The psychological impact, risk factors and coping strategies to COVID-19 pandemic on healthcare workers in the sub-Saharan Africa: a narrative review of existing literature.

BACKGROUND: The ongoing COVID-19 pandemic has significantly impacted the physical and mental health of the general population worldwide, with healthcare workers at particular risk. The pandemic's effect on healthcare workers' mental well-being has been characterized by depression, anxiety, work-related stress, sleep disturbances, and post-traumatic stress disorder. Hence, protecting the mental well-being of healthcare workers (HCWs) is a considerable priority. This review aimed to determine risk factors for adverse mental health outcomes and protective or coping measures to mitigate the harmful effects of the COVID-19 crisis among HCWs in sub-Saharan Africa. METHODS: We performed a literature search using PubMed, Google Scholar, Cochrane Library, and Embase for relevant materials. We obtained all articles published between March 2020 and April 2022 relevant to the subject of review and met pre-defined eligibility criteria. We selected 23 articles for initial screening and included 12 in the final review. RESULT: A total of 5,323 participants in twelve studies, predominantly from Ethiopia (eight studies), one from Uganda, Cameroon, Mali, and Togo, fulfilled the eligibility criteria. Investigators found 16.3-71.9% of HCWs with depressive symptoms, 21.9-73.5% with anxiety symptoms, 15.5-63.7% experienced work-related stress symptoms, 12.4-77% experienced sleep disturbances, and 51.6-56.8% reported PTSD symptoms. Healthcare workers, working in emergency, intensive care units, pharmacies, and laboratories were at higher risk of adverse mental health impacts. HCWs had deep fear, anxious and stressed with the high transmission rate of the virus, high death rates, and lived in fear of infecting themselves and families. Other sources of fear and work-related stress were the lack of PPEs, availability of treatment and vaccines to protect themselves against the virus. HCWs faced stigma, abuse, financial problems, and lack of support from employers and communities. CONCLUSION: The prevalence of depression, anxiety, insomnia, and PTSD in HCWs in sub-Saharan Africa during the COVID-19 pandemic has been high. Several organizational, community, and work-related challenges and interventions were identified, including improvement of workplace infrastructures, adoption of correct and shared infection control measures, provision of PPEs, social support, and implementation of resilience training programs. Setting up permanent multidisciplinary mental health teams at regional and national levels to deal with mental health and providing psychological support to HCWs, supported with long-term surveillance, are recommended.

Factors Associated With Mortality Among the COVID-19 Patients Treated at Gulu Regional Referral Hospital: A Retrospective Study.

Background: The advent of the novel coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide. As of December 2021, there is inadequate data on the outcome of hospitalized patients suffering from COVID-19 in Africa. This study aimed at identifying factors associated with hospital mortality in patients who suffered from COVID-19 at Gulu Regional Referral Hospital in Northern Uganda from March 2020 to October 2021. Methods: This was a single-center, retrospective cohort study in patients hospitalized with confirmed SARS-CoV-2 at Gulu Regional Referral Hospital in Northern Uganda. Socio-demographic characteristics, clinical presentations, co-morbidities, duration of hospital stay, and treatments were analyzed, and factors associated with the odds of mortality were determined. Results: Of the 664 patients treated, 661 (99.5%) were unvaccinated, 632 (95.2%) recovered and 32 (4.8%) died. Mortality was highest in diabetics 11 (34.4%), cardiovascular diseases 12 (37.5%), hypertensives 10 (31.3%), females 18 (56.3%), ≥50-year-olds 19 (59.4%), no formal education 14 (43.8%), peasant farmers 12 (37.5%) and those who presented with difficulty in breathing/shortness of breath and chest pain 32 (100.0%), oxygen saturation (SpO2) at admission <80 4 (12.5%), general body aches and pains 31 (96.9%), tiredness 30 (93.8%) and loss of speech and movements 11 (34.4%). The independent factors associated with mortality among the COVID-19 patients were females AOR = 0.220, 95%CI: 0.059-0.827; p = 0.030; Diabetes mellitus AOR = 9.014, 95%CI: 1.726-47.067; p = 0.010; Ages of 50 years and above AOR = 2.725, 95%CI: 1.187-6.258; p = 0.018; tiredness AOR = 0.059, 95%CI: 0.009-0.371; p < 0.001; general body aches and pains AOR = 0.066, 95%CI: 0.007-0.605; p = 0.020; loss of speech and movement AOR = 0.134, 95%CI: 0.270-0.660; p = 0.010 and other co-morbidities AOR = 6.860, 95%CI: 1.309-35.957; p = 0.020. Conclusion: The overall Gulu Regional Hospital mortality was 32/664 (4.8%). Older age, people with diabetics, females, other comorbidities, severe forms of the disease, and those admitted to HDU were significant risk factors associated with hospital mortality. More efforts should be made to provide "additional social protection" to the most vulnerable population to avoid preventable morbidity and mortality of COVID-19 in Northern Uganda.