ABSTRACT
Objectives: This study assessed the real-world burden of COVID-19 infection in African Union (AU) member states during the first 12 months of the pandemic using selected epidemiological measures. Method(s): Data were sourced from the African CDC and Our World in Data,for time period spanning February 2020 to January 2021. AU member states were classified into low, medium and high burden based on COVID-19 morbidity. We conducted descriptive and inferential analyses of the following epidemiological measures: morbidity and mortality rates (MMRs), case fatality rate (CFR), and case ratios. Result(s): A total of 3.2 million COVID-19 cases were reported during the first 12 months, with 2.6 million recoveries, 536,784 cases remaining active, and 77, 486 deaths. Most countries in AU experienced low burden of COVID-19 (49.1%, n=26) compared to 28.3% (n=15) with medium and 22.6% (n=12) with high burden of the disease. South Africa recorded the highest number of cases (1.31 million) followed by Morocco with 457,625 and Tunisia with 175,065 cases. Correspondently, death tolls for these countries were 36,467, 7,888 and 5,528 deaths, respectively. Of the total COVID-19 tests performed (83.8 million) during the first 12 months, 62.43% were from high burden countries. The least testing occurred in the medium burden (18.42%) countries. The overall CFR of AU was 2.21%. Morbidity rate of 327.52/105 population and mortality rate of 5.96/105 population were recorded during the period with significant (p<0.0001) variations across burden levels and regions. Continental morbidity and mortality rates of 17,359/105 population and 315.933/105 population were recorded with significant correlation (r=0.863, p<0.0001) between them and variations across selected epidemiological measures by COVID-19 burden levels. Conclusion(s): Understanding the true burden of the disease in AU countries is important for establishing the impact of the pandemic in the African continent and for intervention planning and deployment of resources including vaccines.Copyright © 2023
ABSTRACT
Objectives: Angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs) are recommended for patients with comorbid diabetes mellitus and hypertension due to their favorable impact on microvascular and macrovascular events, cardiovascular outcomes, and mortality. Poor adherence to ACEI/ARB is a major public health concern. Motivational interviewing (MI) intervention is an effective patient-centered approach to improve adherence. The objective of this study was to evaluate the effectiveness of a telephonic MI intervention conducted by pharmacy students, tailored by the past ACEI/ARB adherence trajectories among nonadherent patients with comorbid diabetes mellitus and hypertension. Methods: Patients continuously enrolled in a Medicare Advantage Plan from July 2017-July 2021 with an ACEI/ARB prescription between July 2017-December 2017 were identified. Group-based trajectory modeling (GBTM) was used to identify 4 distinct patterns of ACEI/ARB adherence: adherent, gaps in adherence, gradual decline, and rapid decline in adherence. Patients from the 3 nonadherent trajectories were randomized either into MI intervention or control group. The intervention group received an initial call followed by 5 follow-up calls. The primary outcome was adherence measured as proportion of days covered (PDC) ≥ 0.80 for 1-year post-MI implementation. Multivariable logistic regression model evaluated the effect of the intervention on ACEI/ARB adherence. Results: This study included 240 patients who received intervention and 480 randomly selected controls. Patients who had received ≥ 4 calls were more likely to be adherent than those who received ≤ 3 follow-up calls (OR=2.01;P=0.01) despite the gaps in follow-up calls due to the COVID-19 outbreak. Other significant predictors of adherence were baseline adherence trajectories, number of other medications on the index date, prevalent users, regimen complexity, and CMS risk score. Conclusions: At 1 year, patients who received ≥ 4 calls had significantly better adherence than controls. MI intervention by pharmacy students has been demonstrated to improve adherence on a long-term basis.
ABSTRACT
Introduction: COVID-19 is known to have a higher transmission rate in densely populated areas, which has serious implications for populous cities, especially in resource-poor settings. This study aimed to identify the common COVID-19 related information sources used in Onitsha, a populous commercial city in Anambra State, Nigeria, and their associations with demographic characteristics and implementation of COVID-19 preventive practices. Methods: Data from a cross-sectional survey of 140 adult residents of Onitsha in March 2020 was analyzed. Descriptive and inferential statistics were used to describe the study population and determine the associations. Results: Internet/social media (63.5%), radio (61.5%) and television (58.5%) were identified as the topmost COVID-19 information sources. Educational level was significantly associated with the use of TV (P < 0.01), WhatsApp/text messages (P < 0.0001), and internet/social media (P < 0.001). The use of internet/social media, WhatsApp/text messages, and religious places of worship were significantly (P ≤ 0.05) associated with implementing all identified recommended prevention practices. Conclusion: Public health authorities can improve the mass adoption of COVID-19 preventive measures by utilizing the identified effective information sources to design targeted education and awareness cam-paigns. © 2021 Iloanusi et al.
ABSTRACT
Objectives This study aims to understand acceptable strategies to enhance the COVID-19 vaccine uptake among mothers who have no intention to vaccinate their children. Methods In a cross-sectional study, using an online survey in March 2021, we evaluated the variables within the Health Belief Model (severity, susceptibility, benefits, barriers and cues to action) along with parents' sociodemographic characteristics, previous COVID-19 infection, job loss due to COVID-19 pandemic and the presence of healthcare workers among the household. Total number of children in the household and their chronic health conditions were also assessed. Multivariable logistic regression was performed to evaluate the intention to vaccinate children against the COVID-19 and associations with other variables. Key findings The survey response rate was 32.30% (595/1842). Most of the participants were White (72.1%), 31-40 years old (55.46%) and married or in a cohabiting relationship (90.25). Out of 595 mothers with 3-15 years old children, 38.32% had no intention to vaccinate their children. Top factors associated with intention were perceived susceptibility (P = 0.002), benefits (P < 0.001), barriers (P < 0.001), cues to action (P < 0.001) and the presence of healthcare workers in the household (P = 0.032). The main barriers were concerns about vaccine safety, efficacy and side effects. The strongest cue to action was enough information being provided followed by doctors' recommendations. Conclusions Strategies to increase vaccination for children lie in the process of convincing parents with providing reliable information on the vaccine safety, efficacy and side effects by paediatricians and other healthcare providers.