1887
Volume 2022, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: In March 2020, Qatar started reporting increased numbers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19). National preventive measures were implemented, and a testing plan was developed to respond to the pandemic with the Primary Health Care Corporation (PHCC) as the central element. PHCC is the main public primary healthcare provider in Qatar and it operates in 27 health centers with around 1.4 million registered individuals as of January 1, 2020. The latter population was distributed across four main nationality groups; Middle Eastern and North African (51.5%), Asian (41.2%), African (2.4%), and others (5.1%). At the primary healthcare level in Qatar, this study describes the epidemiological characteristics of individuals registered at PHCC who had contracted COVID-19 in 2020 during the first wave before the vaccination phase and examines the factors associated with the positivity rate.

Methods: Retrospective data analysis was conducted for persons screened for SARS-CoV-2 in primary healthcare health centers in Qatar between March 11 and December 31, 2020. The study analyzed the demographic characteristics of the tested persons and noncommunicable disease burden, positivity rate by month, nationality, and age-group, and the factors associated with the positivity rate.

Results: Between March 11 and December 31, 2020, PHCC tested 379,247 persons for SARS-CoV-2, with a median age (IQR) of 32 (21–42) years. Of these, 57.0% were from the Middle East and North Africa, and 32.5% were originally from Asia. Overall, 10.9% had diabetes mellitus and 11.3% had hypertension. The epidemiological curve showed a steep increase in the positivity rate from March till May 2020, at the highest rate of 37.5% in May 2020. The highest positivity rate was observed among Asian males at 15.7%. The positivity rate was the lowest among the age-group aged 60 years and above. It was almost the same among the tested persons for SARS-CoV-2 in the three main age groups (0–18, 19–39, 40–59) at 10.1%, 12.3%, and 12.2%, respectively. In a multi regression model, being a male was associated with a higher risk (OR 1.15; 95% CI 1.13–1.17). Asians were at higher risk than those originally from the Middle East and North Africa (OR 1.29; 95% CI 1.27–1.32). COVID-19 infection was higher among those presenting clinical symptoms than asymptomatic individuals (OR. 4.52; 95% CI 4.42–4.64).

Conclusion: The epidemic among the PHCC-registered population predominantly affected younger ages and males, namely, coming from Asia. At the primary healthcare level, the COVID-19 infection rate was higher among those who presented with clinical symptoms. The lowest positivity rate among individuals >60 years may reflect the effectiveness of public health measures related to the high-risk group. Scaled-up testing at the primary healthcare level helped to detect more cases during the peak of the first wave and was reflected in a steady increase in the positivity rate flattened later due to the established public health measures.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2022.23
2022-07-11
2022-08-10
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2022/3/qmj.2022.23.html?itemId=/content/journals/10.5339/qmj.2022.23&mimeType=html&fmt=ahah

References

  1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727–33. [cited 2020 Oct 20]. Available from: https://www.nejm.org/doi/full/10.1056/nejmoa2001017.
    [Google Scholar]
  2. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;:395:507–13. doi: 10.1016/S0140-6736(20)30211-7. Epub 2020 Jan 30. PMID: 32007143; PMCID: PMC7135076. [cited 2020 Oct 20]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7135076/pdf/main.pdf.
    [Google Scholar]
  3. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;:395:497–506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24. Erratum in: Lancet. 2020 Jan 30;395:497–506 PMID: 31986264; PMCID: PMC7159299. [cited 2020 Oct 20]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159299/pdf/main.pdf.
    [Google Scholar]
  4. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;:395:565–74. [cited 2021 Nov 10]. Available from: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)30251-8.pdf.
    [Google Scholar]
  5. Phan LT, Nguyen TV, Luong QC, Nguyen TV, Nguyen HT, Le HQ, et al. Importation and human-to-human transmission of a novel coronavirus in Vietnam. N Engl J Med. 2020;:382:872–4. doi: 10.1056/NEJMc2001272. Epub 2020 Jan 28. PMID: 31991079; PMCID: PMC7121428. [cited 2020 Oct 20]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121428/pdf/NEJMc2001272.pdf.
    [Google Scholar]
  6. Young BE, Ong SWX, Kalimuddin S, Low JG, Tan SY, Loh J, et al. Singapore 2019 novel coronavirus outbreak research team. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA. 2020;:323:1488–94. doi: 10.1001/jama.2020.3204. Erratum in: JAMA. 2020 Apr 21;323(15):1510. PMID: 32125362; PMCID: PMC7054855. [cited 2020 Oct 10]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054855/.
    [Google Scholar]
  7. Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, et al. Washington State 2019-nCoV case investigation team. First case of 2019 novel coronavirus in the United States. N Engl J Med. 2020;:382:929–36. doi: 10.1056/NEJMoa2001191. Epub 2020 Jan 31. PMID: 32004427; PMCID: PMC7092802. [cited 2020 Oct 20]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092802/pdf/NEJMoa2001191.pdf.
    [Google Scholar]
  8. The World Health Organization. WHO Coronavirus disease (COVID-19) dashboard. World Health Organization. Geneva. 2020. [cited 2020 Oct 20]. Available from: https://covid19.who.int/.
    [Google Scholar]
  9. Oksanen A, Kaakinen M, Latikka R, Savolainen I, Savela N, Koivula A. Regulation and trust: 3- month follow-up study on COVID-19 mortality in 25 European countries. JMIR Public Health Surveill. 2020;:6:e19218. doi: 10.2196/19218. PMID: 32301734; PMCID: PMC7184967. [cited 2020 Nov 10]. Available from: https://publichealth.jmir.org/2020/2/e19218/.
    [Google Scholar]
  10. Central Intelligence Agency. The world factbook. Central Intelligence Agency. 2020. [cited 2020 Dec 23]. Available from: https://www.cia.gov/the-world factbook/countries/qatar/#people-and-society.
    [Google Scholar]
  11. World Population Review. Qatar population demography 2020. World Population Review. 2020 [cited 2020 Dec 28]. Available from: https://worldpopulationreview.com/countries/qatar-population.
    [Google Scholar]
  12. Wu C, Chen X, Cai Y, Zhou X, Xu S, Huang H, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020;:180:934–43. doi: 10.1001/jamainternmed.2020.0994. Erratum in: JAMA Intern Med. 2020;180:1031. PMID: 32167524; PMCID: PMC7070509. [cited 2020 Dec 29]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7070509/.
    [Google Scholar]
  13. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;:395:1052–62. [cited 2020 Dec 29]. Available from: https://www.thelancet.com/action/showPdf?pii = S0140-6736%2820%2930566-3.
    [Google Scholar]
  14. Yang H, Chen D, Jiang Q, Yuan Z. High intensities of population movement were associated with high incidence of COVID-19 during the pandemic. Epidemiol Infect. 2020;148:e177. doi: 10.1017/S0950268820001703. PMID: 32741410; PMCID: PMC7450229hna. [cited 2021 Jan 29]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7450229/.
    [Google Scholar]
  15. Primary Health Care Corporation. Health needs assessment 2019. Strategy planning and health intelligence directorate. Primary Health Care Corporation. Doha. 2020. [cited 2020 Oct 30]. Available from: https://www.phcc.gov.qa/assets/phcc/HealthNeedsAssessment.pdf.
    [Google Scholar]
  16. Qatar Red Crescent. Workers health centers. Qatar Red Crescent. Doha. 2021. [cited 2021 Jul 2] Available from: https://www.qrcs.org.qa/en/Pages/HealthCenters.aspx.
    [Google Scholar]
  17. Al-Kuwari MG et al. The COVID-19 pandemic impact on primary health care services: an experience from Qatar. World Family Medicine. 2021;: 19: (4): 105–110 DOI: 10.5742/MEWFM.2021.94033.
    [Google Scholar]
  18. Al Kuwari HM, Abdul Rahim HF, Abu-Raddad LJ, Abou-Samra AB, Al Kanaani Z, Al Khal A, et al. Epidemiological investigation of the first 5685 cases of SARS-CoV-2 infection in Qatar, 28 February–18 April 2020. BMJ Open. 2020;:10:e040428. doi: 10.1136/bmjopen-2020-040428. [cited 2021 Jan 15]. Available from: https://bmjopen.bmj.com/content/bmjopen/10/10/e040428.full.pdf.
    [Google Scholar]
  19. [Google Scholar]
  20. Roche. Cobas® SARS-CoV-2 test, 2020. [cited 2020 Oct 30]. Available from: https://diagnostics.roche.com/global/en/products/params/cobas-sars-cov-2-test.html.
    [Google Scholar]
  21. Alinier G, Morris B, Abu J, Al Shaikh L, Owen R. Implementation of a drive through testing clinic in Qatar for residents having recently returned from a country with a COVID-19 travel warning. Qatar Med J. 2021;:2020:42. doi: 10.5339/qmj.2020.42.
    [Google Scholar]
  22. Al-Kuwari MG, Al-Abdulla SA, Abdulla MY, Haj Bakri A, Mohammed AM, Kandy MC, et al. Epidemiological health assessment in primary healthcare in the state of Qatar- 2019. Qatar Med J. 2021;:2021:1-57. [cited 2021 Nov 9]. doi: 10.5339/qmj.2021.57.
    [Google Scholar]
  23. Al-Kuwari MG, Al-Nuaimi AA, Abdulmajeed J, Semaan S, Al-Romaihi HE, Kandy MC, et al. COVID-19 infection across workplace settings in Qatar: a comparison of COVID-19 positivity rates of screened workers from March 1st until July 31st, 2020. J Occup Med Toxicol 2021;:16:1–9. [cited 2021 Oct 14]. doi: 10.1186/s12995-021-00311-5.
    [Google Scholar]
  24. Wang J, Li Z, Cheng X, Hu H, Liao C, Li P, et al. Epidemiological characteristics, transmission chain, and risk factors of sever infection of COVID-19 in Tianjin, a representative municipality city of China. Front Public Health. 2020;:8:198. doi: 10.3389/fpubh.2020.00198. [cited 2020 Oct 30]. Available from: https://www.frontiersin.org/articles/10.3389/fpubh.2020.00198/full.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2022.23
Loading
/content/journals/10.5339/qmj.2022.23
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): COVID-19EpidemiologyPrimary Health Care and Qatar
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error