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

Possibilidades de inserção da psicologia no trabalho com os cuidadores de crianças com deficiência / Psychology insertion possibilities in working with caregivers of children with disabilities

Este artigo fala sobre o trabalho realizado com o grupo de cuidadores das pessoas com deficiência beneficiadas com o Programa de Natação Adaptada, oferecido em parceria com o Departamento de Educação Física da Universidade Federal Fluminense entre 2013 e 2015. A partir do que Vinciane Despret (2011) chama de mal-entendido, procuramos pensar a inserção do profissional de psicologia neste espaço. Durante nosso trabalho foi preciso modificar nossa proposta de intervenção algumas vezes, dentre as mudanças, destacamos a proposta de desvincular a figura do cuidador da pessoa que é cuidada. Em seguida, pensamos no trabalho de intervenção em conjunto com a equipe da Educação Física, numa tentativa de ampliar as possibilidades de cuidado. Quando pensamos em cuidado como um processo, como proposto por Annemarie Mol (2008), foi possível aceitar um espaço de intervenção que fugisse do ambiente asséptico normalmente utilizado pela Psicologia. Esta mudança possibilitou o surgimento de afetos e articulações que não eram possíveis anteriormente.

This article is about the work with the caregivers of the people with disability who attend the Adapted Swimming Program, offered in partnership with Federal Fluminense University's Physical Education Department between 2013 and 2015. From what Vinciane Despret calls a misunderstanding, we try to formulate the insertion of the psychology professional in this space. During our work we had to modify our intervention proposition a few times, initially thinking about separating the caregiver's figure from the person who is 'receiving' care. Then, we thought about an intervention made with the P.E. team. When we took care as an ongoing process, as proposed by Annemarie Mol, we could accept an intervention space that escaped the aseptic environment normally used by Psychology. This change allowed the unfold of affections and articulations that were not possible before.

Este artículo habla sobre el trabajo realizado con el grupo de cuidadores de personas con discapacidad beneficiadas con el Programa de Natación Adaptada, que se ofrece en asociación con el Departamento de Educación Física de la Universidad Federal Fluminense entre 2013 y 2015. A partir de lo que Vinciane Despret llama malentendido, procuramos pensar en la inserción del profesional de psicología en este espacio. Durante el trabajo se tuvo que modificar nuestra propuesta de intervención algunas veces, reflejando en primer lugar sobre separar la figura del cuidador a la de la persona que es cuidada. Por último, pensamos en un trabajo de intervención en conjunto con el equipo de Educación Física. Cuando tomamos el cuidado como un proceso, tal como es propuesto por Annemarie Mol, podemos aceptar un espacio de intervención que se aleja del ambiente aséptico normalmente utilizado por la Psicología. Este cambio hizo posible el surgimiento de afecciones y articulaciones que no eran posibles anteriormente.

Therapeutic Misconception in Psychiatry Research: A Systematic Review

Therapeutic misconception (TM) denotes the phenomenon in which research subjects conflate research purpose, protocols and procedures with clinical treatment. We examined the prevalence, contributory factors, clinical associations, impact, and collated solutions on TM within psychiatric research, and made suggestions going ahead. Literature search for relevant empirical research papers was conducted until February 2015. Eighty-eight reports were extracted, of which 31 were selected, summarised into different headings for discussion of implications and collated solutions of TM. We found variable and high rates of TM (ranging from 12.5% to 86%) in some psychiatry research populations. Contributory factors to TM included perceived medical roles of researchers, media, research setting and subject factors. Greater TM in affective, neurodevelopmental and psychotic spectrum conditions were associated with demographic variables (such as lower education, increased age), clinical factors (such as poor insight, cognitive deficits, increased symptoms, poorer self-rated quality of health), and social functioning (such as decreased independence). Inattention to TM may lead to frustration, negative impression and abandonment of participation in psychiatry research. Strategies such as the employment of a neutral educator during the informed consent process and education modules may be effective in addressing TM. Further research is warranted to examine the different TM facets, specific clinical correlates and more effective management strategies.

Investigating the informed consent process, therapeutic misconception and motivations of Egyptian research participants: a qualitative pilot study

Few studies have explored the informed consent process among research participants in developing countries. This study aimed to evaluate the informed consent process, therapeutic misconception and motivation for participation among Egyptians participating in clinical trials. In a cross-sectional qualitative pilot study 103 participants in 10 clinical trials responded to a questionnaire. Over 90% agreed they had time to ask questions and received adequate information about the risks prior to consenting. All participants thought the research and the drug would improve their condition; only 46.1% were aware of receiving a non-approved experimental drug and 21.3% of being randomized. Reasons for participation included: better treatment [100%], to benefit society and advance science [85.4%], to receive free drugs [42.6%] and medical care [43.6%], to get hospitalized [15.8%] and to receive money or gifts [4.9%]. Investigators need to emphasize the distinction between research and clinical care to address the high rate of therapeutic misconception

Miragens perimetrais: sobre o erro como limite / Mirages perimeter: about the error as limit

O erro linguístico tem sido diversamente abordado ao longo das diferentes tradições dos estudos da linguagem. O presente trabalho propõe, a partir da psicanálise, uma discussão a respeito de possíveis considerações e sobre o que o erro viola. Assim, pretendemos vislumbrar onde, na topologia da língua, o erro encontra a sua morada, bem como questionar se, de fato, ele estaria aí em posição de limite...

Perimetrical mirages: on error as a limit. Linguistic error has been approached differently throughout different traditions of language studies. This paper, based on psychoanalytical doctrine, proposes a discussion about some possible considerations and about what error violates. Thus we want to envision where in the topology of language indwells linguistic error, and question whether, in fact, it would be there in some boundary position...

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

Factores asociados al empleo de varios antibióticos en pacientes clínicos / Factors related to the use of several antibiotics in clinical patients

Objetivo: identificar factores asociados con el empleo de varios antibióticos en pacientes clínicos.Métodos: se realizó un estudio de casos y controles en pacientes con infección, egresados de los servicios clínicos en el Hospital Docente Clínicoquirúrgico Joaquín Albarrán entre mayo de 2008 y diciembre de 2011. Se consideró caso al paciente que utilizó tres o más antibióticos. Se obtuvo la siguiente información: edad, sexo, antecedentes patológicos personales, tiempo de inicio de los síntomas sugestivos de un proceso infeccioso, uso previo de antibióticos, signos vitales y estado de conciencia al ingreso, resultados de estudios hematológicos y de química sanguínea, estudios radiográficos de tórax, diagnóstico de infección nosocomial y uso inadecuado de antimicrobianos. Se compararon las frecuencias mediante las pruebas de homogeneidad y prueba exacta de Fisher, pruebas t y de Wilcoxon. Se empleó la regresión logística para la identificación de los factores de riesgo.Resultados: Se estudiaron 92 casos y 184 controles. El riesgo de empleo de varios antibióticos se incrementó 2,68 veces por cada grado centígrado que se encontró elevada la temperatura del paciente (OR= 2,68; IC 95 por ciento 1,21-5,94), 7 veces si existió alteración del nivel de conciencia (OR= 7,32; IC 95 porciento 1,88-28,55), 3,88 veces si se diagnosticó infección nosocomial y 9,98 veces si se consideró inadecuado el uso de antimicrobianos.Conclusiones: Los factores de riesgo para el uso de varios antibióticos identificados pueden contribuir a elaborar estrategias de control de la calidad de prescripción de antimicrobianos

La falacia terapéutica / A falácia terapêutica / The therapeutic misconception

La falacia terapéutica tiene servido para negar la legítima esperanza de pacientes ?sujetos de investigación? que se incorporan a estudios clínicos Fase III para obtener beneficios clínicos directos. Esta ?falacia? busca ratificar los esfuerzos de investigadores en negar la diferencia entre estudios terapéuticos que benefician directamente los afectados e estudios no terapéuticos, que incorporan sujetos a investigaciones totalmente aisladas de sus necesidades. En países con populaciones pobres, precaria educación y acceso a servicios médicos, se intentan reclutar participantes ofreciendo terapias no disponibles localmente; obvio abuso das legítimas esperanzas de estos pacientes de acceder a estas indispensables terapias que les son prometidas al interior de las investigaciones. Así, la falacia terapéutica torna-se un modo de justificar a negativa de ofrecer beneficios médicos a los reclutados constituyendo sesgo de trasgresión ética, especialmente nos países en los cuales el participante no tienen expectativa de tratamiento. Esta justificada expectativa de los reclutados que ingresan en estudios clínicos aleatorios es argumento adicional contra el uso de placebo.

A falácia terapêutica tem servido para negar a legítima esperança de pacientes ?sujeitos da pesquisa? que se incorporam a estudos clínicos Fase III para obter benefícios clínicos diretos. Esta ?falácia? busca ratificar os esforços de pesquisadores em negar a diferença entre estudos terapêuticos que beneficiam diretamente os afetados e estudos não terapêuticos, que incorporam sujeitos a pesquisas totalmente distanciadas de suas necessidades. Em países com populações pobres, precária educação e acesso a serviços médicos, se tentam recrutar participantes oferecendo terapias não disponíveis localmente; óbvio abuso das legítimas esperanças destes pacientes terem acesso às indispensáveis terapias, prometidas pelas pesquisas. Assim, a falácia terapêutica torna-se um modo de justificar a negativa de oferecer benefícios médicos aos recrutados constituindo viés de transgressão ética, especialmente nos países nos quais o participante não tem expectativa de tratamento. Esta justificada expectativa daqueles que ingressam em estudos clínicos randomizados constitui argumento adicional contra o uso de placebo.

The therapeutic misconception has been described as the ?research subjects? unwarranted expectations of obtaining medical benefits by participating in clinical trials. Thus, researchers have found a new conceptual instrument to deny that research ought to be of benefit to subjects involved, once again disregarding the difference between therapeutic and non therapeutic clinical trials. This paper argues that patients involved in research are justified and in fact entitled to expect therapeutic benefits from their participation in research protocols, because the sick should only be recruited for such therapeutic trials as designed to improve their medical condition, and ought never to be involved in non therapeutic research and the risks involved. Insisting that therapeutic expectations research subjects constitute a misguided and erroneous attitude, is an unethical bias when applied to countries with precarious medical services. Subjects with unmet medical needs will willingly participate in research that might be the only way of obtaining badly required medication, an expectation that is obviously understandable and in no way fallacious. These justified expectations will be thwarted in those who randomly fall into the control group, thus delivering an additional argument against the use of placebos.

Contraception; awareness, knowledge and misconceptions regarding the combined oral contraceptive pill amongst parous women

The uptake of oral contraceptive pill as a method of contraception is very low in Pakistan with a high discontinuation rate. This study aimed to assess the knowledge of contraception seeking, married women in Pakistan about the oral contraceptive pill. Gynaecology clinic and family planning department Military hospital Rawalpindi. 1[st] Oct 2011 to 31[st] Dec 2011. 102 eligible women completed a cross-sectional survey that consisted of a detailed questionnaire which was completed by the interviewer to assess the womens' level and source of knowledge concerning the risks and benefits of the oral contraceptive pill. 102 eligible women participated in the survey. Mean age was 33 and mean parity was 4.01.Majority belonged to low income group 42[41%] and 33% had a fair socioeconomic status. Majority 35[34%] had low education level and 11[10.8%] were graduate or more. Majority 49[48%] scored intermediate on knowledge score with 33[32.5%] scoring poorly. Overall only 15% were aware of cancer preventing powers and 70% of non contraceptive virtues of the pill. Misconception rates were particularly high in this study sample with 46[45%] having high misconception scores.96.6%% of the respondents were convinced that pill leads to obesity.58[57%] of the overall subjects felt that pill use could be considered but lack of self efficacy could lead to problems with compliance. Knowledge about pill efficacy and advantages was low and misbelieve regarding safety and side effects was high. More education regarding safety and health benefits is needed to improve acceptance and compliance

Prevailing myths and misconceptions about diabetes mellitus in Qassim region of Saudi Arabia

To identify the prevailing myths and misconception about Diabetes Mellitus among diabetics and non-diabetics attending primary health care centers in Qassim region of Saudi Arabia. We conducted a cross sectional study in 8 randomly selected Primary Health Care [PHC] Centers of Qassim Region from April to July 2010. The study included diabetic and nondiabetic patients attending PHC Centers. Data was collected by 880 pre-tested, self administered questionnaires of which 110 questionnaires were distributed in each PHC Center of Qassim Region. Questionnaire included a sections on socio-demographic information [age, sex, education, marital status and occupation], as well as questions about prevailing myths and misconceptions on diabetes mellitus. Data was analyzed by using SPSS [version 12 for Windows]. The common prevailing myths in the population of Qassim region were, consuming sugar causes diabetes [71.6%], diabetics should avoid sweets. [65.8%], some type of dates don't increase sugar level [53.3%], honey intake doesn't increase sugar level [45.3%], and diabetes mellitus can affect sexual performance in its early stages [40.6%]. There is significant difference in response according to educational status [P=0.044], but there was no significant difference in gender, history of diabetes mellitus and family history of diabetes. There are many myths and misconceptions surrounding diabetes mellitus in Qassim region, which complicate the disease and health-seeking behavior. Launching of a health education program is required with participation of staff and medical students of College of Medicine, Qassim University

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

Knowledge, beliefs and misconceptions regarding contraceptive use amongst women reporting with history of induced abortion

To assess the knowledge, beliefs and misconceptions influencing contraceptive use amongst rural women reporting with septic induced abortion in a university hospital in Rawalpindi. A hospital based cross sectional study. The Gynecological unit of Fauji Foundation Hospital Rawalpindi. Study Period: 1[st] May 2002 to 31[st] May 2005. A total of 100 patients with history of septic induced abortion was included in this study In order to collect complete information regarding knowledge, beliefs and misconceptions about contraceptive use a detailed interview of both the partners were taken separately and a special proforma was filled up. Amongst the 100 women included in this study only 15% had their education uptil primary level and most of them were housewives. 58% of the couples agreed to adopting such a dangerous method to limit the size of their family while 21% had financial restraints. Amongst the husbands 63% showed complete ignorance about any contraception. Knowledge of women was slightly better with complete ignorance in only 38%. Fear of side effects [45%] was a major factor for not using contraceptives while the ignorance factor was found in 36%. Severe morbidities included 11% of women undergoing laparotomy while 74% had to undergo a repeat evacuation for retained products of conception [POCs]. There was one maternal mortality in our study due to tetanus. Information regarding contraceptive methods is very scarce and incorrect. leading to increased number of unwanted pregnancies culminating in induced abortions and climaxing in severe maternal morbidities and even mortalities