Festivals traditionally result in mass public mobility from large cities to rural or semi-urban areas in low- and middle-Income Countries (LMIC), which are inadequately prepared for tackling the consequences of the COVID-19 pandemic. This study aimed to explore the trend of COVID-19 infection in a peripheral region of Bangladesh during one of the largest festivals to develop an evidence-based hypothesis for its influence on the transmission rate of COVID-19. This study conducted a quantitative analysis of secondary data on COVID-19 collected from the Directorate General of Health Services Bangladesh (DGHS) and divisional director’s office in the Mymensingh division. To explore the influence of one of the biggest festivals (Eid-ul-Adha) on the trend of COVID-19 infection, we analyzed data from a week before the festival to 2 weeks following the festival. The infection rate (positive cases per million of the population) and the test positivity rate (positive cases among the total number of conducted diagnostic tests) of each day during this period were calculated both for the Mymensingh region and national level. Both the test positivity rate (TPR) and infection rates in the Mymensingh region demonstrated an increasing trend. The mean test positivity rate of the Mymensingh region on the week before the festival was 9.5%. It increased to a mean test positivity rate of 13% in the following week and further rose to a rate of 17% in the next week. The infection rate of Mymensingh also increased more than 2 folds from the day of the festival (2.0-5.3 cases per million) within the next 2 weeks. The TPR and infection rate on the national level remained similar throughout the study period. Mass mobility during Eid-ul-Adha influences the increased transmission of COVID-19 among the peripheral regions of Bangladesh from the central capital city Dhaka. The findings will help policymakers plan and implement travel restrictions during festivals during the pandemic in LMICs.

Uptake of a vaccine is complete if individuals are aware of the associated risks of the vaccine, accept the vaccine, and respond positively to the nudges (activation) to increase the uptake, and respond when the vaccine is made accessible and affordable. We mapped systematically the existing literature concerning the 5As—acceptability, accessibility, affordability, awareness, and activation—of COVID-19 vaccination among adults and, specifically, older adults (55 years and older) in Africa. We searched multiple databases from 2020 to December 2021. Using predefined inclusion and exclusion criteria, two reviewers screened citations, conducted title and abstract screening, and extracted data independently. We included 68 articles conducted in 33 African countries, primarily cross-sectional studies (n = 49, 72%). None of the articles focused on older adults only, but 22 articles (32%) included at least one older adult (55 years and older) in their sample size. Acceptance (n = 58, 85%) was the most commonly researched aspect of vaccine uptake, followed by accessibility (n = 17, 25%), awareness (n = 13, 19%), and affordability (n = 5, 7.0%). We found only one report on activation. Factors affecting acceptance of the COVID-19 vaccine in Africa were grouped into sociodemographic factors; knowledge-, attitude-, and belief-related factors; a COVID-19 vaccine efficacy and safety concern factor; and trust in government and public health authorities. The governments of African nations should focus on strategies to influence the modifiable factors identified in this review. More studies are needed to evaluate the impact of nudges (activation) to improve COVID-19 vaccine uptake in African nations.

Background: Loneliness is a public and social issue affecting older adults, but in varying degrees across ethnic groups. Black older adults (BOAs) are more prone to loneliness because they have unique and accumulated factors (e.g., low socioeconomic status, high number of chronic conditions) that predispose them to loneliness. This review aims to describe the extent and the nature of research activities on loneliness and identify the contributory factors to loneliness among BOAs as presented in the global literature. Methods/Design: We will follow the five steps of Arksey and O’Malley’s (2005) framework to search multiple databases from inception till June 2021. MeSH terms and keywords, e.g., “older adults,” “blacks,” and “loneliness,” will be adopted for several databases, including CINHAL, Ageline, PsychINFO, Cochrane Central Registers of Control Trials, PubMed, Web of Science, Social Science Abstract. Multiple reviewers will independently screen citations (title/abstract and full text) and extract data using predefined inclusion and exclusion criteria. “Best fit” framework synthesis using the six social provisions of Weiss’ framework as a priori themes will guide the data analysis.  Discussion: This review will inform policy development around contributory factors for loneliness among BOAs and the most relevant issues on loneliness related to BOAs.

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Black older adults’ (BOAs) experience of loneliness differs from other ethnic groups because of the disproportionate disadvantages faced across their life course. This scoping review aimed to describe the range of research on loneliness or subjective social isolation among BOAs, identifying the contributing factors to loneliness in this population, based on Weiss’ Social provision Framework. Of the 15,345 initial retrieved citations from seven databases and corporate websites, we included 27 studies conducted in the USA, Nigeria, South Africa, Ghana, Canada, the United Kingdom, and Uganda. Studies reporting on BOAs’ experience of loneliness focused on the influence of attachment, social integration, opportunity for nurturance, reassurance of worth, guidance, socio-economic factors, health-related factors and behaviors, and technology, media device possession and usage. There is a need for future studies to identify which social provisions (when targeted) could reduce loneliness, allowing clinicians to develop relevant interventions.

Background The quality assessment provides information on the overall strength of evidence and methodological quality of a research design, highlighting the level of confidence the reader should place on the findings for decision making. This paper aimed to assess the quality (methodology and quality of reporting) of ageing studies in Sub-Saharan Africa (SSA). Method This paper is the second of a Four-Part Series paper of a previous systematic mapping review of peer-reviewed literature on ageing studies conducted in SSA. We updated the literature search to include additional 32 articles, a total of 544 articles included in this paper. Downs & Black checklist, Case Report guidelines checklist, the 45-items Lundgren et al. checklist, and the Mixed Method Appraisal Tool were used to assess the methodological quality of quantitative, case reports, qualitative, and mixed-method studies. Quality assessment was piloted and conducted in pairs for each study type. Depending on the checklist, each study was classified as excellent, good, fair, or poor. Result Of the 544 articles, we performed the quality assessment of a total of 451 quantitative studies [Randomized control trials (RCTs) and pre-post (n=15), longitudinal (n=122), case-control (n=15) and cross-sectional (n=300); 4 case reports, 74 qualitative and 15 mixed-method studies. Only 20.4% (n=111) articles were of high quality [one RCT, 27 longitudinal, 4 case-control, 48 cross-sectional studies, 19 qualitative, and 12 mixed-method studies]. The remaining 433 were rated as moderate quality (n=292, 53.7%), fair quality (n = 96, 17.7%) and poor quality (n = 45, 8.2%). Most (80%) quantitative articles’ sample size is small, resulting in insufficient power to detect a clinically or significant important effect. Three-quarter (75%) of the qualitative studies did not report their research team characteristics and a reflexivity component of the 45-items Lundgren et al. checklist. Mixed-method studies with low quality did not report the qualitative studies properly. Conclusion We conclude that the methodological and quality reporting of published studies on ageing in SSA show variable quality, albeit primarily moderate quality, against high quality. Studies with a large sample size are recommended, and qualitative researchers should provide a section on research team members’ characteristics and reflexivity in their paper or as an appendix.

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Background There are currently 1.5 million indigenous people in Bangladesh, constituting 1.8% of the total population and representing one of the country’s most deprived communities. This study explores the health status and quality of life along with their determinants among indigenous older people in Bangladesh in order to fill the knowledge and evidence gap on this topic. Methods A mixed-methods approach was deployed in October 2019 in the Sylhet division of Bangladesh which involved a cross-sectional survey among 400 indigenous older adults (200 males, 200 females) from 8 tea gardens using a pre-tested semi-structured questionnaire. Ten in-depth interviews were also conducted with providers of the tea garden health facilities. Descriptive analysis, multiple logistic and multi-nominal linear regression were performed to explore associated factors around health and quality of life. Results Of the total respondents, the majority (79.5%) had chronic diseases, with visual difficulty being predominant (74%) among the conditions. Almost all (94%) of the respondents experienced delays in receiving treatment and poverty was identified by most (85%) as the primary cause of those delays. Extreme age, being male, living alone and low family income were significantly associated with suffering from chronic conditions. Furthermore, having a chronic condition and extreme age were found to be significantly associated with a low quality of life. Health service providers identified lack of logistical support in the health facilities, the economic crisis and lack of awareness as the major causes of poor health status and poor health seeking behaviour of the indigenous older adults. Conclusion Indigenous older men in extreme old age are more vulnerable to adverse health conditions and poor quality of life. Health literacy and health seeking behaviour is poor among indigenous older adults generally and there is a huge gap in the health services and social supports available to them.