Objectives: To synthesize existing evidence on prevalence as well as clinical and socio-economic aspects of Long COVID.Methods: An umbrella review of reviews and a targeted evidence synthesis of their primary studies, including searches in four electronic databases, reference lists of included reviews, as well as related article lists of relevant publications.Results: Synthesis included 23 reviews and 102 primary studies. Prevalence estimates ranged from 7.5% to 41% in non-hospitalized adults, 2.3%–53% in mixed adult samples, 37.6% in hospitalized adults, and 2%–3.5% in primarily non-hospitalized children. Preliminary evidence suggests that female sex, age, comorbidities, the severity of acute disease, and obesity are associated with Long COVID. Almost 50% of primary studies reported some degree of Long COVID-related social and family-life impairment, long absence periods off work, adjusted workloads, and loss of employment.Conclusion: Long COVID will likely have a substantial public health impact. Current evidence is still heterogeneous and incomplete. To fully understand Long COVID, well-designed prospective studies with representative samples will be essential.

As COVID-19 spreads across the globe, crowdsourced digital technology harbours the potential to improve surveillance and epidemic control, primarily through increased information coverage, higher information speed, fast case tracking and improved proximity tracing. Targeting those aims, COVID-19-related smartphone and webbased health applications are continuously emerging, leading to a multitude of options, raising ethical and legal challenges and potentially overwhelming end users.Building on an existing trustworthiness checklist for digital health applications, we searched the literature and developed a framework to guide the assessment of smartphone and web-based applications that aim to contribute to controlling the current epidemic or mitigating its effects. It further integrates epidemiological subject knowledge and a legal analysis, outlining the mechanisms through which new applications can support the fight against COVID-19.The resulting framework includes 40 questions across 8 domains on "purpose", "usability", "information accuracy", "organisational attributes / reputation", "transparency", "privacy" and "user control / self-determination". All questions should be primarily answerable from publicly available data, as provided by application manufacturers. The framework aims to guide end users in choosing a transparent, safe and valuable application and suggests a set of information items that developers ideally make available to allow a balanced judgement and facilitate the trustworthiness of their products.

BackgroundDigital innovations continue to shape health and health care. As technology socially integrates into daily living, the lives of health care consumers are transformed into a key source of health information, commonly referred to as patient-generated health data (PGHD). With chronic disease prevalence signaling the need for a refocus on primary prevention, electronic PGHD might be essential in strengthening proactive and person-centered health care.ObjectiveThis study aimed to review and synthesize the existing literature on the utilization and implications of electronic PGHD for primary disease prevention and health promotion purposes.MethodsGuided by a well-accepted methodological framework for scoping studies, we screened MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science, EMBASE, and IEEE Digital Library. We hand-searched 5 electronic journals and 4 gray literature sources, additionally conducted Web searches, reviewed relevant Web pages, manually screened reference lists, and consulted authors. Screening was based on predefined eligibility criteria. Data extraction and synthesis were guided by an adapted PGHD-flow framework. Beyond initial quantitative synthesis, we reported narratively, following an iterative thematic approach. Raw data were coded, thematically clustered, and mapped, allowing for the identification of patterns.ResultsOf 183 eligible studies, targeting knowledge and self-awareness, behavior change, healthy environments, and remote monitoring, most literature (125/183, 68.3%) addressed weight reduction, either through physical activity or nutrition, applying a range of electronic tools from socially integrated to full medical devices. Participants generated their data actively (100/183, 54.6%), in combination with passive sensor-based trackers (63/183, 34.4%) or entirely passively (20/183, 10.9%). The proportions of active and passive data generation varied strongly across prevention areas. Most studies (172/183, 93.9%) combined electronic PGHD with reflective, process guiding, motivational and educational elements, highlighting the role of PGHD in multicomponent digital prevention approaches. Most of these interventions (110/183, 60.1%) were fully automatized, underlining broader trends toward low-resource and efficiency-driven care. Only a fraction (47/183, 25.6%) of studies provided indications on the impact of PGHD on prevention-relevant outcomes, suggesting overall positive trends, especially on vitals (eg, blood pressure) and body composition measures (eg, body mass index). In contrast, the impact of PGHD on health equity remained largely unexplored. Finally, our analysis identified a list of barriers and facilitators clustered around data collection and use, technical and design considerations, ethics, user characteristics, and intervention context and content, aiming to guide future PGHD research.ConclusionsThe large, heterogeneous volume of the PGHD literature underlines the topic’s emerging nature. Utilizing electronic PGHD to prevent diseases and promote health is a complex m...

The rapid spread of SARS-CoV-2 has activated the world's "emergency breaks", forcing a slowdown of unprecedented magnitude. As a new temporary "normal" settles in, healthcare systems are making enormous efforts to adjust and mitigate the damage. These adaptation processes accelerate the use of health technologies that were on previously slow adoption paths, including telehealth. Telehealth, or telemedicine, is the use of information and communication technology to provide remote care, outside traditional healthcare contexts [1].Disrupted healthcare systems and the need for physical distancing seem to open a window of opportunity for a broader exposure to telehealth solutions, many of which might have the potential to improve care long after the pandemic passes. As the evidence on the effectiveness, as well as cost-effectiveness of telemedicine, is mounting, harnessing its benefits post-COVID-19 will require careful consideration of arising opportunities, as well as timely, proactive action on existing challenges [1][2][3][4][5].

IntroductionRapidly expanding digital innovations transform the perception, reception and provision of health services. Simultaneously, health system challenges underline the need for patient-centred, empowering and citizen-engaging care, which facilitates a focus on prevention and health promotion. Through enhanced patient-engagement, patient-provider interactions and reduced information gaps, electronic patient-generated health data (PGHD) may facilitate both patient-centeredness and preventive scare. Despite that, comprehensive knowledge syntheses on their utilisation for prevention and health promotion purposes are lacking. The review described in this protocol aims to fill that gap.Methods and analysisOur methodology is guided by Arksey and O’ Malley’s methodological framework for scoping reviews, as well as its advanced version by Levac, Colquhoun and O’Brien. Seven electronic databases will be systematically searched using predefined keywords. Key electronic journals will be hand searched, while reference lists of included documents and grey literature sources will be screened thoroughly. Two independent reviewers will complete study selection and data extraction. One of the team’s senior research members will act as a third reviewer and make the final decision on disputed documents. We will include literature with a focus on electronic PGHD and linked to prevention and health promotion. Literature on prevention that is driven by existing discomfort or disability goes beyond the review’s scope and will be excluded. Analysis will be narrative and guided by Shapiro et al’s adapted framework on PGHD flow.Ethics and disseminationThe scoping review described in this protocol aims to establish a baseline understanding of electronic PGHD generation, collection, communication, sharing, interpretation, utilisation, context and impact for preventive purposes. The chosen methodology is based on the use of publicly available information and does not require ethical approval. Review findings will be disseminated in digital health conferences and symposia. Results will be published and additionally shared with relevant local and national authorities.

Dengue's re-emerging epidemiology poses a major global health threat. India contributes significantly to the global communicable disease burden has been declared highly dengue-endemic, exposing public health authorities to severe challenges. Our study aims to provide a deeper understanding of India's urban dengue surveillance policies as well as to explore the organisation, functioning and integration of existing disease control pillars. We conducted a qualitative regional case study, consisting of semi-structured expert interviews and observational data, covering the urban region of Hyderabad in South India. Our findings indicate that Hyderabad's dengue surveillance system predominantly relies on public reporting units, neglecting India's large private health sector. The surveillance system requires further strengthening and additional efforts to efficiently integrate existing governmental initiatives at all geographical levels and administrative boundaries. We concluded with recommendations for improved consistency, accuracy, efficiency and reduction of system fragmentation to enhance the integration of dengue surveillance and improved health information in urban India. Finally, our study underlines India's overall need to increase investment in public health and health infrastructures. That requires coordinated and multilevel action targeting the development of a competent, effective and motivated public health cadre, as well as truly integrated surveillance and epidemic response infrastructure, for dengue and beyond.

Objective(s): This study explored the effectiveness of gender-based violence (GBV) interventions on young people living with or affected by HIV in low-and middle-income countries (LMICs). Design: Systematic review and meta-analysis. Methods: We pre-registered a protocol, then searched thirteen databases and grey literature. We screened randomised and quasi-experimental studies (n=2199) of young people (aged 10-24) living with or affected by HIV in LMICs. Outcomes were GBV and/or GBV-related attitudes. We appraised the data for risk of bias and quality of evidence. Narrative syntheses and multi-level random effects meta-analyses were conducted. Results: We included 18 studies evaluating 21 interventions. Intervention arms were categorised as: a) sexual health and social empowerment (SHSE) (n=7); b) SHSE plus economic strengthening (n=4); c) self-defence (n=3); d) safer schools (n=2); e) economic strengthening only (n=2); f) GBV sensitisation (n=2) and g) safer schools plus parenting (n=1). Risk of bias was moderate/high and quality of evidence low. Narrative syntheses indicated promising effects on GBV exposure, but no or mixed effects on GBV perpetration and attitudes for self-defence and GBV sensitisation interventions. Safer schools interventions showed no effects. For SHSE interventions and SHSE plus economic strengthening, meta-analysis showed a small reduction in GBV exposure but not perpetration. Economic-only interventions had no overall effect. Conclusions: SHSE, SHSE plus and self-defence and gender sensitisation interventions may be effective for GBV exposure and GBV-related attitudes but not for GBV perpetration. However, the quality of evidence is poor. Future intervention research must include both boys and girls, adolescents living with HIV and key populations.

Background Long-term health consequences following acute SARS-CoV-2 infection, referred to as post-COVID-19 condition or Long COVID, are increasing, with population-based prevalence estimates for adults at around 20%. Persons affected by Long COVID report various health problems, yet evidence to guide clinical decision making remains scarce. Objective The present study aimed to identify Long COVID research priorities using a citizen science approach and solely considering the needs of those affected. Methods This citizen science study followed an iterative process of patient needs identification, evaluation and prioritisation. A Long COVID Citizen Science Board (21 persons with Long COVID, and seven with myalgic encephalomyelitis/chronic fatigue syndrome) and a Long COVID Working Group (25 persons with Long COVID, four patients with myalgic encephalomyelitis/chronic fatigue syndrome and one relative) were formed. The study included four activities: three remote meetings and one online survey. First, Board members identified the needs and research questions. Second, Working Group members and persons affected by Long COVID (241 respondents, 85.5% with Long COVID, 14.5% with myalgic encephalomyelitis/chronic fatigue syndrome and 7.1% relatives) evaluated the research questions on a 1–5 Likert scale using an online survey. Then the Board gave feedback on this evaluation. Finally, Board members set the priorities for research through voting and discussion. Results Sixty-eight research questions were generated by the Board and categorised into four research domains (medicine, healthcare services, socioeconomics and burden of disease) and 14 subcategories. Their average importance ratings were moderate to high and varied from 3.41 (standard deviation = 1.16) for sex-specific diagnostics to 4.86 (standard deviation = 0.41) for medical questions on treatment. Five topics were prioritised: “treatment, rehabilitation and chronic care management”, “availability of interfaces for treatment continuity”, “availability of healthcare structures”, “awareness and knowledge among professionals” and “prevalence of Long COVID in children and adolescents”. Conclusions To our knowledge, this is the first study developing a citizen-driven, explicitly patient-centred research agenda with persons affected by Long COVID, setting it apart from existing multi-stakeholder efforts. The identified priorities could guide future research and funding allocation. Our methodology establishes a framework for citizen-driven research agendas, suitable for transfer to other diseases. Supplementary Information The online version contains supplementary material available at 10.1007/s40271-022-00579-7.