• Community behavioral and perceived responses in the covid-19 outbreak in Afghanistan: a cross-sectional study

      Mousavi, Sayed Hamid; Delshad, Mohammad Hossein; Acuti Martellucci, Cecilia; Bhandari, Divya; Ozaki, Akihiko; Pourhaji, Fatemeh; Pourhaji, Fahimeh; Reza Hosseini, Sayed Mohammad; Roien, Rohullah; Ramozi, Abass Ali; et al. (Cambridge University Press (CUP), 2021-05-05)
      Community responses are important for the management of early-phase outbreaks of coronavirus disease 2019 (COVID-19). Perceived susceptibility and severity are considered key elements that motivate people to adopt non-pharmaceutical interventions. This study aimed to i) explore perceived susceptibility and severity of the COVID-19 pandemic, ii) examine the practice of non-pharmaceutical interventions, and iii) assess the potential association of perceived COVID-19 susceptibility and severity with the practice of non-pharmaceutical interventions among people living in Afghanistan. Methods: A cross-sectional design was employed, using online surveys disseminated from April to May 2020. Convenience sampling was used to recruit the participants of this study. The previously developed scales were used to assess the participants' demographic information, perceived risk of SARS-CoV-2 infection, and perceived severity of COVID-19. Multivariate analyses were conducted to assess the potential association of perceived COVID-19 susceptibility and severity with the practice of non-pharmaceutical interventions. Results: The internet was the main source for obtaining COVID-19 information among participants in this study. While 45.8% of the participants believed it was "very unlikely" for them to get infected with COVID-19, 76.7% perceived COVID-19 as a severe disease. Similarly, 37.5% believed the chance of being cured if infected with COVID-19 is "unlikely/very unlikely". The majority of participants (95.6%) perceived their health to be in "good" and "very good" status. Overall, 74.2% mentioned that they stopped visiting public places, 49.7% started using gloves, and 70.4% started wearing a mask. Participants who believed they have a low probability of survival if infected with COVID-19 were more likely to wear masks and practice hand washing. Conclusions: It appears that communities' psychological and behavioral responses were affected by the early phase of the COVID-19 pandemic in Afghanistan, especially among young internet users. The findings gained from a timely behavioral assessment of the community might be useful to develop interventions and risk communication strategies in epidemics within and beyond COVID-19.
    • Underestimation of COVID-19 cases in Japan: an analysis of RT-PCR testing for COVID-19 among 47 prefectures in Japan

      Sawano, Toyoaki; Kotera, Yasuhiro; Ozaki, Akihiko; Murayama, Anju; Tanimoto, Tetsuya; Sah, Ranjit; Wang, Jiwei; Fukushima Medical University, Japan; University of Derby; Tohoku University, Japan; et al. (Oxford University Press, 2020-06-19)
      Under the unique Japanese policy to restrict reverse transcriptase-polymerase chain reaction (RT-PCR) testing against severe acute respiratory syndrome coronavirus 2, a nationwide number of its confirmed cases and mortality remains to be low. Yet the information is lacking on geographical differences of these measures and their associated factors. Evaluation of prefecture-based geographical differences and associated predictors for the incidence and number of RT-PCR tests for COVID-19. Cross-sectional study using regression and correlation analysis. We retrieved domestic laboratory-confirmed cases, deaths, and the number of RT-PCR testing for COVID-19 from January 15 to April 6, 2020 in 47 prefectures in Japan, using publicly-available data by the Ministry of Health, Labour and Welfare. We did descriptive analyses of these three measures and identified significant predictors for the incidence and RT-PCR testing through multiple regression analyses and correlates with the number of deaths through correlation analysis. The median prefectural-level incidence and number of RT-PCR testing per 100,000 population were 1.14 and 38.6, respectively. Multiple regression analyses revealed that significant predictors for the incidence were prefectural-level population (p < 0.001) and the number of RT-PCR testing (p = 0.03); and those for RT-PCR testing were the incidence (p = 0.025), available beds (p = 0.045) and cluster infections (p = 0.034). Considering bidirectional association between the incidence and RT-PCR testing, there may have been an underdiagnosed population for the infection. The restraint policy for RT-PCR testing should be revisited to meet the increasing demand under the COVID-19 epidemic.