Introduction: The coronavirus disease 2019 (COVID-19) pandemic has affected the care of patients with noncommunicable diseases, including those suffering from kidney-related ailments. Many parts of the world, including India, adopted lockdown to curb community transmission of disease. The lockdown affected transportation, access to health care facilities, and availability of medicines and consumables as well as outpatient and inpatient services. We aimed to analyze the effect of lockdown imposed due to the COVID-19 pandemic on the care of patients with kidney diseases in India. Methods: We surveyed 19 major hospitals (8 in the public and 11 in the private sector) to determine the effect of lockdown on the care of patients with kidney disease, including those on dialysis after the first 3 weeks of lockdown. Results: The total number of dialysis patients in these centers came down from 2517 to 2404. Approximately 710 (28.2%) patients missed 1 or more dialysis sessions, 69 (2.74%) required emergency dialysis sessions, 104 (4.13%) stopped reporting for dialysis, and 9 (0.36%) were confirmed to have died. Outpatient attendance in the surveyed hospital came down by 92.3%, and inpatient service reduced by 61%. Tele-consultation was started but was accessed by only a small number of patients. Conclusion: Lack of preparedness before lockdown resulted in an interruption in health care services and posed an immediate adverse effect on the outcome of dialysis patients and patients with kidney disease in India. The long-term impact on the health of patients with less severe forms of kidney disease remains unknown.
Background The aim of this study was to determine the knowledge, attitude and practice (KAP) regarding the COVID-19 among frontline healthcare workers (F-HCWs) working at different hospitals in Nepal and to identify the factors significantly associated with KAP. Methods We used a web-based survey, and a convenience sampling method was adopted to collect data from 603 F-HCWs working at different hospitals in Nepal during the first week of June 2020. A self-administered questionnaire was utilized to assess the KAP perceived by the F-HCWs. It was divided into 4-parts consisting of 30-items, demographic characteristics (10-items), knowledge (10-items), attitude (5-items), and practice (5-items). It consisted of both multiple-choice questions and Likert scale items questionnaire. Results Among the participants, 76% reported adequate knowledge, 54.7% reported positive attitude, and 78.9% reported appropriate practice. Statistically significant differences regarding the perceived level of knowledge among F-HCWs were observed among independent variables, including age, gender, level of education, marital status, profession, work experience, source of information, infection prevention and control (IPC) training, and online course(p < 0.05). Similarly, statistically significant differences regarding the attitude among F-HCWs were observed among independent variables, including age, gender, level of education, profession, and online course(p < 0.05). Moreover, only 2-independent variables, including the profession and online course, showed statistically significant differences with practice(p < 0.05). Pearson correlation analysis showed a significant association between knowledge, attitude and practice at the level of p = 0.01. The factors significantly associated with adequate knowledge were male gender, nurse and doctor, websites and IPC training. Similarly, factors significantly associated with positive attitude were online course related to COVID-19 only. Moreover, factors significantly associated with appropriate practice were master’s degree or above and online course related to COVID-19. Conclusions F-HCWs reported adequate overall knowledge with a positive attitude and adopted the appropriate practice. The experienced F-HCWs with higher education and who received IPC training and online course regarding COVID-19 had better KAP. So, the stakeholders must arrange the educational programs and training for F-HCWs for better preparedness tackling with COVID-19.
Background: The primary aim of this national survey was to determine the knowledge, attitude and practice(KAP) regarding the COVID-19 among frontline healthcare workers(F-HCWs) working at different hospitals in Nepal, and the secondary aim was to find the factors associated with KAP. Methods: We used a web-based survey to collect data from 603 F-HCWs working at different hospitals in Nepal during the first week of June 2020. A self-administered questionnaire was utilized to assess the KAP perceived by the F-HCWs. It was divided into 4-parts consisting of 30-items, demographic characteristics (10-items), knowledge (10-items), attitude (5-items), and practice (5-items). It consisted of both multiple-choice questions and Likert scale items questionnaire. Results: Among the participants, 76% reported adequate knowledge, 54.7% reported positive attitude, and 78.9% reported appropriate practice. Statistically significant differences regarding the perceived level of knowledge among F-HCWs were observed among independent variables, including age, gender, level of education, marital status, profession, work experience, source of information, infection prevention and control (IPC) training, and online course(p<0.05). Similarly, statistically significant differences regarding the attitude among F-HCWs were observed among independent variables, including age, gender, level of education, profession, and online course(p<0.05). Moreover, only 2-independent variables, including the profession and online course, showed statistically significant differences with practice(p<0.05). Pearson correlation analysis showed a significant association between knowledge, attitude and practice at the level of p=0.01. The factors significantly associated with adequate knowledge were male gender (aOR: 3.66; 95%CI: 1.97-6.82), nurse and doctor (aOR: 2.10; 95%CI: 1.18-3.72), websites (aOR: 1.83; 95%CI: 1.83 (1.13-2.97) and IPC training (aOR: 1.53; 95%CI: 1.02-2.31). Similarly, factors significantly associated with positive attitude were online course related to COVID-19 (aOR: 1.49; 95%CI: 1.02-2.17) only. Moreover, factors significantly associated with appropriate practice were master’s degree or above (aOR: 0.56; 95%CI: 0.31-1.00) and online course related to COVID-19 (aOR: 2.43; 95%CI: 1.44-4.09) Conclusions: F-HCWs reported adequate overall knowledge with a positive attitude and adopted the appropriate practice.The experienced F-HCWs with higher education and who received IPC training and online course regarding COVID-19 had better KAP. So, the stakeholders must arrange the educational programs and training for F-HCWs for better preparedness tackling with COVID-19.
Objective: Chronic kidney disease (CKD) is increasingly recognized as a global public health problem. There is now convincing evidence that CKD can be detected using simple laboratory tests, and that treatment can prevent or delay complications of decreased kidney function, slow the progression of kidney disease and reduce the risk of cardiovascular disease (CVD). Currently, screening for CKD is accepted practice only in patients with hypertension or diabetes, but more widespread screening is increasingly proposed. We screened a sample of population on World Kidney Day on three consecutive years for detecting patients with CKD and to describe the natural course of the disease. Materials and Methods: Everyone aged ≥18 was invited to participate. The study population was general population from Varanasi were screened in OPAL hospital. The survey comprised an extensive questionnaire and a brief clinical examination, including analysis of serum creatinine concentration in all participants. We screened all the participants who had at least one risk factor for CKD (including hypertension, diabetes mellitus, or a family history of CKD). Urine dipstick tests were done and blood sample was obtained to detect proteinuria and measure serum creatinine concentration, respectively. Results: A total of 547 participants were enrolled of which all 547 subjects were included in the analyses. The mean serum creatinine was 0.9525 mg/dL (0.900 to 1.0050). A high serum creatinine level was demonstrated in 16 participants (2.92 %), and 191 (34.91 %) were demonstrated to have proteinuria. There was a signifi cant correlation between CKD and age, DM, urine protein and serum creatinine. There was no signifi cant correlation between serum creatinine level and urinary protein excretion (P = .001). There were no signifi cant differences between CKD and gender. Conclusion: The study demonstrates that increasing age, diabetes mellitus, Serum creatinine and urinary protein were found signifi cantly related to kidney disease with P value of 0.02, 0.0006, <0.0001, 0.0002, respectively, which means that there is a chance for the aged, diabetes patients and patients with elevated serum creatinine and urine protein to suffer with kidney disease with respect to the younger subject. Abstract Access this article onlineWebsite: www.ijmedph.org
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