Dexamethasone can reduce mortality in hospitalised COVID-19 patients needing oxygen and ventilation by 18% and 36%, respectively. Here, we estimate the potential number of lives saved and life years gained if this treatment were to be rolled out in the UK and globally, as well as the cost-effectiveness of implementing this intervention. Assuming SARS-CoV-2 exposure levels of 5% to 15%, we estimate that, for the UK, approximately 12,000 (4,250 - 27,000) lives could be saved between July and December 2020. Assuming that dexamethasone has a similar effect size in settings where access to oxygen therapies is limited, this would translate into approximately 650,000 (240,000 - 1,400,000) lives saved globally over the same time period. If dexamethasone acts differently in these settings, the impact could be less than half of this value. To estimate the full potential of dexamethasone in the global fight against COVID-19, it is essential to perform clinical research in settings with limited access to oxygen and/or ventilators, for example in low- and middle-income countries.

Modification to initial ART was common in this study. Further evaluation of the contribution of guideline changes on regimen modification and treatment outcomes is recommended.

*Objectives: We describe the frequency and types of drug therapy problems (DTPs), and interventions carried out to resolve them, among a cohort of HIV-infected patients on ART in Jos, Nigeria. Methods: A prospective pharmacists' intervention study was conducted between January and August 2012 at the outpatient HIV clinic of the Jos University Teaching Hospital (JUTH). Pharmacists identified DTPs and made recommendations to resolve them. The main outcome measures were number of DTPs encountered, interventions proposed and acceptance rate of recommendations. Results: A total of 42,416 prescriptions were dispensed to 9339 patients during the eight months study. A total of 420 interventions (Intervention rate of 1 per 100 prescriptions) were made to resolve DTPs in 401 (4.3%) patients with a mean age of 41 (SD=10) years, and made up of 73% females. DTPs encountered were drug omission (n=89, 21.2%), unnecessary drug (n=55, 13.1%) and wrong drug indication (n=55, 13.1%). Recommendations offered included; Addition of another drug to the therapy (n=87, 20.7%), rectification of incomplete prescriptions (n=85, 20.2%), change of drug or dosage (n=67, 16.0%), and discontinuation of the offending drug (n=59, 14.0%). A total of 389 (93%) out of 420 of the recommendations were accepted. In all, 50.4% (212) of the problematic prescriptions were changed and dispensed, 22.2% (89) were clarified and dispensed, while wrong identities were corrected in 11.7% (49). However, 7.5% (30) (21) were not dispensed, and 3% (12) were unresolved. Conclusion: Our findings suggest that pharmacistsinitiated interventions can ameliorate DTPs in patients receiving ART given the high intervention acceptance rate recorded. The implication of this finding is that pharmacists with requisite training in HIV pharmacotherapy are an excellent resource in detecting and minimizing the effect of antiretroviral drug-related errors.

Highlight The COVID-19 pandemic and its associated lockdown have had a negative impact on global mental health. Considerable fear and stigma surround the prospects of a return to non-essential international travel. The mental health aspects of travel have been historically neglected in the literature. The current pandemic has prompted a renewed focus on building psychological resilience in travellers by engaging innovative technological tools such as virtual reality.

Background Community health needs and assets assessment is a means of identifying and describing community health needs and resources, serving as a mechanism to gain the necessary information to make informed choices about community health. The current review of the literature was performed in order to shed more light on concepts, rationale, tools and uses of community health needs and assets assessment. Methods We conducted a scoping review of the literature published in English using PubMed, Embase, Scopus, Web of Science, PDQ evidence, NIH database, Cochrane library, CDC library, Trip, and Global Health Library databases until March 2021. Results A total of 169 articles including both empirical papers and theoretical and conceptual work were ultimately retained for analysis. Relevant concepts were examined guided by a conceptual framework. The empirical papers were dominantly conducted in the  United States. Qualitative, quantitative and mixed-method approaches were used to collect data on community health needs and assets, with an increasing trend of using mixed-method approaches. Almost half of the included empirical studies used participatory approaches to incorporate community inputs into the process. Conclusion Our findings highlight the need for having holistic approaches to assess community’s health needs focusing on physical, mental and social wellbeing, along with considering the broader systems factors and structural challenges to individual and population health. Furthermore, the findings emphasize assessing community health assets as an integral component of the process, beginning foremost with community capabilities and knowledge. There has been a trend toward using mixed-methods approaches to conduct the assessment in recent years that led to the inclusion of the voices of all community members, particularly vulnerable and disadvantaged groups. A notable gap in the existing literature is the lack of long-term or longitudinal–assessment of the community health needs assessment impacts.

PurposeSince the appearance of COVID-19 social distancing and staying home have been recommended repeatedly by the governments for disease prevention. As the challenge continues to remain the current study seeks to examine the factors affecting social distancing through space planning and management. More specifically the current study aims to examine the appropriateness of the spatial organization and space configuration of a clubhouse with a linear plan layout in the mitigation of the spread of infections due to serious pandemic COVID-19.Design/methodology/approachFor an enhanced understanding of the impact of spatial arrangements of public spaces plan on the effective implementation of social distancing this study has used the space syntax analysis method. The MPSP clubhouse building in Penang, Malaysia was selected as the case study. The level of permeability and wayfinding were determined in the building plan and were illustrated using photoshop software to depict the interrelation between the indoor spaces and building circulation. Graphs of the depth of space were used to analyze the level of permeability and wayfinding to illustrate the possibility of social distancing in the plan.FindingsThe result of the study shows the significant role of proper plan layout design on social distancing. While clear and direct wayfinding can positively be associated with more effective social distancing, the inefficient design of user access, inappropriate locations of multiple entry and exit and indefinite directions of users' inside buildings can impose slight limitations. The average level of permeability might suggest ineffective spatial arrangement, ignoring the needs of spatial segregation. The study further found that the linear plan layouts with proper zoning and effective management strategies can be considered a proper layout to facilitate social distancing and the spread of COVID-19.Originality/valueThe current study is unique in terms of examination of the spatial configuration of linear public spaces plan layout for possible temporary adaptability to curb disease spread during the unexpected advent of a pandemic. Based on researchers' best of knowledge it is the first time that the impact of recreational space design on social distancing has been examined. The study also originally sheds light on the fact that the commonly used guideline for the social distancing of 1–2 m between 2 persons, in reality, is practically inadequate given the nature of the sports activities.

Introduction: Travel medicine has become firmly established as a medical discipline and, as such, it should undergo periodic assessment of its productivity. Scientometrics is a field of study related to data science, which concerns itself with the measurement and analysis of published scholarly literature. Methods: A scientometric evaluation was conducted of all 240 articles published through February 2021 in the International Journal of Travel Medicine and Global Health (IJTMGH), one of the few academic journals dedicated to the study of travel medicine. Results: The majority of articles belonged to the general category of travel medicine (62%, n=149), with 38% of articles (n=91) being focused on global health and non-travel related infectious diseases. The 149 travel medicine-related articles mapped onto the Body of Knowledge syllabus of the International Society of Travel Medicine, with the majority of articles addressing the domain of pre-travel assessment of travellers (49.7%, n=74), including the sub-domains of patient evaluation, special populations of travellers, special itineraries, prevention and self-treatment, and communication of risks to travellers. The most common thematic designation of IJTMGH articles related to medical and health tourism (12.1%, n=29). High levels of geographic diversity, multi-authorship and inter-institutional collaboration were observed in the journal. The subject matter of the most cited and most popular articles reflected the broad coverage of travel medicine and global health by IJTMGH. Conclusion: We recommend that future bibliometric and citation analyses be performed, which will further enhance our understanding of the evolution of these dynamic fields of academic study.

The controversial subject of transplant tourism has been neglected in the travel medicine literature. According to the Declaration of Istanbul, travel for transplantation can be regarded as transplant tourism if it involves organ trafficking and/or commercialised transplantation activities. While no registry of transplant tourism activities exists, published case series point to significant negative clinical outcomes. Adverse outcomes among donors include postoperative depression and anxiety, deterioration in health status, poor surgical wound care, and negative financial effects. Poor perioperative management, inadequate immunosuppression, blood transfusion-associated infections, antibiotic-resistant bacterial infections and invasive fungal infections, are among the most commonly reported complications in transplanted patients. Iran operates a legal and ethically regulated system of rewarded altruistic kidney donation. Travel medicine practitioners have a role to play in protecting the health of intending transplant tourists through targeted pre-travel health counselling and vaccination.