“Investigating health inequalities and implementing effective interventions for COVID-19 and visual acuity loss in deprived Hungarian adults.”
dc.contributor.advisor | Janos , Dr. Sandor | |
dc.contributor.author | Wasnik, Rahul Naresh | |
dc.contributor.department | Egészségtudományok doktori iskola | hu |
dc.contributor.submitterdep | Általános Orvostudományi Kar | |
dc.date.accessioned | 2024-01-26T15:31:01Z | |
dc.date.available | 2024-01-26T15:31:01Z | |
dc.date.created | 14 september 2023 | |
dc.date.defended | 2024-02-14 | |
dc.description.abstract | Screening for Patients with Visual Acuity Loss in Primary Health Care: A Cross Sectional Study in a Deprived Hungarian Population Background: Screening for visual acuity loss is not applied systematically because of uncertain recommendations based on observations from affordable countries. Our study aimed to evaluate the effectiveness of primary health care-based screening. Methods: A cross-sectional investigation was carried out among adults who did not wear glasses and did not visit an ophthalmologist in a year (N = 2070). The risk factor role of sociodemographic factors and the cardiometabolic status for hidden visual acuity loss was determined by multivariable linear regression models. Results: The prevalence of unknown visual acuity loss of at least 0.5 was 3.7% and 9.1% in adults and in the above-65 population. Female sex (b = 1.27, 95% CI: 0.35; 2.18), age (b = 0.15, 0.12; 0.19), and Roma ethnicity (b = 2.60, 95% CI: 1.22; 3.97) were significant risk factors. Higher than primary school (bsecondaryschoolwithoutgraduation= −2.06, 95% CI: −3.64; −0.47; and bsecondaryschoolwithgraduation= −2.08, 95% CI: −3.65; −0.51), employment (b = −1.33, 95% CI:−2.25; 0.40), and properly treated diabetes mellitus (b = −2.84, 95% CI: −5.08; −0.60) were protective factors. Above 65 years, female sex (b = 3.85, 95% CI: 0.50; 7.20), age (b = 0.39, 95% CI: 0.10; 0.67), Roma ethnicity (b = 24.79, 95% CI: 13.83; 35.76), and untreated diabetes (b = 7.30, 95% CI: 1.29; 13.31) were associated with visual acuity loss. Conclusion: Considering the huge differences between the health care and the population’s social status of the recommendation-establishing countries and Hungary which represent non-high-income countries, the uncertain recommendation of visual acuity loss screening should not discourage general practitioners from organizing population-based screening for visual acuity loss in non-affordable populations. | |
dc.description.abstract | Effectiveness of and Inequalities in COVID-19 Epidemic Control Strategies in Hungary: A Nationwide Cross-Sectional Study Introduction: Before the mass vaccination, epidemiological control measures were the only means of containing the COVID-19 epidemic. Their effectiveness determined the consequences of the COVID-19 epidemic. Our study evaluated the impact of sociodemographic, lifestyle, and clinical factors on patient-reported epidemiological control measures. Methods: A nationwide representative sample of 1008 randomly selected adults were interviewed in person between 15 March and 30 May 2021. The prevalence of test-confirmed SARS-CoV-2 infection was 12.1% of testing was 33.7%, and of contact tracing among test-confirmed infected subjects was 67.9%. The vaccination coverage was 52.4%. Results: According to the multivariable logistic regression models, the occurrence of infection was not influenced by sociodemographic and lifestyle factors or by the presence of chronic disease. Testing was more frequent among middle-aged adults (aOR = 1.53, 95% CI 1.10–2.13) and employed adults (aOR = 2.06, 95% CI 1.42–3.00), and was more frequent among adults with a higher education (aORsecondary= 1.93, 95% CI 1.20–3.13; aORtertiary= 3.19, 95% CI 1.81–5.63). Contact tracing was more frequently implemented among middle-aged (aOR41-70y =3.33, 95% CI 1.17–9.45) and employed (aOR = 4.58, 95% CI 1.38–15.22), and those with chronic diseases (aOR = 5.92, 95% CI 1.56–22.47). Positive correlation was observed between age groups and vaccination frequency (aOR41-70y = 2.94, 95% CI 2.09–4.15; aOR71+y = 14.52, 95% CI 7.33–28.77). Higher than primary education (aORsecondary= 1.69, 95% CI 1.08–2.63; aORtertiary= 4.36, 95% CI 2.46–7.73) and the presence of a chronic disease (aOR = 2.58, 95% CI 1.75–3.80) positively impacted vaccination. Regular smoking was inversely correlated with vaccination (aOR = 0.60; 95% CI 0.44–0.83). Conclusions: The survey indicated that testing, contact tracing, and vaccination were seriously influenced by socioeconomic position, less so by chronic disease prevalence and very minimally by lifestyle. The etiological role of socioeconomic inequalities in epidemic measure implementation likely generated socioeconomic inequality in COVID-19-related complication and death rates | |
dc.format.extent | 63 | |
dc.identifier.uri | https://hdl.handle.net/2437/365585 | |
dc.language.iso | en | |
dc.subject | COVID-19 epidemic; epidemiological measures; effectiveness; social status; inequalities; | |
dc.subject | visual acuity loss; screening; primary care; general health check; deprivation; | |
dc.subject.discipline | Egészségtudományok | hu |
dc.subject.sciencefield | Orvostudományok | hu |
dc.title | “Investigating health inequalities and implementing effective interventions for COVID-19 and visual acuity loss in deprived Hungarian adults.” | |
dc.title.translated | Investigating health inequalities and implementing effective interventions for COVID-19 and visual acuity loss in deprived Hungarian adults.” |
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