Dataset Information

COVID-19 and Undiagnosed Pre-diabetes or Diabetes Mellitus Among International Migrant Workers in Singapore.

ABSTRACT: Objective: Migrant workers, a marginalized and under-resourced population, are vulnerable to coronavirus disease 2019 (COVID-19) due to limited healthcare access. Moreover, metabolic diseases-such as diabetes mellitus (DM), hypertension, and hyperlipidemia-predispose to severe complications and mortality from COVID-19. We investigate the prevalence and consequences of undiagnosed metabolic illnesses, particularly DM and pre-diabetes, in international migrant workers with COVID-19. Methods: In this retrospective analysis, we analyzed the medical records of international migrant workers with laboratory-confirmed COVID-19 hospitalized at a tertiary hospital in Singapore from April 21 to June 1, 2020. We determined the prevalence of DM and pre-diabetes, and analyzed the risk of developing complications, such as pneumonia and electrolyte abnormalities, based on age and diagnosis of DM, and pre-diabetes. Results: Two hundred and fouty male migrant workers, with mean age of 44.2 years [standard deviation (SD), 8.5years], were included. Twenty one patients (8.8%) were diagnosed with pre-diabetes, and 19 (7.9%) with DM. DM was poorly controlled with a mean HbA1c of 9.9% (SD, 2.4%). 73.7% of the patients with DM and all the patients with pre-diabetes were previously undiagnosed. Pre-diabetes was associated with higher risk of pneumonia [odds ratio (OR), 10.8, 95% confidence interval (CI), 3.65-32.1; P < 0.0001], hyponatremia (OR, 8.83; 95% CI, 1.17-66.6; P = 0.0342), and hypokalemia (OR, 4.58; 95% CI, 1.52-13.82; P = 0.0069). Moreover, patients with DM or pre-diabetes developed COVID-19 infection with lower viral RNA levels. Conclusions: The high prevalence of undiagnosed pre-diabetes among international migrant workers increases their risk of pneumonia and electrolyte abnormalities from COVID-19.

SUBMITTER: Tee LY

PROVIDER: S-EPMC7686043 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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COVID-19 and Undiagnosed Pre-diabetes or Diabetes Mellitus Among International Migrant Workers in Singapore.

Tee Louis Y LY Alhamid Sharifah Munirah SM Tan Jeriel L JL Oo Theik Di TD Chien Jaime J Galinato Primavera P Tan Seow Yen SY Humaira Shafi S Fong Raymond Kok Choon RKC Puar Troy H TH Loh Wann Jia WJ Santosa Anindita A Khoo Joan J Rosario Barbara Helen BH

Frontiers in public health 20201111

<b>Objective:</b> Migrant workers, a marginalized and under-resourced population, are vulnerable to coronavirus disease 2019 (COVID-19) due to limited healthcare access. Moreover, metabolic diseases-such as diabetes mellitus (DM), hypertension, and hyperlipidemia-predispose to severe complications and mortality from COVID-19. We investigate the prevalence and consequences of undiagnosed metabolic illnesses, particularly DM and pre-diabetes, in international migrant workers with COVID-19. <b>Meth ...[more]

PMID: 33262970

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Project description:Nationwide lockdown for COVID-19 created an urgent demand for public transportation among migrant workers stranded at different parts of India to return to their native places. Arranging transportation could spike the number of COVID-19 infected cases. Hence, this paper investigates the potential surge in confirmed and active cases of COVID-19 infection and assesses the train and bus fleet size required for the repatriating migrant workers. The expected to repatriate migrant worker population was obtained by forecasting the 2011 census data and comparing it with the information reported in the news media. A modified susceptible-exposed-infected-removed (SEIR) model was proposed to estimate the surge in confirmed and active cases of COVID-19 patients in India's selected states with high outflux of migrants. The developed model considered combinations of different levels of the daily arrival rate of migrant workers, total migrant workers in need of transportation, and the origin of the trip dependent symptomatic cases on arrival. Reducing the daily arrival rate of migrant workers for states with very high outflux of migrants (i.e., Uttar Pradesh and Bihar) can help to lower the surge in confirmed and active cases. Nevertheless, it could create a disparity in the number of days needed to transport all repatriating migrant workers to the home states. Hence, travel arrangements for about 100,000 migrant workers per day to Uttar Pradesh and Bihar, about 50,000 per day to Rajasthan and Madhya Pradesh, 20,000 per day to Maharashtra and less than 20,000 per day to other states of India was recommended. Highlights • Lower daily arrival of migrant workers preferred for Uttar Pradesh and Bihar.• Need a balanced number of days to repatriate all migrant workers from all states.• Daily arrival rate of migrant workers does not affect Rajasthan after May 31, 2020.• Repatriating migrant workers have a minimum implication on Maharashtra and Rajasthan.• Highest number of trains are needed to repatriate migrant workers to Bihar.

Project description:IntroductionWorldwide, there are between 50-67 million migrant domestic workers, the majority of whom are women. In many countries, provisions are not in place to protect female migrant domestic workers. These women may be at risk of occupational and social stressors, including exploitation and abuse, which may negatively impact on their quality of life, including psychological health. Research examining the occupational, social, and psychological needs of FMDWs from a public health perspective is critical to guide the development of policies which ensure wellbeing, prevent abuse, and align with international priorities to improve population health. Though there have been a number of high-profile incidents of exploitation and abuse, there has been limited research on the stressors experienced by these communities, their perceived impact, or coping mechanisms.Materials and methodsThematic analysis was used to analyse qualitative free-text written responses collected as part of a cross-sectional survey on the relationship between social and occupational stressors and the health and quality of life of FMDWs in Singapore. Responses correspond to open-ended questions in the qualitative component of the survey examining three domains: causes of stress, coping strategies, and what people can do to help with stress.ResultsResponses from 182 FMDWs were analysed. Key themes were identified around causes of stress (including 'work and agency', 'the pervasiveness of financial need', and 'family and obligation'), coping strategies, and social support. Each theme describes key factors which contribute to the occupational and social stressors experienced and reported by FMDWs.DiscussionThis research highlights the stressors FMDWs in Singapore experience, as well as key coping mechanisms. There is a clear need for policies which facilitate FMDWs' ability to utilise these coping resources, and which protect against coercive or exploitative employment conditions. Strategies are also needed to monitor and evaluate policies intended to protect FMDWs, and to strengthen the implementation of global frameworks targeted at improving workplace conditions and workers' rights.

Dataset Information

COVID-19 and Undiagnosed Pre-diabetes or Diabetes Mellitus Among International Migrant Workers in Singapore.

Publications

COVID-19 and Undiagnosed Pre-diabetes or Diabetes Mellitus Among International Migrant Workers in Singapore.

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