Nasar Ahmad SHAYAN, Pınar OKYAY, Ahmad AMİRNAJAD

Herat-Afganistan’da pandeminin erken dönemlerinde COVID-19 hastalarının özellikleri ve mortalite risk faktörle

Amaç: Coronavirüsler, farklı hastalık türlerine neden olan geniş bir virüs ailesidir. Bu çalışma, COVID-19 hastalarında komorbidite ve hastaların sosyo-demografik özelliklerine göre mortalite risk faktörlerini değerlendirmeyi amaçlamaktadır. Yöntem: Bu kesitsel çalışma, 24 Şubat-5 Temmuz tarihleri arasında Afganistan’ın Herat ilinde yürütülmüştür. Çalışmanın verileri Herat İl Halk Sağlığı Müdürlüğü tarafından sağlanmış olup hastaların sosyo-demografik verileri, hastalığın belirti ve bulguları, eşlik eden hastalıklar, hastaların hastaneye yatış özellikleri, enfekte bir kişiyle temas öyküsü ve COVID-19’u teşhis etmek için kullanılan test türü incelenmiştir. Çalışmada, kategorik değişkenler arasındaki farklılıkları gözlemlemek için ki-kare testi kullanılmıştır. İki değişkenli analizde, anlamlı bir p değerine sahip tüm bağımsız değişkenler modele alınmıştır. Olasılık oranları ve %95 güven aralıkları hesaplanmış ve 0,05’ten küçük bir p değeri istatistiksel olarak anlamlı kabul edilmiştir. Bulgular: Çalışmada, %53.5 pozitiflik oranıyla 11.183 COVID-19 vakası analiz edilmiştir. Herat il merkezi ve ilçelerinde iyileşme oranları sırasıyla %96.2 ve %94.7 bulunmuştur. Bu çalışma, Herat ili ilçelerinde %94.7 olan iyileşme oranının kent merkezinde yaşayan hastalarda %96.2 olduğunu göstermektedir. Yaşa göre değişkenlik gösteren vaka-ölüm oranları, 1-29 yaşları için %0.4 ve 80-105 yaşları için %33 bulunmuştur. Ölüm oranları sırasıyla %12.5 ve %18.2 ile KOAH ve kanser hastalarında en yüksekti. Lojistik regresyon analizi sonucunda yaş, cinsiyet ve KOAH COVID-19 ölüm oranı ile ilişkili bulunan değişkenler olarak bulunmuştur. Sonuç: Bu çalışma, özellikle kırsal alanlarda daha fazla sağlık hizmeti sağlayarak COVID-19 ve diğer hastalıkların ölüm oranının azaltılabileceğini göstermektedir.

Anahtar Kelimeler:

COVID-19, Herat, Afganistan, Mortalite, Risk faktörü

Characteristics of COVID-19 patients and risk factors of mortality in the early times of pandemic, Herat-Afghanistan

Objective: Coronaviruses are a large family of viruses that cause different types of diseases. This study aims to evaluate the risk factors for mortality based on comorbidity and socio-demographic characteristics among COVID-19 patients. Methods: This cross-sectional study conducted in Herat, Afghanistan, from February 24 to July 5, 2020, used data provided by the public health department, including socio-demographics, symptoms, comorbidities, hospitalization, contact history, and COVID-19 test type. The Chi-square test was used to observe differences between categorical variables. In bivariate analysis, all independent variables with a significant p-value were put into the model. Odds ratios and 95% confidence intervals were calculated, and a p-value less than 0.05 was considered statistically significant. Results: The study analyzed 11,183 COVID-19 cases, with a 53.5% positivity rate. Recovery rates in the city and Herat province districts were 96.2% and 94.7%, respectively. Case-fatality rates varied with age, with 0.4% for those aged 1-29 and 33% for those aged 80-105. Mortality rates were highest for those with COPD and cancer, at 12.5% and 18.2%, respectively. In the logistic regression results, age, gender, and COPD were significant variables for COVID-19 mortality. Conclusion: By providing more health service facilities to people in risk groups, especially in rural areas, the mortality rate of COVID-19 and other diseases can be decreased.

Keywords:

COVID-19, Herat, Afghanistan, Mortality, Risk factor,

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