Impact psychosocial de la COVID-19 chez le personnel de santé

Contexte La pandémie actuelle COVID-19 a mis les professionnels de la santé face à une détresse psychologique croissante, avec un risque élevé d’infection. Objectif Estimer la prévalence des troubles anxiodépressifs chez les professionnels de la santé en Algérie et déterminer les facteurs de risque associés. Méthode Une étude descriptive transversale a été menée du 11 janvier au 9 mars 2021 et a concerné les professionnels de la santé, en Algérie, à travers un auto-questionnaire en ligne. Les échelles d’évaluation de la santé mentale utilisées ont été GAD-7 (7 items) pour l’anxiété, et la CES-D (20 items) pour la dépression. La résilience a été estimée par le CD-RISC (10 items). Un questionnaire original a été utilisé pour évaluer trois facteurs : la peur de l’infection et de la mort, l’isolement et la stigmatisation, ainsi que la motivation et le comportement d’évasion au travail. Résultats Au total, 1005 professionnels de la santé ont été inclus dans l’étude, dont 51,5 % ont été des médecins, 75,6 % ont été des femmes et 41,1 % ont été au premier front de lutte contre la COVID-19. La prévalence d’anxiété et de dépression ont été respectivement de 23,8 % et 44,6 %. Parmi les facteurs de risque de l’anxiété : avoir une comorbidité (OR : 1,70 ;IC95 % : 1,06–2,71), et travailler en poste avancé de lutte contre la COVID-19 (OR : 2,06 ;IC95 % : 1,33–3,23). Etre marié, spécialiste, résident et avoir un score élevé de résilience étaient des facteurs associés à la dépression avec respectivement OR : 0,59 ;IC95 % : 0,38–0,91, OR : 0,22 ;IC95 % : 0,07–0,71, OR : 0,24 ;IC95 % : 0,07–0,81, et OR : 0,97 ;IC95 % : 0,95–0,99. Conclusion En Algérie, la lutte contre la pandémie de COVID-19 a eu un impact sur la santé mentale des professionnels de santé. D’où l’urgence de la mise en place des programmes rapides d’intervention, pour le renforcement de leur santé mentale, dans une lutte plus durable et plus efficace.

Lessons learned from the fight against COVID-19 in the Great Maghreb.Five lessons for better resilience.

OBJECTIVE: To compile the lessons learned in the Greater Maghreb, during the first six months of the fight against the COVID-19 pandemic, in the field of "capacity building" of community resilience. METHODS: An expert consultation was conducted during the first week of May 2020, using the "Delphi" technique. An email was sent requesting the formulation of a lesson, in the form of a "Public Health" good practice recommendation. The final text of the lessons was finalized by the group coordinator and validated by the signatories of the manuscript. RESULTS: A list of five lessons of resilience has been deduced and approved : 1. Elaboration of "white plans" for epidemic management; 2. Training in epidemic management; 3. Uniqueness of the health system command; 4. Mobilization of retirees and volunteers; 5. Revision of the map sanitary. CONCLUSION: Based on the evaluation of the performance of the Maghreb fight against COVID-19, characterized by low resilience, this list of lessons could constitute a roadmap for the reform of Maghreb health systems, towards more performance to manage possible waves of COVID-19 or new emerging diseases with epidemic tendency.

Lessons learned from the fight against COVID-19 in the Greater Maghreb. Five lessons for better preparation.

OBJECTIVE: To compile the lessons learned in the Greater Maghreb, during the first six months of the fight against the COVID-19 pandemic, in the field of preparation of health systems. METHODS: An expert consultation was conducted during the first week of May 2020, using the "Delphi" technique. An email was sent to them requesting the formulation of a lesson, in the form of a "Public Health" good practice recommendation. The final text of the lessons was finalized by the group coordinator and validated by the signatories of the manuscript. RESULTS: A list of five lessons for the preparation of the national health systems of the Greater Maghreb for the fight against epidemics, was deduced and approved: 1. Liberal health systems are incapable of managing epidemics; 2. The specialties of "Public Health" are often marginalized; 3. Health personnel in the Maghreb are doubly devalued; 4. Flagrant regional disparities in the field of health care are still observed; 5. A general shortage of preventive equipment and medical devices has been noted. CONCLUSION: Based on the evaluation of the performance of the Maghreb fight against COVID-19, characterized by the vulnerability of the preparation of health systems, this list of lessons could constitute a roadmap for the reform of health systems. Maghrebian health, towards more performance in managing possible waves of COVID-19 or new emerging diseases with epidemic tendency.

Attitudes of health professionals towards the response to the COVID-19 pandemic in Maghreb.

OBJECTIVE: Measuring the attitudes of health professionals in two Maghreb countries (Tunisia and Algeria) with regard to the response to COVID-19 during the first quarter of 2020. METHODS: This scoping study was based on a "Google Form" covering three constituents of the response plan against COVID-19: responders, activities and crisis communication. The attitudes of health professionals who are working in Tunisia and Algeria were measured through the Likert scale with four propositions, grouped in pairs, during the analysis. RESULTS: The study population consisted of 280 health professionals, 170 of whom are Tunisians along with 110 Algerians. The medians of age and that of professional seniority are, respectively, 37 and 10 years. The role of "health workers", "Mass Media" and "civil society associations" was found to be satisfactory according, respectively, to 92%, 71%, and 55% of the respondents. As far as 72% of health professionals are concerned, the "barrier measures" were respected by the population. Approximately, seven in ten respondents were satisfied with the quality of communication occuring between the Ministries of Health and its epidemiological structures. CONCLUSION: Health professionals of the Maghreb working in Tunisia and Algeria had a generally positive perception of the role of population responders, community engagement, and the quality of official communication in regards to the response plan against COVID- 19. This perception would be a prerequisite for the success of community participation and multisectoral action as well as essential in the strategy of prevention and control of this pandemic and of possible other health emergencies.

Counter-COVID- 19 pandemic strategy in the Maghreb Central. Qualitative study of the perceptions of health professionals.

CONTEXT: The Maghreb Central, like all the countries of the world, was strongly mobilized (governments, ministries of health, population, civil society) in the response against COVID-19, immediately after the registration of the first cases on its territory (end of February, beginning of March) and according to pre-established control strategies. OBJECTIVES: Describe the perceptions of health professionals in the Central Maghreb (Tunisia, Algeria and Morocco) as to the Strengths/Opportunities and Weaknesses/Threats of the national response plans against COVID-19, during the first weeks of their execution, and report their proposals for optimizing the performance of control strategies. METHODS: This is a qualitative study of the perceptions of health professionals in the Maghreb Central regarding their experience of the first six weeks of fighting the COVID-19 pandemic. The data was collected using the "Delphi" technique in one turn, based on an electronic form such as "Google Form", developed according to SWOT analysis. The respondents' verbatim was grouped into homogeneous groups of items, the occurrence of which was subsequently measured. RESULTS: A total of 382 health professionals from the Maghreb Central participated in this study, with a median age of 37 years and a median professional tenure of 10 years. The major force of the Maghreb response strategies, the most shared by the respondents, was the performance of the human resources mobilized (doctors, biologists, nurses, etc.) who succeeded in quickly learning from the international epidemiological expertise accumulated in Asia and in Europe. The fight against COVID-19 in the Central Maghreb was confronted with the general and chronic fragility of the national health systems and the low support of the general population for the recommendations of the steering committees of response, threatening the capacity of the Maghreb to confront new epidemics. CONCLUSION: The success of the national response plans against COVID-19 and of possible epidemics or pandemics in the Central Maghreb, is strongly attributed to the commitment of health professionals and to community participation, necessitating the launch of assistant motivation programs. and development of health personnel and mobilization and loyalty of civil society.