Knowledge, risk-perception, and uptake of COVID-19 prevention measures in sub-Saharan Africa: a scoping review

Background: The COVID-19 pandemic has almost affected the entire globe and is currently in a resurgent phase within the sub-Saharan African region. Objective: This paper presents results from a scoping review of literature on knowledge, risk-perception, conspiracy theories and uptake of COVID-19 prevention measures in sub-Saharan Africa. Methods: We used the following search terms: 'COVID-19', 'knowledge', 'perceptions', 'perspectives', 'misconceptions', 'conspiracy theories', 'practices' and 'sub-Saharan Africa'. Basing on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines, we identified 466 articles for review; 36 articles met the inclusion criteria. We extracted data on knowledge, risk perception, conspiracy theories and uptake of COVID-19 primary prevention measures. Results: Knowledge of COVID-19 was high (91.3-100%) and associated with age and education; risk-perception was equally high (73.3-86.9%) but varied across studies. Uptake of handwashing with water and soap or hand-sanitizing ranged between 63-96.4%, but wearing of face masks and social distancing fared poorly (face masks: 2.7%-37%; social distancing: 19-43%). Conclusion: While knowledge of COVID-19 is nearly universal, uptake of COVID-19 prevention measures remains sub-optimal to defeat the pandemic. These findings suggest a need for continued health promotion to increase uptake of the recommended COVID-19 prevention measures in sub-Saharan Africa

Barriers to cyotherapy treatment services for precancerous cervical lesions among women in Western Kenya

BACKGROUND Cervical cancer is the fourth most fatal and common disease globally among women of reproductive age in Kenya; it ranks the second most frequent type of cancer after breast cancer. Due to the high burden, cryotherapy treatment services, which are effective for the treatment of precancerous lesions are available in selected health facilities in Kenya, however, barriers to the treatment services are poorly understood. Nonetheless, understanding these barriers is critical for enhanced service delivery. MATERIALS AND METHODS :A descriptive facility-based cross-sectional study design was carried out to determine the barriers to cryotherapy treatment services among 60 women of reproductive age on a one-year therapy at Migosi Sub County Hospital in Western Kenya. The participants were selected purposively and interviewed via telephone calls using pre-coded semi-structured questionnaires. However, data from 5 nurses working in the cryotherapy section were collected through face-to-face interviews at the health facility. Data were entered in an excel sheet and then exported to SPSS version 23.0 for analysis. Both descriptive and inferential statistics (Chi-square) were used and data were presented in form of tables. RESULTS :Overall, 52 (85.4%) respondents adhered to post-care treatment instructions and reported no adverse reactions. However, 28 (46.7%) experienced unavailability of cryotherapy services at the time of the appointment and got the services later, 24 (40%) got the services at the time of the appointment but waited for a long time before being served, 37 (61.7%) did not know why they were being treated and 46 (76.7%) had misconceptions and myths about the therapy. In addition, there was a statistically significant association between knowing both the benefits of screening and cryotherapy [X 2 (1, N = 60) = 5.90, p = .02]. Also, the knowledge of the benefits of cryotherapy did not influence one's decision to wait for cryotherapy treatment services, [X 2(1, N = 60) = 3.98, p = .46]. CONCLUSION : The study shows very good adherence to post-treatment instruction but inadequate availability of cryotherapy treatment services. Also, the misconceptions and myths about cryotherapy are public health concerns. Therefore, the study recommends improved awareness campaigns and service delivery for the enhanced uptake of cryotherapy treatment services.

Misconceptions and associated factors of COVID-19 infection among internally displaced persons in Sudan

Coronavirus disease 2019 (COVID-19) is a global public health threat that has spread rapidly and caused morbidity and mortality worldwide. Reducing the myths about infectious diseases is vital for controlling transmission. This study explored the level of misconceptions and associated factors of COVID-19 among internally displaced persons in Sudan. This study is a cross-sectional, descriptive design and community-based study. We collected the data using a self-administered questionnaire via the convenience sampling technique among internally displaced persons in the camps of Zalingei town in the central Darfur region of Sudan. The total mean score of the respondents' misconception was 3.1725 (SD=0.59) with 63.2%, indicating moderate misunderstanding of COVID-19. Multiple linear regression revealed the independent variables together had a significant impact on a misconception, F(14,116)=2.429, p<0.005. The regression model explains 22.7% of the variance in misunderstanding. Analysis of the influence of single factors on the dependent variable showed that people aged 31­40 years had significantly higher levels of misconception, 0.381 (t=2.116, p<0.037), than those aged over 60 years, and university graduates had considerably lower levels of misunderstanding, −0.061 (t=−2.091, p<0.03) than non-graduates. This study found a moderate level of misconception of COVID-19. Non-graduates had higher levels of misunderstanding than graduates. The results suggest that an education campaign should focus on people with low levels of education to correct their misconceptions regarding the prevention of COVID-19 infection

Prevalence, pattern and determinants of myths and misconceptions among patients with diabetes mellitus in South West Nigeria

Background: Diabetes Mellitus is a disease of public health significance in the world and especially the African region. Aim: To assess the myths and misconceptions about DM among patients with DM who are attending a teaching hospital. Methods: This study involved adults diagnosed of type-2 diabetes who were consecutively recruited from the LAUTECH teaching hospital Diabetic Clinic, Ogbomoso, Nigeria. A validated questionnaire was used to collect data about sociodemographic data, and questions about aetiology of diabetes, diets, treatment/management and Insulin therapy. All data were entered and analyzed using SPPS. P­value less than 0.05 were considered as statistically significant. Results: 101 subjects with a mean age of 60.61 ± 12.53 years were enrolled for the study. 61% were females, 76% were retirees and 58% were in the 61­80 years age group. The commonest misconception was that "diabetic patients needed a 'special diabetic diet'" ­ 89.1%, followed by "adding sugar to food is prohibited" ­ 73.3%. 51.5% have adequate knowledge of the diabetes mellitus. Patients receiving oral hypoglycemic agents have good knowledge of the disease. Conclusion: A large of Nigerians has various myths and misconceptions about diabetes. Comprehensive health educational programs for Nigerian patients with diabetes must include sessions to identify and address the presence of these prevailing myths and misconceptions

How to change perceptions on feeding in neonatal care

The transmission of HIV through breastmilk; with the potential to infect the newborn; has had a major impact on child health worldwide. Although South African studies confirmed that exclusive breastfeeding reduced rates of mother-to-child transmission of HIV; the recommendation of formula feeding for HIV-exposed newborn infants; provided their mothers had the facilities for safe preparation of formula milk and complied with the AFASS criteria (formula feeding to be Acceptable; Feasible; Affordable; Sustainable; Safe); was introduced. Observations made by the nursing staff; fully aware of the risks of formula feeding; in the neonatal unit at King Edward VIII Hospital in 2009 showed that an increasing number of small; sick newborns were being formula fed.By conducting focus group discussions with nurses; mothers and counsellors and teasing out the confusions and misconceptions; relevant information was imparted to the groups to allow them to re-consider their misconceptions. Within a period of 2 months nurses were confident about re-counselling mothers with respect to appropriate feeding choices. HIV-positive mothers were trained to flash-heat their milk. Subsequently; policies for the unit were derived from the focus group discussions. In addition; regional hospitals in the Durban area (eThekweni) considered the introduction of flash-heating to their units. The South African Department of Health opted for infants to receive prophylaxis with daily nevirapine as long as they are breastfed; and the Nutrition Directorate decided to withdraw the issue of free replacement feeds in HIV-exposed babies. KZN was the first province to institute this policy. The Department of Health has recommended that neonatal units no longer encourage HIV-infected mothers to flash-heat their breastmilk unless the infant is not receiving ARV prophylaxis or the mother is not on treatment

Knowledge of and Misconceptions about the Spread and Prevention of HIV Infection among Older Urban Women Attending the Tshwane District Hospital; South Africa

Background:Statistics around the world show a rapid increase in HIV infection in the older population. Many older women remain sexually active and are therefore exposed to heterosexual transmission of HIV infection. Older women are most likely considered respected opinion leaders within the families and communities and are likely to influence others' attitudes and behaviours. An increase in knowledge through information plays a fundamental role and is a prerequisite for behavioural change that may prevent new HIV infections. The purpose of the current study was to assess the knowledge and misconceptions regarding the spread and prevention of HIV in older women attending the Tshwane District Hospital (TDH) in South Africa. Methods: A prospective cross-sectional study of 100 women; aged 50 to 80 years; attending the TDH out-patient section during November and December 2006 was done. The levels of knowledge were determined by using a directed questionnaire. Results: Eight per cent of the participants answered all the questions correctly; showing knowledge gaps in the remaining 92(95confidence interval: 86.7-97.3). Many participants were unaware of the protective effects of condom use; especially female condoms; and of HIV spread by anal transmission; the sharing of needles and blood transfusion. Three or more misconceptions were present in 48of the participants; such as HIV spread by casual contact; the sharing of personal items; air-borne infection; mosquito bites; HIV testing and AIDS prevention or cure by traditional medicines or alternatives. Sixty-two per cent of the older women were found to have adequate knowledge (95confidence interval: 52-71.5); knowing the basic concepts regarding HIV transmission.Conclusion: There is a significant need for HIV-related preventive health education in older women; not only to decrease potential high-risk behaviours; but also to reduce unnecessary feelings of anxiety and misconceptions. Family physicians; due to their unique role; might be able to use the present study in their practices in order to optimise the planning and structuring of awareness interventions and prevention programmes