IntroductionTransgender persons in India, who are one of the most vulnerable groups, were particularly impacted by the COVID-19 pandemic. Increased risk of COVID-19, challenges with continuing livelihood, uncertainty, and anxiety around the pandemic over pre-existing social discrimination and exclusion pose risk of a mental health impact as well. To investigate this further, this component of a larger study on experiences in healthcare of transgender persons in India during COVID-19 and looks into the question “How did the COVID-19 pandemic impact the mental health of transgender persons in India”.Methods22 In-depth interviews (IDI) and 6 focus group discussions (FGD) were conducted virtually and in-person with persons self-identifying as transgender or belonging to ethnocultural transgender communities from different parts of India. Community based participatory research approach was used by ensuring representation from the community in the research team and through a series of consultative workshops. Purposive sampling with snowballing was used. The IDIs and FGDs were recorded, transcribed verbatim and analyzed using an inductive thematic analysis.ResultsMental health of transgender persons were affected in the following ways. Firstly, COVID-19, its associated fear and suffering combined with pre-existing inaccessibility of healthcare and reduced access to mental health care affected their mental health. Secondly, unique social support needs of transgender persons were disrupted by pandemic linked restrictions. Thirdly, pre-existing vulnerabilities such as precarious employment and underlying stigma were exacerbated. Finally, gender dysphoria was a key mediating factor in the impact of COVID-19 on mental health with a negative and positive impact.ConclusionsThe study reiterates the need to make systemic changes to make mental healthcare and general healthcare services trans-inclusive while also recognizing the essential nature of gender affirmative services and the need to continue them even during emergencies and disaster situations. While this brings out how public health emergencies can exacerbate vulnerabilities, it also shows how the lived mental health experience of transgender person is intricately linked to the way work, travel and housing is structured in our society and therefore points to the structural nature of the linkage between mental health and gender.
Introduction Healthcare workers (HCW) are most vulnerable to contracting COVID-19 infection. Understanding the extent of human-to-human transmission of the COVID-19 infection among HCWs is critical in managing this infection and for policy making. We did this study to estimate new infection by seroconversion among HCWs in recent contact with COVID-19 and predict the risk factors for infection. Methods A cohort study was conducted at a tertiary care COVID-19 hospital in New Delhi during the first and second waves of the COVID-19 pandemic. All HCWs working in the hospital during the study period who came in recent contact with the patients were our study population. The data was collected by a detailed face-to-face interview, serological assessment for anti- COVID-19 antibodies at baseline and end line, and daily symptoms. Potential risk factors for seroprevalence and seroconversion were analyzed by logistic regression keeping the significance at p<0.05. Results A total of 192 HCWs were recruited in this study, out of which 119 (62.0%) were seropositive. Almost all were wearing Personal protective equipment (PPE) and following Infection prevention and control (IPC) measures during their recent contact with a COVID-19 patient. Seroconversion was observed among 36.7% of HCWs, while 64.0% had a serial rise in the titer of antibodies during the follow-up period. Seropositivity was negatively associated with being a doctor (odds ratio [OR] 0.35, 95% Confidence Interval [CI] 0.18–0.71), having COVID-19 symptoms (OR 0.21, 95% CI 0.05–0.82), having comorbidities (OR 0.14, 95% CI 0.03–0.67), and received IPC training (OR 0.25, 95% CI 0.07–0.86), while positively associated with partial (OR 3.30, 95% CI 1.26–8.69), as well as complete vaccination for COVID-19 (OR 2.43, 95% CI 1.12–5.27). Seroconversion was positively associated with doctor as a profession (OR 13.04, 95% CI 3.39–50.25) and with partially (OR 4.35, 95% CI 1.07–17.65), as well as fully vaccinated for COVID-19 (OR 6.08, 95% CI 1.73–21.4). No significant association was observed between adherence to any IPC measures and PPE adopted by the HCW during the recent contact with COVID-19 patients and seroconversion. Conclusion Almost all the HCW practiced IPC measures in these settings. High seropositivity and seroconversion are most likely due to concurrent vaccination against COVID-19 rather than recent exposure to COVID-19 patients. Further studies using anti-N antibodies serology may help us find the reason for the seropositivity and seroconversion among HCWs.
Background: Doctors are often ignorant of safeguarding their own health. The present COVID-19 pandemic has necessitated maintenance of social distancing. Handshake is one of the forms of greeting and physical contact to show empathy to patient, however it carries risk of transfer of microbes. The need of the hour is to find a suitable alternative to handshake. Aims was to study the knowledge, attitude and practice of medical doctors in an Indian tertiary care hospital towards hand shake.Methods: Study targeted 500 medical practitioners in a tertiary care hospital by presenting them with a google based questionnaire form. The questions were based on the practice of handshake amongst medical practitioners and the preferred alternatives. Statistical analysis used: Descriptive and analytic statistics.Results: Despite 100% respondents being aware about guidelines to avoid non-essential physical contact, 37.3% respondents shook hands. Out of the 85 respondents who had a handshake only 57.6% (n=49) washed hands after handshake. Namaste or Aadab followed by wave gesture are the most acceptable alternatives to handshake for medical practitioners.Conclusions: According to the study a large number of medical practitioners find it difficult to completely quit handshakes, mostly because of habit even in this pandemic emergency. Namaste or Aadab or hand waving are the best alternatives to handshake. A long term change of habit to a universally acceptable “wave” gesture needs to be developed to prevent possible community transmission of infectious diseases.
Background: Healthcare personnel providing COVID-19 care are at increased risk of acquiring infection. Understanding the factors associated with the transmission of infection among healthcare workers provides input for the development of prevention strategies. The objectives of this study were to study the adherence to Infection Prevention and Control (IPC) measures followed between different categories of healthcare workers, to estimate seroconversion rate based on the type of exposure with COVID-19 patients, and to study the association between seroconversion and IPC practices. Methods: A prospective cohort study was conducted from December 2020 to June 2021 among the healthcare workers in two tertiary healthcare institutes selected by purposive sampling. All Healthcare workers (HCWs) participating in the clinical management or having any exposure to a laboratory-confirmed COVID-19 case were included. A total of 817 subjects were enrolled in the study. At baseline, details on IPC training and adherence along with details of the type of exposure with the COVID-19 patient were collected. The end-line visit was scheduled at 22-31 (preferably 28 days) days from the first visit for the collection of the symptom diary and end-line form. Results: Hand hygiene practices were found to be best among paramedics (98.0%), followed by doctors (84.5%) and nurses (90.1%). Maximum HCWs (99.5%; 99.8%; 97.1%) reported using Personal Protective Equipment (PPE) appropriately and regular availability of PPE in the hospital setting. Among the various categories of HCWs, nurses had the highest proportion (28.7%) of untrained personnel. Conclusion: The HCWs who had contact with the surroundings of an infected patient showed higher odds of seroconversion although not statistically significant. Further, analyzing the types of PPE used, we found that the use of masks and gloves was protective in preventing infection. Strengthening IPC training through refresher training and demonstrating the correct use of PPE can enhance adherence to IPC measures.
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