ABSTRACT
BACKGROUND: In Ghana, as of 30 July 2022, around one-third of the eligible population are considered fully-vaccinated against COVID-19, and efforts are being made to increase coverage. Vaccine hesitancy is defined by the World Health Organization (WHO) as the delay in the acceptance, or blunt refusal of, vaccines. This study assesses vaccine hesitancy and confidence in Nkwanta South, a rural municipal in Oti region, Ghana. METHODS: Data collection within Nkwanta South took place in sub-municipalities of Alokpatsa (11,028 population), Brewaniase (14,483), and Tutukpene (15,453). Data was collected by 47 local residents, known as Community-Based Surveillance Volunteers (CBSVs), using Kobo Toolbox forms on electronic devices (tablets). Information collected included numerous demographic variables, including age, gender, relationship status, and religion. Further questions covered reasons for vaccine hesitancy and COVID-19 vaccine status. Descriptive and inferential statistics assessed the association between variables to identify predictors of hesitancy. FINDINGS: Across 1500 respondents, 700 (46.7%) reported having received at least one COVID-19 vaccine dose, and 800 (53.3%) reported being unvaccinated against COVID-19. Among unvaccinated respondents, 556 (69.4%) reported willingness to receive the vaccine once available, 190 (23.7%) said they would not be willing to be vaccinated, and 55 (6.9%) said they were unsure. Overall, this represented 30.6% hesitancy within the currently-unvaccinated group. Common reasons for hesitancy included believing that they did not need the vaccine (33.8%), believing the vaccine to be dangerous (30.6%), concerns about side effects (25.3%), and not having enough information (20.1%). Key predictors of hesitancy among our participants included high levels of mistrust, being female, greater years of education, and being Christian. INTERPRETATION: The information gathered here can inform how best to target national and local health promotion strategies. Locally-tailored efforts, that understand local context and social dynamics, must remain a core component of public health activity to achieve a high vaccine uptake.
Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , Female , Male , Cross-Sectional Studies , COVID-19/epidemiology , COVID-19/prevention & control , Ghana/epidemiology , Data Collection , VaccinationABSTRACT
Uptake of preventive measures to reduce transmission of viruses such as SARS-CoV-2, is crucial in the control of pandemics. To ensure equitable uptake we explored contextual factors that shaped uptake of COVID-19 preventive measures amongst smaller, albeit substantial, migrant populations in the Netherlands. 39 persons of Eritrean, Ghanaian, Indonesian and Filipino origin, with diverse legal status and length of stay in the Netherlands, participated in five online focus group discussions. Thematic analysis of data was informed by concepts from the Precaution Adoption Process Model and Protection Motivation Theory. Awareness and knowledge of preventive measures was shaped by limited Dutch proficiency, access to understandable information and interference of misinformation. Engagement by preventive measures was subject to COVID-19 threat appraisal and the ease with which complex behavioural messages could be translated to individual situations. Perceived vulnerability of undocumented migrants in particular, motivated information-seeking. A strong social norm to keep with cultural and religious practices, and limited opportunity for preventive behaviour in work and home context hindered uptake of preventive behaviour. Preventive measures brought about job, food, and housing insecurity, and increased barriers in access to healthcare for undocumented migrants. Migration-related, sociocultural, and socioeconomic factors shape uptake of preventive measures. Preventive measures negatively impact work, housing and access to healthcare of undocumented migrants. Our results suggest importance of multilingual information tailored to literacy needs;education and modelling of behaviour;and, regulations to ensure continued access to financial and material resources to minimise negative spill-over effects. Results were incorporated in two policy briefs advising local and national government. Collaboration with municipal health services lead to multilingual public health information. Key messages • Migration-related, sociocultural, and socioeconomic factors shape uptake of preventive measures. • Preventive measures negatively impact work, housing and access to healthcare of undocumented migrants.
ABSTRACT
The emergence of the coronavirus infectious disease-2019 (COVID-19) pandemic has since affected the global health system in the past years. The pandemic has posed crises on blood transfusion services (BTS) across the world and most BTS are struggling to have enough donor units for elective and urgent surgeries, trauma emergencies, obstetric cases and severely anaemic paediatric patients. This crisis is aggravated by the reduction in the number of blood donors during the pandemic. It is critical for African BTS to plan for the appropriate allocation of resources within a defined ethical and scientific framework for donors, patients and BTS-staff. This highlight contingency planning in blood transfusion services amidst African COVID experience. Although the COVID-19 pandemic was far felt in most countries including China, Italy, United States of America, United Kingdom, Russia and India, Africa was not left out. Although COVID-19 mortality was low in Africa, most African countries struggled to manage the increasing number of cases. Most African countries and health systems implemented policies such as mandatory wearing of nose masks, frequent handwashing and lockdowns to manage the pandemic. However, the pandemic led to an influx of hospitalized patients, with simultaneously yielding virus exposures and self-quarantines in African healthcare facilities. Thus, African BTS had to operate with limited staff to meet targets during the first phase of the COVID-19 pandemic. This resulted in shortage of donor units in BTS across Africa, especially in the first wave of the African pandemic. However, it was noted that there was no pre-existing contingency plan for infectious agents in the quality management system in African BTS and a few BTS had plans to ensure the safety and continuous blood transfusion during the first wave of the pandemic. Africa's COVID experience has shown that addressing future plans for the blood donors' safety, the BTS personnel safety and continuity of blood supply in future phase of the COVID-19 pandemic and other pandemics is critical. In this plan, there is the need for sustainability and safety of blood supply strategies including adjusting operating hours for blood collection, implementing of information campaigns (via personal phone-calls, text messages, emails, social media) targeting especially the donors who were registered in BTS and extending storage of blood units up to more than 35 days. Again, there is the need to reconsider blood donors' safety by remodelling access to BTS through an exclusive, direct entrance, spatial interventions in the reception, examination and blood collection rooms, to ensure safe presence of donors. Moreover, there is the need to ensure staff safety by re-training BTS staff on correct hygiene practices and modifying worktimetable to avoid unnecessary contact of staff members. Conclusion: Although African BTS faced challenges in meeting demands of blood supply amidst the COVID-19 pandemic, there was no preexisting contingency plan for infectious agents in the quality management system in African BTS during the first wave of the pandemic. There is the need for wide design and further optimization of this plan to help in efficient management of similar circumstances in the future.
ABSTRACT
Molecular docking and Targeted Molecular Dynamics Simulations were conducted to elucidate binding properties of SARS-CoV-2 nonstructural protein 1 (nspl) onto the human ribosomal 40S complex. Nspl serves as a host shutoff factor by blocking ribosome assembly on host mRNAs, thereby suppressing host gene expression. Recently, cryo-electron microscope structure of both 40S and 80S ribosome purified in the presence of SARS-CoV-2 nspl revealed the presence of the C-terminal region of nspl in the mRNA binding site of the 40S ribosome. This structure gives the first insight into the molecular mechanism of nspl-mediated suppression of host protein translation. In this study we have utilized the most recent emerging partial structures of nspl bound to 40S ribosome as the reference point of implementing a Targeted Molecular Dynamics Simulation of the entire nspl bound to the 40S complex. Our final bound structure of nspl exhibits the previously reported helix-turn-helix conformation of the C-terminal region of nspl and satisfies all the previously reported proximity restraints. Finally, we have established the interaction and stability of this final bound state of the full nspl and 40S. The observation that C-terminal region of nspl folds into a helix-turn-helix structure to occupy the mRNA binding site in the 40S ribosome enables further inquiry into the understanding of the entire nspl structure bound to the 40S ribosome to reveal relative positioning of the two termini when nspl is bound to ribosome. © 2021 ACM.