Ratnayake, Ruwan; Rawashdeh, Fatma; AbuAlRub, Raeda; Al-Ali, Nahla; Fawad, Muhammad; Bani Hani, Mohammad; Zoubi, Saleem; Goyal, Ravi; Al-Amire, Khaldoun; Mahmoud, Refqi; +2 more... AlMaaitah, Rowaida; Parmar, Parveen K; (2022) Rapidly adapted community health strategies to prevent treatment interruption and improve COVID-19 detection for Syrian refugees and the host population with hypertension and diabetes in Jordan. International health, 15 (6). pp. 664-675. ISSN 1876-3413 DOI: https://doi.org/10.1093/inthealth/ihac083
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Abstract
BACKGROUND: We evaluated community health volunteer (CHV) strategies to prevent non-communicable disease (NCD) care disruption and promote coronavirus disease 2019 (COVID-19) detection among Syrian refugees and vulnerable Jordanians, as the pandemic started. METHODS: Alongside medication delivery, CHVs called patients monthly to assess stockouts and adherence, provide self-management and psychosocial support, and screen and refer for complications and COVID-19 testing. Cohort analysis was undertaken of stockouts, adherence, complications and suspected COVID-19. Multivariable models of disease control assessed predictors and non-inferiority of the strategy pre-/post-initiation. Cost-efficiency and patient/staff interviews assessed implementation. RESULTS: Overall, 1119 patients were monitored over 8 mo. The mean monthly proportion of stockouts was 4.9%. The monthly proportion non-adherent (past 5/30 d) remained below 5%; 204 (18.1%) patients had complications, with 63 requiring secondary care. Mean systolic blood pressure and random blood glucose remained stable. For hypertensive disease control, age 41-65 y (OR 0.46, 95% CI 0.2 to 0.78) and with diabetes (OR 0.73, 95% CI 0.54 to 0.98) had decreased odds, and with baseline control had increased odds (OR 3.08, 95% CI 2.31 to 4.13). Cumulative suspected COVID-19 incidence (2.3/1000 population) was suggestive of ongoing transmission. While cost-efficient (108 US${\$}$/patient/year), funding secondary care was challenging. CONCLUSIONS: During multiple crises, CHVs prevented care disruption and reinforced COVID-19 detection.
Item Type | Article |
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Faculty and Department | Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & International Health (2023-) |
Research Centre | Covid-19 Research |
PubMed ID | 36576492 |
Elements ID | 197184 |
Official URL | http://dx.doi.org/10.1093/inthealth/ihac083 |
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Filename: Ratnayake-etal-2022-Rapidly-adapted-community-health-strategies.pdf
Licence: Creative Commons: Attribution 4.0
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