COVID-19 Case Management Research Articles

Utilization of the Healthy Indonesia Program With a Family Approach Data During the COVID-19 Pandemic.

The public health center conducted the Healthy Indonesia Program With a Family Approach (HIPFA) in their working area and had family and personal data. It can be used as a priority target for efforts to cut the COVID-19 transmission chain. The aim was to describe HIPFA data's utilization in mapping the vulnerable groups, monitoring cases during the COVID-19 pandemic, and analyzing the obstacles faced. This analysis uses secondary data of HIPFA and patient visits at Kalibawang Public Health Center Kulonprogo. The result shows that HIPFA data were useful in mapping the vulnerable age groups and comorbidity. The data can be presented by personal and village areas. The output of merging HIPFA and patients' visit data confirmed by COVID-19 shows that there are household members who have children below 5 years old and hypertension. Data can use as a basis for COVID-19 case management. The obstacles of the analysis like the Healthy Family application have not shown updated data longitudinally; using National Identity Number (NIN) was not uniform in program reporting, limitation of human resource capabilities to analyze data. The HIPFA data were useful in mapping the vulnerable groups to prevent transmission and COVID-19 case management.

Experience of Rwanda on COVID-19 Case Management: From Uncertainties to the Era of Neutralizing Monoclonal Antibodies.

The management of COVID-19 in Rwanda has been dynamic, and the use of COVID-19 therapeutics has gradually been updated based on scientific discoveries. The treatment for COVID-19 remained patient-centered and entirely state-sponsored during the first and second waves. From the time of identification of the index case in March 2020 up to August 2021, three versions of the clinical management guidelines were developed, with the aim of ensuring that the COVID-19 patients treated in Rwanda were receiving care based on the most recent therapeutic discoveries. As the case load increased and imposed imminent heavy burdens on the healthcare system, a smooth transition was made to enable that the asymptomatic and mild COVID-19 cases could continue to be closely observed and managed while they remained in their homes. The care provided to patients requiring facility-based interventions mainly focused on the provision of anti-inflammatory drugs, anticoagulation, broad-spectrum antibiotic therapy, management of hyperglycemia and the provision of therapeutics with a direct antiviral effect such as favipiravir and neutralizing monoclonal antibodies. The time to viral clearance was observed to be shortest among eligible patients treated with neutralizing monoclonal antibodies (bamlanivimab). Moving forward, as we strive to continue detecting COVID-19 cases as early as possible, and promptly initiate supportive interventions, the use of neutralizing monoclonal antibodies constitutes an attractive and cost-effective therapeutic approach. If this approach is used strategically along with other measures in place (i.e., COVID-19 vaccine roll out, etc.), it will enable us to bring this global battle against the COVID-19 pandemic under full control and with a low case fatality rate.

Awareness and preparedness of healthcare workers against the first wave of the COVID-19 pandemic: A cross-sectional survey across 57 countries.

BackgroundSince the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave.MethodsThis multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training.ResultsWe surveyed 24,653 HCWs from 371 hospitals across 57 countries and received 17,302 responses from 70.2% HCWs overall. The median COVID-19 preparedness score was 11.0 (interquartile range [IQR] = 6.0–14.0) and the median awareness score was 29.6 (IQR = 26.6–32.6). HCWs at COVID-19 designated facilities with previous outbreak experience, or HCWs who were trained for dealing with the SARS-CoV-2 outbreak, had significantly higher levels of preparedness and awareness (p<0.001). Association rule mining suggests that nurses and doctors who had a ’great-extent-of-confidence’ in handling suspected COVID-19 patients had participated in COVID-19 training courses. Male participants (mean difference = 0.34; 95% CI = 0.22, 0.46; p<0.001) and nurses (mean difference = 0.67; 95% CI = 0.53, 0.81; p<0.001) had higher preparedness scores compared to women participants and doctors.InterpretationThere was an unsurprising high level of awareness and preparedness among HCWs who participated in COVID-19 training courses. However, disparity existed along the lines of gender and type of HCW. It is unknown whether the difference in COVID-19 preparedness that we detected early in the pandemic may have translated into disproportionate SARS-CoV-2 burden of disease by gender or HCW type.

Preparedness, Identification and Care of COVID-19 Cases by Front Line Health Workers in Selected Health Facilities in Mbale District Uganda: A Cross-Sectional Study.

Introduction:The nature of work of Health care professionals exposes them to high risks of contracting COVID-19 and spreading it among themselves, to their patients and subsequently to the general community. Thus, it is essential that frontline health workers are equipped with both material and knowledge to enable them accurately suspect, detect, isolate, and manage COVID-19 cases. Findings have indicated a high prevalence of COVID-19 infections among front-line health workers. The Current Study assessed preparedness, identification, and care of COVID-19 Cases by frontline health workers in selected health facilities in Mbale District.Methodology:Across sectional survey was used to collect quantitative data using Google forms, An online platform for data collection. Data was collected from 189 frontline health workers in both government and private Health facilities in Mbale District between April and August 2020. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 20.Findings:The study found that a good proportion of frontline health workers can identify cases by symptom and case definitions as probable case 113/189(59.8%), suspected case 60/189(36%) and confirmed case 22/189 (11.6%). There were generally low levels of preparedness in terms of initial service care being offered with the highest being 53/189(28.2%) and 50/189(26.4%) for facilities that had places for isolation and those with intravenous fluids respectively and the least was being able to offer oxygen and Intensive Care Services at 43/189(22.0%) and 20/189(10.3%) respectively.Conclusion and recommendations:There's a need to ensure a continuous supply of PPEs and IPC materials to health facilities. CPD programs are essential in equipping Health workers with up-to-date information on COVID-19 Case Management. Facilities should be supported to setup isolation facilities at all levels, both permanent and temporary. Provision of Face masks to health workers should be prioritised and hand washing facilities should be installed at every serving point.

Clustering COVID-19 Case Management to Prevent Healthcare Workers Burnout and Personal Protective Equipment Shortages; The Bhutan Experience

The COVID-19 pandemic has caused critical shortages of health human resources and medical supplies globally. These shortages probably resulted into inadequate management of COVID-19 cases and increased the risk of COVID-19 infections among healthcare workers. Bhutan being a small developing country, the existing health workforce deployed in various hospitals throughout the country are insufficient even for the routine health services. The Ministry of Health realizing the limitations of healthcare workers and medical supplies, decided that all COVID-19 positive cases in Bhutan be managed in the four regionalized National COVID-19 centers instead of all hospitals in the country managing their own cases. This strategy was mainly aimed at rationalizing the deployment of the limited healthcare workers and also optimize the utilization of medical supplies. Through this clustering strategy, Bhutan has not only managed to utilize its limited healthcare workers effectively without burnout but also prevented shortages of its scarce imported personal protective equipment to date. This strategy also enabled uninterrupted care of COVID-19 patients and prevented major disruptions in routine healthcare services in the country.

Examining unit costs for COVID-19 case management in Kenya

IntroductionWe estimated unit costs for COVID-19 case management for patients with asymptomatic, mild-to-moderate, severe and critical COVID-19 disease in Kenya.MethodsWe estimated per-day unit costs of COVID-19 case management for patients....

Do the Clinical Management Guidelines for Covid-19 in African Countries Reflect the African Quality Palliative Care Standards? A Review of Current Guidelines

ContextPalliative care should be a component of COVID-19 management to relieve suffering, improve patient outcomes and save cost. ObjectivesWe aimed to identify and critically appraise the palliative care recommendations within COVID-19 case management guidelines in African countries. MethodsThe study employed systematic guideline review design. All guidelines from any country in Africa, of any language, published between December 2019 and June 2020 were retrieved through online search and email to in-country key contacts. We conducted a content analysis of the palliative care recommendations within the guidelines and appraised the recommendations using African Palliative Care Association standards for providing quality palliative care. ResultsWe retrieved documents from 29 of 54 African countries. Fifteen documents from 15 countries were included in the final analysis, of which eight countries have identifiable PC recommendations in their COVID-19 management guidelines. Of these eight, only one country (South Sudan) provided comprehensive palliative care recommendations covering the domains of physical, psychological, social and spiritual wellbeing, two (Namibia and Uganda) addressed only physical and psychological wellbeing while the remaining five countries addressed only physical symptom management. ConclusionsComprehensive palliative care which addresses physical, psychological, social and spiritual concerns must be prioritized within case management guidelines in African countries.

Availability of Oxygen and Other Essential Medical Products in COVID-19 Treatment Facilities of Nepal

Background: There is paucity of data globally regarding availability of essential medical products and oxygen supply in healthcare facilities to inform surge capacity and strategic healthcare development. Due to continued waves of COVID-19 pandemic caused by virus variants with increased transmissibility, many facilities worldwide, particularly in the Indian subcontinent, have reported sudden increase in demand for oxygen and its delivery systems to treat patients with COVID pneumonia. Therefore, we aimed to assess the status of essential medical products, oxygen supply, and methods of procurement in COVID-19 treatment facilities across Nepal. Methods: We performed cross-sectional survey among 120 COVID-19 treatment facilities designated by the Government of Nepal in June 2020. Data were collected via an online semi-structured questionnaire based on validated healthcare capacity assessments. responded (49 clinics, 20 level hospitals). Findings: Sixty-nine facilities responded (49 clinics, 20 hospitals). All 69 facilities reported at least one form of oxygen availability: 25 facilities (36%) had their own oxygen plant, 65% had oxygen concentrators, and 88% had portable oxygen cylinders. Majority (38/49; 77%) of clinics and 60% (12/20) of hospitals had sufficient stock (³5 pieces in clinics, >20 pieces in hospitals) of functional oxygen cylinders, which were generally procured through the private sector (78% of facilities with oxygen cylinders). Almost all clinics had at least one piece of pulse oximeter device, blood pressure measuring set, thermometer, thermal gun, and resuscitation kit (oral or nasal airway, suction), compared to approximately a half of hospitals which had sufficient quantity (>10 pieces) of these products. Interpretation: It is crucial for hard-hit countries to timely map the availability and usage of essential medical products including oxygen in COVID-19 care hospitals. If needed, relevant policies and processes around oxygen production and supply should be revised. Furthermore, countries should not delay in adopting innovation for quicker, safer and sustainable production of medical oxygen to ensure continuous supply to the needy. Funding Information: No funding was received to conduct this study.Declaration of Interests: We declare no competing interests.Ethics Approval Statement: The study was approved by the Ethical Review Board (ERB) of Nepal Health Research Council ((Ref: NHRC-ERB Reg. No. 267/2020P), and utilizes specific data collected from a larger study done “to assess the service availability and infection prevention status of hospitals in Nepal in the context of possible COVID-19 case management need”.

Home management of mild-moderate coronavirus disease-19 patients in low-resource countries: Reducing the burden on hospitals and a guide to clinical excellence

The severe acute respiratory syndrome coronavius-2 (SARS-CoV-2) pandemic since when it was reported from Wuhan, China, in December 2019 has spread dramatically and rapidly affecting all countries and territories of the world. The morbidity and mortality rates of coronavirus disease (COVID-19) continue to climb each day with over 88 million people infected and more than 2 million deaths reported worldwide. This puts health-care systems and health-care professionals/providers (HCPs) at risk. At present, the health-care systems of the poor and low resource are unable to cope with these extremely difficult circumstances. The main objective of this article is to serves as a guideline for treating patients with mild or moderate symptoms of COVID-19 at home in over to reduce the already over burden health infrastructure, especially in developing nations. With the permission of the ethical committee of the institutions COVID-19 case management team, this article reviewed protocol-based guideline aimed at infection prevention and control to protect the health worker, the patient, his relatives, and the community and also drug treatment to help prevent the progression of the disease to severe or critical. The home treatment guideline will help poor and low-resource countries cope with the increase in number of patients with COVID-19 and ameliorate the negative effects on health-care resources for such countries that are already burden by poor or limited health system infrastructure, low workforce, and inadequate expertise to cope with the rapidity with which the virus spread.

How working at NHS Test and Trace landed me a role heading my university’s COVID-19 case management team

For two days a week, I work as GP practice pharmacist. For another two days, I lecture in pharmacy practice at the University of Reading. And one day every other week, I work in a Boots community pharmacy in Wiltshire; all while having two children aged under four years. A real portfolio career! But in […]

The health and economic burden of the coronavirus in sub-Saharan Africa.

The current coronavirus (COVID-19) pandemic continues to overwhelm healthcare systems and to exert a negative influence on the global economy. Of particular concern is the impact of COVID-19 in low-income settings - especially in terms of their capacity to mitigate a surge in COVID-19 cases. Indeed, response measures currently in place to tackle the spread of COVID-19 in geographic regions predominantly consisting of low-income nations, such as Sub-Saharan Africa (SSA), remain tenuous and will require context-appropriate interventions. Control measures to tackle COVID-19 in SSA should therefore be informed through lessons learned from past outbreaks and emergencies on the continent. These lessons will represent a key source of guidance for the strategic implementation and promotion of public health interventions to assist scale-up of COVID-19 case management, infection prevention and control. Importantly, as governments in SSA continue to combat the spread of COVID-19, there will be a need to expand the coverage of social safety net programs and fiscal policy responses to tackle the socio-economic and health impact of COVID-19.

Knowledge and Preparedness on Corona Virus Pandemic among Healthcare Workers in Igembe South Health Facilities, Meru County, Kenya

Worldwide Corona virus outbreak has cause panic and enormous health and economic effects due to inadequate or lack of appropriate information about COVID -19.&#x0D; Aims: The aim of the study was to determine the Level of knowledge and Preparedness to Corona Virus (COVID –19) Pandemic among Health Workers in Igembe South, Meru County, Kenya.&#x0D; Study Design: This was cross-sectional study was conducted to determine their Knowledge and Preparedness among HCWs on COVID-19 pandemic.&#x0D; Place and Duration of Study: The study was conducted in Igembe South Health Facilities between March and June 2020.&#x0D; Methodology: A facility based cross-sectional study was conducted in Igembe South Sub County of Meru County from March 2020 to June 2020 among 87 Health Care Workers to determine their Knowledge and Preparedness on COVID-19 pandemic. Data was collected using structured Likert’s Scale questionnaire. Descriptive analysis was performed to obtain frequencies and distribution of the variables.&#x0D; Results: The results shows that eight seven (87) health care workers with mean age of 34± 9 (SD) years with a minimum age of 19 years and maximum age of 60 years were recruited responded to the questions of the study. Among the 87 participants, 51 (58.6%) had at least a bachelor's degree, 30 (34.5%) participants had a diploma and 6 (6.9%) participants had a certificate. About 32 (36.8%) of the participants were nurses. Other professional disciplines included nutritionists, records officers, supporting staff, social workers among others. Majority of the facilities acknowledged receiving Ministry of Health guidelines and protocols on COVID-19 case management. Regarding knowledge of COVID -19 Almost half (48.3%) of the participants somewhat agreed that health care workers had knowledge of Corona Virus Pandemic, however, most of the respondents (50.6%) strongly disagreed that they are equipped with adequate Knowledge to manage severe Corona Case compared to (8%) respondents who strongly agreed that Corona Virus Incubation period is an average of 7 days and maximum of 14 days.&#x0D; Conclusion: The study concludes that knowledge and preparedness level on COVID - 19 was above average, however, there is need for continuous professional development (CPD) training and support supervision for HCWs to ensure maintenance of appropriate practices during the COVID-19 pandemic. The study further concludes that those with knowledge and are conversant with their respective areas of practice are at less risk, considering that inadequate knowledge is not only a risk factor for poor delivery of WHO approved COVID -19 guidelines met to prevent the spread of COVID -19, but also increases the occupational risk to health care workers.

Designing and Developing An Integrative Application Based on Cross-Functional &amp;amp; Virtual Team as a COVID-19 Case Management

Synergic and integrated actions between every-elements is needed to overcome the Covid-19 global pandemic case. We need an innovation that can bridge the cooperation between the government, health workers, and society. Therefore, the design and development of this applications made as one of the solutions that can help to reduce the number Covid-19 cases. The application was created with a variety of features/services that are real-time and transparent, then integrated with cross-functional work systems and virtual teams, so it will provide positive results for the epidemic Covid-19 case management.