COVID, Volume 5, Issue 2 (February 2025) – 6 articles

This research study explores the readiness, strengths, and challenges of the district health system and local bodies during Nepal’s COVID-19 vaccination program. The primary aim of this study is to identify gaps in the current health system and provide actionable insights for the effective implementation and management of large-scale health programs in the future. A qualitative approach was employed, gathering perspectives of key stakeholders through twelve key informant interviews of stakeholders involved in the planning, management, and execution of the vaccination program in Makwanpur district, the district with the administrative headquarters of Bagmati Province. The study was conducted in the context of Nepal’s transitioning health system following federalization. The qualitative data were analyzed using thematic analysis, guided by the VIRAT2.0 framework for vaccine readiness provided by the WHO. Seven domains from the framework were used to assess readiness and challenges faced by the newly formed health system. The challenges identified by key informants included insufficient logistics and supply chain management, poor coordination between local and higher levels of government, limited awareness about vaccination among the public, vaccine hesitancy, and lack of a robust system for data management and reporting. These findings highlight critical areas for improvement and can be useful evidence to inform the design and implementation of future health programs and policies. Full article

The COVID-19 pandemic lockdown restrictions had significant impacts on the well-being and academic functioning of students worldwide. When universities closed campuses and moved teaching and learning online, students faced numerous challenges. The researchers conducted a study to establish which factors most affected South African students’ academic competence during the initial months of lockdown and the shift to online learning. Using an online survey that focused on students’ wellness, perceived academic competence and coping behaviour, data were collected from 3239 university students. Multiple linear regression showed that students’ subjective sense of intellectual wellness, coping behaviour, satisfaction with support from the university, and mental health were strong predictors of academic competence. Other factors that influenced students’ academic competence were emotional and spiritual wellness, perceptions of safety and security, and hopefulness. Females, undergraduates, and Faculty of Law students reported higher perceptions of academic competence. These findings have practical implications for universities as they identify factors that contribute to students’ academic competence, especially during times of crisis and online learning. Academic and support services staff at universities may find the findings valuable when developing policies to provide appropriate resources and services to promote and sustain students’ academic functioning. Full article

This bibliometric review analyzes global research on COVID-19 vaccine side effects, focusing on publication trends, collaborations, and key topic areas. Using VOSviewer and Bibliometrix for data analysis and visualization, this study examines 1353 unique papers indexed in Scopus and Web of Science (2020–2024). The results indicate a significant increase in publications in 2021 and 2022, with the United States, China, and Europe contributing the most. While many studies focused on common side effects, such as headache, fatigue, and injection-site pain, rare but serious adverse events, such as myocarditis, thrombocytopenia, Guillain–Barré syndrome, pericarditis, and thrombosis, were also reported. However, regions with limited research infrastructure, particularly in developing countries, remain underrepresented despite the critical need for vaccine safety studies in these areas. Additionally, journals such as Vaccines, Vaccine, and Human Vaccines and Immunotherapeutics, all ranked Q1, dominate the publication volume, ensuring wide dissemination through open-access availability. This analysis also highlights global collaboration networks, identifying key authors and regions with high levels of co-authorship. Thematic mapping distinguishes niche topics focused on rare and severe side effects from driving topics addressing more common reactions. This review, therefore, underscores the importance of scaling up research efforts in underrepresented regions and strengthening global collaborations to ensure effective pharmacovigilance. Finally, future research should prioritize the long-term, ongoing monitoring of side effects and address disparities in scientific output, particularly in developing countries where vaccine safety data are urgently needed. Full article

Background: Understanding the extent of the disease penetration and assessing its impact is critical during a pandemic. However, laboratory-based COVID-19 estimation can be resource-intensive and may not be feasible during an emergency, particularly in low-resource settings. Aim: To investigate whether self-reported symptoms can be used for COVID-19 screening to estimate the burden among individuals aged 18 years and above in a rural setting. Methods: A community-based cross-section study was conducted in a rural district of Haryana, a state in north India, using a self-reported semi-structured questionnaire developed on a digital platform. Information on COVID-19 manifestations as essential and non-essential, confirmed laboratory tests, and disability data using Washington Groups of Short Set were obtained. The sensitivity of the COVID-19 symptoms was estimated against laboratory-confirmed true positives. A chi-square or Fisher exact test for association and a multivariable regression to determine the predictors of the prevalence was carried out. Results: In total, 2954 respondents (79.8%), out of 3700 enumerated, were interviewed. The mean age of respondents was 42 years (SD 17.2), with 54.8% female respondents. The prevalence of COVID-19 based on self-reported symptoms was 6.2% (95%CI: 5.3–7.1). The age-adjusted prevalence was 6.04% (95%CI: 5.9–6.1). Of the total COVID-19 cases, 170 (5.7%, 95%CI: 4.9–6.5) revealed a laboratory-confirmed test. Given three essential symptoms to declare provisionally COVID-19 cases, the sensitivity was 82.9% (141/170), but considering two or more essential symptoms along with two or more non-essential, the sensitivity reached up to 91.8% (156/170). The multivariable analysis showed that increased age, higher education attainment, students, entrepreneurs, persons working in private sectors, and participants with poor hygiene were predictors. Conclusions: A symptoms-based identification of COVID-19 cases can give a reliable estimate and valuable insight into the extent of the penetration, especially in low-middle-income countries, and can be a supplement, not a replacement, to a laboratory test. Full article

This study scrutinizes the influence of “blame attribution” and the Theory of Planned Behaviour (TPB) on compliance with COVID-19 public health measures in Australia. This study elucidates that blaming individuals rather than governments surprisingly augments support for governmental regulations, highlighting the complexities of blame attribution in shaping public adherence to health policies. It underscores the nuanced roles of TPB elements like subjective norms and behavioural control, revealing that feelings of empowerment, social responsibility, and recognizing personal roles in pandemic control enhance the inclination to support governmental directives. The outcomes emphasize the criticality of understanding blame attribution and TPB dynamics for devising efficacious communication and management strategies, promoting societal adherence to essential regulations and actions during health crises, and fostering a more resilient societal infrastructure for dealing with pandemics. Full article

The association between family violence and the COVID-19 pandemic remains complex. This meta-analysis aimed to determine trends in the observed changes in family violence comparing the pre-pandemic period to the pandemic period. A systematic search was performed in electronic databases to identify all relevant research reporting on COVID-19 and family violence. There was a statistically significant increase in family violence after the first lockdown. The odds ratio for the prevalence of physical and sexual violence together was 7.24 (95% CI = 4.74, 11.03 p < 0.001). A small marginal increase in the prevalence of various types of family violence leading to hospitalization was found, however, the result was not statistically significant (OR = 1.91, 95% CI = 0.91, 3.96, p = 0.09). A small significant increase in the prevalence of victims with a perception of increased violence during the pandemic lockdown was observed (proportion = 33%, 95% CI = 15.72%, 50.34%, p = 0.002). This meta-analysis found that during the COVID-19 lockdown, there was an increase in the prevalence of overall family violence, a small, non-significant, increase in the prevalence of hospitalizations due to family violence, as well as an increase in the perception of family violence by victims. These results are clinically relevant for implementing effective measures of violence prevention to safeguard vulnerable populations. Full article