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Makonokaya L, Kapanda L, Maphosa T, Kalitera LU, Machekano R, Nkhoma H, Chamanga R, Zimba SB, Mwale AC, Maida A, Woelk G. Factors associated with COVID-19 vaccine receipt among mobile phone users in Malawi: Findings from a national mobile-based syndromic surveillance survey, July 2021-April 2022. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002722. [PMID: 38206893 PMCID: PMC10783752 DOI: 10.1371/journal.pgph.0002722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/23/2023] [Indexed: 01/13/2024]
Abstract
Malawi recommended COVID-19 vaccines for adults aged ≥18 years in March 2021. We assessed factors associated with receiving COVID-19 vaccines in Malawi as part of a telephone-based syndromic surveillance survey. We conducted telephone-based syndromic surveillance surveys with questions on COVID-19 vaccine receipt among adults (≥18 years old) upon verbal consent from July 2021 to April 2022. We used random digit dialing to select mobile phone numbers and employed electronic data collection forms on secure tablets. Survey questions included whether the respondent had received at least one dose of a COVID-19 vaccine. We used multivariable analysis to identify factors associated with COVID-19 vaccine receipt. Of the 51,577 participants enrolled; 65.7% were male. Males were less likely to receive the COVID-19 vaccine than females (AOR 0.83, 95% CI 0.80-0.86). Compared to those aged 18-24 years, older age had increased odds of vaccine receipt: 25-34 years (AOR 1.32, 95% CI 1.24-1.40), 35-44 years (AOR 2.00, 95% CI 1.88-2.13), 45-54 years (AOR 3.02, 95% CI 2.82-3.24), 55-64 years (AOR 3.24, 95% CI 2.93-3.57) and 65 years+ (AOR 3.98, 95% CI 3.52-4.49). Respondents without formal education were less likely to receive vaccination compared to those with primary (AOR 1.30, 95% CI 1.14-1.48), secondary (AOR 1.76, 95% CI 1.55-2.01), and tertiary (AOR 3.37, 95% CI 2.95-3.86) education. Respondents who thought COVID-19 vaccines were unsafe were less likely to receive vaccination than those who thought it was very safe (AOR 0.26, 95% CI 0.25-0.28). Residents of the Central and Southern regions had reduced odds of vaccine receipt compared to those in the North (AORs 0.79, (95% CI 0.74-0.84) and 0.55, (95% CI 0.52-0.58) respectively). Radio (72.6%), health facilities (52.1%), and social media (16.0%) were the more common self-reported sources of COVID-19 vaccine information. COVID-19 vaccine receipt is associated with gender, age, education, and residence. It is important to consider these factors when implementing COVID-19 vaccination programs.
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Affiliation(s)
| | - Lester Kapanda
- Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Malawi
| | - Thulani Maphosa
- Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Malawi
| | | | - Rhoderick Machekano
- Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, United States of America
| | - Harrid Nkhoma
- Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Malawi
| | - Rachel Chamanga
- Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Malawi
| | - Suzgo B. Zimba
- Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Malawi
| | | | - Alice Maida
- Centers for Disease Control and Prevention, Lilongwe, Malawi
| | - Godfrey Woelk
- Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, United States of America
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Anglewicz P, Lamba S, Kohler I, Mwera J, Zulu A, Kohler HP. Is experience of the HIV/AIDS epidemic associated with responses to COVID-19? Evidence from the Rural Malawi. PLoS One 2023; 18:e0292378. [PMID: 37878643 PMCID: PMC10599567 DOI: 10.1371/journal.pone.0292378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/19/2023] [Indexed: 10/27/2023] Open
Abstract
INTRODUCTION Starting in late 2019, the coronavirus "SARS-CoV-2", which causes the disease Covid-19, spread rapidly and extensively. Although many have speculated that prior experience with infectious diseases like HIV/AIDS, Ebola, or SARS would better prepare populations in sub-Saharan Africa for COVID-19, this has not been formally tested, primarily due to data limitations. METHODS We use longitudinal panel data from the Malawi Longitudinal Study of Families and Health (MLSFH, waves 2006, 2008, and 2020) to examine the association between exposure to the HIV/AIDS epidemic and perceptions of, and behavioral response to, the COVID-19 pandemic. We measured exposure to HIV infection through perceived prevalence of HIV/AIDS in the community, worry about HIV infection, perceived likelihood of HIV infection, and actual HIV status; and the experience of HIV/AIDS-related mortality through self-reports of knowing members of the community and extended family who died from AIDS (measured in 2006 or 2008). Our outcome measures were perceptions of COVID-19 presence in the community, perceptions of individual vulnerability to COVID-19, and prevention strategies to avoid COVID-19 collected through phone-interviews in 2020. RESULTS Based on our data analysis using multivariable regression models, we found that the experience of HIV-related mortality was positively associated with perceptions of COVID-19 prevalence in the community and preventive behaviors for COVID-19. However, perceived vulnerability to HIV-AIDS infection and actual HIV positive status 10-years prior to the COVID-19 pandemic are generally not associated with COVID-19 perceptions and behaviors. CONCLUSIONS Our results suggest that COVID-19-related behaviors are impacted more by experience of AIDS mortality instead of HIV/AIDS risk perceptions, and that individuals may be correctly viewing HIV/AIDS and COVID-19 transmission as distinct disease processes.
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Affiliation(s)
- Philip Anglewicz
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Sneha Lamba
- Department of Development Economics and Centre for Modern Indian Studies (CeMIS), University of Göttingen, Waldweg Göttingen, Germany
| | - Iliana Kohler
- Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - James Mwera
- Invest in Knowledge Initiative (IKI), Zomba, Malawi
| | - Andrew Zulu
- Invest in Knowledge Initiative (IKI), Zomba, Malawi
| | - Hans-Peter Kohler
- Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Zaniku HR, Aron MB, Vrkljan K, Tyagi K, Ndambo MK, Banda GM, Nyirongo R, Mphande I, Mailosi B, Talama G, Munyaneza F, Connolly E, Dullie L, Barnhart DA, Ruderman T. COVID-19-Related Testing, Knowledge and Behaviors among Severe and Chronic Non-Communicable Disease Patients in Neno District, Malawi: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105877. [PMID: 37239604 DOI: 10.3390/ijerph20105877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/07/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
COVID-19-related knowledge and behaviors remain essential for controlling the spread of disease, especially among vulnerable patients with advanced, chronic diseases. We prospectively assessed changes over 11 months in COVID-19-related testing, knowledge, and behaviors among patients with non-communicable diseases in rural Malawi using four rounds of telephone interviews between November 2020 to October 2021. The most commonly reported COVID-19-related risks among patients included visiting health facilities (35-49%), attending mass gatherings (33-36%), and travelling outside the district (14-19%). Patients reporting having experienced COVID-like symptoms increased from 30% in December 2020 to 41% in October 2021. However, only 13% of patients had ever received a COVID-19 test by the end of the study period. Respondents answered 67-70% of the COVID-19 knowledge questions correctly, with no significant changes over time. Hand washing, wearing face masks and maintaining a safe distance were the most frequently reported strategies to prevent the spreading of COVID-19. Wearing face masks significantly improved over time (p < 0.001). Although the majority reported accurate knowledge about COVID-19 and enhanced adherence to infection prevention measures over time, patients commonly visited locations where they could be exposed to COVID-19. Government and other stakeholders should increase COVID-19 testing accessibility to primary and secondary facilities.
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Affiliation(s)
- Haules Robbins Zaniku
- Neno District Health Office, Ministry of Health, Neno P.O. Box 52, Malawi
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre 312225, Malawi
| | - Moses Banda Aron
- Partners In Health/Abwenzi Pa za Umoyo (PIH/APZU), Neno P.O. Box 56, Malawi
| | - Kaylin Vrkljan
- Harvard College, Harvard University, Cambridge, MA 02138, USA
| | - Kartik Tyagi
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Myness Kasanda Ndambo
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe P.O. Box 148, Malawi
| | | | | | - Isaac Mphande
- Partners In Health/Abwenzi Pa za Umoyo (PIH/APZU), Neno P.O. Box 56, Malawi
| | - Bright Mailosi
- Partners In Health/Abwenzi Pa za Umoyo (PIH/APZU), Neno P.O. Box 56, Malawi
| | | | - Fabien Munyaneza
- Partners In Health/Abwenzi Pa za Umoyo (PIH/APZU), Neno P.O. Box 56, Malawi
| | - Emilia Connolly
- Partners In Health/Abwenzi Pa za Umoyo (PIH/APZU), Neno P.O. Box 56, Malawi
- Division of Pediatrics, College of Medicine, University of Cincinnati, 3230 Eden Ave., Cincinnati, OH 45267, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45529, USA
| | - Luckson Dullie
- Partners In Health/Abwenzi Pa za Umoyo (PIH/APZU), Neno P.O. Box 56, Malawi
| | - Dale A Barnhart
- Partners in Health/Inshuti Mu Buzima (PIH/IMB), Kigali P.O. Box 3432, Rwanda
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02138, USA
| | - Todd Ruderman
- Partners In Health/Abwenzi Pa za Umoyo (PIH/APZU), Neno P.O. Box 56, Malawi
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Zhang C, Ou P, Guo P. Does Public Health Emergency Experience Have an Impact on Individual Reactions during COVID-19? Healthcare (Basel) 2023; 11:healthcare11091212. [PMID: 37174754 PMCID: PMC10178868 DOI: 10.3390/healthcare11091212] [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: 02/08/2023] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 05/15/2023] Open
Abstract
Local historical experience in public health emergencies has been perceived to largely affect COVID-19's social influence. Specifically, individuals' personal experience in public health emergencies would likely have an impact on their reactions to the next similar event. Herein, we combined life course and risk analysis frameworks to explore how individuals' experiences influence current risk perception and protective behaviors. We collected 1000 questionnaires of random network samples in six Chinese provinces of different risk levels from 29 April to 8 May 2020, and used the propensity score matching (PSM) model and multivariable linear regression to process the data. We categorized individual public emergency experience into three patterns: (1) having ever witnessed a public health emergency, (2) having ever experienced a public health emergency, and (3) currently experiencing a public health emergency. The study indicates that individuals' experiences had significant positive effects on protective behaviors against COVID-19. The average effects of the three patterns on behaviors were 0.371 (p < 0.001), 0.898 (p < 0.001) and 0.319 (p < 0.05), respectively. The study also shows that for those experiencing any one pattern, the effect of risk perception on protective behaviors appeared null in the early stage of the pandemic. We propose the potential interactive mechanism of risk factors in the life course at the individual level. Academically, this study develops the risk theory of perception and behavior and expands the application of the life course approach in the public health arena. Practically, our research indicates that public health emergency experiences are valuable for responding to a future pandemic and normalizing prevention policies.
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Affiliation(s)
- Chenggang Zhang
- Department of Sociology, Tsinghua University, Beijing 100084, China
| | - Pengrui Ou
- Department of Sociology, Tsinghua University, Beijing 100084, China
| | - Pengfei Guo
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT 06520, USA
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Moucheraud C, Phiri K, Whitehead HS, Songo J, Lungu E, Chikuse E, Phiri S, van Oosterhout JJ, Hoffman RM. Uptake of the COVID-19 vaccine among healthcare workers in Malawi. Int Health 2023; 15:77-84. [PMID: 35294960 PMCID: PMC9808523 DOI: 10.1093/inthealth/ihac007] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/06/2022] [Accepted: 02/01/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Little is known about coronavirus disease 2019 (COVID-19) vaccination in Africa. We sought to understand Malawian healthcare workers' (HCWs') COVID-19 vaccination and its hypothesized determinants. METHODS In March 2021, as the COVID-19 vaccine roll-out commenced in Malawi, we surveyed clinical and lay cadre HCWs (n=400) about their uptake of the vaccine and potential correlates (informed by the WHO Behavioral and Social Drivers of COVID-19 Vaccination framework). We analyzed uptake and used adjusted multivariable logistic regression models to explore how 'what people think and feel' constructs were associated with HCWs' motivation to be vaccinated. RESULTS Of the surveyed HCWs, 82.5% had received the first COVID-19 vaccine dose. Motivation (eagerness to be vaccinated) was strongly associated with confidence in vaccine benefits (adjusted OR [aOR] 9.85, 95% CI 5.50 to 17.61) and with vaccine safety (aOR 4.60, 95% CI 2.92 to 7.23), but not with perceived COVID-19 infection risk (aOR 1.38, 95% CI 0.88 to 2.16). Of all the information sources about COVID-19 vaccination, 37.5% were reportedly negative in tone. CONCLUSIONS HCWs in Malawi have a high motivation to be vaccinated and a high COVID-19 vaccine uptake. Disseminating vaccine benefits and safety messages via social media and social networks may be persuasive for individuals who are unmotivated to be vaccinated and less likely to accept the COVID-19 vaccine.
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Affiliation(s)
- Corrina Moucheraud
- Department of Health Policy and Management, Fielding School of Public Health, UCLA, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
| | - Khumbo Phiri
- Partners in Hope, PO Box 302, Area 36/Plot 8, M1 Road South, Lilongwe, Malawi
| | - Hannah S Whitehead
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - John Songo
- Partners in Hope, PO Box 302, Area 36/Plot 8, M1 Road South, Lilongwe, Malawi
| | - Eric Lungu
- Partners in Hope, PO Box 302, Area 36/Plot 8, M1 Road South, Lilongwe, Malawi
| | - Elijah Chikuse
- Partners in Hope, PO Box 302, Area 36/Plot 8, M1 Road South, Lilongwe, Malawi
| | - Sam Phiri
- Partners in Hope, PO Box 302, Area 36/Plot 8, M1 Road South, Lilongwe, Malawi
| | - Joep J van Oosterhout
- Partners in Hope, PO Box 302, Area 36/Plot 8, M1 Road South, Lilongwe, Malawi
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Risa M Hoffman
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
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Chasukwa M, Choko AT, Muthema F, Nkhalamba MM, Saikolo J, Tlhajoane M, Reniers G, Dulani B, Helleringer S. Collecting mortality data via mobile phone surveys: A non-inferiority randomized trial in Malawi. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000852. [PMID: 36962430 PMCID: PMC10021539 DOI: 10.1371/journal.pgph.0000852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/08/2022] [Indexed: 11/18/2022]
Abstract
Despite the urgent need for timely mortality data in low-income and lower-middle-income countries, mobile phone surveys rarely include questions about recent deaths. Such questions might a) be too sensitive, b) take too long to ask and/or c) generate unreliable data. We assessed the feasibility of mortality data collection using mobile phone surveys in Malawi. We conducted a non-inferiority trial among a random sample of mobile phone users. Participants were allocated to an interview about their recent economic activity or recent deaths in their family. In the group that was asked mortality-related questions, half of the respondents completed an abridged questionnaire, focused on information necessary to calculate recent mortality rates, whereas the other half completed an extended questionnaire that also included questions about symptoms and healthcare. The primary trial outcome was the cooperation rate, i.e., the number of completed interviews divided by the number of mobile subscribers invited to participate. Secondary outcomes included self-reports of negative feelings and stated intentions to participate in future interviews. We called more than 7,000 unique numbers and reached 3,054 mobile subscribers. In total, 1,683 mobile users were invited to participate. The difference in cooperation rates between those asked to complete a mortality-related interview and those asked to answer questions about economic activity was 0.9 percentage points (95% CI = -2.3, 4.1), which satisfied the non-inferiority criterion. The mortality questionnaire was non-inferior to the economic questionnaire on all secondary outcomes. Collecting mortality data required 2 to 4 additional minutes per reported death, depending on the inclusion of questions about symptoms and healthcare. More than half of recent deaths elicited during mobile phone interviews had not been registered with the National Registration Bureau. Including mortality-related questions in mobile phone surveys is feasible. It might help strengthen the surveillance of mortality in countries with deficient civil registration systems. Registration: AEA RCT Registry, #0008065 (14 September 2021).
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Affiliation(s)
- Michael Chasukwa
- Institute of Public Opinion and Research, Zomba, Malawi
- Department of Political and Administrative Studies, University of Malawi, Zomba, Malawi
| | - Augustine T. Choko
- Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Funny Muthema
- Institute of Public Opinion and Research, Zomba, Malawi
| | | | - Jacob Saikolo
- Institute of Public Opinion and Research, Zomba, Malawi
| | - Malebogo Tlhajoane
- Program in Social Research and Public Policy, Division of Social Science, New York University, Abu Dhabi, United Arab Emirates
| | - Georges Reniers
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Boniface Dulani
- Institute of Public Opinion and Research, Zomba, Malawi
- Department of Political and Administrative Studies, University of Malawi, Zomba, Malawi
| | - Stéphane Helleringer
- Program in Social Research and Public Policy, Division of Social Science, New York University, Abu Dhabi, United Arab Emirates
- Department of Sociology, New York University, New York, United States of America
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Chilanga E, Dzimbiri M, Mwanjawala P, Keller A, Mbeya RA. Religion, politics and COVID-19 risk perception among urban residents in Malawi. BMC Public Health 2022; 22:1430. [PMID: 35897087 PMCID: PMC9326149 DOI: 10.1186/s12889-022-13858-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 07/21/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Majority of Malawians have not yet adopted COVID-19 mitigation measures despite having knowledge about its infectivity, morbidity, and fatality. Understanding drivers of hesitancy to adoption of COVID-19 mitigation measures is critical as it can inform prevention programs. This study explores Malawians' COVID-19 risk perception, and the associated constraints in the adoption of mitigation efforts. A Health Belief Model (HBM) approach was used to understand perceived factors that undermine public health COVID-19 messages to reduce the spread of the pandemic in Malawi. METHODS The study applied rapid appraisal and photovoice qualitative inquiry to comprehend risk perception regarding COVID-19. We purposively selected 52 participants from three major cities in Malawi. Audio and video interviews were transcribed verbatim, and transcripts were coded manually to derive key themes and concepts. RESULTS The study identified that social factors particularly religious and political beliefs influenced COVID-19 risk perception. Specific religious beliefs pertaining to individuals recognizing signs of the 'Christian apocalypse' were particularly associated with lower risk perceptions. Politically, participants believed COVID-19 lockdown measures were a ploy by the then-ruling party to remain in power. CONCLUSION The study suggests that religious beliefs and political environment undermine self -perceived risk of contracting COVID-19 among urban dwellers in Malawi. We recommend that diverse actors in Malawi should collaborate to promote the dissemination of accurate COVID-19 discourses and reduce the severity of the pandemic's impact in Malawi.
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Affiliation(s)
| | - Mastano Dzimbiri
- College of Education, Health, and Society, Miami University, Oxford, USA
| | | | - Amanda Keller
- School of Social Work, McGill University, Montreal, Canada
| | - Ruth Agather Mbeya
- Department of Basic Science, University of Livingstonia, Livingstonia, Malawi.
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Adewoyin Y, Ajaero CK, Odimegwu CO. Contexts, beliefs and health behaviour: Are individuals who engage in risky sexual behaviour likely to wear facemasks against COVID-19? J Public Health Afr 2022; 13:2032. [PMID: 36051515 PMCID: PMC9425937 DOI: 10.4081/jphia.2022.2032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 04/29/2022] [Indexed: 11/22/2022] Open
Abstract
Beside age, underlying comorbidities and availability of sanitation facilities, individual health beliefs and behaviour are critical in combating the sustained prevalence of Covid-19. Behaviour has, however, been shown to be consistent but could be context- dependent based on the individual’s beliefs. To investigate whether or not individuals’ protective behaviour against coronavirus is associated with their behaviour in a previous health context. Facemask usage and engagement in risky sexual behaviour (RSB) were employed as corollaries of Covid-19 protective behaviour and a previous health context respectively. Data on them and other sociodemographic correlates of health behaviour were collected on 522 Nigerians via a web-based survey. The data were analyzed using frequency, Chi Square and Binary Logistics Regression. About 31% of the population wore facemasks in public, 48.1% believed Covid existed and was severe, and 31.6% had engaged in RSB. Individuals who engaged in RSB had lower odds of wearing facemasks in public in both the general population and across the rural-urban divide. The relationship was, however, only statistically significant (OR:0.642, p<0.05) in the adjusted regression model. Other significant determinants of facemask use were gender, place of residence, employment status and beliefs about Covid. The similarity of individual beliefs and behaviours in different health contexts provides an opportunity to model behaviour change communication policies for preventing and combating the spread of coronavirus and other infectious diseases.
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Rojpaisarnkit K, Kaewpan W, Pengpid S, Peltzer K. COVID-19 Preventive Behaviors and Influencing Factors in the Thai Population: A Web-Based Survey. Front Public Health 2022; 10:816464. [PMID: 35646759 PMCID: PMC9133839 DOI: 10.3389/fpubh.2022.816464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/29/2022] [Indexed: 01/07/2023] Open
Abstract
Objectives To identify factors influencing COVID-19 preventive behaviors among the Thai population. Methods A cross-sectional web-based survey was used. A total of 6,521 Thai people completed the survey. The multiple linear regression analysis was performed to identify factors that influenced coronavirus disease 2019 (COVID-19) preventive behaviors. The Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model was applied to propose factors influencing COVID-19 preventive behaviors. Results The factors that mostly influenced COVID-19 prevention behaviors when controlling for the other variables are social support (β = 0.173, p < 0.001) follow by age (β = 0.162, p < 0.001), flu-like symptoms (β = 0.130, p < 0.001), gender (β = -0.084, p < 0.001), perceived risk of exposure (β = 0.035, p < 0.05), lock down policy (β = 0.029, p < 0.05), and residential area (β = -0.027, p < 0.05), respectively. These factors explained 52% of the COVID-19 preventive behaviors in Thai population. Conclusion The result of this study was a foundation for further studies on different groups of people to develop different strategies to adopt preventive behaviors to reduce the spread of the COVID-19.
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Affiliation(s)
- Kunwadee Rojpaisarnkit
- Department of Public Health, Faculty of Sciences and Technology, Rajabhat Rajanagarindra University, Chachoengsao, Thailand
| | - Wonpen Kaewpan
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Supa Pengpid
- Department of Health Education and Behavioural Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
| | - Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
- Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
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Ginsburg C, Collinson MA, Gómez-Olivé FX, Harawa S, Pheiffer CF, White MJ. The impact of COVID-19 on a cohort of origin residents and internal migrants from South Africa's rural northeast. SSM Popul Health 2022; 17:101049. [PMID: 35252532 PMCID: PMC8889408 DOI: 10.1016/j.ssmph.2022.101049] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/14/2022] [Accepted: 02/14/2022] [Indexed: 11/27/2022] Open
Abstract
South Africa has a large temporary migrant population with people commonly moving to metropolitan areas to access employment, while maintaining links with their rural origin households. The COVID-19 pandemic has impacted patterns of movement, livelihoods and health seeking, and the effects on internal, temporary migrants are unclear. Using longitudinal data spanning 2018 to 2020, this paper employs descriptive statistics and regression analyses to assess the impacts of COVID-19 on a cohort of 2971 persons aged 18-40 at baseline, both residents and migrants, from a rural district in South Africa's northeast. In contrast with 2018-2019, in 2020 the share of rural residents initiating a migration decreased by 11 percentage points (p<0.001), while the share of temporary migrants returning to origin households increased by 5 percentage points (p<0.001). Study participants who were continuing migrants reported fewer job losses in comparison with rural-stayers, while 76% of return migrants who were employed in 2019 were no longer employed in 2020. Further, among those who did not experience food shortages in 2019, rural-stayers had 1.42 times the odds of continuing migrants of suffering shortages in 2020. In 2020 health service use in the cohort decreased overall, with return migrants having still lower odds of utilising health services. The results highlight the differential geographic and socioeconomic manifestations of the pandemic, with worsening socioeconomic circumstances observed for rural-staying (disproportionately female) and returning populations, while continuing migrants fared relatively better. It is vital that a COVID-19 response considers the potentially heterogeneous impact of the pandemic on mobile and stable populations. Policy responses may include targeting migrants at their destinations in health promotion of COVID-19 messaging, and strengthening health care and social support in origin communities in recognition that these areas receive return migrants into their catchment population.
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Affiliation(s)
- Carren Ginsburg
- 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
| | - Mark A. 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, South Africa
| | - F. 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
| | - Sadson Harawa
- 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
| | | | - Michael J. White
- 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
- Population Studies and Training Centre, Brown University, USA
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11
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Iyaniwura SA, Rabiu M, David JF, Kong JD. The basic reproduction number of COVID-19 across Africa. PLoS One 2022; 17:e0264455. [PMID: 35213645 PMCID: PMC8880647 DOI: 10.1371/journal.pone.0264455] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/10/2022] [Indexed: 12/15/2022] Open
Abstract
The pandemic of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) took the world by surprise. Following the first outbreak of COVID-19 in December 2019, several models have been developed to study and understand its transmission dynamics. Although the spread of COVID-19 is being slowed down by vaccination and other interventions, there is still a need to have a clear understanding of the evolution of the pandemic across countries, states and communities. To this end, there is a need to have a clearer picture of the initial spread of the disease in different regions. In this project, we used a simple SEIR model and a Bayesian inference framework to estimate the basic reproduction number of COVID-19 across Africa. Our estimates vary between 1.98 (Sudan) and 9.66 (Mauritius), with a median of 3.67 (90% CrI: 3.31-4.12). The estimates provided in this paper will help to inform COVID-19 modeling in the respective countries/regions.
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Affiliation(s)
- Sarafa A. Iyaniwura
- Department of Mathematics and Institute of Applied Mathematics, University of British Columbia, Vancouver, BC, Canada
| | - Musa Rabiu
- School of Mathematics, Statistics & Computer Science, University of KwaZulu-Natal, Durban, South Africa
| | - Jummy F. David
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario, Canada
- Fields-CQAM Laboratory of Mathematics for Public Health (MfPH), York University, Toronto, Ontario, Canada
| | - Jude D. Kong
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario, Canada
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, Ontario, Canada
- Laboratory for Applied and Industrial Mathematics (LIAM), York University, Toronto, Ontario, Canada
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12
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Lusmilasari L, Putra ADM, Sandhi A, Saifullah AD. COVID-19 Preventive Behavior Practices and Determinants: A Scoping Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Coronary Heart Diseases (CHD) is one of the leading causes of death worldwide. Proper management for CHD patients is needed to reduce mortality. Nurses have a very important role in making CHD patients can carry out optimal health behaviors.
AIM: This review study aims to identify the effect of the nurse-led program on CHD patients.
METHODS: This systematic review was based on four electronic databases (Scopus, Science Direct, ProQuest, SAGE Journals) and published between 2011 and 2020. This review used the Joanna Briggs Institute and Prisma guidelines. The study’s eligibility was assessed from the title, abstract, research methodology, and full text. The review results were presented in tabulated data and narrative form.
RESULTS: Nine articles showed that the nurse-led program significantly improved health behavior, health-related quality of life, clinical outcome, and illness perception in CHD patients.
CONCLUSIONS: It is expected that the improvement of management in CHD patients will improve patients’ quality of life. Hence, it could reduce the number of morbidities and mortality.
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13
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Mmanga C, Ndasauka Y, Kainja J, Kondowe F, Mchenga M, Maliwichi L, Nyamali S. The world is coming to an end! COVID-19, depression, and anxiety among adolescents in Malawi. Front Psychiatry 2022; 13:1024793. [PMID: 36684001 PMCID: PMC9849886 DOI: 10.3389/fpsyt.2022.1024793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/02/2022] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION This paper assessed the effects of Covid-19 on adolescent mental health in Malawi. There is minimal research on adolescent mental health in Africa, Malawi in particular. The study shows a link between the pandemic and mental health. Some factors that may have contributed to this link include; Covid-19 preventive measures, media exposure and the increase in unemployment. METHODS The study used a mixed methods approach, quantitative and qualitative methods. It was conducted in Malawi's four districts (Blantyre, Mangochi, Lilongwe and Karonga). RESULTS Overall 22%, 21%, and 23% of the respondents had depression, anxiety and post-traumatic stress disorder, respectively. The Chi-square test showed that significantly more adolescents with secondary education (28%) had anxiety than those with primary education (14%). Further, regression analysis revealed that adolescents with anxiety were 18 [95%CI: 9.34, 35.8] times more likely to have depression compared to those who did not have anxiety. The study found no significant differences in the proportions of adolescents with the three outcomes when comparing different groups within the explanatory variable. The ratio of female and male adolescents with depression and anxiety was the same. DISCUSSION The adolescents expressed that Covid-19 affected their social, academic, and financial status. These effects had a significant bearing on their mental health in that they led to depression, anxiety, fear of the unknown, and stress. During the Covid-19 pandemic, adolescents' mental health diminished and posed a considerable risk to productivity of adolescents. As a result, adolescents may not fully realize their potential, form and maintain good relationships, contribute to their community and become resilient. These effects have devastating consequences for this young generation without proper coping strategies.
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Affiliation(s)
| | | | - Jimmy Kainja
- Department of Philosophy, University of Malawi, Zomba, Malawi
| | - Fiskani Kondowe
- Department of Philosophy, University of Malawi, Zomba, Malawi
| | - Martina Mchenga
- Department of Media and Communication Studies, University of Cape Town, Cape Town, South Africa
| | | | - Simunye Nyamali
- Department of Mathematical Sciences, University of East Anglia, Norwich, United Kingdom
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14
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Osei E, Amu H, Appiah PK, Amponsah SB, Danso E, Oppong S, Lotse CW, Owusu BE, Agongo SA, Yakubu E, Kye-Duodu G. Stigma and discrimination tendencies towards COVID-19 survivors: Evidence from a nationwide population-based survey in Ghana. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000307. [PMID: 36962445 PMCID: PMC10021222 DOI: 10.1371/journal.pgph.0000307] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 04/26/2022] [Indexed: 11/19/2022]
Abstract
Historically, infectious diseases have generated fears among populations. Unhealthy handling of these fears result in the stigma and discrimination of infected patients. Globally, measures taken so far by governments to curb the spread of the novel coronavirus disease-2019 (COVID-19) pandemic, although helpful, have created fears in people. Consequently, there are reported Ghanaian media cases of stigmatisation against persons who were infected and recovered from COVID-19. However, these reports remain unsubstantiated. This study, therefore, sought to examine stigma and discriminatory tendencies towards COVID-19 survivors among the adult population in Ghana. This was a population-based cross-sectional study among 3,259 adults. A multi-stage sampling technique was used to recruit study participants. Descriptive and inferential statistics comprising frequency, percentage, chi-square, and multivariable logistic regression were employed in analysing the data. Knowledge on COVID-19 was poor among 33.6% of the participants. Forty-three per cent had a good attitude towards COVID-19. Nearly half (45.9%) exhibited stigma and discriminatory tendencies towards COVID-19 survivors. Participants who had poor COVID-19 related knowledge (aOR = 1.91, 95%CI = 1.59-2.29, p<0.001) and poor attitude towards COVID-19 (aOR = 5.83, 95% CI = 4.85-6.98, p<0.001) were more likely to exhibit stigma and discriminatory tendencies towards COVID-19 survivors. Our study found relatively high proportions of poor knowledge and negative attitudes towards COVID-19. Stigma and discriminatory tendencies were consequently high. Our findings call for increased public education on COVID-19 by the Ghana Health Service and the Information Services Department, to increase the level of knowledge on the pandemic while reducing stigma and discrimination associated with it.
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Affiliation(s)
- Eric Osei
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
- Department of Public Health, Yonsei University of Graduate School, Seoul, Republic of Korea
| | - Hubert Amu
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Prince Kubi Appiah
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
- Department of Medical Law and Bioethics, Yonsei University, Seoul, Republic of Korea
| | - Solomon Boamah Amponsah
- Department of Health Research and Development, Regional Health Directorate, Ghana Health Service, Eastern Region, Koforidua, Ghana
| | - Evans Danso
- Department of Community Health, College of Health, Yamfo, Bono East Region, Sunyani, Ghana
| | - Samuel Oppong
- Municipal Health Directorate, Ghana Health Service, Bono Region, Sunyani, Ghana
| | - Comfort Worna Lotse
- Department of Nursing, School of Nurses and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Bright Emmanuel Owusu
- Department of Mathematics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Simon Azure Agongo
- Department of Community Health, College of Health, Yamfo, Bono East Region, Sunyani, Ghana
| | - Eliasu Yakubu
- Department of Community Health, College of Health, Yamfo, Bono East Region, Sunyani, Ghana
| | - Gideon Kye-Duodu
- Department of Epidemiology and Biostatistics, University of Health and Allied Sciences, Ho, Ghana
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15
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Meinus C, Singer R, Nandi B, Jagot O, Becker-Ziaja B, Karo B, Mvula B, Jansen A, Baumann J, Schultz A. SARS-CoV-2 prevalence and immunity: a hospital-based study from Malawi. Int J Infect Dis 2021; 116:157-165. [PMID: 34929356 PMCID: PMC8679501 DOI: 10.1016/j.ijid.2021.12.336] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 11/06/2022] Open
Abstract
Background COVID-19 transmission and disease dynamics in sub-Saharan Africa are not well understood. Our study aims to provide insight into COVID-19 epidemiology in Malawi by estimating SARS-CoV-2 prevalence and immunity after SARS-CoV-2 infection in a hospital-based setting. Methods We conducted a hospital-based, convenience sampling, cross-sectional survey for SARS-CoV-2 in Lilongwe, Malawi. Participants answered a questionnaire and were tested for SARS-CoV-2 by enzyme-linked immunosorbent assay and real-time reverse-transcription polymerase chain reaction (RT-PCR). A surrogate virus neutralization test (sVNT) was performed in seropositive samples to estimate immunity. Poisson regression was used to assess SARS-CoV-2 point prevalence association with demographic and behavioral variables. Findings The study included 930 participants. We found a combined point prevalence of 10.1%. Separately analyzed, RT-PCR positivity was 2.0%, and seropositivity was 9.3%. Of tested seropositive samples, 90.1% were sVNT positive. We found a high rate (45.7%) of asymptomatic SARS-CoV-2 infection. SARS-CoV-2 point prevalence was significantly associated with being a healthcare worker. Interpretation Our study suggests that official data underestimate COVID-19 transmission. Using sVNTs to estimate immunity in Malawi is feasible and revealed considerable post-infection immunity in our cohort. Subclinical infection and transmission are probably a game-changer in surveillance, mitigation and vaccination strategies.
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Affiliation(s)
- C Meinus
- Charité - Universitätsmedizin Berlin, Institute of Tropical Medicine and International Health
| | - R Singer
- Robert Koch Institute Berlin, Germany
| | - B Nandi
- Baylor College of Medicine, Houston, USA; Kamuzu Central Hospital Lilongwe, Malawi
| | - O Jagot
- Kamuzu Central Hospital Lilongwe, Malawi
| | | | - B Karo
- Robert Koch Institute Berlin, Germany
| | - B Mvula
- Public health institute of Malawi, Lilongwe, Malawi
| | - A Jansen
- Robert Koch Institute Berlin, Germany
| | - J Baumann
- Robert Koch Institute Berlin, Germany
| | - A Schultz
- College of Medicine, Department of Paediatrics, University of Malawi, Lilongwe, Malawi; University Hospital Bonn, section global health, University of Bonn, Germany.
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16
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Clavel N, Badr J, Gautier L, Lavoie-Tremblay M, Paquette J. Risk Perceptions, Knowledge and Behaviors of General and High-Risk Adult Populations Towards COVID-19: A Systematic Scoping Review. Public Health Rev 2021; 42:1603979. [PMID: 34909234 PMCID: PMC8636827 DOI: 10.3389/phrs.2021.1603979] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 10/25/2021] [Indexed: 12/23/2022] Open
Abstract
Objectives: The COVID-19 pandemic represents a major crisis for governments and populations. The public’s risk perceptions, knowledge, and behaviors are key factors that play a vital role in the transmission of infectious diseases. Our scoping review aims to map the early evidence on risk perceptions, knowledge, and behaviors of general and high-risk adult populations towards COVID-19. Methods: A systematic scoping review was conducted of peer-reviewed articles in five databases on studies conducted during the early stages of COVID-19. Thirty-one studies meeting the inclusion criteria were appraised and analyzed. Results: The levels of risk perceptions, knowledge, and behaviors towards COVID-19 were moderate to high in both general and high-risk adult populations. Adults were knowledgeable about preventive behaviors. Our review identified hand-washing and avoiding crowded places as dominant preventive behaviors. Being a female, older, more educated, and living in urban areas was associated with better knowledge of COVID-19 and appropriate preventive behaviors. Conclusion: This review offers a first understanding of risk perceptions, knowledge and behaviors of adult populations during the early stages of the COVID-19 pandemic.
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Affiliation(s)
- Nathalie Clavel
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Janine Badr
- École de Santé Publique, Université de Montréal, Montreal, QC, Canada
| | - Lara Gautier
- École de Santé Publique, Université de Montréal, Montreal, QC, Canada
| | | | - Jesseca Paquette
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
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17
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Wamai RG, Hirsch JL, Van Damme W, Alnwick D, Bailey RC, Hodgins S, Alam U, Anyona M. What Could Explain the Lower COVID-19 Burden in Africa despite Considerable Circulation of the SARS-CoV-2 Virus? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8638. [PMID: 34444386 PMCID: PMC8391172 DOI: 10.3390/ijerph18168638] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 01/12/2023]
Abstract
The differential spread and impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing Coronavirus Disease 2019 (COVID-19), across regions is a major focus for researchers and policy makers. Africa has attracted tremendous attention, due to predictions of catastrophic impacts that have not yet materialized. Early in the pandemic, the seemingly low African case count was largely attributed to low testing and case reporting. However, there is reason to consider that many African countries attenuated the spread and impacts early on. Factors explaining low spread include early government community-wide actions, population distribution, social contacts, and ecology of human habitation. While recent data from seroprevalence studies posit more extensive circulation of the virus, continuing low COVID-19 burden may be explained by the demographic pyramid, prevalence of pre-existing conditions, trained immunity, genetics, and broader sociocultural dynamics. Though all these prongs contribute to the observed profile of COVID-19 in Africa, some provide stronger evidence than others. This review is important to expand what is known about the differential impacts of pandemics, enhancing scientific understanding and gearing appropriate public health responses. Furthermore, it highlights potential lessons to draw from Africa for global health on assumptions regarding deadly viral pandemics, given its long experience with infectious diseases.
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Affiliation(s)
- Richard G. Wamai
- Department of Cultures, Societies, and Global Studies, Northeastern University, 201 Renaissance Park, 360 Huntington Ave., Boston, MA 02115, USA;
| | - Jason L. Hirsch
- Department of Cultures, Societies, and Global Studies, Northeastern University, 201 Renaissance Park, 360 Huntington Ave., Boston, MA 02115, USA;
| | - Wim Van Damme
- Department of Public Health, Institute of Tropical Medicine, B-2000 Antwerp, Belgium;
| | - David Alnwick
- DUNDEX (Deployable U.N.-Experienced Development Experts), FX68 Belturbet, Ireland;
| | - Robert C. Bailey
- School of Public Health, University of Illinois at Chicago, Chicago, IL 60607, USA;
| | - Stephen Hodgins
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Uzma Alam
- Researcher Africa Institute for Health Policy Foundation, Nairobi 020, Kenya;
| | - Mamka Anyona
- T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA;
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18
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Eyeberu A, Mengistu DA, Negash B, Alemu A, Abate D, Raru TB, Wayessa AD, Debela A, Bahiru N, Heluf H, Kure MA, Abdu A, Dulo AO, Bekele H, Bayu K, Bogale S, Atnafe G, Assefa T, Belete R, Muzeyin M, Asmerom H, Arkew M, Mohammed A, Asfaw H, Taddesse B, Alemu D, Yihun D, Amare SN, Kebira JY, Adem SA, Dirirsa G, Girmay SH, Godana A, Dechasa DB, Dessie Y. Community risk perception and health-seeking behavior in the era of COVID-19 among adult residents of Harari regional state, eastern Ethiopia. SAGE Open Med 2021; 9:20503121211036132. [PMID: 34377473 PMCID: PMC8323417 DOI: 10.1177/20503121211036132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/12/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND COVID-19 brought significant challenges to public health. It changed the view of global health and safety, trust in the healthcare system, and clients' willingness to seek healthcare. To contain the course of the COVID-19 pandemic and its detrimental effects, understanding peoples' health behavior, especially healthcare-seeking, and determining the community risk perception is very important. Thus, this study aimed to determine the health-seeking behavior, community's risk perception to COVID-19 pandemics, and factors influencing the community risk perception in Harari regional state, Ethiopia. METHODS Community-based cross-sectional study was conducted from 5 to 30 February 2021. A total of 1320 adult (>18 years) participants were selected using systematic random sampling. The data were collected using an online kobo collect toolbox and analyzed using descriptive statistical tests. Chi-square test and multiple binary logistic regression were applied to examine the difference between variables. A p-value < 0.05 was considered to be of statistical significance. RESULTS The study included 1296 respondents >18 years old. The overall prevalence of willingness to seek healthcare in the study area was 35.6% (95% CI: 33%-38.3.0%). The mean cumulative score of risk perception was 30.5 (SD ± 7.25) with the minimum and maximum score of 13 and 63, respectively. A total of 656 (50.6%) of the participants had low-risk perceptions concerning COVID-19. The study found a statistically significant association between risk perception and sociodemographic characteristics (age, educational status, and income), and knowledge of the respondents. CONCLUSION The overall prevalence of willingness to seek healthcare was 35.6%. Healthcare intervention aimed to contain the COVID-19 pandemic should consider the factors associated with the study area. Similarly, the study found a low-risk perception among the community that needs critical action to manage the COVID-19 pandemic and to protect the community as a whole. Thus, it is necessary to improve community risk perception through health education.
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Affiliation(s)
- Addis Eyeberu
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dechasa Adare Mengistu
- Department of Environmental Health,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Belay Negash
- School of Public Health, College of
Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of
Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Degu Abate
- Department of Medical Laboratory
Sciences, College of Health and Medical Sciences, Haramaya University, Harar,
Ethiopia
| | - Temam Beshir Raru
- School of Public Health, College of
Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Alemayehu Deressa Wayessa
- School of Public Health, College of
Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Debela
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Nebiyu Bahiru
- School of Public Health, College of
Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Helina Heluf
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohammed Abdurke Kure
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ahmedmenewer Abdu
- Department of Medical Laboratory
Sciences, College of Health and Medical Sciences, Haramaya University, Harar,
Ethiopia
| | - Amanuel Oljira Dulo
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Habtamu Bekele
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kefelegn Bayu
- Department of Environmental Health,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Saron Bogale
- School of Pharmacy, College of Health
and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Genanaw Atnafe
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tewodros Assefa
- School of Pharmacy, College of Health
and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Rabuma Belete
- Department of Medical Laboratory
Sciences, College of Health and Medical Sciences, Haramaya University, Harar,
Ethiopia
| | - Mohammed Muzeyin
- Department of Environmental Health,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Haftu Asmerom
- Department of Medical Laboratory
Sciences, College of Health and Medical Sciences, Haramaya University, Harar,
Ethiopia
| | - Mesay Arkew
- Department of Medical Laboratory
Sciences, College of Health and Medical Sciences, Haramaya University, Harar,
Ethiopia
| | - Anumein Mohammed
- Department of Medical Laboratory
Sciences, College of Health and Medical Sciences, Haramaya University, Harar,
Ethiopia
| | - Henock Asfaw
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Barkot Taddesse
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Daniel Alemu
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawit Yihun
- School of Pharmacy, College of Health
and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Shambel Nigussie Amare
- School of Pharmacy, College of Health
and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Jemal Yusuf Kebira
- School of Public Health, College of
Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Siraj Aliyi Adem
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gebisa Dirirsa
- Department of Environmental Health,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Saba Hailu Girmay
- School of Public Health, College of
Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abduro Godana
- School of Pharmacy, College of Health
and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Deribe Bekele Dechasa
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of
Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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19
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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.
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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
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20
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Li Y, Liu G, Egolet RO, Yang R, Huang Y, Zheng Z. Knowledge, Attitudes, and Practices Related to COVID-19 Among Malawi Adults: A Community-Based Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084090. [PMID: 33924451 PMCID: PMC8069913 DOI: 10.3390/ijerph18084090] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 11/16/2022]
Abstract
Introduction: It is well-recognized that containing COVID-19 successfully is determined by people’s prevention measures which are related to their knowledge, attitudes, and practices (KAP). This perception has attracted attention in low- and middle-income countries (LMIC) due to their fragile health systems and economies. The objective of this study was to understand how residents in Malawi perceived COVID-19, to determine the factors related to KAP. Methods: A semi-structured questionnaire was used for the data collection. A field-based survey was conducted among adult residents in Lilongwe, Malawi. Descriptive statistic, linear regression, the Chi-square test, and Pearson’s correlation statistics were used for data analysis. Results: A total of 580 questionnaires were involved. The mean knowledge, attitude, and practice (KAP) scores were 10 (SD = ±3, range: 3–19), 16 (SD = ±4, range: 5–25), and 2 (SD = ±1, range: 0–5), respectively. Lack of money and resources (39%) was the biggest challenge for people who practice prevention measures. Among the participants, the radio (70%) and friends/family (56%) were the main sources of information. A higher economic status was associated with better KAP. Conclusions: A low level of KAP was detected among the population. The people faced challenges regarding a lack of necessary preventive resources and formal information channels. The situation was worse considering vulnerable population who had low economic status. Further all-round health education is urgently needed along with providing adequate health supplies and ensuring proper information management.
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Affiliation(s)
- Yutong Li
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Y.L.); (G.L.); (Z.Z.)
- Institute for Global Health, Peking University, Beijing 100191, China
| | - Guangqi Liu
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Y.L.); (G.L.); (Z.Z.)
- Institute for Global Health, Peking University, Beijing 100191, China
| | - Robert Okia Egolet
- Global Health Collaborating Centre for Research and Training in Health Sciences, Peking University, P.O. Box 166, Lilongwe 265, Malawi;
| | - Runqing Yang
- Department of Economics, HSBC Business School, Peking University, University Town, Nanshan District, Shenzhen 518055, China;
| | - Yangmu Huang
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Y.L.); (G.L.); (Z.Z.)
- Institute for Global Health, Peking University, Beijing 100191, China
- Correspondence:
| | - Zhijie Zheng
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Y.L.); (G.L.); (Z.Z.)
- Institute for Global Health, Peking University, Beijing 100191, China
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