COVID-19 Vaccine Acceptance and Hesitancy among Healthcare Workers in Lusaka, Zambia; Findings and Implications for the Future

Vaccines, Journal Year: 2023, Volume and Issue: 11(8), P. 1350 - 1350

Published: Aug. 9, 2023

The uptake of COVID-19 vaccines is critical to address the severe consequences disease. Previous studies have suggested that many healthcare workers (HCWs) are hesitant receive vaccine, further enhancing hesitancy rates within countries. vaccine acceptance and levels currently unknown among HCWs in Zambia, which a concern given burden infectious diseases country. Consequently, this study assessed Lusaka, Zambia. A cross-sectional was conducted 240 between August September 2022, using semi-structured questionnaire. Multivariable analysis used determine key factors associated with HCWs. Of who participated, 54.2% were females. total 72.1% would accept being vaccinated, while 27.9% hesitant. Moreover, 93.3% had positive attitudes towards vaccines, medical doctors having highest mean attitude score (82%). Encouragingly, reduced odds (AOR = 0.02, 95% CI: 0.01-0.11,

Language: Английский

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Real-world prescription of anti-COVID-19 drugs in hospitalized patients with COVID-19 in Japan

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(1), P. e0297679 - e0297679

Published: Jan. 26, 2024

Objective Prescription trends and patterns of anti-COVID-19 drugs in hospitalized patients were examined based on real world data to understand the use clinical practice Japan. Design The longitudinal cross-sectional study was conducted utilizing from January 1, 2019 December 31, 2021 MID-NET ® medical information database, which stored electronic records, administrative claim data, diagnosis procedure combination Participants Hospitalized with a COVID-19-related who received at least one drug between April 2020 2021. Exposures following 14 included this study: remdesivir, baricitinib, product casirivimab imdevimab, favipiravir, dexamethasone, ivermectin, azithromycin, nafamostat mesylate, camostat ciclesonide, tocilizumab, sarilumab, lopinavir ritonavir, hydroxychloroquine. Results We identified 5,717 COVID-19 prescribed drug. entire cohort generally over 41–50 years more males. most common prescription pattern dexamethasone monotherapy (22.9%), followed by concomitant remdesivir (15.0%), azithromycin (10.2%), mesylate (8.5%). However, an often differed depending period. Conclusions relevance This revealed real-world situation prescriptions A would depend latest scientific evidence, such as efficacy, safety, approval status, time prescription. Understanding will be important for providing up-to-date treatments evaluating benefit and/or risk utilization record database.

Language: Английский

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A Comprehensive Review on the Efficacy of Several Pharmacologic Agents for the Treatment of COVID-19

Life, Journal Year: 2022, Volume and Issue: 12(11), P. 1758 - 1758

Published: Nov. 1, 2022

SARS-CoV-2, the coronavirus disease-2019 (COVID-19), and cause of pandemic is extremely contagious among people has spread around world. Antivirals, immunomodulators, other medications, such as antibiotics, stem cells, plasma therapy, have all been utilized in treatment COVID-19. To better understand clinical efficacy these agents to aid selection effective COVID-19 therapies various countries, this study reviewed effectiveness pharmacologic that used for therapy globally by summarizing outcomes obtained from trials published on each drug related infection. The Food Drug Administration (FDA) authorized use remdesivir, paxlovid, molnupiravir, baricitinib, tixagevimab–cilgavimab, bebtelovimab management On hand, most research advises against using chloroquine hydroxychloroquine treat patients because they are not beneficial. Although FDA given emergency authorization some monoclonal antibodies, including bamlanivimab, etesevimab, casirivimab, imdevimab managing COVID-19, currently approved Omicron variant significantly reduced their vitro susceptibility. In study, we also included a wide range alternative strategies effectively patients, although further randomized studies necessary support assess applicability.

Language: Английский

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Ivermectin under scrutiny: a systematic review and meta-analysis of efficacy and possible sources of controversies in COVID-19 patients

Virology Journal, Journal Year: 2022, Volume and Issue: 19(1)

Published: June 13, 2022

Abstract Background We conducted a systematic review and meta-analysis to evaluate the efficacy of ivermectin for COVID-19 patients based on current peer-reviewed RCTs address disputes over existing evidence. Methods MEDLINE (Pubmed), Scopus, Web Science, Cochrane library, Google scholar Clinicaltrials.gov were searched assessing Ivermectin up 20 February 2022. A studies was performed PRISMA 2020 statement criteria. Results 19 17 included in this meta-analysis, respectively. There no significant difference progression severe disease (log OR − 0.27 [95% CI 0.61 0.08], I2 = 42.29%), negative RT-PCR 0.25 0.18–0.68], 58.73%), recovery 0.11 0.22–0.45], 13.84%), duration hospitalization (SMD 0.40 0.85–0.06], 88.90%), time 0.36 0.89–0.17], 46.2%), viral load -0.17 -0.45 0.12], I^2 0%). It is worth noting that, low-certainty evidence, may possibly reduce mortality 0.67 1.20 0.13], 28.96%). However, with higher risk bias more likely indicate positive effects drug, according our subgroup analyses study quality. Conclusion did not have any effect outcomes as WHO recommends, use should be limited clinical trials.

Language: Английский

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Effectiveness of fluconazole as antifungal prophylaxis in cancer patients undergoing chemotherapy, radiotherapy, or immunotherapy: systematic review and meta‐analysis

Apmis, Journal Year: 2023, Volume and Issue: 131(11), P. 668 - 684

Published: May 18, 2023

This review assessed the effectiveness of fluconazole as antifungal prophylaxis on incidence oral fungal diseases in patients undergoing cancer treatment. The secondary outcomes evaluated were adverse effects, discontinuation therapy due to infection, mortality by a and mean duration prophylaxis. Twelve databases records searched. RoB 2 ROBINS I tools used assess risk bias. relative (RR), difference, standard difference (SMD) applied with 95% confidence intervals (CI). certainty evidence was determined GRADE. Twenty‐four studies included this systematic review. In randomized controlled trials pooling, protective factor for primary outcome (RR = 0.30; CI: 0.16, 0.55; p < 0.01, vs placebo). Compared other antifungals, only more effective than subgroup amphotericin B nystatin (alone or combination) 0.19; 0.09, 0.43; 0.01). Fluconazole also non‐randomized pooling 0.05, 0.78; 0.02, untreated). results showed no significant differences outcomes. low very low. conclusion, prophylactic antifungals are necessary during treatment, shown be reducing compared assessing nystatin, administered alone combination.

Language: Английский

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Unlocking insights: Navigating COVID-19 challenges and Emulating future pandemic Resilience strategies with strengthening natural immunity

Heliyon, Journal Year: 2024, Volume and Issue: 10(15), P. e34691 - e34691

Published: July 18, 2024

The original COVID-19 vaccines, developed against SARS-CoV-2, initially mitigated hospitalizations. Bivalent vaccine boosters were used widely during 2022-23, but the outbreaks persisted. Despite this, hospitalizations, mortality, and involving dominant mutants like Alpha Delta increased winters when population's vitamin D levels at their lowest. Notably, 75 % of human immune cell/system functions, including post-vaccination adaptive immunity, rely on adequate circulatory levels. Consequently, hypovitaminosis compromises innate responses, heightening susceptibility to infections complications. vaccines primarily target SARS-CoV-2 Spike proteins, thus offering only a limited protection through antibodies. mRNA such as those for COVID-19, fail generate secretory/mucosal immunity-like IgG rendering them ineffective in halting viral spread. Additionally, mutations binding domain reduce recognition by vaccine-derived antibodies, leading evasion mutant viruses Omicron variants. Meanwhile, repeated administration bivalent intended enhance efficacy resulted immunoparesis recipients. As result, relying solely outbreak prevention, it became less effective. Dominant variants exhibit affinity angiotensin-converting enzyme receptor-2, enhancing infectivity reducing virulence. spike protein-related do not impact potency available, repurposed early therapies, ivermectin. With re-emergence impending coronaviral pandemics, regulators health organizations should proactively consider approval strategic use cost-effective adjunct therapies mentioned above counter loss emerging novel coronaviruses eliminate vaccine- anti-viral agents-related serious adverse effects. Timely implementation these strategies could morbidity, healthcare costs provide rational approach address future epidemics pandemics. This perspective critically reviews relevant literature, providing insights, justifications, viewpoints into how scientific community authorities can leverage this knowledge cost-effectively.

Language: Английский

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Early COVID-19 therapy with azithromycin plus nitazoxanide, ivermectin or hydroxychloroquine in outpatient settings significantly improved COVID-19 outcomes compared to known outcomes in untreated patients

New Microbes and New Infections, Journal Year: 2021, Volume and Issue: 43, P. 100915 - 100915

Published: July 7, 2021

In a prospective observational study (pre-AndroCoV Trial), the use of nitazoxanide, ivermectin and hydroxychloroquine demonstrated unexpected improvements in COVID-19 outcomes when compared to untreated patients. The apparent yet likely positive results raised ethical concerns on employment further full placebo controlled studies early-stage COVID-19. present analysis aimed elucidate, through comparative with two control groups, whether placebo-control randomized clinical trials (RCTs) are still ethically acceptable. Active group (AG) consisted patients enrolled Pre-AndroCoV-Trial (n = 585). Control Group 1 (CG1) retrospectively obtained same population 137), 2 (CG2) resulted from precise prediction based thorough structured review indexed articles official statements. Patients were matched for sex, age, comorbidities disease severity at baseline. Compared CG1 CG2, AG showed reduction 31.5-36.5% viral shedding (p < 0.0001), 70-85% duration 100% respiratory complications, hospitalization, mechanical ventilation, deaths post-COVID manifestations 0.0001 all). For every 1000 confirmed cases COVID-19, least 70 hospitalizations, 50 ventilations five prevented. Benefits combination early detection pharmacological approaches consistent overwhelming which, together well-established safety profile drug combinations tested Pre-AndroCoV Trial, precluded our continuing employing

Language: Английский

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Ivermectin: a multifaceted drug of Nobel prize-honoured distinction with indicated efficacy against a new global scourge, COVID-19

New Microbes and New Infections, Journal Year: 2021, Volume and Issue: 43, P. 100924 - 100924

Published: Aug. 3, 2021

In 2015, the Nobel Committee for Physiology or Medicine, in its only award treatments of infectious diseases since six decades prior, honoured discovery ivermectin (IVM), a multifaceted drug deployed against some world's most devastating tropical diseases. Since March 2020, when IVM was first used new global scourge, COVID-19, more than 20 randomized clinical trials (RCTs) have tracked such inpatient and outpatient treatments. Six seven meta-analyses treatment RCTs reporting 2021 found notable reductions COVID-19 fatalities, with mean 31% relative risk mortality vs. controls. During mass Peru, excess deaths fell by 74% over 30 days ten states extensive Reductions correlated extent distributions all 25 p < 0.002. Sharp morbidity using were also observed two animal models, SARS-CoV-2 related betacoronavirus. The indicated biological mechanism IVM, competitive binding spike protein, is likely non-epitope specific, possibly yielding full efficacy emerging viral mutant strains.

Language: Английский

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Repurposing Anthelmintic Drugs for COVID-19 Treatment: A Comprehensive Meta-Analysis of Randomized Clinical Trials on Ivermectin and Mebendazole

Antibiotics, Journal Year: 2025, Volume and Issue: 14(5), P. 459 - 459

Published: April 30, 2025

Background: The COVID-19 pandemic necessitated the urgent exploration of therapeutic options, including drug repurposing. Anthelmintic drugs such as ivermectin and mebendazole have garnered interest due to their potential antiviral immunomodulatory properties. However, conflicting evidence from randomized clinical trials (RCTs) necessitates a comprehensive meta-analysis determine efficacy safety in management. Objective: This evaluates treating by analyzing impact on viral clearance, symptom resolution, hospitalization duration, profiles. Methods: A systematic search Scopus, PubMed, Embase, Cochrane Library was conducted following PRISMA guidelines identify RCTs published up February 2025. Eligible studies included adult patients with confirmed who received or compared placebo standard care. Data extraction risk bias assessment were performed using Risk Bias Tool. Statistical heterogeneity evaluated I2 statistic, pooled effect sizes calculated for primary outcomes. Results: Twenty-three (n = 12,345) included, twenty-one two mebendazole. analysis suggested no statistically significant improvement clearance (p 0.39), duration 0.15), resolution 0.08) individual indicated benefits, particularly mebendazole, reducing load inflammation. Both exhibited favorable profiles, increase adverse events. Conclusions: promising propensities observed selected underscore adjunct therapies COVID-19. With well-established effects, affordability, these present strong candidates further exploration. Advancing research through well-designed, large-scale will help unlock full expand treatment options fight against

Language: Английский

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Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines. American Journal of Therapeutics, 28, e434–e460, July 2021

American Journal of Therapeutics, Journal Year: 2021, Volume and Issue: 28(5), P. e573 - e576

Published: Aug. 27, 2021

To the Editor: Our meta-analysis of trial data on ivermectin for prevention and treatment COVID-191 is potentially affected by a recent newspaper article2 making 2 significant claims. First, preprint manuscript Elgazzar et al3 has been withdrawn; second, "if you get rid just this research, most meta-analyses that have found positive results would their conclusions entirely reversed." The first claim seems untrue at writing second unsustainable. server Research Square makes explicit3 was not withdrawn authors but removed receipt complaint, Prof. confirmed4 without any opportunity reply. complaints denied as defamatory, his said to remain under review publication elsewhere. Currently, these claims counterclaims appeared only in news social media had no independent adjudication. inclusion Elgazzar3 full conformity with PRISMA guidelines5 which encourage use unpublished data, supported where necessary direct author inquiries, ameliorate tendencies bias. Such inquiries were indeed made during process. Where satisfactory clarification received, included. We basis excluding met criteria our protocol. This applied equally study Lopez-Medina al6 also received postpublication criticism7 its protocol violations (with different consequences analysis) likewise criteria. mechanism systematic reviews noting doubts over reliability lies risk bias assessments, appropriately both cases. Pending al,3 we turn press2 are reversed if removed. If Figure 3 Bryant al1 reanalyzed exclude Elgazzar,3 there still clear result, showing 49% reduction mortality favor (aRR = 0.51, 95% confidence interval 0.27–0.95) (Figure 1). Similarly, conduct same sensitivity analysis 15 (prophylaxis outcome), an 87% COVID-19 infection 0.13, 0.08–0.21) 2), virtually unchanged from previous analysis. Revised Figures shown below. Hence, leading outcome (ie, prophylaxis) robust removal contrary press claims.2FIGURE 1.: Mortality removed.FIGURE 2.: Prophylaxis removed.Removal single part exercise "leave one out" already performed others,8 finding similarly evidence efficacy robust. Other selected subsets known randomized trials available. WHO "Living Guideline"9 noted Discussion1 excluded March yet reported odds ratio 81%, narrow intervals. Roman al10 recently offered reduced set, including Elgazzar.3 Their conclusion shows advantage elegantly refuted Neil Fenton11 Bayesian subset. approach amenable removing Preliminary findings12 show benefit mortality. course applicable other selections, own. These will be due course. In conclusion, accusations fraud very serious. colleagues must however given appropriate respond. A comprehensive correction issued unreliable, premature while disputed. resolution conflicting counterclaims, simply point out quantitative measures effect do change study, overall findings treatment, prophylaxis, disputed data. "entirely reversed"2 cannot sustained evidence.

Language: Английский

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