Psychological impact on healthcare workers, general population and affected individuals of SARS and COVID-19: A systematic review and meta-analysis.

Background: Any infectious disease outbreak may lead to a negative detrimental psychological impact on individuals and the community at large, however; there was no systematic review nor meta-analysis that examined the relationship between the psychological/mental health impact of SARS and COVID-19 outbreak in Asia. Methods and design: A systematic search was conducted using PubMed, EMBASE, Medline, PsycINFO, and CINAHL databases from 1/1/2000 to 1/6/2020. In this systematic review and meta-analysis, we analyzed the psychological impact on confirmed/suspected cases, healthcare workers and the general public during the Severe Acute Respiratory Syndrome (SARS) outbreak and Coronavirus disease (COVID-19) epidemics. Primary outcomes included prevalence of depression, anxiety, stress, post-traumatic stress disorder, aggression, sleeping problems and psychological symptoms. Result: Twenty-three eligible studies (N = 27,325) were included. Random effect model was used to analyze the data using STATA. Of these studies, 11 were related to the SARS outbreak and 12 related to COVID-19 outbreaks. The overall prevalence rate of anxiety during SARS and COVID-19 was 37.8% (95% CI: 21.1-54.5, P < 0.001, I2 = 96.9%) and 34.8% (95% CI: 29.1-40.4), respectively. For depression, the overall prevalence rate during SARS and COVID-19 was 30.9% (95% CI: 18.6-43.1, P < 0.001, I2 = 97.3%) and 32.4% (95% CI: 19.8-45.0, P < 0.001, I2 = 99.8%), respectively. The overall prevalence rate of stress was 9.4% (95% CI: -0.4 -19.2, P = 0.015, I2 = 83.3%) and 54.1% (95% CI: 35.7-72.6, P < 0.001, I2 = 98.8%) during SARS and COVID-19, respectively. The overall prevalence of PTSD was 15.1% (95% CI: 8.2-22.0, P < 0.001) during SARS epidemic, calculated by random-effects model (P < 0.05), with significant between-study heterogeneity (I2 = 93.5%). Conclusion: The SARS and COVID-19 epidemics have brought about high levels of psychological distress to individuals. Psychological interventions and contingent digital mental health platform should be promptly established nationwide for continuous surveillance of the increasing prevalence of negative psychological symptoms. Health policymakers and mental health experts should jointly collaborate to provide timely, contingent mental health treatment and psychological support to those in need to reduce the global disease burden. Systematic review registration: CRD42020182787, identifier PROSPER.

Assessment of undergraduate student knowledge, attitude, and practices towards COVID-19 in Debre Berhan University, Ethiopia.

BACKGROUND: Novel coronavirus-2019 (COVID-19) is a highly infectious disease that has caused a global pandemic. As of July 2020, there were 8,475 confirmed cases of COVID-19 in Ethiopia, and a total of 52 cases and 1 death were reported in Debre Berhan where this study was conducted. Under these conditions, we sought to assess what undergraduate students at Debre Berhan University knew about COVID-19 and how it shaped their attitudes and practices regarding this disease. OBJECTIVE: The aim of the current study was to assess undergraduate student knowledge, attitudes and practices towards COVID-19 in Debre Berhan University, Ethiopia. METHODS: A cross-sectional survey was conducted from March 18-24, 2020 among undergraduate students at Debre Berhan University. A two-stage cluster sampling technique was employed with a total sample size of 634. Proportional allocation of samples was used to the randomly selected colleges, and a systematic random sampling technique was employed to recruit the students. The data were checked for completeness, coded, entered into Epi-Data VS 3.1, and then exported into STATA™ Version 14 software for analysis. Descriptive statistics were conducted. Binary logistic regression analyses were used to identify factors. Factors were selected with the entry method. Adjusted odds ratios (AORs) and their 95% confidence intervals (CIs) were used to assess the associations between variables and knowledge, attitude and practices (KAP). RESULTS: From a total of 546 included participants, more than half of them, 307 (57%) were males. Seventy-three percent of them heard about novel coronavirus from social media. In this study, 73.8% of the participants were knowledgeable, and their overall attitude was favorable. Approximately 71.4% correctly responded that the main clinical symptoms of COVID-19 are fever, fatigue, dry cough, and shortness of breath. Nearly half, 229 (42%) of the students approved that they had no concern of being infected with COVID-19. Moreover, most participants showed poor practices; more than half of the study subjects were not maintaining a physical distance. In multivariable analyses, people older than 25 years (AOR = 1.6, 95% CI; 1.2, 4.6) and those who lived in urban areas (AOR = 4.3, 95% CI; 2.6, 15.8) were significantly more knowledgeable about COVID-19. Furthermore, those students that have information about COVID-19 (AOR = 2.3, 95% CI; 1.6, 8.7) was significantly associated with the attitude undergraduate students had about COVID-19 as compared with its counterpart. CONCLUSION: The undergraduate students at Debre Berhan University were moderately knowledgeable about COVID-19 and had an optimistic attitude towards its resolution. However, this optimism may lead to poor public health practices within this community. Therefore, greater efforts need to be made through more comprehensive and directed actions and awareness campaigns to increase the knowledge, attitude and practice of the students.