1
|
Banda J, Dube AN, Brumfield S, Crampin AC, Reniers G, Amoah AS, Helleringer S. Controlling the first wave of the COVID-19 pandemic in Malawi: Results from a multi-round study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003474. [PMID: 39446835 PMCID: PMC11500973 DOI: 10.1371/journal.pgph.0003474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 09/19/2024] [Indexed: 10/26/2024]
Abstract
We investigated behavioral responses to COVID-19 in Malawi, where a first wave of the pandemic occurred between June and August 2020. Contrary to many countries on the African continent, the Government of Malawi did not impose a lockdown or a stay-at-home order in response to the initial spread of SARS-CoV-2. We hypothesized that, in the absence of such requirements to restrict social interactions, individuals would primarily seek to reduce the risk of SARS-CoV-2 transmission during contacts, rather than reduce the extent of their social contacts. We analyzed 4 rounds of a panel survey spanning time periods before, during and after the first wave of the COVID-19 pandemic in Malawi. Five hundred and forty-three participants completed 4 survey interviews between April and November 2020. We found that the likelihood of attending various places and events where individuals work and/or socialize remained largely unchanged during that time. Over the same time frame, however, participants reported adopting on a large scale several behaviors that reduce the transmissibility of SARS-CoV-2 during contacts. The percentage of panel participants who reported practicing physical distancing thus increased from 9.8% to 47.0% in rural areas between April-May 2020 and June-July 2020, and from 11.4% to 59.4% in urban areas. The percentage of respondents who reported wearing a facial mask to prevent the spread of SARS-CoV-2 also increased, reaching 67.7% among rural residents in August-September 2020, and 89.6% among urban residents. The pace at which these behaviors were adopted varied between population groups, with early adopters of mask use more commonly found among more educated office workers, residing in urban areas. The adoption of mask use was also initially slower among women, but later caught up with mask use among men. These findings stress the importance of behavioral changes in containing future SARS-CoV-2 outbreaks in settings where access to vaccination remains low. They also highlight the need for targeted outreach to members of socioeconomic groups in which the adoption of protective behaviors, such as mask use, might be delayed.
Collapse
Affiliation(s)
- Jethro Banda
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Albert N. Dube
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Department of Community Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Sarah Brumfield
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, United States of America
| | - Amelia C. Crampin
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Georges Reniers
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Abena S. Amoah
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stéphane Helleringer
- Program in Social Research and Public Policy, Division of Social Science, New York University-Abu Dhabi, Abu Dhabi, United Arab Emirates
| |
Collapse
|
2
|
Manna A, Koltai J, Karsai M. Importance of social inequalities to contact patterns, vaccine uptake, and epidemic dynamics. Nat Commun 2024; 15:4137. [PMID: 38755162 PMCID: PMC11099065 DOI: 10.1038/s41467-024-48332-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 04/29/2024] [Indexed: 05/18/2024] Open
Abstract
Individuals' socio-demographic and economic characteristics crucially shape the spread of an epidemic by largely determining the exposure level to the virus and the severity of the disease for those who got infected. While the complex interplay between individual characteristics and epidemic dynamics is widely recognised, traditional mathematical models often overlook these factors. In this study, we examine two important aspects of human behaviour relevant to epidemics: contact patterns and vaccination uptake. Using data collected during the COVID-19 pandemic in Hungary, we first identify the dimensions along which individuals exhibit the greatest variation in their contact patterns and vaccination uptake. We find that generally higher socio-economic groups of the population have a higher number of contacts and a higher vaccination uptake with respect to disadvantaged groups. Subsequently, we propose a data-driven epidemiological model that incorporates these behavioural differences. Finally, we apply our model to analyse the fourth wave of COVID-19 in Hungary, providing valuable insights into real-world scenarios. By bridging the gap between individual characteristics and epidemic spread, our research contributes to a more comprehensive understanding of disease dynamics and informs effective public health strategies.
Collapse
Affiliation(s)
- Adriana Manna
- Department of Network and Data Science, Central European University, Quellenstraße 51, Vienna, 1100, Austria
| | - Júlia Koltai
- National Laboratory for Health Security, HUN-REN Centre for Social Sciences, Tóth Kálmán utca 4, Budapest, 1097, Hungary
- Department of Social Research Methodology, Faculty of Social Sciences, Eötvös Loránd University, Pázmány Péter sétány 1/A, Budapest, 1117, Hungary
| | - Márton Karsai
- Department of Network and Data Science, Central European University, Quellenstraße 51, Vienna, 1100, Austria.
- National Laboratory for Health Security, HUN-REN Rényi Institute of Mathematics, Reáltanoda utca 13-15, Budapest, 1053, Hungary.
| |
Collapse
|
3
|
Mirieri H, Nasimiyu C, Dawa J, Mburu C, Jalang'o R, Kamau P, Igboh L, Ebama M, Wainaina D, Gitonga J, Karanja J, Njenga E, Kariuki J, Machani J, Oginga P, Baraka I, Wamaru P, Muhula S, Ratemo P, Ayugi J, Kariuki Njenga M, Emukule GO, Osoro E, Otieno NA. Resilience of routine childhood immunization services in two counties in Kenya in the face of the COVID-19 pandemic. Vaccine 2023; 41:7695-7704. [PMID: 38008664 PMCID: PMC11284176 DOI: 10.1016/j.vaccine.2023.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/03/2023] [Accepted: 09/13/2023] [Indexed: 11/28/2023]
Abstract
The recently emerged coronavirus disease 2019 (COVID-19) has caused considerable morbidity and mortality worldwide and disrupted health services. We describe the effect of the COVID-19 pandemic on utilization of childhood vaccination services during the pandemic. Using a mixed methods approach combining retrospective data review, a cross-sectional survey, focus group discussions among care givers and key informant interviews among nurses, we collected data between May and September 2021 in Mombasa and Nakuru counties. Overall, there was a <2 % decline in the number of vaccine doses administered during the pandemic period compared to the pre-pandemic period but this was statistically insignificant, both for the pentavalent-1 vaccine (ß = -0.013, p = 0.505) and the pentavalent-3 vaccine (ß = -0.012, p = 0.440). In government health facilities, there was 7.7 % reduction in the number of pentavalent-1 (ß = -0.08, p = 0.010) and 10.4 % reduction in the number of pentavalent-3 (ß = -0.11, p < 0.001) vaccine doses that were administered during the pandemic period. In non-government facilities, there was a 25.8 % increase in the number of pentavalent-1 (ß=0.23, p < 0.001) and 31.0 % increase in the number of pentavalent-3 (ß = -0.27, p < 0.001) vaccine doses that were administered facilities during the pandemic period. The strategies implemented to maintain immunization services during the pandemic period included providing messaging on the availability and importance of staying current with routine vaccination and conducting catch-up vaccinations and vaccination outreaches. Our findings suggest that the COVID-19 pandemic did not impact childhood vaccination services in Mombasa and Nakuru counties in Kenya. The private health facilities cushioned vaccination services against the effects of the pandemic and the strategies that were put in place by the ministry of health ensured continuation of vaccination services and encouraged uptake of the services during the pandemic period in the two counties in Kenya. These findings provide useful information to safeguard vaccination services during future pandemics.
Collapse
Affiliation(s)
- Harriet Mirieri
- Washington State University (WSU) Global Health Kenya, Nairobi, Kenya.
| | - Carolyne Nasimiyu
- Washington State University (WSU) Global Health Kenya, Nairobi, Kenya
| | - Jeanette Dawa
- Washington State University (WSU) Global Health Kenya, Nairobi, Kenya
| | - Caroline Mburu
- Department of Social Anthropology, University of St Andrews, Fife, Scotland, UK
| | - Rose Jalang'o
- National Vaccines and Immunization Program, Ministry of Health, Kenya
| | - Peter Kamau
- National Vaccines and Immunization Program, Ministry of Health, Kenya
| | - Ledor Igboh
- Global Immunization Division, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jorim Ayugi
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - M Kariuki Njenga
- Washington State University (WSU) Global Health Kenya, Nairobi, Kenya; Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, USA
| | - Gideon O Emukule
- Influenza Division, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Eric Osoro
- Washington State University (WSU) Global Health Kenya, Nairobi, Kenya; Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, USA
| | - Nancy A Otieno
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| |
Collapse
|
4
|
Gómez-Pérez GP, de Groot R, Abajobir AA, Wainaina CW, Rinke de Wit TF, Sidze E, Pradhan M, Janssens W. Reduced incidence of respiratory, gastrointestinal and malaria infections among children during the COVID-19 pandemic in Western Kenya: An analysis of facility-based and weekly diaries data. J Glob Health 2023; 13:06024. [PMID: 37448326 DOI: 10.7189/jogh.13.06024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
Background Epidemics can cause significant disruptions of essential health care services. This was evident in West-Africa during the 2014-2016 Ebola outbreak, raising concerns that COVID-19 would have similar devastating consequences for the continent. Indeed, official facility-based records show a reduction in health care visits after the onset of COVID-19 in Kenya. Our question is whether this observed reduction was caused by lower access to health care or by reduced incidence of communicable diseases resulting from reduced mobility and social contacts. Methods We analysed monthly facility-based data from 2018 to 2020, and weekly health diaries data digitally collected by trained fieldworkers between February and November 2020 from 342 households, including 1974 individuals, in Kisumu and Kakamega Counties, Kenya. Diaries data was collected as part of an ongoing longitudinal study of a digital health insurance scheme (Kakamega), and universal health coverage implementation (Kisumu). We assessed the weekly incidence of self-reported medical symptoms, formal and informal health-seeking behaviour, and foregone care in the diaries and compared it with facility-based records. Linear probability regressions with household fixed-effects were performed to compare the weekly incidence of health outcomes before and after COVID-19. Results Facility-based data showed a decrease in health care utilization for respiratory infections, enteric illnesses, and malaria, after start of COVID-19 measures in Kenya in March 2020. The weekly diaries confirmed this decrease in respiratory and enteric symptoms, and malaria / fever, mainly in the paediatric population. In terms of health care seeking behaviour, our diaries data find a temporary shift in consultations from health care centres to pharmacists / chemists / medicine vendors for a few weeks during the pandemic, but no increase in foregone care. According to the diaries, for adults the incidence of communicable diseases/symptoms rebounded after COVID-19 mobility restrictions were lifted, while for children the effects persisted. Conclusions COVID-19-related containment measures in Western Kenya were accompanied by a decline in respiratory infections, enteric illnesses, and malaria / fever mainly in children. Data from a population-based survey and facility-based records aligned regarding this finding despite the temporary shift to non-facility-based consultations and confirmed that the drop in utilization of health care services was not due to decreased accessibility, but rather to a lower incidence of these infections.
Collapse
Affiliation(s)
- Gloria P Gómez-Pérez
- Amsterdam Institute of Global Health and Development, Amsterdam, the Netherlands
- PharmAccess Foundation, Amsterdam, the Netherlands
| | - Richard de Groot
- Amsterdam Institute of Global Health and Development, Amsterdam, the Netherlands
| | | | - Caroline W Wainaina
- African Population and Health Research Centre, Nairobi, Kenya
- Universiteit Utrecht, Amsterdam, the Netherlands
| | - Tobias F Rinke de Wit
- Amsterdam Institute of Global Health and Development, Amsterdam, the Netherlands
- PharmAccess Foundation, Amsterdam, the Netherlands
| | - Estelle Sidze
- African Population and Health Research Centre, Nairobi, Kenya
| | - Menno Pradhan
- Amsterdam Institute of Global Health and Development, Amsterdam, the Netherlands
- Vrije Universiteit, Amsterdam, the Netherlands
- Universiteit van Amsterdam, the Netherlands
| | - Wendy Janssens
- Amsterdam Institute of Global Health and Development, Amsterdam, the Netherlands
- Vrije Universiteit, Amsterdam, the Netherlands
| |
Collapse
|
5
|
Choi S, Kim C, Park KH, Kim JH. Direct indicators of social distancing effectiveness in COVID-19 outbreak stages: a correlational analysis of case contacts and population mobility in Korea. Epidemiol Health 2023; 45:e2023065. [PMID: 37448123 PMCID: PMC10876423 DOI: 10.4178/epih.e2023065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/25/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVES The effectiveness of social distancing during the coronavirus disease 2019 (COVID-19) pandemic has been evaluated using the magnitude of changes in population mobility. This study aimed to investigate a direct indicator-namely, the number of close contacts per patient with confirmed COVID-19. METHODS From week 7, 2020 to week 43, 2021, population movement changes were calculated from the data of two Korean telecommunication companies and Google in accordance with social distancing stringency levels. Data on confirmed cases and their close contacts among residents of Gyeonggi Province, Korea were combined at each stage. Pearson correlation analysis was conducted to compare the movement data with the change in the number of contacts for each confirmed case calculated by stratification according to age group. The reference value of the population movement data was set using the value before mid-February 2020, considering each data's characteristics. RESULTS In the age group of 18 or younger, the number of close contacts per confirmed case decreased or increased when the stringency level was strengthened or relaxed, respectively. In adults, the correlation was relatively low, with no correlation between the change in the number of close contacts per confirmed case and the change in population movement after the commencement of vaccination for adults. CONCLUSIONS The effectiveness of governmental social distancing policies against COVID-19 can be evaluated using the number of close contacts per confirmed case as a direct indicator, especially for each age group. Such an analysis can facilitate policy changes for specific groups.
Collapse
Affiliation(s)
- Sojin Choi
- Gyeonggi Infectious Disease Control Center, Health Bureau, Gyeonggi Provincial Government, Suwon, Korea
| | - Chanhee Kim
- Gyeonggi Infectious Disease Control Center, Health Bureau, Gyeonggi Provincial Government, Suwon, Korea
| | - Kun-Hee Park
- Gyeonggi Infectious Disease Control Center, Health Bureau, Gyeonggi Provincial Government, Suwon, Korea
| | - Jong-Hun Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| |
Collapse
|
6
|
Loedy N, Coletti P, Wambua J, Hermans L, Willem L, Jarvis CI, Wong KLM, Edmunds W, Robert A, Leclerc QJ, Gimma A, Molenberghs G, Beutels P, Faes C, Hens N. Longitudinal social contact data analysis: insights from 2 years of data collection in Belgium during the COVID-19 pandemic. BMC Public Health 2023; 23:1298. [PMID: 37415096 PMCID: PMC10326964 DOI: 10.1186/s12889-023-16193-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/26/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the CoMix study, a longitudinal behavioral survey, was designed to monitor social contacts and public awareness in multiple countries, including Belgium. As a longitudinal survey, it is vulnerable to participants' "survey fatigue", which may impact inferences. METHODS A negative binomial generalized additive model for location, scale, and shape (NBI GAMLSS) was adopted to estimate the number of contacts reported between age groups and to deal with under-reporting due to fatigue within the study. The dropout process was analyzed with first-order auto-regressive logistic regression to identify factors that influence dropout. Using the so-called next generation principle, we calculated the effect of under-reporting due to fatigue on estimating the reproduction number. RESULTS Fewer contacts were reported as people participated longer in the survey, which suggests under-reporting due to survey fatigue. Participant dropout is significantly affected by household size and age categories, but not significantly affected by the number of contacts reported in any of the two latest waves. This indicates covariate-dependent missing completely at random (MCAR) in the dropout pattern, when missing at random (MAR) is the alternative. However, we cannot rule out more complex mechanisms such as missing not at random (MNAR). Moreover, under-reporting due to fatigue is found to be consistent over time and implies a 15-30% reduction in both the number of contacts and the reproduction number ([Formula: see text]) ratio between correcting and not correcting for under-reporting. Lastly, we found that correcting for fatigue did not change the pattern of relative incidence between age groups also when considering age-specific heterogeneity in susceptibility and infectivity. CONCLUSIONS CoMix data highlights the variability of contact patterns across age groups and time, revealing the mechanisms governing the spread/transmission of COVID-19/airborne diseases in the population. Although such longitudinal contact surveys are prone to the under-reporting due to participant fatigue and drop-out, we showed that these factors can be identified and corrected using NBI GAMLSS. This information can be used to improve the design of similar, future surveys.
Collapse
Affiliation(s)
- Neilshan Loedy
- Data Science Institute, I-BioStat, Hasselt University, Hasselt, Belgium
| | - Pietro Coletti
- Data Science Institute, I-BioStat, Hasselt University, Hasselt, Belgium
| | - James Wambua
- Data Science Institute, I-BioStat, Hasselt University, Hasselt, Belgium
| | - Lisa Hermans
- Data Science Institute, I-BioStat, Hasselt University, Hasselt, Belgium
| | - Lander Willem
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Christopher I. Jarvis
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Kerry L. M. Wong
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - W. John Edmunds
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Alexis Robert
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Quentin J. Leclerc
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Public Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Epidemiology and Modelling of Bacterial Escape to Antimicrobials, Institut Pasteur, Paris, France
| | - Amy Gimma
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Geert Molenberghs
- Data Science Institute, I-BioStat, Hasselt University, Hasselt, Belgium
- L-BioStat, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
| | - Christel Faes
- Data Science Institute, I-BioStat, Hasselt University, Hasselt, Belgium
| | - Niel Hens
- Data Science Institute, I-BioStat, Hasselt University, Hasselt, Belgium
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
7
|
Sahoo KC, Negi S, Mahapatra P, Samantaray K, Dash GC, Dubey S, Sahay MR, Sahoo RK, Bhattacharya D, Sahoo B, Pani SP, Otmani del Barrio M, Pati S. Gender dimensions of health-related challenges among urban poor during COVID-19 pandemic in low-and middle-income countries: a systematic review and gap analysis. Front Public Health 2023; 11:1170386. [PMID: 37361176 PMCID: PMC10288984 DOI: 10.3389/fpubh.2023.1170386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/11/2023] [Indexed: 06/28/2023] Open
Abstract
The COVID-19 pandemic has varying effects on men, women, and the transgender population. However, there is a paucity of systematic evidence on how gender and other social determinants of health during COVID-19 are affected in resource constraint urban settings. This review describes the gender dimensions of health-related challenges among the urban poor during COVID-19 in LMICs. We searched 11 scholarly online repositories including PubMed, Embase, Web of Science, CINAHL using the domain "slums," "COVID-19", "LMICs" and "gender identities." We used thematic framework analysis to synthesize qualitative data, and meta-analysis to determine the pooled prevalence. We registered in PROSPERO (CRD42020203783). We identified 6490 records, and 37 articles included. The studies reported stress among 74% women and 78% men, depression among 59% women and 62% men, and anxiety among 79% women and 63% men. Men had more stress than women during COVID-19; men are primarily responsible for household sustenance. Women had more anxiety than men, possibly because they are often the primary caregivers for children and the older population. While the severity varies according to gender identity, their vulnerability mostly related to their literacy and economy, highlighting the significance of including all social determinants in future primary studies. Systematic review registration https://www.crd.york.ac.uk/prospero/#recordDetails.
Collapse
Affiliation(s)
- Krushna Chandra Sahoo
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Sapna Negi
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Pranab Mahapatra
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kajal Samantaray
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Girish Chandra Dash
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Shubhankar Dubey
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Mili Roopchand Sahay
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Rakesh Kumar Sahoo
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Banamber Sahoo
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Mariam Otmani del Barrio
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Sanghamitra Pati
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| |
Collapse
|
8
|
Walde J, Chaturvedi M, Berger T, Bartz A, Killewald R, Tomori DV, Rübsamen N, Lange B, Scholz S, Treskova M, Bucksch K, Jarvis CI, Mikolajczyk R, Karch A, Jaeger VK. Effect of risk status for severe COVID-19 on individual contact behaviour during the SARS-CoV-2 pandemic in 2020/2021-an analysis based on the German COVIMOD study. BMC Infect Dis 2023; 23:205. [PMID: 37024810 PMCID: PMC10078023 DOI: 10.1186/s12879-023-08175-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 03/16/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND One of the primary aims of contact restriction measures during the SARS-CoV-2 pandemic has been to protect people at increased risk of severe disease from the virus. Knowledge about the uptake of contact restriction measures in this group is critical for public health decision-making. We analysed data from the German contact survey COVIMOD to assess differences in contact patterns based on risk status, and compared this to pre-pandemic data to establish whether there was a differential response to contact reduction measures. METHODS We quantified differences in contact patterns according to risk status by fitting a generalised linear model accounting for within-participant clustering to contact data from 31 COVIMOD survey waves (April 2020-December 2021), and estimated the population-averaged ratio of mean contacts of persons with high risk for a severe COVID-19 outcome due to age or underlying health conditions, to those without. We then compared the results to pre-pandemic data from the contact surveys HaBIDS and POLYMOD. RESULTS Averaged across all analysed waves, COVIMOD participants reported a mean of 3.21 (95% confidence interval (95%CI) 3.14,3.28) daily contacts (truncated at 100), compared to 18.10 (95%CI 17.12,19.06) in POLYMOD and 28.27 (95%CI 26.49,30.15) in HaBIDS. After adjusting for confounders, COVIMOD participants aged 65 or above had 0.83 times (95%CI 0.79,0.87) the number of contacts as younger age groups. In POLYMOD, this ratio was 0.36 (95%CI 0.30,0.43). There was no clear difference in contact patterns due to increased risk from underlying health conditions in either HaBIDS or COVIMOD. We also found that persons in COVIMOD at high risk due to old age increased their non-household contacts less than those not at such risk after strict restriction measures were lifted. CONCLUSIONS Over the course of the SARS-CoV-2 pandemic, there was a general reduction in contact numbers in the German population and also a differential response to contact restriction measures based on risk status for severe COVID-19. This differential response needs to be taken into account for parametrisations of mathematical models in a pandemic setting.
Collapse
Affiliation(s)
- Jasmin Walde
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Madhav Chaturvedi
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Tom Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Antonia Bartz
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Robin Killewald
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Damilola Victoria Tomori
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Nicole Rübsamen
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Center for Infection Research, Braunschweig, Germany
| | - Stefan Scholz
- Immunization Unit, Infectious Disease Epidemiology, Robert Koch-Institute, Berlin, Germany
| | - Marina Treskova
- Immunization Unit, Infectious Disease Epidemiology, Robert Koch-Institute, Berlin, Germany
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Karolin Bucksch
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | | | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Veronika K Jaeger
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
| |
Collapse
|
9
|
Galli M, Zardini A, Gamshie WN, Santini S, Tsegaye A, Trentini F, Marziano V, Guzzetta G, Manica M, d'Andrea V, Putoto G, Manenti F, Ajelli M, Poletti P, Merler S. Priority age targets for COVID-19 vaccination in Ethiopia under limited vaccine supply. Sci Rep 2023; 13:5586. [PMID: 37019980 PMCID: PMC10075159 DOI: 10.1038/s41598-023-32501-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/28/2023] [Indexed: 04/07/2023] Open
Abstract
The worldwide inequitable access to vaccination claims for a re-assessment of policies that could minimize the COVID-19 burden in low-income countries. Nine months after the launch of the national vaccination program in March 2021, only 3.4% of the Ethiopian population received two doses of COVID-19 vaccine. We used a SARS-CoV-2 transmission model to estimate the level of immunity accrued before the launch of vaccination in the Southwest Shewa Zone (SWSZ) and to evaluate the impact of alternative age priority vaccination targets in a context of limited vaccine supply. The model was informed with available epidemiological evidence and detailed contact data collected across different geographical settings (urban, rural, or remote). We found that, during the first year of the pandemic, the mean proportion of critical cases occurred in SWSZ attributable to infectors under 30 years of age would range between 24.9 and 48.0%, depending on the geographical setting. During the Delta wave, the contribution of this age group in causing critical cases was estimated to increase on average to 66.7-70.6%. Our findings suggest that, when considering the vaccine product available at the time (ChAdOx1 nCoV-19; 65% efficacy against infection after 2 doses), prioritizing the elderly for vaccination remained the best strategy to minimize the disease burden caused by Delta, irrespectively of the number of available doses. Vaccination of all individuals aged ≥ 50 years would have averted 40 (95%PI: 18-60), 90 (95%PI: 61-111), and 62 (95%PI: 21-108) critical cases per 100,000 residents in urban, rural, and remote areas, respectively. Vaccination of all individuals aged ≥ 30 years would have averted an average of 86-152 critical cases per 100,000 individuals, depending on the setting considered. Despite infections among children and young adults likely caused 70% of critical cases during the Delta wave in SWSZ, most vulnerable ages should remain a key priority target for vaccination against COVID-19.
Collapse
Affiliation(s)
- Margherita Galli
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
- Department of Mathematics, Computer Science and Physics, University of Udine, Udine, Italy
| | - Agnese Zardini
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | | | | | | | - Filippo Trentini
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
| | | | - Giorgio Guzzetta
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
- Epilab-JRU, FEM-FBK Joint Research Unit, Trento, Italy
| | - Mattia Manica
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
- Epilab-JRU, FEM-FBK Joint Research Unit, Trento, Italy
| | - Valeria d'Andrea
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | | | | | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Piero Poletti
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy.
- Epilab-JRU, FEM-FBK Joint Research Unit, Trento, Italy.
| | - Stefano Merler
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
- Epilab-JRU, FEM-FBK Joint Research Unit, Trento, Italy
| |
Collapse
|
10
|
Ahoya B, Kavle JA, Kiige L, Gathi C, Samburu B, Maina L, Ramirez L, Wambu R, Codjia P. How COVID-19 affected food systems, health service delivery and maternal and infant nutrition practices: Implications for moving forward in Kenya. MATERNAL & CHILD NUTRITION 2023; 19:e13466. [PMID: 36484395 PMCID: PMC9878145 DOI: 10.1111/mcn.13466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/05/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022]
Abstract
This implementation research study sought to examine the impact of the COVID-19 pandemic on maternal and infant nutrition practices, and related aspects of health and food systems in Nairobi and Uasin Gishu Counties, Kenya. The study triangulated in-depth interviews with 16 pregnant women, 31 lactating women (including COVID-19 positive), 10 facility health workers, 10 community health volunteers, 6 focus group discussions (FGDs) with food vendors, 4 FGDs and 15 stakeholder interviews with government and implementing partners. Trends from Kenyan Health Information System indicators (i.e., exclusive breastfeeding and initiation of breastfeeding, antenatal care) were also examined. During the COVID-19 pandemic, a decline in attendance of antenatal care, and maternity facilities was observed, and corroborated by Kenyan Health Information System data. Lack of clarity among health workers on COVID-19 breastfeeding guidance and fear of COVID-19 infection early in the pandemic were key drivers of early infant formula use, mother-child separation following delivery and delayed initiation of breastfeeding. Most women exclusively breastfed due to Government of Kenya restrictions in movement. Unemployment and job loss was linked to food insecurity and worsened by increased food prices and limited social protection measures. In response, pregnant and lactating women resorted to skipping meals and reducing quantity and variety of foods consumed. Efforts to build forward from COVID-19 in Kenya should include facility and community health education to prevent disruptions in breastfeeding and to support maternal dietary intake, and in the provision of targeted social protection measures alongside other multisectoral interventions (i.e., psychosocial support) for Kenyan pregnant and lactating women.
Collapse
Affiliation(s)
| | | | | | | | | | - Lucy Maina
- Nutrition DivisionUNICEF KenyaNairobiKenya
| | - Lacey Ramirez
- Kavle Consulting LLCWashingtonDistrict of ColumbiaUSA
| | - Rose Wambu
- Division of Nutrition and DieteticsMinistry of HealthNairobiKenya
| | | |
Collapse
|
11
|
Backer JA, Bogaardt L, Beutels P, Coletti P, Edmunds WJ, Gimma A, van Hagen CCE, Hens N, Jarvis CI, Vos ERA, Wambua J, Wong D, van Zandvoort K, Wallinga J. Dynamics of non-household contacts during the COVID-19 pandemic in 2020 and 2021 in the Netherlands. Sci Rep 2023; 13:5166. [PMID: 36997550 PMCID: PMC10060924 DOI: 10.1038/s41598-023-32031-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/21/2023] [Indexed: 04/04/2023] Open
Abstract
The COVID-19 pandemic was in 2020 and 2021 for a large part mitigated by reducing contacts in the general population. To monitor how these contacts changed over the course of the pandemic in the Netherlands, a longitudinal survey was conducted where participants reported on their at-risk contacts every two weeks, as part of the European CoMix survey. The survey included 1659 participants from April to August 2020 and 2514 participants from December 2020 to September 2021. We categorized the number of unique contacted persons excluding household members, reported per participant per day into six activity levels, defined as 0, 1, 2, 3-4, 5-9 and 10 or more reported contacts. After correcting for age, vaccination status, risk status for severe outcome of infection, and frequency of participation, activity levels increased over time, coinciding with relaxation of COVID-19 control measures.
Collapse
Affiliation(s)
- Jantien A Backer
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
| | - Laurens Bogaardt
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Pietro Coletti
- UHasselt, Data Science Institute and I-BioStat, Hasselt, Belgium
| | - W John Edmunds
- London School of Hygiene and Tropical Medicine, London, UK
| | - Amy Gimma
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Niel Hens
- University of Antwerp, Antwerp, Belgium
- UHasselt, Data Science Institute and I-BioStat, Hasselt, Belgium
| | | | - Eric R A Vos
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - James Wambua
- UHasselt, Data Science Institute and I-BioStat, Hasselt, Belgium
| | - Denise Wong
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Jacco Wallinga
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
12
|
Li L, Taeihagh A, Tan SY. A scoping review of the impacts of COVID-19 physical distancing measures on vulnerable population groups. Nat Commun 2023; 14:599. [PMID: 36737447 PMCID: PMC9897623 DOI: 10.1038/s41467-023-36267-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Most governments have enacted physical or social distancing measures to control COVID-19 transmission. Yet little is known about the socio-economic trade-offs of these measures, especially for vulnerable populations, who are exposed to increased risks and are susceptible to adverse health outcomes. To examine the impacts of physical distancing measures on the most vulnerable in society, this scoping review screened 39,816 records and synthesised results from 265 studies worldwide documenting the negative impacts of physical distancing on older people, children/students, low-income populations, migrant workers, people in prison, people with disabilities, sex workers, victims of domestic violence, refugees, ethnic minorities, and people from sexual and gender minorities. We show that prolonged loneliness, mental distress, unemployment, income loss, food insecurity, widened inequality and disruption of access to social support and health services were unintended consequences of physical distancing that impacted these vulnerable groups and highlight that physical distancing measures exacerbated the vulnerabilities of different vulnerable populations.
Collapse
Affiliation(s)
- Lili Li
- Policy Systems Group, Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore
| | - Araz Taeihagh
- Policy Systems Group, Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore.
| | - Si Ying Tan
- Alexandra Research Centre for Healthcare in The Virtual Environment (ARCHIVE), Department of Healthcare Redesign, Alexandra Hospital, National University Health System, Singapore, Singapore
| |
Collapse
|
13
|
Wood SN, Milkovich R, Thiongo M, Gichangi P, Byrne ME, Devoto B, Anglewicz P, Decker MR. Disruptions to youth contraceptive use during COVID-19: Mixed-methods results from Nairobi, Kenya. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001005. [PMID: 36962989 PMCID: PMC10021138 DOI: 10.1371/journal.pgph.0001005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/16/2023] [Indexed: 02/25/2023]
Abstract
Ensuring access to sexual and reproductive health (SRH) services for adolescents is a global priority, given the detrimental health and economic impact of unintended pregnancies. To examine whether and how COVID-19 affected access to SRH services, we use mixed-methods data from young men and women in Nairobi, Kenya to identify those at greatest risk of contraceptive disruptions during COVID-19 restrictions. Analyses utilize cross-sectional data collected from August to October 2020 from an existing cohort of youth aged 16-26. Unadjusted and adjusted logistic regression examined sociodemographic, contraceptive, and COVID-19-related correlates of contraceptive disruption among users of contraception. Qualitative data were collected concurrently via focus group discussions (n = 64, 8 groups) and in-depth interviews (n = 20), with matrices synthesizing emergent challenges to obtaining contraception by gender. Among those using contraception, both young men (40.4%) and young women (34.6%) faced difficulties obtaining contraception during COVID-19. Among young men, difficulty was observed particularly for those unable to meet their basic needs (aOR = 1.60; p = 0.05). Among young women, risk centered around those with multiple partners (aOR = 1.91; p = 0.01), or who procured their method from a hospital (aOR = 1.71; p = 0.04) or clinic (aOR = 2.14; p = 0.03). Qualitative data highlight economic barriers to obtaining contraceptives, namely job loss and limited supply of free methods previously available. Universal access to a variety of contraceptive methods during global health emergencies, including long-acting reversible methods, is an essential priority to help youth avert unintended pregnancies and withstand periods of disruptions to services. Non-judgmental, youth-friendly services must remain accessible throughout the pandemic into the post-COVID-19 period.
Collapse
Affiliation(s)
- Shannon N Wood
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Bill & Melinda Gates Institute for Population and Reproductive Health, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Rachel Milkovich
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Mary Thiongo
- International Centre for Reproductive Health-Kenya, Nairobi, Kenya
| | - Peter Gichangi
- International Centre for Reproductive Health-Kenya, Nairobi, Kenya
- Department of Public Health and Primary Care, Technical University of Mombasa, Mombasa, Kenya
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Meagan E Byrne
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Bill & Melinda Gates Institute for Population and Reproductive Health, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Bianca Devoto
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Philip Anglewicz
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Bill & Melinda Gates Institute for Population and Reproductive Health, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Bill & Melinda Gates Institute for Population and Reproductive Health, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Johns Hopkins School of Nursing, Baltimore, Maryland, United States of America
| |
Collapse
|
14
|
Masina HV, Lin IF, Chien LY. The Impact of the COVID-19 Pandemic on Tuberculosis Case Notification and Treatment Outcomes in Eswatini. Int J Public Health 2022; 67:1605225. [PMID: 36387290 PMCID: PMC9643149 DOI: 10.3389/ijph.2022.1605225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 10/17/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives: We investigated the impact of COVID-19 on tuberculosis (TB) case notification and treatment outcomes in Eswatini. Methods: A comparative retrospective cohort study was conducted using TB data from eight facilities. An interrupted time series analysis, using segmented Poisson regression was done to assess the impact of COVID-19 on TB case notification comparing period before (December 2018-February 2020, n = 1,560) and during the pandemic (March 2020–May 2021, n = 840). Case notification was defined as number of TB cases registered in the TB treatment register. Treatment outcomes was result assigned to patients at the end of treatment according to WHO rules. Results: There was a significant decrease in TB case notification (IRR 0.71, 95% CI: 0.60–0.83) and a significant increase in death rate among registrants during the pandemic (21.3%) compared to pre-pandemic (10.8%, p < 0.01). Logistic regression indicated higher odds of unfavorable outcomes (death, lost-to-follow-up, and not evaluated) during the pandemic than pre-pandemic (aOR 2.91, 95% CI: 2.17–3.89). Conclusion: COVID-19 negatively impacted TB services in Eswatini. Eswatini should invest in strategies to safe-guard the health system against similar pandemics.
Collapse
Affiliation(s)
| | - I-Feng Lin
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Yin Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
- *Correspondence: Li-Yin Chien,
| |
Collapse
|
15
|
Chege CGK, Onyango K, Kabach J, Lundy M. Effects of COVID-19 on dietary behavior of urban consumers in Nairobi, Kenya. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.718443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The disruptions wrought by the COVID-19 pandemic on food systems worldwide have endangered food and nutrition security for many consumers. The resource-poor, especially those in urban areas, are more susceptible to pandemic-related disturbances. This study uses primary data collected from 2,465 households located in and outside of informal settlements (slums) in Nairobi, Kenya to assess how COVID-19 and related public-health measures have influenced diets of urban consumers, their purchasing patterns and overall food security. Questions about food security and consumption behavior, including household dietary diversity scores, were used to capture the pre- and mid-pandemic situation. The data show that low-income households in the informal settlements were more affected than middle-income households. About 90% of slum households reported dire food insecurity situations, including being unable to eat preferred kinds of food, eating a limited variety of foods, consuming smaller portions than they felt they needed, and eating fewer meals in a day. With a score of four food groups out of nine, household in the informal settlements have lower dietary diversity than middle-income households, whose score is five out of nine. The consumption of nutritious foods, including fruits, vegetables, and animal products, fell among people living in slums during the pandemic. In addition to assessing dietary changes, this study highlights the factors associated with quality food consumption during the pandemic period such as household income levels and male-vs-female headed households. Our research demonstrates the need to attend to slums and vulnerable, poor consumers when enacting mitigation measures or designing and implementing policy.
Collapse
|
16
|
Bevilacqua KG, Williams A, Wood SN, Wamue-Ngare G, Thiongo M, Gichangi P, Decker MR. Sexual harassment before and during the COVID-19 pandemic among adolescent girls and young women (AGYW) in Nairobi, Kenya: a cross-sectional study. BMJ Open 2022; 12:e066777. [PMID: 36253036 PMCID: PMC9577274 DOI: 10.1136/bmjopen-2022-066777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Sexual harassment among adolescent girls and young women (AGYW) is a prevalent and understudied form of gender-based violence (GBV) with negative impacts on health and well-being. The COVID-19 pandemic raised global concern about GBV within homes; less is known about how it affected GBV in public spaces. METHODS Present analyses use cross-sectional data from a cohort of adolescents and young adults residing in Nairobi, Kenya, restricted to female participants. Data were collected August-October 2020 via phone after implementation of COVID-19 restrictions. Prevalence of past-year sexual harassment and harassment relative to COVID-19 restrictions were calculated for overall sample, and by individual, household, and pandemic-related factors. Multivariate negative binomial regression models examine correlates of (1) past-year sexual harassment and (2) increases in sexual harassment relative to COVID-19 restrictions. RESULTS Overall, 18.1% of AGYW experienced past-year sexual harassment at the 2020 survey. Among this group, 14.6% experienced sexual harassment pre-COVID-19 only, 18.8% after only and 66.6% at both time points. Among the latter group, 34.9% reported more occurrences following COVID-19 restrictions, 20.5% reported less occurrences and 44.7% reported no change in occurrence. Overall, 42.0% of AGYW experienced an increase in sexual harassment while 58.0% experienced no increase since COVID-19. In adjusted models, past-year sexual harassment was associated with higher educational attainment (adjusted risk ratio, aRR 2.11; 95% CI 1.27 to 3.52) and inability to meet basic financial needs (aRR 1.67; 95% CI 1.05 to 2.66). Increased sexual harassment since COVID-19 was associated with having full control to leave the home (aRR 1.69; 95% CI 1.00 to 2.90). CONCLUSIONS Sexual harassment among AGYW in Nairobi, Kenya was prevalent before and during COVID-19 restrictions. Safety in public spaces remains a highly gendered issue that impacts women's safety and ability to participate in public life. Prevention and support services to address sexual harassment remain an important element in ensuring safe, sustainable public spaces.
Collapse
Affiliation(s)
- Kristin G Bevilacqua
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - A Williams
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shannon N Wood
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Baltimore, Maryland, USA
| | - G Wamue-Ngare
- Department of Sociology, Gender and Development Studies, Kenyatta University, Nairobi, Kenya
- Women's Economic Empowerment Hub, Kenyatta University, Nairobi, Kenya
| | - Mary Thiongo
- International Centre for Reproductive Health Kenya, Mombasa, Kenya
| | - P Gichangi
- International Centre for Reproductive Health Kenya, Mombasa, Kenya
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Baltimore, Maryland, USA
| |
Collapse
|
17
|
Dobreva Z, Gimma A, Rohan H, Djoudalbaye B, Tshangela A, Jarvis CI, van Zandvoort K, Quaife M. Characterising social contacts under COVID-19 control measures in Africa. BMC Med 2022; 20:344. [PMID: 36221094 PMCID: PMC9553295 DOI: 10.1186/s12916-022-02543-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 08/26/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Early in the COVID-19 pandemic, countries adopted non-pharmaceutical interventions (NPIs) such as lockdowns to limit SARS-CoV-2 transmission. Social contact studies help measure the effectiveness of NPIs and estimate parameters for modelling SARS-CoV-2 transmission. However, few contact studies have been conducted in Africa. METHODS We analysed nationally representative cross-sectional survey data from 19 African Union Member States, collected by the Partnership for Evidence-based Responses to COVID-19 (PERC) via telephone interviews at two time points (August 2020 and February 2021). Adult respondents reported contacts made in the previous day by age group, demographic characteristics, and their attitudes towards COVID-19. We described mean and median contacts across these characteristics and related contacts to Google Mobility reports and the Oxford Government Response Stringency Index for each country at the two time points. RESULTS Mean reported contacts varied across countries with the lowest reported in Ethiopia (9, SD=16, median = 4, IQR = 8) in August 2020 and the highest in Sudan (50, SD=53, median = 33, IQR = 40) in February 2021. Contacts of people aged 18-55 represented 50% of total contacts, with most contacts in household and work or study settings for both surveys. Mean contacts increased for Ethiopia, Ghana, Liberia, Nigeria, Sudan, and Uganda and decreased for Cameroon, the Democratic Republic of Congo (DRC), and Tunisia between the two time points. Men had more contacts than women and contacts were consistent across urban or rural settings (except in Cameroon and Kenya, where urban respondents had more contacts than rural ones, and in Senegal and Zambia, where the opposite was the case). There were no strong and consistent variations in the number of mean or median contacts by education level, self-reported health, perceived self-reported risk of infection, vaccine acceptance, mask ownership, and perceived risk of COVID-19 to health. Mean contacts were correlated with Google mobility (coefficient 0.57, p=0.051 and coefficient 0.28, p=0.291 in August 2020 and February 2021, respectively) and Stringency Index (coefficient -0.12, p = 0.304 and coefficient -0.33, p=0.005 in August 2020 and February 2021, respectively). CONCLUSIONS These are the first COVID-19 social contact data collected for 16 of the 19 countries surveyed. We find a high reported number of daily contacts in all countries and substantial variations in mean contacts across countries and by gender. Increased stringency and decreased mobility were associated with a reduction in the number of contacts. These data may be useful to understand transmission patterns, model infection transmission, and for pandemic planning.
Collapse
Affiliation(s)
- Zlatina Dobreva
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
| | - Amy Gimma
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Hana Rohan
- UK Public Health Rapid Support Team, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Akhona Tshangela
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Christopher I Jarvis
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Kevin van Zandvoort
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Matthew Quaife
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
18
|
Assaye BT, Shimie AW. Telemedicine use during COVID-19 pandemics and associated factors among health professionals working in health facilities at resource-limited setting 2021. INFORMATICS IN MEDICINE UNLOCKED 2022; 33:101085. [PMID: 36105540 PMCID: PMC9462923 DOI: 10.1016/j.imu.2022.101085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/08/2022] [Accepted: 09/08/2022] [Indexed: 11/28/2022] Open
Abstract
Background Digitizing healthcare has been a potential solution for transforming healthcare service delivery in the era of COVID-19 pandemics. To limit and minimize the virus spread, telemedicine helps control and prevent the pandemic by delivering healthcare services over long distances using Information communication technology. The objective of the study was to determine the level of telemedicine utilization among health professionals in the era of the COVID-19 Pandemic and the factors associated with it. Methods An institutional-based cross-sectional study design was used to collect data from 845 healthcare professionals. A pilot study was conducted on 5% of the study participants before the actual data collection process. After completion, changes were made based on the pilot study results, and a Cronbach alpha value of 0.76 was obtained. Descriptive and binary logistic regression models were used. Variables with a P-Value of less than or equal to 0.2 from the bivariable analysis were entered into the multivariable analysis. The odds ratio, 95% confidence interval, and p-value less than 0.05 were used to interpret a significant association, Hosmer-Lemeshow goodness-of-fit test, and the multicollinearity test were used to assess the assumptions. Result 64.2% of the respondents had good use of telemedicine during COVID-19 with a response rate of 87.2%. 507 (62.8%) were male, and 525(71.2%) reported by nearly threefold (AOR = 2.96, % CI: [1.54-5.76]), IT support staff in the health facility (AOR = 8.32, 95 %CI: [4.77-14.52]), ICT training (AOR = 4.15, % CI: [2.13-8.02]), the frequency of searching health information (AOR = 6.19, % CI: [2.12-18.07]), and social media used (AOR = 3.46, % CI: [1.43-8.32]) were found significantly associated with health professionals' use of telemedicine. Conclusion The majority of healthcare providers practice telemedicine to control and prevent the spread of the COVID-19 virus. However, the availability of the internet, the presence of IT support staff, ICT training, the frequency of searching for health information, and the use of social media were significantly associated with the level of telemedicine utilization. Initiatives for full implementation of telemedicine in the health facility and motivating the health professionals are needed to carry out their medical practice by providing training and improving internet access in health facilities.
Collapse
Affiliation(s)
- Bayou Tilahun Assaye
- Department of Health Informatics, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Aynadis Worku Shimie
- Department of Health Informatics, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| |
Collapse
|
19
|
Trentini F, Manna A, Balbo N, Marziano V, Guzzetta G, O’Dell S, Kummer AG, Litvinova M, Merler S, Ajelli M, Poletti P, Melegaro A. Investigating the relationship between interventions, contact patterns, and SARS-CoV-2 transmissibility. Epidemics 2022; 40:100601. [PMID: 35772295 PMCID: PMC9212945 DOI: 10.1016/j.epidem.2022.100601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND After a rapid upsurge of COVID-19 cases in Italy during the fall of 2020, the government introduced a three-tiered restriction system aimed at increasing physical distancing. The Ministry of Health, after periodic epidemiological risk assessments, assigned a tier to each of the 21 Italian regions and autonomous provinces. It is still unclear to what extent these different sets of measures altered the number of daily interactions and the social mixing patterns. METHODS AND FINDINGS We conducted a survey between July 2020 and March 2021 to monitor changes in social contact patterns among individuals in the metropolitan city of Milan, Italy, which was hardly hit by the second wave of the COVID-19 pandemic. The number of daily contacts during periods characterized by different levels of restrictions was analyzed through negative binomial regression models and age-specific contact matrices were estimated under the different tiers of restrictions. By relying on the empirically estimated mixing patterns, we quantified relative changes in SARS-CoV-2 transmission potential associated with the different tiers. As tighter restrictions were implemented during the fall of 2020, a progressive reduction in the mean number of daily contacts recorded by study participants was observed: from 15.9 % under mild restrictions (yellow tier), to 41.8 % under strong restrictions (red tier). Higher restrictions levels were also found to increase the relative contribution of contacts occurring within the household. The SARS-CoV-2 reproduction number was estimated to decrease by 17.1 % (95 %CI: 1.5-30.1), 25.1 % (95 %CI: 13.0-36.0) and 44.7 % (95 %CI: 33.9-53.0) under the yellow, orange, and red tiers, respectively. CONCLUSIONS Our results give an important quantification of the expected contribution of different restriction levels in shaping social contacts and decreasing the transmission potential of SARS-CoV-2. These estimates can find an operational use in anticipating the effect that the implementation of these tiered restriction can have on SARS-CoV-2 reproduction number under an evolving epidemiological situation.
Collapse
Affiliation(s)
- Filippo Trentini
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy,Covid Crisis Lab, Bocconi University, Italy,Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy,Correspondence to: Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Via Roentgen 1, 20141 Milan, Italy
| | - Adriana Manna
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy,Department of Network and Data Science, Central European University, Wien, Austria
| | - Nicoletta Balbo
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy,Department of Social and Political Sciences, Bocconi University, Milan, Italy
| | | | - Giorgio Guzzetta
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Samantha O’Dell
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Allisandra G. Kummer
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Maria Litvinova
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Stefano Merler
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Piero Poletti
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Alessia Melegaro
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy,Covid Crisis Lab, Bocconi University, Italy,Department of Social and Political Sciences, Bocconi University, Milan, Italy,Corresponding author at: Department of Social and Political Sciences, Bocconi University, Milan, Italy
| |
Collapse
|
20
|
Joshi N, Lopus S, Hannah C, Ernst KC, Kilungo AP, Opiyo R, Ngayu M, Davies J, Evans T. COVID-19 lockdowns: Employment and business disruptions, water access and hygiene practices in Nairobi's informal settlements. Soc Sci Med 2022; 308:115191. [PMID: 35930847 PMCID: PMC9258418 DOI: 10.1016/j.socscimed.2022.115191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/25/2022] [Accepted: 06/30/2022] [Indexed: 12/05/2022]
Abstract
Host to one billion people around the world, informal settlements are especially vulnerable to COVID-19 lockdown measures as they already lack basic services such as water, toilets, and secure housing. Additionally, many residents work in informal labor markets that have been affected by the lockdowns, resulting in further reductions in access to resources, including clean water. This study uses a cross-sectional design (n = 532) to examine the vulnerabilities of households to employment and business disruptions, water access and hygiene practices during the COVID-19 lockdowns between April and June 2020 in three informal settlements in Nairobi, Kenya. We used survey questions from the Household Water Insecurity Experience Scale (HWISE) to investigate the relationship between employment and business disruptions, water access, and hygiene practices (i.e., hand washing, body washing, clothes washing, and being able to use or drink clean water). Of the sampled households, 96% were forced to reduce work hours during the lockdowns, and these households had 92% lower odds of being able to afford water than households who did not experience a work hour reduction (OR = 0.08, p < .001). Household challenges in affording water were likely due to a combination of reduced household income, increased water prices, and pre-existing poverty, and were ultimately associated with lower hygiene scores (Beta = 1.9, p < .001). Our results highlight a compounding tragedy of reduced water access in informal settlements that were already facing water insecurities at a time when water is a fundamental requirement for following hygiene guidelines to reduce disease burden during an ongoing pandemic. These outcomes emphasize the need for targeted investments in permanent water supply infrastructures and improved hygiene behaviors as a public health priority among households in informal settlements.
Collapse
Affiliation(s)
- Nupur Joshi
- School of Geography, Development and Environment, University of Arizona, United States.
| | - Sara Lopus
- Department of Social Sciences, California Polytechnic State University - San Luis Obispo, United States.
| | - Corrie Hannah
- Arizona Institutes for Resilient Environment and Societies (AIRES), University of Arizona, United States.
| | - Kacey C Ernst
- Epidemiology and Biostatistics Department, University of Arizona, United States.
| | - Aminata P Kilungo
- Community, Environment, and Policy Department, University of Arizona, United States.
| | - Romanus Opiyo
- Department of Urban and Regional Planning, University of Nairobi, Kenya.
| | - Margaret Ngayu
- Department of Urban and Regional Planning, University of Nairobi, Kenya.
| | - Julia Davies
- School of Geography, Development and Environment, University of Arizona, United States.
| | - Tom Evans
- School of Geography, Development and Environment, University of Arizona, United States.
| |
Collapse
|
21
|
Chamberlain HR, Macharia PM, Tatem AJ. Mapping urban physical distancing constraints, sub-Saharan Africa: a case study from Kenya. Bull World Health Organ 2022; 100:562-569. [PMID: 36062248 PMCID: PMC9421546 DOI: 10.2471/blt.21.287572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/27/2022] Open
Abstract
With the onset of the coronavirus disease 2019 (COVID-19) pandemic, public health measures such as physical distancing were recommended to reduce transmission of the virus causing the disease. However, the same approach in all areas, regardless of context, may lead to measures being of limited effectiveness and having unforeseen negative consequences, such as loss of livelihoods and food insecurity. A prerequisite to planning and implementing effective, context-appropriate measures to slow community transmission is an understanding of any constraints, such as the locations where physical distancing would not be possible. Focusing on sub-Saharan Africa, we outline and discuss challenges that are faced by residents of urban informal settlements in the ongoing COVID-19 pandemic. We describe how new geospatial data sets can be integrated to provide more detailed information about local constraints on physical distancing and can inform planning of alternative ways to reduce transmission of COVID-19 between people. We include a case study for Nairobi County, Kenya, with mapped outputs which illustrate the intra-urban variation in the feasibility of physical distancing and the expected difficulty for residents of many informal settlement areas. Our examples demonstrate the potential of new geospatial data sets to provide insights and support to policy-making for public health measures, including COVID-19.
Collapse
Affiliation(s)
- Heather R Chamberlain
- WorldPop, Geography and Environmental Science, Building 39, University of Southampton, University Road, Southampton, SO17 1BJ, England
| | - Peter M Macharia
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Andrew J Tatem
- WorldPop, Geography and Environmental Science, Building 39, University of Southampton, University Road, Southampton, SO17 1BJ, England
| |
Collapse
|
22
|
Thindwa D, Jambo KC, Ojal J, MacPherson P, Dennis Phiri M, Pinsent A, Khundi M, Chiume L, Gallagher KE, Heyderman RS, Corbett EL, French N, Flasche S. Social mixing patterns relevant to infectious diseases spread by close contact in urban Blantyre, Malawi. Epidemics 2022; 40:100590. [PMID: 35691100 PMCID: PMC9176177 DOI: 10.1016/j.epidem.2022.100590] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/08/2022] [Accepted: 05/30/2022] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Understanding human mixing patterns relevant to infectious diseases spread through close contact is vital for modelling transmission dynamics and optimisation of disease control strategies. Mixing patterns in low-income countries like Malawi are not well known. METHODOLOGY We conducted a social mixing survey in urban Blantyre, Malawi between April and July 2021 (between the 2nd and 3rd wave of COVID-19 infections). Participants living in densely-populated neighbourhoods were randomly sampled and, if they consented, reported their physical and non-physical contacts within and outside homes lasting at least 5 min during the previous day. Age-specific mixing rates were calculated, and a negative binomial mixed effects model was used to estimate determinants of contact behaviour. RESULTS Of 1201 individuals enroled, 702 (58.5%) were female, the median age was 15 years (interquartile range [IQR] 5-32) and 127 (10.6%) were HIV-positive. On average, participants reported 10.3 contacts per day (range: 1-25). Mixing patterns were highly age-assortative, particularly those within the community and with skin-to-skin contact. Adults aged 20-49 y reported the most contacts (median:11, IQR: 8-15) of all age groups; 38% (95%CI: 16-63) more than infants (median: 8, IQR: 5-10), who had the least contacts. Household contact frequency increased by 3% (95%CI: 2-5) per additional household member. Unemployed participants had 15% (95%CI: 9-21) fewer contacts than other adults. Among long range (>30 m away from home) contacts, secondary school children had the largest median contact distance from home (257 m, IQR 78-761). HIV-positive status in adults >=18 years-old was not associated with changed contact patterns (rate ratio: 1.01, 95%CI: (0.91-1.12)). During this period of relatively low COVID-19 incidence in Malawi, 301 (25.1%) individuals stated that they had limited their contact with others due to COVID-19 precautions; however, their reported contacts were 8% (95%CI: 1-13) higher. CONCLUSION In urban Malawi, contact rates, are high and age-assortative, with little reported behavioural change due to either HIV-status or COVID-19 circulation. This highlights the limits of contact-restriction-based mitigation strategies in such settings and the need for pandemic preparedness to better understand how contact reductions can be enabled and motivated.
Collapse
Affiliation(s)
- Deus Thindwa
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi.
| | - Kondwani C Jambo
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - John Ojal
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; KEMRI-Wellcome Research Programme, Geographic Medicine Centre, Kilifi, Kenya
| | - Peter MacPherson
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Mphatso Dennis Phiri
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - McEwen Khundi
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi
| | - Lingstone Chiume
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi
| | - Katherine E Gallagher
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK; KEMRI-Wellcome Research Programme, Geographic Medicine Centre, Kilifi, Kenya
| | - Robert S Heyderman
- NIHR Global Health Research Unit on Mucosal Pathogens, Research Department of Infection, Division of Infection and Immunity, University College London, London, UK
| | - Elizabeth L Corbett
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Neil French
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi; Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, UK
| | - Stefan Flasche
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| |
Collapse
|
23
|
Adu PA, Binka M, Mahmood B, Jeong D, Buller-Taylor T, Damascene MJ, Iyaniwura S, Ringa N, Velásquez García HA, Wong S, Yu A, Bartlett S, Wilton J, Irvine MA, Otterstatter M, Janjua NZ. Cohort profile: the British Columbia COVID-19 Population Mixing Patterns Survey (BC-Mix). BMJ Open 2022; 12:e056615. [PMID: 36002217 PMCID: PMC9412046 DOI: 10.1136/bmjopen-2021-056615] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Several non-pharmaceutical interventions, such as physical distancing, handwashing, self-isolation, and school and business closures, were implemented in British Columbia (BC) following the first laboratory-confirmed case of COVID-19 on 26 January 2020, to minimise in-person contacts that could spread infections. The BC COVID-19 Population Mixing Patterns Survey (BC-Mix) was established as a surveillance system to measure behaviour and contact patterns in BC over time to inform the timing of the easing/re-imposition of control measures. In this paper, we describe the BC-Mix survey design and the demographic characteristics of respondents. PARTICIPANTS The ongoing repeated online survey was launched in September 2020. Participants are mainly recruited through social media platforms (including Instagram, Facebook, YouTube, WhatsApp). A follow-up survey is sent to participants 2-4 weeks after completing the baseline survey. Survey responses are weighted to BC's population by age, sex, geography and ethnicity to obtain generalisable estimates. Additional indices such as the Material and Social Deprivation Index, residential instability, economic dependency, and others are generated using census and location data. FINDINGS TO DATE As of 26 July 2021, over 61 000 baseline survey responses were received of which 41 375 were eligible for analysis. Of the eligible participants, about 60% consented to follow-up and about 27% provided their personal health numbers for linkage with healthcare databases. Approximately 83.5% of respondents were female, 58.7% were 55 years or older, 87.5% identified as white and 45.9% had at least a university degree. After weighting, approximately 50% were female, 39% were 55 years or older, 65% identified as white and 50% had at least a university degree. FUTURE PLANS Multiple papers describing contact patterns, physical distancing measures, regular handwashing and facemask wearing, modelling looking at impact of physical distancing measures and vaccine acceptance, hesitancy and uptake are either in progress or have been published.
Collapse
Affiliation(s)
- Prince A Adu
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mawuena Binka
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Bushra Mahmood
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Dahn Jeong
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Makuza Jean Damascene
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarafa Iyaniwura
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Mathematics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Notice Ringa
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Héctor A Velásquez García
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Stanley Wong
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Amanda Yu
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Sofia Bartlett
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - James Wilton
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Mike A Irvine
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Michael Otterstatter
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Naveed Zafar Janjua
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation & Outcome Sciences, St. Paul's Hospital, Vancouver, British Columbia, Canada
| |
Collapse
|
24
|
Ngoy N, Conteh IN, Oyugi B, Abok P, Kobie A, Phori P, Hamba C, Ejiofor NE, Fitzwanga K, Appiah J, Edwin A, Fawole T, Kamara R, Cihambanya LK, Mzozo T, Ryan C, Braka F, Yoti Z, Kasolo F, Okeibunor JC, Gueye AS. Coordination and Management of COVID-19 in Africa through Health Operations and Technical Expertise Pillar: A Case Study from WHO AFRO One Year into Response. Trop Med Infect Dis 2022; 7:tropicalmed7080183. [PMID: 36006275 PMCID: PMC9415043 DOI: 10.3390/tropicalmed7080183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 11/24/2022] Open
Abstract
Background: following the importation of the first Coronavirus disease 2019 (COVID-19) case into Africa on 14 February 2020 in Egypt, the World Health Organisation (WHO) regional office for Africa (AFRO) activated a three-level incident management support team (IMST), with technical pillars, to coordinate planning, implementing, supervision, and monitoring of the situation and progress of implementation as well as response to the pandemic in the region. At WHO AFRO, one of the pillars was the health operations and technical expertise (HOTE) pillar with five sub-pillars: case management, infection prevention and control, risk communication and community engagement, laboratory, and emergency medical team (EMT). This paper documents the learnings (both positive and negative for consideration of change) from the activities of the HOTE pillar and recommends future actions for improving its coordination for future emergencies, especially for multi-country outbreaks or pandemic emergency responses. Method: we conducted a document review of the HOTE pillar coordination meetings’ minutes, reports, policy and strategy documents of the activities, and outcomes and feedback on updates on the HOTE pillar given at regular intervals to the Regional IMST. In addition, key informant interviews were conducted with 14 members of the HOTE sub pillar. Key Learnings: the pandemic response revealed that shared decision making, collaborative coordination, and planning have been significant in the COVID-19 response in Africa. The HOTE pillar’s response structure contributed to attaining the IMST objectives in the African region and translated to timely support for the WHO AFRO and the member states. However, while the coordination mechanism appeared robust, some challenges included duplication of coordination efforts, communication, documentation, and information management. Recommendations: we recommend streamlining the flow of information to better understand the challenges that countries face. There is a need to define the role and responsibilities of sub-pillar team members and provide new team members with information briefs to guide them on where and how to access internal information and work under the pillar. A unified documentation system is important and could help to strengthen intra-pillar collaboration and communication. Various indicators should be developed to constantly monitor the HOTE team’s deliverables, performance and its members.
Collapse
Affiliation(s)
- Nsenga Ngoy
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Ishata Nannie Conteh
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Boniface Oyugi
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
- Centre for Health Services Studies (CHSS), University of Kent, George Allen Wing, Canterbury CT2 7NF, UK
| | - Patrick Abok
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Aminata Kobie
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Peter Phori
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Cephas Hamba
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Nonso Ephraim Ejiofor
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Kaizer Fitzwanga
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - John Appiah
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Ama Edwin
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Temidayo Fawole
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Rashidatu Kamara
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Landry Kabego Cihambanya
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Tasiana Mzozo
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Nairobi Hub, United Nations Office in Nairobi UN Avenue Gigiri, Nairobi 00100, Kenya
| | - Caroline Ryan
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Nairobi Hub, United Nations Office in Nairobi UN Avenue Gigiri, Nairobi 00100, Kenya
| | - Fiona Braka
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Zabulon Yoti
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Francis Kasolo
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| | - Joseph C. Okeibunor
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
- Correspondence:
| | - Abdou Salam Gueye
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Cité du Djoué, Brazzaville P.O. Box 06, Congo
| |
Collapse
|
25
|
Merchant EV, Fatima T, Fatima A, Maiyo N, Mutuku V, Keino S, Simon JE, Hoffman DJ, Downs SM. The Influence of Food Environments on Food Security Resilience during the COVID-19 Pandemic: An Examination of Urban and Rural Difference in Kenya. Nutrients 2022; 14:2939. [PMID: 35889896 PMCID: PMC9322483 DOI: 10.3390/nu14142939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 02/04/2023] Open
Abstract
Hunger and food insecurity has worsened due to the COVID-19 pandemic. The types of food environments (e.g., natural/built) that people can access may improve household resilience to food-system shocks. This paper examines (1) urban and rural differences in the perceived influence of the COVID-19 pandemic on agricultural, livelihoods, food environment attributes, diets; and (2) whether access to different food environments was associated with food security. A two-part telephonic survey (COVID-19 Surveillance Community Action Network Food Systems Tool and Household Food Insecurity Access Scale) was conducted in Western Kenya (n = 173) and an informal settlement in Nairobi (n = 144) in January/February 2021. Limitations on the acquisition of farm inputs and movement restrictions had an adverse impact on agriculture and food sales. Urban residents reported a more significant impact on livelihoods (97% vs. 87%, p < 0.001), with day laborers being the most impacted. Rural respondents reported access to significantly more food environments and lower food insecurity. Multiple linear regression analysis revealed that younger respondents, ≤1 income source, had more difficulty acquiring food, decreased access to cultivated environments, and increased access to informal markets were predictors for higher food insecurity. These data indicate that access to specific types of food environments may improve household resilience.
Collapse
Affiliation(s)
- Emily V. Merchant
- New Use Agriculture and Natural Plant Products Program, Department of Plant Biology, Rutgers University, New Brunswick, NJ 08901, USA; (E.V.M.); (J.E.S.)
- Center for Agricultural Food Ecosystems, The New Jersey Institute for Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ 08901, USA;
| | - Tasneem Fatima
- Urban-Global Public Health, Rutgers School of Public Health, Newark, NJ 07102, USA; (T.F.); (A.F.)
| | - Alisa Fatima
- Urban-Global Public Health, Rutgers School of Public Health, Newark, NJ 07102, USA; (T.F.); (A.F.)
| | - Norah Maiyo
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret 30100, Kenya;
| | | | - Susan Keino
- Department of Health Management & Human Nutrition, School of Public Health, Moi University, P.O. Box 4606, Eldoret 30100, Kenya;
| | - James E. Simon
- New Use Agriculture and Natural Plant Products Program, Department of Plant Biology, Rutgers University, New Brunswick, NJ 08901, USA; (E.V.M.); (J.E.S.)
- Center for Agricultural Food Ecosystems, The New Jersey Institute for Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ 08901, USA;
| | - Daniel J. Hoffman
- Center for Agricultural Food Ecosystems, The New Jersey Institute for Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ 08901, USA;
- Department of Nutritional Sciences, New Jersey Institute for Food, Nutrition, and Health, Center for Childhood Nutrition Education and Research, Rutgers University, New Brunswick, NJ 08901, USA
| | - Shauna M. Downs
- Center for Agricultural Food Ecosystems, The New Jersey Institute for Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ 08901, USA;
- Urban-Global Public Health, Rutgers School of Public Health, Newark, NJ 07102, USA; (T.F.); (A.F.)
| |
Collapse
|
26
|
Wamalwa M, Tonnang HEZ. Using outbreak data to estimate the dynamic COVID-19 landscape in Eastern Africa. BMC Infect Dis 2022; 22:531. [PMID: 35681129 PMCID: PMC9178551 DOI: 10.1186/s12879-022-07510-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 05/27/2022] [Indexed: 12/13/2022] Open
Abstract
Background The emergence of COVID-19 as a global pandemic presents a serious health threat to African countries and the livelihoods of its people. To mitigate the impact of this disease, intervention measures including self-isolation, schools and border closures were implemented to varying degrees of success. Moreover, there are a limited number of empirical studies on the effectiveness of non-pharmaceutical interventions (NPIs) to control COVID-19. In this study, we considered two models to inform policy decisions about pandemic planning and the implementation of NPIs based on case-death-recovery counts.
Methods We applied an extended susceptible-infected-removed (eSIR) model, incorporating quarantine, antibody and vaccination compartments, to time series data in order to assess the transmission dynamics of COVID-19. Additionally, we adopted the susceptible-exposed-infectious-recovered (SEIR) model to investigate the robustness of the eSIR model based on case-death-recovery counts and the reproductive number (R0). The prediction accuracy was assessed using the root mean square error and mean absolute error. Moreover, parameter sensitivity analysis was performed by fixing initial parameters in the SEIR model and then estimating R0, β and γ. Results We observed an exponential trend of the number of active cases of COVID-19 since March 02 2020, with the pandemic peak occurring around August 2021. The estimated mean R0 values ranged from 1.32 (95% CI, 1.17–1.49) in Rwanda to 8.52 (95% CI: 3.73–14.10) in Kenya. The predicted case counts by January 16/2022 in Burundi, Ethiopia, Kenya, Rwanda, South Sudan, Tanzania and Uganda were 115,505; 7,072,584; 18,248,566; 410,599; 386,020; 107,265, and 3,145,602 respectively. We show that the low apparent morbidity and mortality observed in EACs, is likely biased by underestimation of the infected and mortality cases. Conclusion The current NPIs can delay the pandemic pea and effectively reduce further spread of COVID-19 and should therefore be strengthened. The observed reduction in R0 is consistent with the interventions implemented in EACs, in particular, lockdowns and roll-out of vaccination programmes. Future work should account for the negative impact of the interventions on the economy and food systems. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07510-3.
Collapse
Affiliation(s)
- Mark Wamalwa
- International Centre of Insect Physiology and Ecology (Icipe), P.O. Box 30772-00100, Nairobi, Kenya.
| | - Henri E Z Tonnang
- International Centre of Insect Physiology and Ecology (Icipe), P.O. Box 30772-00100, Nairobi, Kenya
| |
Collapse
|
27
|
Mwai J, Nyole D, Abdi MH, Omogi J. Factors associated with tungiasis among school-age children in Kwale County, rural Kenya. Int Health 2022; 15:85-92. [PMID: 35390149 PMCID: PMC9808516 DOI: 10.1093/inthealth/ihac013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/03/2022] [Accepted: 03/14/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The parasitic disease tungiasis, caused by the flea Tunga penetrans, remains an important public health problem among children and the elderly. The study assessed the factors influencing prevention and control of tungiasis infection among school-age children in Kwale County, Kenya. METHODS A cross-sectional survey was conducted in five villages in Lunga Lunga subcounty among 538 children ages 5-14 y. The study employed a mobile application tool in collecting sociodemographic, knowledge, perception and practice data on prevention and control of tungiasis with frequencies and bivariate and multivariate regression analysis used. RESULTS The prevalence of tungiasis was found to be 62.1% (328/528), with fathers' education level, place of residence and wearing shoes being factors associated with infection. Those who wore shoes were less likely to be infected compared with those who did not (odds ratio 0.059 [95% confidence interval 0.29 to 0.12]). Children living in Dzombo B and Kinyungu were less likely to be infected with tungiasis compared with those living in Bandu, holding other factors constant. CONCLUSION Creating awareness of the cause of tungiasis remains of key public importance. Hygiene promotion, including wearing of shoes and the general cleanliness of the environment at the community level, needs to be implemented.
Collapse
Affiliation(s)
- Judy Mwai
- Kenya Medical Research Institute-CPHR
| | - Diana Nyole
- ITROMID-Jomo Kenyatta University of Agriculture and Technology
| | | | - Jarim Omogi
- Corresponding author: Tel: +254720573449; E-mail:
| |
Collapse
|
28
|
Wu JS, Font X, McCamley C. COVID-19 social distancing compliance mechanisms: UK evidence. ENVIRONMENTAL RESEARCH 2022; 205:112528. [PMID: 34953882 PMCID: PMC8696958 DOI: 10.1016/j.envres.2021.112528] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/25/2021] [Accepted: 12/04/2021] [Indexed: 06/14/2023]
Abstract
Non-compliance with social distancing (SD) measures clearly has negative effects on both public health and post-pandemic economic recovery. However, little is as yet known about people's views on and factors influencing their behavioral intentions toward SD measures. This study draws on moral disengagement theory and the norm-activation model to investigate mechanisms that promote or hinder compliance with SD measures. A longitudinal research approach was adopted to compare changes in the main factors over three periods of the COVID-19 pandemic in England (UK). The results reveal significant differences between the three periods regarding intentions to comply with SD measures, altruistic value, moral obligation and moral disengagement, with no significant change in ascription of responsibility. Residents showed the strongest intentions to comply with SD measures during the first national lockdown, with the highest moral obligation and lowest moral disengagement levels, compared with the lowest intention to comply during the first re-opening period. Altruistic value is important in promoting moral obligation and compliance with SD measures, whereas the predictive powers of ascription of responsibility and moral disengagement were weaker than expected. These findings offer guidance to policymakers and researchers in developing more effective policies and public communication strategies. The results suggest that communication is key to normalizing SD compliance, which can be achieved most effectively by fostering residents' altruistic value and moral considerations. Particular attention must be paid to re-opening periods between lockdowns, with clear messages to remind residents of prosocial aspects of SD compliance and public health. In addition to appropriate communication and education, technologies such as apps, QR codes and contactless shopping settings may also be used to facilitate compliance with SD measures.
Collapse
Affiliation(s)
- Jialin Snow Wu
- Huddersfield Business School, University of Huddersfield, Huddersfield, UK.
| | - Xavier Font
- School of Hospitality and Tourism Management, University of Surrey, Guildford, UK; Department of Business and Economics, UiT the Arctic University of Norway, Tromsø, Norway
| | - Claire McCamley
- Huddersfield Business School, University of Huddersfield, Huddersfield, UK
| |
Collapse
|
29
|
Wambua S, Malla L, Mbevi G, Kandiah J, Nwosu AP, Tuti T, Paton C, Wambu B, English M, Okiro EA. Quantifying the indirect impact of COVID-19 pandemic on utilisation of outpatient and immunisation services in Kenya: a longitudinal study using interrupted time series analysis. BMJ Open 2022; 12:e055815. [PMID: 35273053 PMCID: PMC8914407 DOI: 10.1136/bmjopen-2021-055815] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 01/31/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE In this study, we assess the indirect impact of COVID-19 on utilisation of immunisation and outpatient services in Kenya. DESIGN Longitudinal study. SETTING Data were analysed from all healthcare facilities reporting to Kenya's health information system from January 2018 to March 2021. Multiple imputation was used to address missing data, interrupted time series analysis was used to quantify the changes in utilisation of services and sensitivity analysis was carried out to assess robustness of estimates. EXPOSURE OF INTEREST COVID-19 outbreak and associated interventions. OUTCOME MEASURES Monthly attendance to health facilities. We assessed changes in immunisation and various outpatient services nationally. RESULTS Before the first case of COVID-19 and pursuant intervention measures in March 2020, uptake of health services was consistent with historical levels. There was significant drops in attendance (level changes) in April 2020 for overall outpatient visits for under-fives (rate ratio, RR 0.50, 95% CI 0.44 to 0.57), under-fives with pneumonia (RR 0.43, 95% CI 0.38 to 0.47), overall over-five visits (RR 0.65, 95% CI 0.57 to 0.75), over-fives with pneumonia (RR 0.62, 95% CI 0.55 to 0.70), fourth antenatal care visit (RR 0.86, 95% CI 0.80 to 0.93), total hypertension (RR 0.89, 95% CI 0.82 to 0.96), diabetes cases (RR 0.95 95% CI, 0.93 to 0.97) and HIV testing (RR 0.97, 95% CI 0.94 to 0.99). Immunisation services, first antenatal care visits, new cases of hypertension and diabetes were not affected. The post-COVID-19 trend was increasing, with more recent data suggesting reversal of effects and health services reverting to expected levels as of March 2021. CONCLUSION COVID-19 pandemic has had varied indirect effects on utilisation of health services in Kenya. There is need for proactive and targeted interventions to reverse these effects as part of the pandemic's response to avert non-COVID-19 indirect mortality.
Collapse
Affiliation(s)
- Steven Wambua
- Population Health Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Lucas Malla
- Health Services Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - George Mbevi
- Health Services Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Joel Kandiah
- Mathematics Institute, University of Warwick, Coventry, UK
| | - Amen-Patrick Nwosu
- Nuffield Department of Clinical Medicine, Oxford Centre for Global Health Research, Oxford, UK
| | - Timothy Tuti
- Health Services Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Chris Paton
- Nuffield Department of Clinical Medicine, Oxford Centre for Global Health Research, Oxford, UK
| | - Bernard Wambu
- Division of Neonatal and Child Health, Kenya Ministry of Health, Nairobi, Kenya
| | - Mike English
- Health Services Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
- Nuffield Department of Clinical Medicine, Oxford Centre for Global Health Research, Oxford, UK
| | - Emelda A Okiro
- Population Health Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
- Nuffield Department of Clinical Medicine, Oxford Centre for Global Health Research, Oxford, UK
| |
Collapse
|
30
|
Li H, Yuan K, Sun YK, Zheng YB, Xu YY, Su SZ, Zhang YX, Zhong Y, Wang YJ, Tian SS, Gong YM, Fan TT, Lin X, Gobat N, Wong SYS, Chan EYY, Yan W, Sun SW, Ran MS, Bao YP, Shi J, Lu L. Efficacy and practice of facemask use in general population: a systematic review and meta-analysis. Transl Psychiatry 2022; 12:49. [PMID: 35105851 PMCID: PMC8804079 DOI: 10.1038/s41398-022-01814-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 12/14/2021] [Accepted: 01/18/2022] [Indexed: 11/17/2022] Open
Abstract
In recent decades, respiratory infections, including SARS, HINI and the currently spreading COVID-19, caused by various viruses such as influenza and coronavirus have seriously threatened human health. It has generated inconsistent recommendations on the mandatory use of facemasks across countries on a population level due to insufficient evidence on the efficacy of facemask use among the general population. This meta-analysis aimed to explore (1) the efficacy of facemask use on preventing respiratory infections, and (2) the perceptions, intentions, and practice about facemask use among the general population worldwide. We searched PubMed, MEDLINE, Web of Science, Cochrane, bioRxiv, and medRxiv databases since inception to August 17, 2020. From 21,341 records identified, eight RCTs on facemask in preventing infections and 78 studies on perception, intention, and practice of facemask use among the general population were included in the analysis. The meta-analysis of RCTs found a significant protective effect of facemask intervention (OR = 0.84; 95% CI = 0.71-0.99; I2 = 0%). This protective effect was even more pronounced when the intervention duration was more than two weeks (OR = 0.76; 95% CI = 0.66-0.88; I2 = 0%). The meta-analysis of observational studies on perception, intention, and practice on facemask use showed that 71% of respondents perceived facemasks to be effective for infection prevention, 68% of respondents would wear facemasks, and 54% of respondents wore facemasks for preventing respiratory infections. Differences in perception, intention, and practice behavior of facemask use in different regions may be related to the impact of respiratory infections, regional culture, and policies. The governments and relevant organizations should make effort to reduce the barriers in the use of facemasks.
Collapse
Affiliation(s)
- Hui Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Yan-Kun Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Yong-Bo Zheng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Ying-Ying Xu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China
- School of Public Health, Peking University, 100191, Beijing, China
| | - Si-Zhen Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Yu-Xin Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- School of Public Health, Peking University, 100191, Beijing, China
| | - Yi Zhong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Yi-Jie Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Shan-Shan Tian
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Yi-Miao Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Teng-Teng Fan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Xiao Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Nina Gobat
- Nuffield Dept of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Emily Ying Yang Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, School of Public Health and Primary Care, Prince of Wales Hospital, Sha tin, Hong Kong
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Si-Wei Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China.
- School of Public Health, Peking University, 100191, Beijing, China.
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China.
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China.
| |
Collapse
|
31
|
Morante-García W, Zapata-Boluda RM, García-González J, Campuzano-Cuadrado P, Calvillo C, Alarcón-Rodríguez R. Influence of Social Determinants of Health on COVID-19 Infection in Socially Vulnerable Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031294. [PMID: 35162317 PMCID: PMC8834846 DOI: 10.3390/ijerph19031294] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/19/2022] [Accepted: 01/23/2022] [Indexed: 12/18/2022]
Abstract
The coronavirus 2019 (COVID-19) pandemic has had a significant impact on the economy and health, especially for the most vulnerable social groups. The social determinants of health are one of the most relevant risks for becoming infected with COVID-19, due to the health consequences for those who are exposed to it. The objective of this study was to analyze the influence of social determinants in health on COVID-19 infection in vulnerable social groups. A transversal epidemiological study was carried out on 746 individuals in vulnerable situations living in conditions of extreme poverty in disadvantaged areas in the province of Almeria (southeast of Spain). Social determinants of health such access to drinking water (p < 0.001) and economic income (p = 0.04) influenced the infection of COVID-19. A binary logistic regression model showed that the significant predictors of COVID-19 infection were the lack of economic income and inaccessible drinking water. The government and social health services must be aware of this problem in order to play an active role in searching for solutions and implementing public health prevention measures to eliminate social inequalities in health.
Collapse
Affiliation(s)
| | - Rosa María Zapata-Boluda
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain; (R.M.Z.-B.); (C.C.); (R.A.-R.)
| | - Jessica García-González
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain; (R.M.Z.-B.); (C.C.); (R.A.-R.)
- Correspondence:
| | | | - Cristobal Calvillo
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain; (R.M.Z.-B.); (C.C.); (R.A.-R.)
| | - Raquel Alarcón-Rodríguez
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain; (R.M.Z.-B.); (C.C.); (R.A.-R.)
| |
Collapse
|
32
|
Thuku P. The Relationship Between Community Adherence to COVID-19 Containment Measures and the Wellbeing of Older Adults in Rural Kenya. Gerontol Geriatr Med 2022; 8:23337214221105981. [PMID: 35686117 PMCID: PMC9171127 DOI: 10.1177/23337214221105981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has disrupted lives globally but disproportionately affected older adults due to their increased vulnerability to severe illness and higher mortality. To protect older adults from infection, community members in rural Kenya have ensured enhanced adherence to COVID-19 containment measures. However, while restricted social contact is highly recommended in the control of COVID-19 infection, limited research exists on its effect on the psychosocial wellbeing of older adults. This study therefore assessed the relationship between community adherence to COVID-19 containment measures and the overall wellbeing of older adults. Nyeri County in Central Kenya was selected for the study and all adults aged 70 years and above targeted. Snowball sampling was used to collect data from a sample of 360 respondents. Both descriptive and inferential statistics were used in data analysis. The study established a significant inverse relationship between the level of community adherence to COVID-19 protocols and the wellbeing of older adults. Furthermore, the wellbeing of most older adults had deteriorated during the pandemic, with older married women with higher incomes being less affected. The study concluded that although the COVID-19 pandemic had affected everyone, effective containment is a multi-dimensional issue that requires targeted interventions.
Collapse
|
33
|
Ogira D, Bharali I, Onyango J, Mao W, McDade KK, Kokwaro G, Yamey G. Identifying the impact of COVID-19 on health systems and lessons for future emergency preparedness: A stakeholder analysis in Kenya. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001348. [PMID: 36962867 PMCID: PMC10021887 DOI: 10.1371/journal.pgph.0001348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 11/10/2022] [Indexed: 12/24/2022]
Abstract
The coronavirus pandemic (COVID-19) has triggered a public health and economic crisis in high and low resource settings since the beginning of 2020. With the first case being discovered on 12th March 2020, Kenya has responded by using health and non-health strategies to mitigate the direct and indirect impact of the disease on its population. However, this has had positive and negative implications for the country's overall health system. This paper aimed to understand the pandemic's impact and develop lessons for future response by identifying the key challenges and opportunities Kenya faced during the pandemic. We conducted a qualitative study with 15 key informants, purposefully sampled for in-depth interviews from September 2020 to February 2021. We conducted direct content analysis of the transcripts to understand the stakeholder's views and perceptions of how COVID-19 has affected the Kenyan healthcare system. Most of the respondents noted that Kenya's initial response was relatively good, especially in controlling the pandemic with the resources it had at the time. This included relaying information to citizens, creating technical working groups and fostering multisectoral collaboration. However, concerns were raised regarding service disruption and impact on reproductive health, HIV, TB, and non-communicable diseases services; poor coordination between the national and county governments; shortage of personal protective equipment and testing kits; and strain of human resources for health. Effective pandemic preparedness for future response calls for improved investments across the health system building blocks, including; human resources for health, financing, infrastructure, information, leadership, service delivery and medical products and technologies. These strategies will help build resilient health systems and improve self-reliance, especially for countries transitioning from donor aid such as Kenya in the event of a pandemic.
Collapse
Affiliation(s)
- Dosila Ogira
- Institute of Healthcare Management, Strathmore Business School, Strathmore University, Nairobi, Kenya
| | - Ipchita Bharali
- Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Joseph Onyango
- Institute of Healthcare Management, Strathmore Business School, Strathmore University, Nairobi, Kenya
| | - Wenhui Mao
- Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Kaci Kennedy McDade
- Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Gilbert Kokwaro
- Institute of Healthcare Management, Strathmore Business School, Strathmore University, Nairobi, Kenya
| | - Gavin Yamey
- Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| |
Collapse
|
34
|
Jiang X, Chen Y, Wang J. Global Food Security under COVID-19: Comparison and Enlightenment of Policy Responses in Different Countries. Foods 2021; 10:foods10112850. [PMID: 34829131 PMCID: PMC8618370 DOI: 10.3390/foods10112850] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/13/2021] [Accepted: 11/16/2021] [Indexed: 11/24/2022] Open
Abstract
(1) Background: COVID-19 has exacerbated global food security risks, and the global food supply chain, especially in developing countries, has become more vulnerable. (2) Methods: In this paper, we discussed the current security of global food, response measures, and potential impacts, and analyzed the characteristics and evolution of food security policies in four representative countries: China, Italy, Malawi, Argentina. (3) Results: The results showed that most countries give priority to ensuring food access. Most underdeveloped countries adopt humanitarian intervention measures such as food distribution and transfer payments, while developed countries tend to implement development intervention policies such as supporting small- and medium-sized enterprises and guaranteeing employment. (4) Conclusions: Despite the ample global supply, developing countries still face long-term food security risks, highlighting the importance of strengthening global food security governance and risk management. Finally, a food security risk response policy framework was built to provide suggestions for effectively handling COVID-19 and similar public health emergencies in the future.
Collapse
Affiliation(s)
- Xiaoyu Jiang
- Institute of Agricultural Economics and Development, Chinese Academy of Agricultural Sciences, Beijing 100081, China;
| | - Yangfen Chen
- Institute of Agricultural Economics and Development, Chinese Academy of Agricultural Sciences, Beijing 100081, China;
- Correspondence: (Y.C.); (J.W.)
| | - Jieyong Wang
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
- Correspondence: (Y.C.); (J.W.)
| |
Collapse
|
35
|
Talic S, Shah S, Wild H, Gasevic D, Maharaj A, Ademi Z, Li X, Xu W, Mesa-Eguiagaray I, Rostron J, Theodoratou E, Zhang X, Motee A, Liew D, Ilic D. Effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality: systematic review and meta-analysis. BMJ 2021; 375:e068302. [PMID: 34789505 PMCID: PMC9423125 DOI: 10.1136/bmj-2021-068302] [Citation(s) in RCA: 288] [Impact Index Per Article: 96.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and World Health Organization COVID-19 database (preprints). ELIGIBILITY CRITERIA FOR STUDY SELECTION Observational and interventional studies that assessed the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality. MAIN OUTCOME MEASURES The main outcome measure was incidence of covid-19. Secondary outcomes included SARS-CoV-2 transmission and covid-19 mortality. DATA SYNTHESIS DerSimonian Laird random effects meta-analysis was performed to investigate the effect of mask wearing, handwashing, and physical distancing measures on incidence of covid-19. Pooled effect estimates with corresponding 95% confidence intervals were computed, and heterogeneity among studies was assessed using Cochran's Q test and the I2 metrics, with two tailed P values. RESULTS 72 studies met the inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures as a "package of interventions." Eight of 35 studies were included in the meta-analysis, which indicated a reduction in incidence of covid-19 associated with handwashing (relative risk 0.47, 95% confidence interval 0.19 to 1.12, I2=12%), mask wearing (0.47, 0.29 to 0.75, I2=84%), and physical distancing (0.75, 0.59 to 0.95, I2=87%). Owing to heterogeneity of the studies, meta-analysis was not possible for the outcomes of quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces. The effects of these interventions were synthesised descriptively. CONCLUSIONS This systematic review and meta-analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19. Public health efforts to implement public health measures should consider community health and sociocultural needs, and future research is needed to better understand the effectiveness of public health measures in the context of covid-19 vaccination. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020178692.
Collapse
Affiliation(s)
- Stella Talic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
- Monash Outcomes Research and health Economics (MORE) Unit, Monash University, VIC, Australia
| | - Shivangi Shah
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
| | - Holly Wild
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
- Torrens University, VIC, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ashika Maharaj
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
- Monash Outcomes Research and health Economics (MORE) Unit, Monash University, VIC, Australia
| | - Xue Li
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
- School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Xu
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ines Mesa-Eguiagaray
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Jasmin Rostron
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Evropi Theodoratou
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Xiaomeng Zhang
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ashmika Motee
- Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
- Monash Outcomes Research and health Economics (MORE) Unit, Monash University, VIC, Australia
| | - Dragan Ilic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
| |
Collapse
|
36
|
Dear N, Duff E, Esber A, Parikh A, Iroezindu M, Bahemana E, Kibuuka H, Owuoth J, Maswai J, Crowell TA, Ake JA, Polyak CS. Transient Reductions in Human Immunodeficiency Virus (HIV) Clinic Attendance and Food Security During the Coronavirus Disease 2019 (COVID-19) Pandemic for People Living With HIV in 4 African Countries. Clin Infect Dis 2021; 73:1901-1905. [PMID: 33906235 PMCID: PMC8135576 DOI: 10.1093/cid/ciab379] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Indexed: 01/12/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic and associated public health responses have disrupted daily living activities with economic and health consequences globally. We observed transient decreases in human immunodeficiency virus (HIV) clinic visit adherence and food security among persons living with HIV early in the pandemic, and an increase in viral suppression later in the pandemic.
Collapse
Affiliation(s)
- Nicole Dear
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Emma Duff
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Allahna Esber
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Ajay Parikh
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Michael Iroezindu
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- HJF Medical Research International, Abuja, Nigeria
| | - Emmanuel Bahemana
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- HJF Medical Research International, Mbeya, Tanzania
| | - Hannah Kibuuka
- Makerere University-Walter Reed Project, Kampala, Uganda
| | - John Owuoth
- US Army Medical Research Directorate-Africa, Kisumu, Kenya
- HJF Medical Research International, Kisumu, Kenya
| | - Jonah Maswai
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- HJF Medical Research International, Kericho, Kenya
| | - Trevor A Crowell
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Julie A Ake
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Christina S Polyak
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| |
Collapse
|
37
|
Decker MR, Wood SN, Thiongo M, Byrne ME, Devoto B, Morgan R, Bevilacqua K, Williams A, Stuart HC, Wamue- Ngare G, Heise L, Glass N, Anglewicz P, Gummerson E, Gichangi P. Gendered health, economic, social and safety impact of COVID-19 on adolescents and young adults in Nairobi, Kenya. PLoS One 2021; 16:e0259583. [PMID: 34752473 PMCID: PMC8577767 DOI: 10.1371/journal.pone.0259583] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/21/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Infectious disease outbreaks like COVID-19 and their mitigation measures can exacerbate underlying gender disparities, particularly among adolescents and young adults in densely populated urban settings. METHODS An existing cohort of youth ages 16-26 in Nairobi, Kenya completed a phone-based survey in August-October 2020 (n = 1217), supplemented by virtual focus group discussions and interviews with youth and stakeholders, to examine economic, health, social, and safety experiences during COVID-19, and gender disparities therein. RESULTS COVID-19 risk perception was high with a gender differential favoring young women (95.5% vs. 84.2%; p<0.001); youth described mixed concern and challenges to prevention. During COVID-19, gender symmetry was observed in constrained access to contraception among contraceptive users (40.4% men; 34.6% women) and depressive symptoms (21.8% men; 24.3% women). Gender disparities rendered young women disproportionately unable to meet basic economic needs (adjusted odds ratio [aOR] = 1.21; p<0.05) and in need of healthcare during the pandemic (aOR = 1.59; p<0.001). At a bivariate level, women had lower full decisional control to leave the house (40.0% vs. 53.2%) and less consistent access to safe, private internet (26.1% vs. 40.2%), while men disproportionately experienced police interactions (60.1%, 55.2% of which included extortion). Gender-specific concerns for women included menstrual hygiene access challenges (52.0%), increased reliance on transactional partnerships, and gender-based violence, with 17.3% reporting past-year partner violence and 3.0% non-partner sexual violence. Qualitative results contextualize the mental health impact of economic disruption and isolation, and, among young women, privacy constraints. IMPLICATIONS Youth and young adults face gendered impacts of COVID-19, reflecting both underlying disparities and the pandemic's economic and social shock. Economic, health and technology-based supports must ensure equitable access for young women. Gender-responsive recovery efforts are necessary and must address the unique needs of youth.
Collapse
Affiliation(s)
- Michele R. Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Department of Population, Family and Reproductive Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Shannon N. Wood
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Department of Population, Family and Reproductive Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Mary Thiongo
- International Centre for Reproductive Health-Kenya, Nairobi, Kenya
| | - Meagan E. Byrne
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Department of Population, Family and Reproductive Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Bianca Devoto
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Rosemary Morgan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Kristin Bevilacqua
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Anaise Williams
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - H. Colleen Stuart
- Johns Hopkins Carey Business School, Baltimore, MD, United States of America
| | - Grace Wamue- Ngare
- Department of Sociology, Gender and Development Studies, Kenyatta University, Nairobi, Kenya
- Women’s Economic Empowerment Hub, Kenyatta University, Nairobi, Kenya
| | - Lori Heise
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Nancy Glass
- Johns Hopkins School of Nursing, Baltimore, MD, United States of America
- Center for Global Health, Johns Hopkins University, Baltimore, MD, United States of America
| | - Philip Anglewicz
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Department of Population, Family and Reproductive Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Elizabeth Gummerson
- Department of Population, Family and Reproductive Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Peter Gichangi
- International Centre for Reproductive Health-Kenya, Nairobi, Kenya
- Technical University of Mombasa, Mombasa, Kenya
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
38
|
Del Fava E, Adema I, Kiti MC, Poletti P, Merler S, Nokes DJ, Manfredi P, Melegaro A. Individual's daily behaviour and intergenerational mixing in different social contexts of Kenya. Sci Rep 2021; 11:21589. [PMID: 34732732 PMCID: PMC8566563 DOI: 10.1038/s41598-021-00799-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/15/2021] [Indexed: 12/20/2022] Open
Abstract
We investigated contact patterns in diverse social contexts in Kenya and the daily behaviours that may play a pivotal role in infection transmission to the most vulnerable leveraging novel data from a 2-day survey on social contacts and time use (TU) from a sample of 1407 individuals (for a total of 2705 person days) from rural, urban formal, and informal settings. We used TU data to build six profiles of daily behaviour based on the main reported activities, i.e., Homestayers (71.1% of person days), Workers (9.3%), Schoolers (7.8%), or locations at increasing distance from home, i.e., Walkers (6.6%), Commuters (4.6%), Travelers (0.6%). In the rural setting, we observed higher daily contact numbers (11.56, SD 0.23) and percentages of intergenerational mixing with older adults (7.5% of contacts reported by those younger than 60 years vs. less than 4% in the urban settings). Overall, intergenerational mixing with older adults was higher for Walkers (7.3% of their reported contacts), Commuters (8.7%), and Homestayers (5.1%) than for Workers (1.5%) or Schoolers (3.6%). These results could be instrumental in defining effective interventions that acknowledge the heterogeneity in social contexts and daily routines, either in Kenya or other demographically and culturally similar sub-Saharan African settings.
Collapse
Affiliation(s)
- Emanuele Del Fava
- Carlo F. Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Irene Adema
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Moses C Kiti
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | | | - D James Nokes
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- School of Life Sciences and Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research (SBIDER), University of Warwick, Coventry, UK
| | | | - Alessia Melegaro
- Carlo F. Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy.
- Department of Social and Political Sciences, Bocconi University, Milan, Italy.
| |
Collapse
|
39
|
Liu CY, Berlin J, Kiti MC, Del Fava E, Grow A, Zagheni E, Melegaro A, Jenness SM, Omer SB, Lopman B, Nelson K. Rapid Review of Social Contact Patterns During the COVID-19 Pandemic. Epidemiology 2021; 32:781-791. [PMID: 34392254 PMCID: PMC8478104 DOI: 10.1097/ede.0000000000001412] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/02/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Physical distancing measures aim to reduce person-to-person contact, a key driver of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. In response to unprecedented restrictions on human contact during the coronavirus disease 2019 (COVID-19) pandemic, studies measured social contact patterns under the implementation of physical distancing measures. This rapid review synthesizes empirical data on the changing social contact patterns during the COVID-19 pandemic. METHOD We conducted a systematic review using PubMed, Medline, Embase, and Google Scholar following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We descriptively compared the distribution of contacts observed during the pandemic to pre-COVID data across countries to explore changes in contact patterns during physical distancing measures. RESULTS We identified 12 studies reporting social contact patterns during the COVID-19 pandemic. Eight studies were conducted in European countries and eleven collected data during the initial mitigation period in the spring of 2020 marked by government-declared lockdowns. Some studies collected additional data after relaxation of initial mitigation. Most study settings reported a mean of between 2 and 5 contacts per person per day, a substantial reduction compared to pre-COVID rates, which ranged from 7 to 26 contacts per day. This reduction was pronounced for contacts outside of the home. Consequently, levels of assortative mixing by age substantially declined. After relaxation of initial mitigation, mean contact rates increased but did not return to pre-COVID levels. Increases in contacts post-relaxation were driven by working-age adults. CONCLUSION Information on changes in contact patterns during physical distancing measures can guide more realistic representations of contact patterns in mathematical models for SARS-CoV-2 transmission.
Collapse
Affiliation(s)
- Carol Y. Liu
- From the Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | - Juliette Berlin
- From the Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | - Moses C. Kiti
- From the Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | - Emanuele Del Fava
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - André Grow
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Emilio Zagheni
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Alessia Melegaro
- Department of Social and Political Sciences, Centre for Research on Social Dynamics and Public Policy and Covid Crisis Lab, Bocconi University, Milan, Italy
| | - Samuel M. Jenness
- From the Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | - Saad B. Omer
- Department of Epidemiology of Microbial Diseases, Yale Institute of Global Health, Yale University, CT
| | - Benjamin Lopman
- From the Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | - Kristin Nelson
- From the Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| |
Collapse
|
40
|
Del Fava E, Cimentada J, Perrotta D, Grow A, Rampazzo F, Gil-Clavel S, Zagheni E. Differential impact of physical distancing strategies on social contacts relevant for the spread of SARS-CoV-2: evidence from a cross-national online survey, March-April 2020. BMJ Open 2021; 11:e050651. [PMID: 34675016 PMCID: PMC8532142 DOI: 10.1136/bmjopen-2021-050651] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We investigate changes in social contact patterns following the gradual introduction of non-pharmaceutical interventions and their implications for infection transmission in the early phase of the pandemic. DESIGN, SETTING AND PARTICIPANTS We conducted an online survey based on targeted Facebook advertising campaigns across eight countries (Belgium, France, Germany, Italy, the Netherlands, Spain, UK and USA), achieving a sample of 51 233 questionnaires in the period 13 March-12 April 2020. Poststratification weights based on census information were produced to correct for selection bias. OUTCOME MEASURES Participants provided data on social contact numbers, adoption of protective behaviours and perceived level of threat. These data were combined to derive a weekly index of infection transmission, the net reproduction number [Formula: see text] . RESULTS Evidence from the USA and UK showed that the number of daily contacts mainly decreased after governments issued the first physical distancing guidelines. In mid-April, daily social contact numbers had decreased between 61% in Germany and 87% in Italy with respect to pre-COVID-19 levels, mostly due to a contraction in contacts outside the home. Such reductions, which were uniform across age groups, were compatible with an [Formula: see text] equal or smaller than one in all countries, except Germany. This indicates lower levels of infection transmission, especially in a period of gradual increase in the adoption rate of the face mask outside the home. CONCLUSIONS We provided a comparable set of statistics on social contact patterns during the COVID-19 pandemic for eight high-income countries, disaggregated by week and other demographic factors, which could be leveraged by the scientific community for developing more realistic epidemic models of COVID-19.
Collapse
Affiliation(s)
- Emanuele Del Fava
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Jorge Cimentada
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Daniela Perrotta
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - André Grow
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Francesco Rampazzo
- Saïd Business School, Leverhulme Centre for Demographic Science, and Nuffield College, University of Oxford, Oxford, UK
| | - Sofia Gil-Clavel
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Emilio Zagheni
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| |
Collapse
|
41
|
Angwenyi V, Kabue M, Chongwo E, Mabrouk A, Too EK, Odhiambo R, Nasambu C, Marangu J, Ssewanyana D, Njoroge E, Ombech E, Mokaya MM, Obulemire EK, Khamis A, Abubakar A. Mental Health during COVID-19 Pandemic among Caregivers of Young Children in Kenya's Urban Informal Settlements. A Cross-Sectional Telephone Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10092. [PMID: 34639394 PMCID: PMC8508326 DOI: 10.3390/ijerph181910092] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 11/16/2022]
Abstract
The emergence of COVID-19 has profoundly affected mental health, especially among highly vulnerable populations. This study describes mental health issues among caregivers of young children and pregnant women in three urban informal settlements in Kenya during the first pandemic year, and factors associated with poor mental health. A cross-sectional telephone survey was administered to 845 participants. Survey instruments included the Patient Health Questionnaire-9, General Anxiety Disorder-7 scale, COVID-19 Anxiety Scale, and questions on the perceived COVID-19 effects on caregiver wellbeing and livelihood. Data were analyzed using descriptive statistics, and univariate and multivariate analysis. Caregivers perceived COVID-19 as a threatening condition (94.54%), affecting employment and income activities (>80%). Caregivers experienced discrimination (15.27%) and violence (12.6%) during the pandemic. Levels of depression (34%), general anxiety (20%), and COVID-19 related anxiety (14%) were highly prevalent. There were significant associations between mental health outcomes and economic and socio-demographic factors, violence and discrimination experiences, residency, and perceptions of COVID-19 as a threatening condition. Caregivers high burden of mental health problems highlights the urgent need to provide accessible mental health support. Innovative and multi-sectoral approaches will be required to maximize reach to underserved communities in informal settlements and tackle the root causes of mental health problems in this population.
Collapse
Affiliation(s)
- Vibian Angwenyi
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
| | - Margaret Kabue
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
| | - Esther Chongwo
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
| | - Adam Mabrouk
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
| | - Ezra Kipngetich Too
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
| | - Rachel Odhiambo
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
| | - Carophine Nasambu
- Neurosciences Group, KEMRI/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi P.O. Box 230-80108, Kenya;
| | - Joyce Marangu
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
| | - Derrick Ssewanyana
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5T 3L9, Canada
| | - Eunice Njoroge
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
| | - Eunice Ombech
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
| | - Mercy Moraa Mokaya
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
| | - Emmanuel Kepha Obulemire
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
| | - Anil Khamis
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
- Institute of Education, University College London, 20 Bedford Way, London WC1H 0AL, UK
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (M.K.); (E.C.); (A.M.); (E.K.T.); (R.O.); (J.M.); (D.S.); (E.N.); (E.O.); (M.M.M.); (E.K.O.); (A.K.); (A.A.)
- Neurosciences Group, KEMRI/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi P.O. Box 230-80108, Kenya;
| |
Collapse
|
42
|
McCreesh N, Dlamini V, Edwards A, Olivier S, Dayi N, Dikgale K, Nxumalo S, Dreyer J, Baisley K, Siedner MJ, White RG, Herbst K, Grant AD, Harling G. Impact of the Covid-19 epidemic and related social distancing regulations on social contact and SARS-CoV-2 transmission potential in rural South Africa: analysis of repeated cross-sectional surveys. BMC Infect Dis 2021; 21:928. [PMID: 34496771 PMCID: PMC8424154 DOI: 10.1186/s12879-021-06604-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 08/23/2021] [Indexed: 12/11/2022] Open
Abstract
Background South Africa implemented rapid and strict physical distancing regulations to minimize SARS-CoV-2 epidemic spread. Evidence on the impact of such measures on interpersonal contact in rural and lower-income settings is limited. Methods We compared population-representative social contact surveys conducted in the same rural KwaZulu-Natal location once in 2019 and twice in mid-2020. Respondents reported characteristics of physical and conversational (‘close interaction’) contacts over 24 hours. We built age-mixing matrices and estimated the proportional change in the SARS-CoV-2 reproduction number (R0). Respondents also reported counts of others present at locations visited and transport used, from which we evaluated change in potential exposure to airborne infection due to shared indoor space (‘shared air’). Results Respondents in March–December 2019 (n = 1704) reported a mean of 7.4 close interaction contacts and 196 shared air person-hours beyond their homes. Respondents in June-July 2020 (n = 216), as the epidemic peaked locally, reported 4.1 close interaction contacts and 21 shared air person-hours outside their home, with significant declines in others’ homes and public spaces. Adults aged over 50 had fewer close contacts with others over 50, but little change in contact with 15–29 year olds, reflecting ongoing contact within multigenerational households. We estimate potential R0 fell by 42% (95% plausible range 14–59%) between 2019 and June-July 2020. Conclusions Extra-household social contact fell substantially following imposition of Covid-19 distancing regulations in rural South Africa. Ongoing contact within intergenerational households highlighted a potential limitation of social distancing measures in protecting older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06604-8.
Collapse
Affiliation(s)
- Nicky McCreesh
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Vuyiswa Dlamini
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Anita Edwards
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Stephen Olivier
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Njabulo Dayi
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Keabetswe Dikgale
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Siyabonga Nxumalo
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Jaco Dreyer
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Kathy Baisley
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.,Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Mark J Siedner
- Harvard Medical School and the Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
| | - Richard G White
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Kobus Herbst
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa.,DSI-MRC South African Population Research Infrastructure Network, Durban, South Africa
| | - Alison D Grant
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa.,TB Centre, London School of Hygiene and Tropical Medicine, London, UK.,School of Laboratory and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, KwaZulu-Natal, Durban, South Africa.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Guy Harling
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa. .,Institute for Global Health, University College London, London, UK. .,Department of Epidemiology & Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA. .,MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| |
Collapse
|
43
|
Bonnet E, Bodson O, Le Marcis F, Faye A, Sambieni NE, Fournet F, Boyer F, Coulibaly A, Kadio K, Diongue FB, Ridde V. The COVID-19 pandemic in francophone West Africa: from the first cases to responses in seven countries. BMC Public Health 2021; 21:1490. [PMID: 34340668 PMCID: PMC8327893 DOI: 10.1186/s12889-021-11529-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 07/21/2021] [Indexed: 12/11/2022] Open
Abstract
Background In early March 2020, the COVID-19 pandemic hit West Africa. In response, countries in the region quickly set up crisis management committees and implemented drastic measures to stem the spread of the SARS-CoV-2 virus. The objective of this article is to analyse the epidemiological evolution of COVID-19 in seven Francophone West African countries (Benin, Burkina Faso, Côte d’Ivoire, Guinea, Mali, Niger, Senegal) as well as the public health measures decided upon during the first 7 months of the pandemic. Methods Our method is based on quantitative and qualitative data from the pooling of information from a COVID-19 data platform and collected by a network of interdisciplinary collaborators present in the seven countries. Descriptive and spatial analyses of quantitative epidemiological data, as well as content analyses of qualitative data on public measures and management committees were performed. Results Attack rates (October 2020) for COVID-19 have ranged from 20 per 100,000 inhabitants (Benin) to more than 94 per 100,000 inhabitants (Senegal). All these countries reacted quickly to the crisis, in some cases before the first reported infection, and implemented public measures in a relatively homogeneous manner. None of the countries implemented country-wide lockdowns, but some implemented partial or local containment measures. At the end of June 2020, countries began to lift certain restrictive measures, sometimes under pressure from the general population or from certain economic sectors. Conclusion Much research on COVID-19 remains to be conducted in West Africa to better understand the dynamics of the pandemic, and to further examine the state responses to ensure their appropriateness and adaptation to the national contexts. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11529-7.
Collapse
Affiliation(s)
- E Bonnet
- Résiliences / PRODIG, French National Research Institute for Sustainable Development, 32 Avenue Henri Varagnat, 93140, Bondy, France
| | - O Bodson
- Faculty of Social Sciences, University of Liège, Place des Orateurs 3, 4000, Liège, Belgium
| | - F Le Marcis
- Triangle (UMR 5206), ENS de Lyon, TransVIHMI (UMI 233), French National Research Institute for Sustainable Development, Lyon, France
| | - A Faye
- Institut de Santé et Développement (ISED), Université Cheikh Anta Diop, Dakar, Senegal
| | - N E Sambieni
- Faculty of Letters, Arts and Human Sciences (FLASH) and Laboratoire de recherches sur les dynamiques sociales et le développement local (Lasdel), University of Parakou, Parakou, Benin
| | - F Fournet
- MIVEGEC (Univ Montpellier, IRD, CNRS), French National Research Institute for Sustainable Development, 911 Avenue Agropolis, BP 64501, 34394, Montpellier Cedex 5, France
| | - F Boyer
- Research Unit "Migration and Society", French National Research Institute for Sustainable Development, Associated with the Study and Research Group on Migration, Spaces and Societies, Abdou Moumouni University, Niamey, Niger
| | - A Coulibaly
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - K Kadio
- Institute for Health Science Research (IRSS), Ouagadougou, Burkina Faso.,Institute of Research for Development, Ouagadougou, Burkina Faso
| | - F B Diongue
- Institut de Santé et Développement (ISED), Université Cheikh Anta Diop, Dakar, Senegal
| | - V Ridde
- Centre Population et Développement (Ceped), IRD, French National Research Institute for Sustainable Development and Université de Paris, Inserm ERL 1244, 45 rue des Saints-Pères, 75006, Paris, France. .,Institut de Santé et Développement, Université Cheikh Anta Diop, Dakar, Senegal.
| |
Collapse
|
44
|
Shupler M, Mwitari J, Gohole A, Anderson de Cuevas R, Puzzolo E, Čukić I, Nix E, Pope D. COVID-19 impacts on household energy & food security in a Kenyan informal settlement: The need for integrated approaches to the SDGs. RENEWABLE & SUSTAINABLE ENERGY REVIEWS 2021; 144:None. [PMID: 34276242 PMCID: PMC8262075 DOI: 10.1016/j.rser.2021.111018] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 02/13/2021] [Accepted: 03/21/2021] [Indexed: 05/12/2023]
Abstract
This longitudinal study presents the joint effects of a COVID-19 community lockdown on household energy and food security in an informal settlement in Nairobi, Kenya. Randomly administered surveys were completed from December 2019-March 2020 before community lockdown (n = 474) and repeated in April 2020 during lockdown (n = 194). Nearly universal (95%) income decline occurred during the lockdown and led to 88% of households reporting food insecurity. During lockdown, a quarter of households (n = 17) using liquefied petroleum gas (LPG), a cleaner cooking fuel typically available in pre-set quantities (e.g. 6 kg cylinders), switched to polluting cooking fuels (kerosene, wood), which could be purchased in smaller amounts or gathered for free. Household size increases during lockdown also led to participants' altering their cooking fuel, and changing their cooking behaviors and foods consumed. Further, households more likely to switch away from LPG had lower consumption prior to lockdown and had suffered greater income loss, compared with households that continued to use LPG. Thus, inequities in clean cooking fuel access may have been exacerbated by COVID-19 lockdown. These findings demonstrate the complex relationship between household demographics, financial strain, diet and cooking patterns, and present the opportunity for a food-energy nexus approach to address multiple Sustainable Development Goals (SDGs): achieving zero hunger (SDG 2) and universal affordable, modern and clean energy access (SDG 7) by 2030. Ensuring that LPG is affordable, accessible and meets the dietary and cooking needs of families should be a policy priority for helping improve food and energy security among the urban poor.
Collapse
Affiliation(s)
- Matthew Shupler
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - James Mwitari
- School of Public Health, Amref International University, Nairobi, Kenya
| | - Arthur Gohole
- School of Public Health, Amref International University, Nairobi, Kenya
| | | | - Elisa Puzzolo
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
- Global LPG Partnership (GLPGP), 654 Madison Avenue, New York, United States
| | - Iva Čukić
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Emily Nix
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Daniel Pope
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
45
|
Shupler M, Mwitari J, Gohole A, Anderson de Cuevas R, Puzzolo E, Čukić I, Nix E, Pope D. COVID-19 impacts on household energy & food security in a Kenyan informal settlement: The need for integrated approaches to the SDGs. RENEWABLE & SUSTAINABLE ENERGY REVIEWS 2021. [PMID: 34276242 DOI: 10.1101/2020.05.27.20115113v1.full.pdf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This longitudinal study presents the joint effects of a COVID-19 community lockdown on household energy and food security in an informal settlement in Nairobi, Kenya. Randomly administered surveys were completed from December 2019-March 2020 before community lockdown (n = 474) and repeated in April 2020 during lockdown (n = 194). Nearly universal (95%) income decline occurred during the lockdown and led to 88% of households reporting food insecurity. During lockdown, a quarter of households (n = 17) using liquefied petroleum gas (LPG), a cleaner cooking fuel typically available in pre-set quantities (e.g. 6 kg cylinders), switched to polluting cooking fuels (kerosene, wood), which could be purchased in smaller amounts or gathered for free. Household size increases during lockdown also led to participants' altering their cooking fuel, and changing their cooking behaviors and foods consumed. Further, households more likely to switch away from LPG had lower consumption prior to lockdown and had suffered greater income loss, compared with households that continued to use LPG. Thus, inequities in clean cooking fuel access may have been exacerbated by COVID-19 lockdown. These findings demonstrate the complex relationship between household demographics, financial strain, diet and cooking patterns, and present the opportunity for a food-energy nexus approach to address multiple Sustainable Development Goals (SDGs): achieving zero hunger (SDG 2) and universal affordable, modern and clean energy access (SDG 7) by 2030. Ensuring that LPG is affordable, accessible and meets the dietary and cooking needs of families should be a policy priority for helping improve food and energy security among the urban poor.
Collapse
Affiliation(s)
- Matthew Shupler
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - James Mwitari
- School of Public Health, Amref International University, Nairobi, Kenya
| | - Arthur Gohole
- School of Public Health, Amref International University, Nairobi, Kenya
| | | | - Elisa Puzzolo
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
- Global LPG Partnership (GLPGP), 654 Madison Avenue, New York, United States
| | - Iva Čukić
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Emily Nix
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Daniel Pope
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
46
|
Shupler M, O'Keefe M, Puzzolo E, Nix E, Anderson de Cuevas R, Mwitari J, Gohole A, Sang E, Čukić I, Menya D, Pope D. Pay-as-you-go liquefied petroleum gas supports sustainable clean cooking in Kenyan informal urban settlement during COVID-19 lockdown. APPLIED ENERGY 2021; 292:116769. [PMID: 34140750 PMCID: PMC8121759 DOI: 10.1016/j.apenergy.2021.116769] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Approximately 2.8 billion people rely on polluting fuels (e.g. wood, kerosene) for cooking. With affordability being a key access barrier to clean cooking fuels, such as liquefied petroleum gas (LPG), pay-as-you-go (PAYG) LPG smart meter technology may help resource-poor households adopt LPG by allowing incremental fuel payments. To understand the potential for PAYG LPG to facilitate clean cooking, objective evaluations of customers' cooking and spending patterns are needed. This study uses novel smart meter data collected between January 2018-June 2020, spanning COVID-19 lockdown, from 426 PAYG LPG customers living in an informal settlement in Nairobi, Kenya to evaluate stove usage (e.g. cooking events/day, cooking event length). Seven semi-structured interviews were conducted in August 2020 to provide context for potential changes in cooking behaviours during lockdown. Using stove monitoring data, objective comparisons of cooking patterns are made with households using purchased 6 kg cylinder LPG in peri-urban Eldoret, Kenya. In Nairobi, 95% of study households continued using PAYG LPG during COVID-19 lockdown, with consumption increasing from 0.97 to 1.22 kg/capita/month. Daily cooking event frequency also increased by 60% (1.07 to 1.72 events/day). In contrast, average days/month using LPG declined by 75% during lockdown (17 to four days) among seven households purchasing 6 kg cylinder LPG in Eldoret. Interviewed customers reported benefits of PAYG LPG beyond fuel affordability, including safety, time savings and cylinder delivery. In the first study assessing PAYG LPG cooking patterns, LPG use was sustained despite a COVID-19 lockdown, illustrating how PAYG smart meter technology may help foster clean cooking access.
Collapse
Affiliation(s)
- Matthew Shupler
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
- Corresponding author at: Department of Public Health, Policy and Systems, 3rd Floor, Whelan Building, Brownlow Hill, Liverpool L69 3GB, United Kingdom.
| | | | - Elisa Puzzolo
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
- Global LPG Partnership (GLPGP), 654 Madison Avenue, New York, United States
| | - Emily Nix
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | | | - James Mwitari
- School of Public Health, Amref International University, Nairobi, Kenya
| | - Arthur Gohole
- School of Public Health, Amref International University, Nairobi, Kenya
| | - Edna Sang
- School of Public Health, Moi University, Eldoret, Kenya
| | - Iva Čukić
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Diana Menya
- School of Public Health, Moi University, Eldoret, Kenya
| | - Daniel Pope
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
47
|
Impact of the First Wave of the COVID-19 Pandemic on HIV/AIDS Programming in Kenya: Evidence from Kibera Informal Settlement and COVID-19 Hotspot Counties. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116009. [PMID: 34205036 PMCID: PMC8199875 DOI: 10.3390/ijerph18116009] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/24/2021] [Accepted: 05/27/2021] [Indexed: 01/28/2023]
Abstract
The study sought to determine the impact of COVID-19 on HIV/AIDS programming in the Kibera informal settlement and COVID-19 hotspot counties during the first wave of the pandemic. The study was conducted in two phases. The first phase entailed the analysis of HIV care and treatment secondary data (2018–2020) from the Kenya Health Information System. In the second phase, a prospective cohort study was conducted among people living with HIV in the Kibera informal settlement. A total of 176 participants aged 18 years and above accessing HIV services at selected healthcare facilities in Kibera were randomly sampled from facility electronic medical records and followed up for three months. Socio-demographics and contact details were abstracted from the records and telephone interviews were conducted with consenting participants. Results from the retrospective review of HIV program data indicated a 56% (p < 0.000, 95% CI: 31.3%–62.8%) reduction in uptake of HIV services. Clients starting antiretroviral therapy (ART) reduced significantly by 48% (p < 0.001, 95% CI: 35.4%–77%) in hotspot counties. However, pre-exposure prophylaxis uptake increased significantly by 24% (p < 0.019, 95% CI: 4%–49%). In Kibera, 14% reported missing medications at the onset of the COVID-19 pandemic because of lack of food (38%) and government measures (11%), which affected ART access; 11% did not access health facilities due to fear of contracting COVID-19, government regulations and lack of personal protective equipment. Socioeconomic factors, food insecurity and government measures affected uptake of HIV/AIDS services; hence, the need for scaling up measures to increase access to HIV/AIDS services during the onset of pandemics.
Collapse
|
48
|
McQuaid CF, Vassall A, Cohen T, Fiekert K, White RG. The impact of COVID-19 on TB: a review of the data. Int J Tuberc Lung Dis 2021; 25:436-446. [PMID: 34049605 PMCID: PMC8171247 DOI: 10.5588/ijtld.21.0148] [Citation(s) in RCA: 150] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/23/2021] [Indexed: 12/12/2022] Open
Abstract
Early in the COVID-19 pandemic, models predicted hundreds of thousands of additional TB deaths as a result of health service disruption. To date, empirical evidence on the effects of COVID-19 on TB outcomes has been limited. Here we summarise the evidence available at a country level, identifying broad mechanisms by which COVID-19 may modify TB burden and mitigation efforts. From the data, it is clear that there have been substantial disruptions to TB health services and an increase in vulnerability to TB. Evidence for changes in Mycobacterium tuberculosis transmission is limited, and it remains unclear how the resources required and available for the TB response have changed. To advocate for additional funding to mitigate the impact of COVID-19 on the global TB burden, and to efficiently allocate resources for the TB response, requires a significant improvement in the TB data available.
Collapse
Affiliation(s)
- C F McQuaid
- TB Modelling Group, TB Centre and Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - A Vassall
- Department of Global Health Development, Faculty of Public Health and Policy, LSHTM, London, UK
| | - T Cohen
- Yale School of Public Health, Laboratory of Epidemiology and Public Health, New Haven, CT, USA
| | - K Fiekert
- KNCV Tuberculosefonds, The Hague, the Netherlands
| | - R G White
- TB Modelling Group, TB Centre and Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| |
Collapse
|
49
|
Harling G, Gómez-Olivé FX, Tlouyamma J, Mutevedzi T, Kabudula CW, Mahlako R, Singh U, Ohene-Kwofie D, Buckland R, Ndagurwa P, Gareta D, Gunda R, Mngomezulu T, Nxumalo S, Wong EB, Kahn K, Siedner MJ, Maimela E, Tollman S, Collinson M, Herbst K. Protective Behaviors and Secondary Harms Resulting From Nonpharmaceutical Interventions During the COVID-19 Epidemic in South Africa: Multisite, Prospective Longitudinal Study. JMIR Public Health Surveill 2021; 7:e26073. [PMID: 33827046 PMCID: PMC8121138 DOI: 10.2196/26073] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/25/2021] [Accepted: 03/31/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In March 2020, South Africa implemented strict nonpharmaceutical interventions (NPIs) to contain the spread of COVID-19. Over the subsequent 5 months, NPI policies were eased in stages according to a national strategy. COVID-19 spread throughout the country heterogeneously; the disease reached rural areas by July and case numbers peaked from July to August. A second COVID-19 wave began in late 2020. Data on the impact of NPI policies on social and economic well-being and access to health care are limited. OBJECTIVE We aimed to determine how rural residents in three South African provinces changed their behaviors during the first COVID-19 epidemic wave. METHODS The South African Population Research Infrastructure Network nodes in the Mpumalanga (Agincourt), KwaZulu-Natal, (Africa Health Research Institute) and Limpopo (Dikgale-Mamabolo-Mothiba) provinces conducted up to 14 rounds of longitudinal telephone surveys among randomly sampled households from rural and periurban surveillance populations every 2-3 weeks. Interviews included questions on the following topics: COVID-19-related knowledge and behaviors, the health and economic impacts of NPIs, and mental health. We analyzed how responses varied based on NPI stringency and household sociodemographics. RESULTS In total, 5120 households completed 23,095 interviews between April and December 2020. Respondents' self-reported satisfaction with their COVID-19-related knowledge and face mask use rapidly rose to 85% and 95%, respectively, by August. As selected NPIs were eased, the amount of travel increased, economic losses were reduced, and the prevalence of anxiety and depression symptoms fell. When the number of COVID-19 cases spiked at one node in July, the amount of travel dropped rapidly and the rate of missed daily medications doubled. Households where more adults received government-funded old-age pensions reported concerns about economic matters and medication access less often. CONCLUSIONS South Africans complied with stringent, COVID-19-related NPIs despite the threat of substantial social, economic, and health repercussions. Government-supported social welfare programs appeared to buffer interruptions in income and health care access during local outbreaks. Epidemic control policies must be balanced against the broader well-being of people in resource-limited settings and designed with parallel support systems when such policies threaten peoples' income and access to basic services.
Collapse
Affiliation(s)
- Guy Harling
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Institute for Global Health, University College London, London, United Kingdom
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
- Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Francesc Xavier Gómez-Olivé
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- International Network for the Demographic Evaluation of Populations and Their Health Network, Accra, Ghana
| | - Joseph Tlouyamma
- Dikgale-Mamabolo-Mothiba Population Health Research Centre, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Mankweng, South Africa
- Department of Computer Science, School of Mathematical and Computer Sciences, Faculty of Science and Agriculture, University of Limpopo, Mankweng, South Africa
| | - Tinofa Mutevedzi
- Department of Science and Innovation-Medical Research Council South African Population Research Infrastructure Network, Johannesburg, South Africa
| | - Chodziwadziwa Whiteson Kabudula
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ruth Mahlako
- Dikgale-Mamabolo-Mothiba Population Health Research Centre, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Mankweng, South Africa
| | - Urisha Singh
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Daniel Ohene-Kwofie
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rose Buckland
- Institute for Global Health, University College London, London, United Kingdom
| | - Pedzisai Ndagurwa
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Dickman Gareta
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Resign Gunda
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | | | | | - Emily B Wong
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Division of Infectious Diseases, University of Alabama, Birmingham, Birmingham, AL, United States
| | - Kathleen Kahn
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- International Network for the Demographic Evaluation of Populations and Their Health Network, Accra, Ghana
| | - Mark J Siedner
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Harvard Medical School and the Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, United States
| | - Eric Maimela
- Dikgale-Mamabolo-Mothiba Population Health Research Centre, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Mankweng, South Africa
- Department of Public Health, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Mankweng, South Africa
| | - Stephen Tollman
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- International Network for the Demographic Evaluation of Populations and Their Health Network, Accra, Ghana
| | - Mark Collinson
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Science and Innovation-Medical Research Council South African Population Research Infrastructure Network, Johannesburg, South Africa
| | - Kobus Herbst
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Department of Science and Innovation-Medical Research Council South African Population Research Infrastructure Network, Johannesburg, South Africa
| |
Collapse
|
50
|
Food Security and COVID-19: A Systematic Review of the First-Year Experience. SUSTAINABILITY 2021. [DOI: 10.3390/su13095294] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
For decades, global food security has not been able to address the structural problem of economic access to food, resulting in a recent increase in the number of undernourished people from 2014. In addition, the FAO estimates that the number of undernourished people drastically increased by 82–132 million people in 2020 due to the COVID-19 pandemic. To alleviate this dramatic growth in food insecurity, it is necessary to understand the nature of the increase in the number of malnourished during the pandemic. In order to address this, we gathered and synthesized food-security-related empirical results from the first year of the pandemic in a systematic review. The vast majority (78%) of the 51 included articles reported household food insecurity has increased (access, utilization) and/or disruption to food production (availability) was a result of households having persistently low income and not having an adequate amount of savings. These households could not afford the same quality and/or quantity of food, and a demand shortfall immediately appeared on the producer side. Producers thus had to deal not only with the direct consequences of government measures (disruption in labor flow, lack of demand of the catering sector, etc.) but also with a decline in consumption from low-income households. We conclude that the factor that most negatively affects food security during the COVID-19 pandemic is the same as the deepest structural problem of global food security: low income. Therefore, we argue that there is no need for new global food security objectives, but there is a need for an even stronger emphasis on poverty reduction and raising the wages of low-income households. This structural adjustment is the most fundamental step to recover from the COVID-19 food crises, and to avoid possible future food security crises.
Collapse
|