Assessment of early COVID-19 compliance to and challenges with public health and social prevention measures in the Kingdom of Eswatini, using an online survey

Expanding Youth-Friendly HIV Self-Testing Services During the COVID-19 Pandemic: Qualitative Analysis of a Crowdsourcing Open Call in Nigeria

BACKGROUND

HIV self-testing (HIVST) among young people is an effective approach to enhance the uptake of HIV testing recommended by the World Health Organization. However, the COVID-19 pandemic disrupted conventional facility-based HIV testing services, necessitating the exploration of innovative strategies for the effective delivery of HIVST.

OBJECTIVE

This study analyzed the outcomes of a digital World AIDS Day crowdsourcing open call, designed to elicit youth responses on innovative approaches to promote HIVST among young people (14-24 years) in Nigeria during COVID-19 restrictions.

METHODS

From November 2 to 22, 2020, a World AIDS Day 2020 crowdsourcing open call was held digitally due to COVID-19 restrictions. The crowdsourcing open call followed World Health Organization standardized steps, providing a structured framework for participant engagement. Young people in Nigeria, aged 10-24 years, participated by submitting ideas digitally through Google Forms or email in response to this crowdsourcing open call prompt: "How will you promote HIV self-testing among young people during COVID-19 pandemic?" Data and responses from each submission were analyzed, and proposed ideas were closely examined to identify common themes. Four independent reviewers (AE, SM, AZM, and TG) judged each submission based on the desirability, feasibility, and impact on a 9-point scale (3-9, with 3 being the lowest and 9 being the highest).

RESULTS

The crowdsourcing open call received 125 eligible entries, 44 from women and 65 from men. The median age of participants was 20 (IQR 24-20) years, with the majority having completed their highest level of education at the senior secondary school level. The majority of participants lived in the South-West region (n=61) and Lagos state (n=36). Of the 125 eligible entries, the top 20 submissions received an average total score of 7.5 (SD 2.73) or above. The panel of judges ultimately selected 3 finalists to receive a monetary award. Three prominent themes were identified from the 125 crowdsourcing open call submissions as specific ways that HIVST can adapt during the COVID-19 pandemic: (1) digital approaches (such as gamification, photoverification system, and digital media) to generate demand for HIVST and avoid risks associated with attending clinics, (2) awareness and sensitization through existing infrastructures (such as churches, schools, and health facilities), and (3) partnerships with influencers, role models, and leaders (such as religious and youth leaders and social influencers in businesses, churches, organizations, and schools) to build trust in HIVST services.

CONCLUSIONS

The crowdsourcing open call effectively engaged a diverse number of young people who proposed a variety of ways to improve the uptake of HIVST during the COVID-19 pandemic. Findings contribute to the need for innovative HIVST strategies that close critical knowledge and practice gaps on ways to reach young people with HIVST during and beyond the pandemic.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04710784; https://clinicaltrials.gov/study/NCT04710784.

Healthcare utilization and associated factors during the first wave of COVID-19 pandemic in Ghana: A cross-sectional survey

Background and Aims

Understanding healthcare utilization during the coronavirus disease 2019 (COVID-19) pandemic is crucial to inform policy and to prepare health systems for future pandemics. We examined self-reported healthcare utilization and associated factors, including public health preventive practices, perceptions, and coping strategies among the general public in Ghana during the first wave of the COVID-19 pandemic.

Methods

We adopted a cross-sectional study design using a public survey to recruit 643 respondents between May 23, and July 11, 2020 during the first wave of confirmed COVID-19 cases and after the fifth week of a partial lockdown in Ghana. Descriptive, bivariate, and binary logistic regression analyses were carried out in Stata version 15.

Results

Overall, there was a high level of compliance with COVID-19 public health preventive measures. In terms of perception, 357 (55.5%) of respondents stated unnecessary worry was created about the disease. In relation to coping strategies, 376 (58.5%) of respondents stayed home for more than 6 h, while 35 (5%) reported drinking alcohol to overcome the fear created by the disease. The results showed that 176 (27.4%) of the respondents utilized healthcare while 44 (9.4%) did not utilized healthcare for fear of contracting the disease at the health facility. Marital status (adjusted odds ratio [aOR] = 0.63; 95% confidence interval [CI] = 0.409, 0.963), religion (aOR = 2.34; 95% CI = 1.10, 4.98), and possession of valid health insurance (aOR = 1.51; 95% CI = 1.020, 2.235) were associated with healthcare utilization.

Conclusion

There was low healthcare utilization coupled with fear of contracting the COVID-19 disease at the health facilities among the respondents. The findings suggest the need for effective public education that ensures that future pandemics' prevention information and recommendations are easily understandable by the general public. Additionally, investment in health insurance coverage may contribute to healthcare utilization during future pandemics.

Snakebite epidemiology, outcomes and multi-cluster risk modelling in Eswatini

BACKGROUND

Halving snakebite morbidity and mortality by 2030 requires countries to develop both prevention and treatment strategies. The paucity of data on the global incidence and severity of snakebite envenoming causes challenges in prioritizing and mobilising resources for snakebite prevention and treatment. In line with the World Health Organisation's 2019 Snakebite Strategy, this study sought to investigate Eswatini's snakebite epidemiology and outcomes, and identify the socio-geographical factors associated with snakebite risk.

METHODOLOGY

Programmatic data from the Ministry of Health, Government of Eswatini 2019-2021, was used to assess the epidemiology and outcomes of snakebite in Eswatini. We developed a snake species richness map from the occurrence data of all venomous snakes of medical importance in Eswatini that was subjected to niche modelling. We formulated four risk indices using snake species richness, various geospatial datasets and reported snakebites. A multivariate cluster modelling approach using these indices was developed to estimate risk of snakebite and the outcomes of snakebite in Eswatini.

PRINCIPAL FINDINGS

An average of 466 snakebites was recorded annually in Eswatini. Bites were recorded across the entire country and peaked in the evening during summer months. Two cluster risk maps indicated areas of the country with a high probability of snakebite and a high probability of poor snakebite outcomes. The areas with the highest rate of snakebite risk were primarily in the rural and agricultural regions of the country.

SIGNIFICANCE

These models can be used to inform better snakebite prevention and treatment measures to enable Eswatini to meet the global goal of reducing snakebite morbidity and mortality by 50% by 2030. The supply chain challenges of antivenom affecting southern Africa and the high rates of snakebite identified in our study highlight the need for improved snakebite prevention and treatment tools that can be employed by health care workers stationed at rural, community clinics.

Leveraging lessons from the COVID-19 pandemic to strengthen low-income and middle-income country preparedness for future global health threats

Although the global COVID-19 pandemic response was quick to develop medical countermeasures, it failed to fully prevent morbidity and mortality in high-income countries and low-income and middle-income countries (LMICs). As new variants and post-COVID-19 condition continue to emerge and affect health systems and economies, the full human and economic cost is yet to be felt. We should now learn from these shortcomings and implement more inclusive and equitable frameworks to prevent and respond to outbreaks. This Series offers specific learnings from COVID-19 vaccination campaigns and non-pharmaceutical interventions, highlighting the need for resilient, inclusive, and equitable health systems. Taking action to rebuild trust and invest in resilient local manufacturing capacity, supply chains, regulatory frameworks, and placing LMIC voices at the centre of decision making will help to ensure preparedness for future threats. It is time to move beyond mere talk of learning and implementing lessons and instead take action towards a more resilient future.

A multi-country survey of the socio-demographic factors associated with adherence to COVID-19 preventive measures during the first wave of the COVID-19 pandemic

BACKGROUND

Health behaviours are influenced by individual characteristics including age, gender, education and economic level. This study aimed to assess the associations between individual-level determinants and adherence to COVID-19 preventive measures.

METHODS

We performed secondary analyses of international data collected using an online survey during the first wave of the COVID-19 pandemic between June and December 2020. The dependent variables were self-reported adherence to COVID-19 preventive measures (wearing of face masks, frequent washing/sanitizing of hands, physical distancing, working remotely). The independent variables were age, sex at birth (female vs male), having a chronic disease related elevated risk for severe COVID-19 (none/little, might be at increased risk, at increased risk), educational level completed (no formal education, primary, secondary vs college/university) and employment status (retiree, students, not employed vs employed). Four multivariate logistic regression analyses were conducted to determine the associations between the dependent variables and independent variables. Interaction terms with country-income level were tested in regressions to explore its moderating effect.

RESULTS

Out of 16,866 respondents, 12,634 (74.9%) wore masks or face coverings, 12,336 (73.1%) washed or sanitized their hands frequently, 11,464 (68.0%) reported adherence to physical distancing and 5,646 (33.5%) worked remotely. In adjusted analyses, increased age, college/university education, employment, and having risks for severe COVID-19 were associated with significantly higher odds of adhering to COVID-19 preventive measures. Retirees and students had lower odds of adhering to COVID-19 prevention measures than employed individuals. Males had significantly lower odds of wearing face masks (AOR: 0.901), frequent washing/sanitizing hands (AOR: 0.774) and working remotely (AOR: 0.875) compared to females. Country-income level generally moderated the above relationships such that the associations disappeared in lower income countries.

CONCLUSION

The study findings suggest that the individual socio-demographic factors-age, sex, employment status, education status and having a chronic disease - influence adherence to COVID-19 preventive measures. Findings further reiterate the need for health education and health promotion campaigns on preventive health measures to focus on subpopulations, such as younger males, students and retirees, that require targeted or unique messaging.

Impact of Social Media Usage on Users' COVID-19 Protective Behavior: Survey Study in Indonesia

BACKGROUND

Social media have become the source of choice for many users to search for health information on COVID-19 despite possible detrimental consequences. Several studies have analyzed the association between health information-searching behavior and mental health. Some of these studies examined users' intentions in searching health information on social media and the impact of social media use on mental health in Indonesia.

OBJECTIVE

This study investigates both active and passive participation in social media, shedding light on cofounding effects from these different forms of engagement. In addition, this study analyses the role of trust in social media platforms and its effect on public health outcomes. Thus, the purpose of this study is to analyze the impact of social media usage on COVID-19 protective behavior in Indonesia. The most commonly used social media platforms are Instagram, Facebook, YouTube, TikTok, and Twitter.

METHODS

We used primary data from an online survey. We processed 414 answers to a structured questionnaire to evaluate the relationship between these users' active and passive participation in social media, trust in social media, anxiety, self-efficacy, and protective behavior to COVID-19. We modeled the data using partial least square structural equation modeling.

RESULTS

This study reveals that social media trust is a crucial antecedent, where trust in social media is positively associated with active contribution and passive consumption of COVID-19 content in social media, users' anxiety, self-efficacy, and protective behavior. This study found that active contribution of content related to COVID-19 on social media is positively correlated with anxiety, while passive participation increases self-efficacy and, in turn, protective behavior. This study also found that active participation is associated with negative health outcomes, while passive participation has the opposite effects. The results of this study can potentially be used for other infectious diseases, for example, dengue fever and diseases that can be transmitted through the air and have handling protocols similar to that of COVID-19.

CONCLUSIONS

Public health campaigns can use social media for health promotion. Public health campaigns should post positive messages and distil the received information parsimoniously to avoid unnecessary and possibly counterproductive increased anxiety of the users.

Assessing the Saudi Population Knowledge, Acceptance, and Perception on the Effectiveness of Following the Safety Precautions During COVID-19 Pandemic

Background

Coronavirus disease 2019 (COVID-19) has become an alarming issue worldwide. Kingdom of Saudi Arabia was fast in adopting the safety precaution measures and is considered one of the major countries that place preventive precautions measures to control the spread of the disease. The current study aims to assess the knowledge, effectiveness, and acceptance of the public regarding COVID-19 safety precautions measures: face masks, physical distance, wash hands/use hand sanitizer, and the use of Tawakkalna application as a preventive measure in the Kingdom of Saudi Arabia.

Methods

The study design was quantitative cross-sectional using a self-administered questionnaire.

Results

Of the 400 received responses, the data analysis showed that there was a significant association between knowledge about the safety precaution measures score with nationality and gender with P value less than 0.05.

Conclusion

The awareness of Saudi citizens of the importance of implementing preventive precautions and their compliance greatly contributed in limiting the virus spread.

Indicators of Mental Health Disorder, COVID-19 Prevention Compliance and Vaccination Intentions among Refugees in Kenya

Background and Objectives: COVID-19 remains a major development challenge in many developing countries. This study analysed the effect of mental health disorder and indicators of COVID-19 preventive practices on vaccination intentions among refugees in Kenya. Materials and Methods: The data were the fourth and fifth waves of the High Frequency Phone Surveys on the impacts of COVID-19 that were collected by the Kenyan National Bureau of Statistics (KNBS) between May 2020 and June 2021. The data were collected from Kakuma, Kalobeyei, Dadaab and Shona camps using the stratified random sampling method. The data were analysed with random effects instrumental variable Probit regression model. Results: The results showed that 69.32% and 93.16% of the refugees were willing to be vaccinated during the 4th and 5th waves, respectively. The fear of dying was reported by 85.89% and 74.19% during the 4th and 5th waves, respectively. COVID-19 contact prevention and immune boosting indicators were differently influenced by some demographic and anxiety index variables, while being endogenous influenced vaccine hesitancy along with urban residence, age, knowing infected persons, days of depression, days of anxiety, days of physical reactions, members losing job, searching for jobs, accepting job offers and being employed. Conclusions: It was concluded that efforts to promote COVID-19 vaccination should address mental health disorder and compliance with existing COVID-19 contact and immune boosting behaviour with a focus on urban residents and youths.

Assessment of the Impact of COVID-19 on Operations of Local Businesses and Level of Enforcement of Public Health Safety Measure within Business Premises: A Quantitative Study of Businesses in Huye-Rwanda

The impact of COVID-19 has been felt across all sectors, from transportation, education, and public works to the daily operations of businesses like selling, retailing, and so forth. The business sector is among those badly affected, especially micro, small, and medium enterprises. The understanding of ground prevailing conditions is key in driving informed policies that would have meaningful impact on society with regard to overcoming the effects of the virus. Hence, this work is an attempt to report the real ground statistics and necessity of technological support with the goal of submitting a report of recommended policies to the concerned authorities. In this direction, this work presents the outcome of a survey conducted to assess the impact of COVID-19 on operations of micro, small, and medium enterprises and also to find out the interventions put in place around business environments so as to enforce adherence to COVID-19 health safety measures. The survey was part of a study to develop automated IoT-powered technological solutions that would help to enforce proper mask wearing in indoor environments and also observance of social distance requirements within business premises. A customized questionnaire was designed to capture data on various aspects central to the focus of the study. The study was carried out in the month of May 2021, in the Huye district of Rwanda. According to the survey findings, the major challenges faced by businesses due to COVID-19 include failure by clients to settle bills, reduced ability to expand investment, difficulty in accessing inputs domestically, lower domestic sales to consumers, and lower domestic sales to businesses. The results also reveal some positive points that most businesses were found to have: hand washing points, hand sanitizer dispensers, and mechanisms to enforce social distance between customer and customer and also customer and front desk worker. In a nutshell, this work is unique in terms of (1) the customized questionnaire about Rwanda’s needs, (2) field visit-based data collection for accurate data, and (3) including an assessment of the importance of technological intervention for better handling of public safety, especially in the MSME business sector.

Compliance Indicators of COVID-19 Prevention and Vaccines Hesitancy in Kenya: A Random-Effects Endogenous Probit Model

Vaccine hesitancy remains a major public health concern in the effort towards addressing the COVID-19 pandemic. This study analyzed the effects of indicators of compliance with preventive practices on the willingness to take COVID-19 vaccines in Kenya. The data were from the COVID-19 Rapid Response Phone Surveys conducted between January and June 2021 during the fourth and fifth waves. The data were analyzed with the random-effects endogenous Probit regression model, with estimated parameters tested for robustness and stability. The results showed that willingness to take vaccines increased between the fourth and fifth waves. Compliance with many of the preventive practices also improved, although the utilizations of immune system-promoting practices were very low. The panel Probit regression results showed that compliance indicators were truly endogenous and there was existence of random effects. Immune system-boosting and contact-prevention indicators significantly increased and decreased the willingness to take vaccines, respectively (p < 0.01). The experience of mental health disorders in the form of nervousness and hopelessness also significantly influenced vaccine hesitancy (p < 0.10). Willingness to take vaccines also significantly increased among older people and those with a formal education (p < 0.01). Different forms of association exist between vaccine hesitancy and the prevention compliance indicators. There is a need to properly sensitize the people to the need to complement compliance with COVID-19 contact-prevention indicators with vaccination. Addressing mental health disorders in the form of loneliness, nervousness, depression, hopelessness and anxiety should also become the focus of public health, while efforts to reduce vaccine hesitancy should focus on individuals without formal education, males and youths.

Coping strategies used by nurses during the COVID-19 pandemic: A narrative literature review

BACKGROUND

During the coronavirus disease 2019 (COVID-19) pandemic, it is understandable that nurses are working under stressful conditions. A successful use of effective coping strategies during the COVID-19 pandemic will help nurses to manage stressful conditions.

AIM

The objective of this narrative literature review was to explore and describe the coping strategies used by nurses during the COVID-19 pandemic.

SETTING

This study was conducted from all available literature related to the coping strategies used by nurses during the COVID-19 pandemic globally.

METHODS

A narrative literature review was conducted to answer researchers' concern of coping strategies used by nurses during COVID-19. The purposive sampling technique was used to select three online databases that were used to search for the relevant literature, namely Google Scholar, Science Direct and African Journals (formerly SAePublications). Search terms used to conduct this study include coping, coping strategies, nurses, nursing and COVID-19 pandemic. This study included English studies focusing on coping strategies used by nurses during COVID-19 published between 2019 and 2021. The study excluded newspaper articles, conference reports and other databases not mentioned in this study.

RESULTS

The findings identified the following strategies: use of COVID-19 protective measures, avoidance strategy, social support, faith-based practices, psychological support and management support are used by nurses as coping strategies during the COVID-19 pandemic.

CONCLUSION

The use of the identified coping strategies by nurses may reduce stress and burnout during the COVID-19 pandemic. Recommendations were made for future research, nursing education and practice.

CONTRIBUTION

This is the first narrative literature review focusing on the coping strategies used by nurses during the COVID-19 pandemic. The findings of this narrative literature review provide insight that may be used by nurses of all categories to cope during the COVID-19 pandemic.

Framing of and Attention to COVID-19 on Twitter: Thematic Analysis of Hashtags

Background

Although past research has focused on COVID-19–related frames in the news media, such research may not accurately capture and represent the perspectives of people from diverse backgrounds. Additionally, research on the public attention to COVID-19 as reflected through frames on social media is scarce.

Objective

This study identified the frames about the COVID-19 pandemic in the public discourse on Twitter, which voices diverse opinions. This study also investigated the amount of public attention to those frames on Twitter.

Methods

We collected 22 trending hashtags related to COVID-19 in the United States and 694,582 tweets written in English containing these hashtags in March 2020 and analyzed them via thematic analysis. Public attention to these frames was measured by evaluating the amount of public engagement with frames and public adoption of those frames.

Results

We identified 9 frames including “public health guidelines,” “quarantine life,” “solidarity,” “evidence and facts,” “call for action,” “politics,” “post-pandemic life,” “shortage panic,” and “conflict.” Results showed that some frames such as “call for action” are more appealing than others during a global pandemic, receiving greater public adoption and engagement. The “call for action” frame had the highest engagement score, followed by “conflict” and “evidence and facts.” Additionally, “post-pandemic life” had the highest adoption score, followed by “call for action” and “shortage panic.” The findings indicated that the frequency of a frame on social media does not necessarily mean greater public adoption of or engagement with the frame.

Conclusions

This study contributes to framing theory and research by demonstrating how trending hashtags can be used as new user-generated data to identify frames on social media. This study concludes that the identified frames such as “quarantine life” and “conflict” and themes such as “isolation” and “toilet paper panic” represent the consequences of the COVID-19 pandemic. The consequences could be (1) exclusively related to COVID-19, such as hand hygiene or isolation; (2) related to any health crisis such as social support of vulnerable groups; and (3) generic that are irrespective of COVID-19, such as homeschooling or remote working.