-19 patients are at increased risks of contracting illness, transmitting infection back home to the elderly relatives. Several recent studies have highlighted the significant psychological effect of health workers during the COVID-19 outbreak in other countries.[7, 8] There is a burning need for appropriate measures to maintain the mental health and well-being of healthcare professionals in such stressful situations.[9,10] Despite the clear emphasis on the mental
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