Search

Unverified information concerning COVID-19 can affect mental health. Understanding perceived trust in information sources and associated mental health outcomes during the COVID-19 pandemic is vital to ensure ongoing media coverage of the crisis does not exacerbate mental health impacts. A number of studies have been conducted in other parts of the world to determine associations between information exposure relating to COVID-19 and mental health. However, the mechanism by which trust in information sources may affect mental health is not fully explained in the developing country context. To address this issue, the present study examined associations between perceived trust in three sources of information concerning COVID-19 and anxiety/stress with the mediating effects of COVID-19 stress in Bangladesh. An online cross-sectional study was conducted with 744 Bangladeshi adults between 17 April and 1 May 2020. Perceived trust in traditional, social, and health media for COVID-19 information, demographics, frontline service status, COVID-19-related stressors, anxiety (GAD-7), and stress (PSS-4) were assessed via self-report. Linear regression tested for associations between perceived trust and mental health. Mediation analyses investigated whether COVID-19-related stressors affected perceived trust and mental health associations. In fully adjusted models, more trust in social media was associated with more anxiety (B = 0.03, CI = 0.27–0.97) and stress (B = 0.01, CI = −0.34–0.47), while more trust in traditional media was associated with more anxiety (B = 0.09, CI = 0.17–2.26) but less stress (B = −0.08, CI = −0.89–0.03). Mediation analyses showed that COVID-19-related stressors partially explained associations between perceived trust and anxiety. These findings suggest that trusting social media to provide accurate COVID-19 information may exacerbate poor mental health. These findings also indicate that trusting traditional media (i.e., television, radio, and the newspaper) may have stress-buffering effects. We recommend that responsible authorities call attention to concerns about the trustworthiness of social media as well as broadcast positive and authentic news in traditional media outcomes based on these results.

Recurrent influenza epidemics and pandemic potential are significant risks to global health. Public health authorities use clinical surveillance to locate and monitor influenza and influenza-like cases and outbreaks to mitigate hospitalizations and deaths. Currently, global integration of clinical surveillance is the only reliable method for reporting influenza types and subtypes to warn of emergent pandemic strains. The utility of wastewater surveillance (WWS) during the COVID-19 pandemic as a less resource intensive replacement or complement for clinical surveillance has been predicated on analyzing viral fragments in wastewater. We show here that influenza virus targets are stable in wastewater and partitions favorably to the solids fraction. By quantifying, typing, and subtyping the virus in municipal wastewater and primary sludge during a community outbreak, we forecasted a citywide flu outbreak with a 17-day lead time and provided population-level viral subtyping in near real-time to show the feasibility of influenza virus WWS at the municipal and neighbourhood levels in near real time using minimal resources and infrastructure.

A novel coronavirus disease known as COVID-19 has spread globally and brought a public health emergency to all nations. To respond to the pandemic, the Bangladesh Government imposed a nationwide lockdown that may have degraded mental health among residents, in particular, university students and working professionals. We examined clinically significant anxiety levels with the Generalized Anxiety Disorder (GAD-7) scale and perceived stress levels with the Perceived Stress Scale (PSS-4) in an online cross-sectional study with 744 adults. Approximately 70% of respondents were afflicted with clinically significant anxiety levels, and more than 43.82% were afflicted with moderate or high perceived stress levels. Multivariate logistic regression models showed that postgraduates (OR = 2.78, 95% confidence interval [CI] = 1.03–8.75, p < 0.05) were more likely to experience anxiety than their student counterparts. No such differences emerged for working professionals, however. Living with family members compared to living alone was a risk factor for perceived stress among working professionals (OR = 4.05, 95% CI = 1.45–11.32, p < 0.05). COVID-19 stressors such as financial hardship (OR = 1.84, 95% CI = 1.11–3.05, p < 0.05) and worries of family members’ health (OR = 1.84, 95% CI = 1.12–2.99) were risk factors for anxiety among students. Questionable social media news exposure (OR = 2.99, 95% CI = 1.13–7.92, p < 0.05) contributed to the development of mental stress among working professionals. These findings confirm that effective initiatives and proactive efforts from concerned authorities are necessary to cope with the mental health correlates of the COVID-19 pandemic, including in developing contexts such as Bangladesh.

Clinical testing has been the cornerstone of public health monitoring and infection control efforts in communities throughout the COVID-19 pandemic. With the extant and anticipated reduction of clinical testing as the disease moves into an endemic state, SARS-CoV-2 wastewater surveillance (WWS) is likely to have greater value as an important diagnostic tool to inform public health. As the widespread adoption of WWS is relatively new at the scale employed for COVID-19, interpretation of data, including the relationship to clinical cases, has yet to be standardized. An in-depth analysis of the metrics derived from WWS is required for public health units/agencies to interpret and utilize WWS-acquired data effectively and efficiently. In this study, the SARS-CoV-2 wastewater signal to clinical cases (WC) ratio was investigated across seven different cities in Canada over periods ranging from 8 to 21 months. Significant increases in the WC ratio occurred when clinical testing eligibility was modified to appointment-only testing, identifying a period of insufficient clinical testing in these communities. The WC ratio decreased significantly during the emergence of the Alpha variant of concern (VOC) in a relatively non-immunized community’s wastewater (40-60% allelic proportion), while a more muted decrease in the WC ratio signaled the emergence of the Delta VOC in a relatively well-immunized community’s wastewater (40-60% allelic proportion). Finally, a rapid and significant decrease in the WC ratio signaled the emergence of the Omicron VOC, likely because of the variant’s greater effectiveness at evading immunity, leading to a significant number of new reported clinical cases, even when vaccine-induced community immunity was high. The WC ratio, used as an additional monitoring metric, complements clinical case counts and wastewater signals as individual metrics in its ability to identify important epidemiological occurrences, adding value to WWS as a diagnostic technology during the COVID-19 pandemic and likely for future pandemics.

Wastewater surveillance (WWS) of SARS-CoV-2 was proven to be a reliable and complementary tool for population-wide monitoring of COVID-19 disease incidence but was not as rigorously explored as an indicator for disease burden throughout the pandemic. Prior to global mass immunization campaigns and during the spread of the wildtype COVID-19 and the Alpha variant of concern (VOC), viral measurement of SARS-CoV-2 in wastewater was a leading indicator for both COVID-19 incidence and disease burden in communities. As the two-dose vaccination rates escalated during the spread of the Delta VOC in Jul. 2021 through Dec. 2021, relations weakened between wastewater signal and community COVID-19 disease incidence and maintained a strong relationship with clinical metrics indicative of disease burden (new hospital admissions, ICU admissions, and deaths). Further, with the onset of the vaccine-resistant Omicron BA.1 VOC in Dec. 2021 through Mar. 2022, wastewater again became a strong indicator of both disease incidence and burden during a period of limited natural immunization (no recent infection), vaccine escape, and waned vaccine effectiveness. Lastly, with the populations regaining enhanced natural and vaccination immunization shortly prior to the onset of the Omicron BA.2 VOC in mid-Mar 2022, wastewater is shown to be a strong indicator for both disease incidence and burden. Hospitalization-to-wastewater ratio is further shown to be a good indicator of VOC virulence when widespread clinical testing is limited. In the future, WWS is expected to show moderate indication of incidence and strong indication of disease burden in the community during future potential seasonal vaccination campaigns.HighlightsNeed to elucidate interpretation of CoV-2 WWS for seasonal vaccination campaigns.WWS to incidence relation weakens with peak natural and vaccination immunization.WWS to hospitalization remains strong with natural and vaccination immunization.WWS as indicator of hospitalization during future seasonal vaccination campaigns.WWS/hospitalization as indicator of VOC virulence with limited clinical testing.

Widespread vaccination against COVID-19 is critical for controlling the pandemic. Despite the development of safe and efficacious vaccinations, low-and lower-middle income countries (LMICs) continue to encounter barriers to care owing to inequitable access and vaccine apprehension. This study aimed to summarize the available data on COVID-19 vaccine acceptance rates and factors associated with acceptance in LMICs. A comprehensive search was performed in PubMed, Scopus, and Web of Science from inception through August 2021. Quality assessments of the included studies were carried out using the eight-item Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies. We performed a meta-analysis to estimate pooled acceptance rates with 95% confidence intervals (CI). A total of 36 studies met the inclusion criteria and were included in the review. A total of 83,867 respondents from 33 countries were studied. Most of the studies were conducted in India (n = 9), Egypt (n = 6), Bangladesh (n = 4), or Nigeria (n = 4). The pooled-effect size of the COVID-19 vaccine acceptance rate was 58.5% (95% CI: 46.9, 69.7, I2 = 100%, 33 studies) and the pooled vaccine hesitancy rate was 38.2% (95% CI: 27.2–49.7, I2 = 100%, 32 studies). In country-specific sub-group analyses, India showed the highest rates of vaccine acceptancy (76.7%, 95% CI: 65.8–84.9%, I2= 98%), while Egypt showed the lowest rates of vaccine acceptancy (42.6%, 95% CI: 16.6–73.5%, I2= 98%). Being male and perceiving risk of COVID-19 infection were predictors for willingness to accept the vaccine. Increasing vaccine acceptance rates in the global south should be prioritized to advance global vaccination coverage.

A novel coronavirus disease, known as COVID-19 has spread globally and brought a public health emergency to all the nations. This study aimed to evaluate the mental health status of the university student of Bangladesh during the COVID-19 pandemic. A total of 544 respondents participated in the study through a self-reported questionnaire and their mental health was assessed by the Generalized Anxiety Disorder (GAD-7) scale. Results found that about 78% of the students were afflicted with mental disorders during the COVID-19 lockdown. COVID-19 stressors including financial hardship, academic delays, worry about family member’s health and social media exposure were positively correlated with the anxiety levels of the students. Multivariate logistic regression results showed that the gender and educational status of the students were significant predictors for their anxiety level. These findings will help both the government and university authority to implement the appropriate mental health interventions during the pandemic.

Safe drinking water is scarce in southwest coastal Bangladesh. Harvested rainwater and rain-fed pond water are the main sources of drinking water for people living in this area. Both government and non-government organizations are promoting aquifer storage and recovery (ASR) schemes to provide safe drinking water for this population. This study assessed the bacteriological quality of both source water and abstracted water from five ASR sites. Water sampling and laboratory analysis for indicator bacteria and physico-chemical parameters were conducted once every 2 months, over a period of 1 year. Samples were taken from source ponds, abstraction wells and household storage containers (point of use) for each of the ASR sites. Although the water from abstraction wells showed a 97% and 82% lowering of E. coli and Enterococci counts, respectively, from that of the source ponds, they did not satisfy the WHO drinking water standard. Moreover, the microbial quality of the water deteriorated at the point of use. This indicates the requirement for both in-house treatment and improved hygiene practice for consuming ASR water.

Rainwater is a typical source of drinking water in the coastal areas of Bangladesh given the acute scarcity of drinking water. This study assessed potability of harvested rainwater of primary schools in southwest coastal Bangladesh. Water samples collected from 23 primary schools of Mongla sub-district under Bagerhat district were evaluated for indicator bacteria (total coliform (TC) and E. coli) and physico-chemical parameters (pH, electrical conductivity, turbidity, total dissolved solid, Fe, Zn, Pb, and Cd). Median concentrations of TC and E. coli in the harvested rainwater samples were respectively 3000 cfu/100 ml and 6 cfu/100 ml. However, concentrations of these indicator bacteria were lower at the consumption points which received a prior treatment. Concentration of Pb exceeded the maximum allowable limit for drinking water indicated by WHO and Bangladesh drinking water guideline value in 92% and 61% of the samples respectively, and the mean concentration was 0.08 mg/l (8 times higher than the WHO guideline value). The Pb contamination possibly occurred from the painting on roof railing and roof stair room. Therefore, consumption of harvested rainwater at primary schools may cause substantial health risk for the school-going children.

Safe drinking water is scarce in southwest coastal Bangladesh because of unavailability of fresh water. Given the high salinity of both groundwater and surface water in this area, harvested rainwater and rain-fed pond water became the main sources of drinking water. Both the government and non-government organizations have recently introduced pipe water supply in the rural coastal areas to ensure safe drinking water. We assessed the bacteriological quality of water at different points along the piped water distribution system (i.e., the source, treatment plant, household taps, street hydrants, and household storage containers) of Mongla municipality under Mongla Upazila in Bagerhat district. Water samples were collected at 2-month interval from May 2014 to March 2015. Median E. coli and total coliform counts at source, treatment plant, household taps, street hydrants, and household storage containers were respectively 225, 4, 7, 7, and 15 cfu/100 ml and 42,000, 545, 5000, 6150, and 18,800 cfu/100 ml. Concentrations of both of the indicator bacteria reduced after treatment, although it did not satisfy the WHO drinking water standards. However, re-contamination in distribution systems and household storage containers indicate improper maintenance of distribution system and lack of personal hygiene.