Establishing a sentinel surveillance system for the novel COVID-19 in a resource-limited country: methods, system attributes and early findings
Objectives To establish a hospital-based platform to explore the epidemiological and clinical characteristics of patients screened for COVID-19.Design Hospital-based surveillance.Setting This study was conducted in four selected hospitals in Bangladesh during 10 June–31 August 2020.Participants In t...
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BMJ Publishing Group
2021-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/12/e055169.full |
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| author | Sayera Banu Zubair Akhtar Fahmida Chowdhury Mahmudur Rahman Syeda Mah-e-Muneer Md Ariful Islam Mohammed Ziaur Rahman Pritimoy Das Mallick Masum Billah ASM Alamgir |
| author_facet | Sayera Banu Zubair Akhtar Fahmida Chowdhury Mahmudur Rahman Syeda Mah-e-Muneer Md Ariful Islam Mohammed Ziaur Rahman Pritimoy Das Mallick Masum Billah ASM Alamgir |
| author_sort | Sayera Banu |
| collection | DOAJ |
| description | Objectives To establish a hospital-based platform to explore the epidemiological and clinical characteristics of patients screened for COVID-19.Design Hospital-based surveillance.Setting This study was conducted in four selected hospitals in Bangladesh during 10 June–31 August 2020.Participants In total, 2345 patients of all age (68% male) attending the outpatient and inpatient departments of surveillance hospitals with any one or more of the following symptoms within last 7 days: fever, cough, sore throat and respiratory distress.Outcome measures The outcome measures were COVID-19 positivity and mortality rate among enrolled patients. Pearson’s χ2 test was used to compare the categorical variables (sign/symptoms, comorbidities, admission status and COVID-19 test results). Regression analysis was performed to determine the association between potential risk factors and death.Results COVID-19 was detected among 922 (39%) enrolled patients. It was more common in outpatients with a peak positivity in second week of July (112, 54%). The median age of the confirmed COVID-19 cases was 38 years (IQR: 30–50), 654 (71%) were male and 83 (9%) were healthcare workers. Cough (615, 67%) was the most common symptom, followed by fever (493, 53%). Patients with diabetes were more likely to get COVID-19 than patients without diabetes (48% vs 38%; OR: 1.5; 95% CI: 1.2 to 1.9). The death rate among COVID-19 positive was 2.3%, n=21. Death was associated with age ≥60 years (adjusted OR (AOR): 13.9; 95% CI: 5.5 to 34), shortness of breath (AOR: 9.7; 95% CI: 3.0 to 30), comorbidity (AOR: 4.8; 95% CI: 1.1 to 21.7), smoking history (AOR: 2.2, 95% CI: 0.7 to 7.1), attending the hospital in <2 days of symptom onset due to critical illness (AOR: 4.7; 95% CI: 1.2 to 17.8) and hospital admission (AOR: 3.4; 95% CI: 1.2 to 9.8).Conclusions COVID-19 positivity was observed in more than one-third of patients with suspected COVID-19 attending selected hospitals. While managing such patients, the risk factors identified for higher death rates should be considered. |
| format | Article |
| id | doaj-art-f50ccbafeb3844a39a18d71404634914 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-12-01 |
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| spelling | doaj-art-f50ccbafeb3844a39a18d714046349142024-12-10T18:35:10ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2021-055169Establishing a sentinel surveillance system for the novel COVID-19 in a resource-limited country: methods, system attributes and early findingsSayera Banu0Zubair Akhtar1Fahmida Chowdhury2Mahmudur Rahman3Syeda Mah-e-Muneer4Md Ariful Islam5Mohammed Ziaur Rahman6Pritimoy Das7Mallick Masum Billah8ASM Alamgir9Infectious Disease Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, BangladeshInfectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh1UCL Queen Square Institute of Neurology, London, UKInfectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, BangladeshInfectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, BangladeshInfectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, BangladeshInfectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, BangladeshInfectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, BangladeshInstitute of Epidemiology Disease Control and Research, Dhaka, BangladeshInstitute of Epidemiology Disease Control and Research, Dhaka, BangladeshObjectives To establish a hospital-based platform to explore the epidemiological and clinical characteristics of patients screened for COVID-19.Design Hospital-based surveillance.Setting This study was conducted in four selected hospitals in Bangladesh during 10 June–31 August 2020.Participants In total, 2345 patients of all age (68% male) attending the outpatient and inpatient departments of surveillance hospitals with any one or more of the following symptoms within last 7 days: fever, cough, sore throat and respiratory distress.Outcome measures The outcome measures were COVID-19 positivity and mortality rate among enrolled patients. Pearson’s χ2 test was used to compare the categorical variables (sign/symptoms, comorbidities, admission status and COVID-19 test results). Regression analysis was performed to determine the association between potential risk factors and death.Results COVID-19 was detected among 922 (39%) enrolled patients. It was more common in outpatients with a peak positivity in second week of July (112, 54%). The median age of the confirmed COVID-19 cases was 38 years (IQR: 30–50), 654 (71%) were male and 83 (9%) were healthcare workers. Cough (615, 67%) was the most common symptom, followed by fever (493, 53%). Patients with diabetes were more likely to get COVID-19 than patients without diabetes (48% vs 38%; OR: 1.5; 95% CI: 1.2 to 1.9). The death rate among COVID-19 positive was 2.3%, n=21. Death was associated with age ≥60 years (adjusted OR (AOR): 13.9; 95% CI: 5.5 to 34), shortness of breath (AOR: 9.7; 95% CI: 3.0 to 30), comorbidity (AOR: 4.8; 95% CI: 1.1 to 21.7), smoking history (AOR: 2.2, 95% CI: 0.7 to 7.1), attending the hospital in <2 days of symptom onset due to critical illness (AOR: 4.7; 95% CI: 1.2 to 17.8) and hospital admission (AOR: 3.4; 95% CI: 1.2 to 9.8).Conclusions COVID-19 positivity was observed in more than one-third of patients with suspected COVID-19 attending selected hospitals. While managing such patients, the risk factors identified for higher death rates should be considered.https://bmjopen.bmj.com/content/11/12/e055169.full |
| spellingShingle | Sayera Banu Zubair Akhtar Fahmida Chowdhury Mahmudur Rahman Syeda Mah-e-Muneer Md Ariful Islam Mohammed Ziaur Rahman Pritimoy Das Mallick Masum Billah ASM Alamgir Establishing a sentinel surveillance system for the novel COVID-19 in a resource-limited country: methods, system attributes and early findings BMJ Open |
| title | Establishing a sentinel surveillance system for the novel COVID-19 in a resource-limited country: methods, system attributes and early findings |
| title_full | Establishing a sentinel surveillance system for the novel COVID-19 in a resource-limited country: methods, system attributes and early findings |
| title_fullStr | Establishing a sentinel surveillance system for the novel COVID-19 in a resource-limited country: methods, system attributes and early findings |
| title_full_unstemmed | Establishing a sentinel surveillance system for the novel COVID-19 in a resource-limited country: methods, system attributes and early findings |
| title_short | Establishing a sentinel surveillance system for the novel COVID-19 in a resource-limited country: methods, system attributes and early findings |
| title_sort | establishing a sentinel surveillance system for the novel covid 19 in a resource limited country methods system attributes and early findings |
| url | https://bmjopen.bmj.com/content/11/12/e055169.full |
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