Behavioural Response To Self-Medication Practice Before and During Covid-19 Pandemic in Western Uganda.

Background: Self-medication has become a serious public health problem posing great risks, especially with the increasing number of cases of COVID-19 disease globally and in Uganda. This may be partly because of the absence of a recognized treatment for the disease, however, the differing prevalence and nature from country to country may influence human behavioral responses. Purpose: This study aimed to investigate the behavioral response to self-medication practices during the COVID-19 pandemic and lockdown in comparison to the pre-COVID period in Western Uganda. Methods: A descriptive cross-sectional survey was conducted from June to August 2020 in western Uganda using online Google forms and printed questionnaires to investigate the level of self-medication practice before and during the COVID-19 pandemic. This included 280 participants, aged 18 and above who consented to participate in the study. Participants were selected using a convenience sampling technique, and sampling was done by sending a structured online questionnaire via Google forms and printed questionnaires to participants who did not use the online Google forms. Results: Respondents that knew about self-medication were 97% of the 272 participants. Those that are aware of self-medication, have heard about it either through different avenues. Respondents who practiced self-medication before the COVID-19 pandemic were 239 (88%); those who practiced self-medication during the COVID-19 pandemic were 156 (57%); those that did not were 115 (43%). There was a statistically significant decrease in the number of respondents who practice self-medication during the COVID-19 pandemic lockdown compared to the practice before the pandemic lockdown. p < 0.05 at 95% confidence interval (OR = 5.39, 95% CI = 3.48, 8.32). Conclusion: Our investigation showed adequate knowledge of self-medication and a high level of self-medication practice with a decrease in self-medication practices during the COVID-19 pandemic lockdown compared to the practice before the lockdown.

Anxiety, Anger and Depression Amongst Low-Income Earners in Southwestern Uganda During the COVID-19 Total Lockdown.

Background: Low-income earners are particularly vulnerable to mental health, consequence of the coronavirus disease 2019 (COVID-19) lockdown restrictions, due to a temporary or permanent loss of income and livelihood, coupled with government-enforced measures of social distancing. This study evaluates the mental health status among low-income earners in southwestern Uganda during the first total COVID-19 lockdown in Uganda. Methods: A cross-sectional descriptive study was undertaken amongst earners whose income falls below the poverty threshold. Two hundred and fifty-three (n = 253) male and female low-income earners between the ages of 18 and 60 years of age were recruited to the study. Modified generalized anxiety disorder (GAD-7), Spielberger's State-Trait Anger Expression Inventory-2 (STAXI-2), and Beck Depression Inventory (BDI) tools as appropriate were used to assess anxiety, anger, and depression respectively among our respondents. Results: Severe anxiety (68.8%) followed by moderate depression (60.5%) and moderate anger (56.9%) were the most common mental health challenges experienced by low-income earners in Bushenyi district. Awareness of mental healthcare increased with the age of respondents in both males and females. A linear relationship was observed with age and depression (r = 0.154, P = 0.014) while positive correlations were observed between anxiety and anger (r = 0.254, P < 0.001); anxiety and depression (r = 0.153, P = 0.015) and anger and depression (r = 0.153, P = 0.015). Conclusion: The study shows the importance of mental health awareness in low resource settings during the current COVID-19 pandemic. Females were identified as persons at risk to mental depression, while anger was highest amongst young males.

COVID-19-Related Mental Health Burdens: Impact of Educational Level and Relationship Status Among Low-Income Earners of Western Uganda.

Objective: The study aimed to investigate the relationship between mental health with the level of education, relationship status, and awareness on mental health among low-income earners in Western Uganda. Methods: This was a cross-sectional descriptive study carried out among 253 participants. Anxiety, anger, and depression were assessed using a modified generalized anxiety disorder (GAD-7), Spielberger's State-Trait Anger Expression Inventory-2, and Beck Depression Inventory item tools, respectively. Results: The majority of our respondents were male (n = 150/253, 59.3), had a secondary level of education (104/253, 41.1), and were single (137/253, 54.2). No formal education and primary education (r2 = 47.4% and 6.4%, respectively) had a negative correlation with awareness of mental health care. In addition, no formal education had a positive correlation with anger and depression (r2 = 1.9% and 0.3%, respectively). Singleness in this study had a negative correlation with awareness of mental health care, anger, and depression (r2 = 1.9, 0.8, and 0.3%, respectively), and a positive correlation with anxiety (r2 = 3.9%). Conclusion: It is evident that education and relationship status influenced awareness on mental health care and mental health state among low-income earners in Western Uganda during the first COVID-19 lockdown. Therefore, policymakers should strengthen social transformation through the proper engagement of low-income earners in this COVID-19 era.

The Rise of SARS-CoV-2 Variants and the Role of Convalescent Plasma Therapy for Management of Infections.

Novel therapies for the treatment of COVID-19 are continuing to emerge as the SARS-Cov-2 pandemic progresses. PCR remains the standard benchmark for initial diagnosis of COVID-19 infection, while advances in immunological profiling are guiding clinical treatment. The SARS-Cov-2 virus has undergone multiple mutations since its emergence in 2019, resulting in changes in virulence that have impacted on disease severity globally. The emergence of more virulent variants of SARS-Cov-2 remains challenging for effective disease control during this pandemic. Major variants identified to date include B.1.1.7, B.1.351; P.1; B.1.617.2; B.1.427; P.2; P.3; B.1.525; and C.37. Globally, large unvaccinated populations increase the risk of more and more variants arising. With successive waves of COVID-19 emerging, strategies that mitigate against community transmission need to be implemented, including increased vaccination coverage. For treatment, convalescent plasma therapy, successfully deployed during recent Ebola outbreaks and for H1N1 influenza, can increase survival rates and improve host responses to viral challenge. Convalescent plasma is rich with cytokines (IL-1ß, IL-2, IL-6, IL-17, and IL-8), CCL2, and TNFα, neutralizing antibodies, and clotting factors essential for the management of SARS-CoV-2 infection. Clinical trials can inform and guide treatment policy, leading to mainstream adoption of convalescent therapy. This review examines the limited number of clinical trials published, to date that have deployed this therapy and explores clinical trials in progress for the treatment of COVID-19.

A Descriptive-Multivariate Analysis of Community Knowledge, Confidence, and Trust in COVID-19 Clinical Trials among Healthcare Workers in Uganda.

Background-misinformation and mistrust often undermines community vaccine uptake, yet information in rural communities, especially of developing countries, is scarce. This study aimed to identify major challenges associated with coronavirus disease 2019 (COVID-19) vaccine clinical trials among healthcare workers and staff in Uganda. Methods-a rapid exploratory survey was conducted over 5 weeks among 260 respondents (66% male) from healthcare centers across the country using an online questionnaire. Twenty-seven questions assessed knowledge, confidence, and trust scores on COVID-19 vaccine clinical trials from participants in 46 districts in Uganda. Results-we found low levels of knowledge (i.e., confusing COVID-19 with Ebola) with males being more informed than females (OR = 1.5, 95% CI: 0.7-3.0), and mistrust associated with policy decisions to promote herbal treatments in Uganda and the rushed international clinical trials, highlighting challenges for the upcoming Oxford-AstraZeneca vaccinations. Knowledge, confidence and trust scores were higher among the least educated (certificate vs. bachelor degree holders). We also found a high level of skepticism and possible community resistance to DNA recombinant vaccines, such as the Oxford-AstraZeneca vaccine. Preference for herbal treatments (38/260; 14.6%, 95% CI: 10.7-19.3) currently being promoted by the Ugandan government raises major policy concerns. High fear and mistrust for COVID-19 vaccine clinical trials was more common among wealthier participants and more affluent regions of the country. Conclusion-our study found that knowledge, confidence, and trust in COVID-19 vaccines was low among healthcare workers in Uganda, especially those with higher wealth and educational status. There is a need to increase transparency and inclusive participation to address these issues before new trials of COVID-19 vaccines are initiated.

Bee Venom-A Potential Complementary Medicine Candidate for SARS-CoV-2 Infections.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by severe cytokine storm syndrome following inflammation. SARS-CoV-2 directly interacts with angiotensin-converting enzyme 2 (ACE-2) receptors in the human body. Complementary therapies that impact on expression of IgE and IgG antibodies, including administration of bee venom (BV), have efficacy in the management of arthritis, and Parkinson's disease. A recent epidemiological study in China showed that local beekeepers have a level of immunity against SARS-CoV-2 with and without previous exposure to virus. BV anti-inflammatory properties are associated with melittin and phospholipase A2 (PLA2), both of which show activity against enveloped and non-enveloped viruses, including H1N1 and HIV, with activity mediated through antagonist activity against interleukin-6 (IL-6), IL-8, interferon-γ (IFN-γ), and tumor necrosis factor-α (TNF-α). Melittin is associated with the underexpression of proinflammatory cytokines, including nuclear factor-kappa B (NF-κB), extracellular signal-regulated kinases (ERK1/2), and protein kinase Akt. BV therapy also involves group III secretory phospholipase A2 in the management of respiratory and neurological diseases. BV activation of the cellular and humoral immune systems should be explored for the application of complementary medicine for the management of SARS-CoV-2 infections. BV "vaccination" is used to immunize against cytomegalovirus and can suppress metastases through the PLA2 and phosphatidylinositol-(3,4)-bisphosphate pathways. That BV shows efficacy for HIV and H1NI offers opportunity as a candidate for complementary therapy for protection against SARS-CoV-2.

University Lecturers and Students Could Help in Community Education About SARS-CoV-2 Infection in Uganda.

BACKGROUND: The World Health Organization has placed a lot of attention on vulnerable communities of Africa due to their chronically weak health care systems. Recent findings from Uganda show that medical staff members have sufficient knowledge but poor attitudes toward coronavirus disease 2019 (COVID-19) pandemic. AIM: The aim of this study was to determine the knowledge, attitudes, and preparedness/practices of lecturers and students in the fight against COVID-19. METHOD: This was a descriptive cross-sectional study of 103 lecturers and students both men and women of age group 18 to 69 years in western Uganda. Data were obtained through a pretested questionnaire availed online. RESULTS: Knowledge on COVID-19 symptoms was highest in this order: fever > dry cough > difficulty breathing > fatigue > headache with no significant differences between lecturers and students. Knowledge of participants on transmission of COVID-19 was highest in the order of cough drops > contaminated surfaces > person-to-person contact > asymptomatic persons > airborne > zoonotic with no significant differences among lecturers and students. Lecturers and students were all willing to continue using personal protective equipment like masks, and personal practices such as covering the mouth while sneezing and coughing, no handshaking, and washing of hands with no significant differences in the responses. The positive attitudes that COVID-19 could kill, anyone can get COVID-19, and willing to abide by the set regulations against the pandemic showed personal concerns and desired efforts against COVID-19. CONCLUSION: The study identifies lecturers and students as potential stakeholders in the fight against community transmission of COVID-19.

Community Drivers Affecting Adherence to WHO Guidelines Against COVID-19 Amongst Rural Ugandan Market Vendors.

Background: Market vendors occupy a strategic position in the fight against the spread of SARS CoV-2 in rural Uganda. To successfully contain the spread of the virus, special attention needs to be given to this set of people by assessing the type of information, source of information, and practices they inculcate as regards adherence to WHO guidelines in the fight against COVID-19 in Uganda. The study aimed to assess the role of information sources, education level, and phone internet connectivity in influencing COVID-19 knowledge among the rural market vendors; and the relationship existing between knowledge, attitude, and practices among them. Methods: The study was a descriptive cross-sectional study among rural market vendors (n = 248) in southwestern Uganda. Information was collected using a questionnaire and descriptively presented as frequency and percentages. Results: The study showed that the majority of the rural market vendors had sufficient information regarding COVID-19 with the majority being female individuals and have attained a secondary level of education, The general percentage score for knowledge, attitude, and practices were (75.57, 82.6, and 76.50% respectively). There was a positive correlation between attitude and practices (r = 0.17, p = 0.007), as well as their knowledge with practices (r = 0.29, p < 0.001). The majority of the people in the population did not have their phones connected to the internet (OR = 1.96, 95%CI: 1.16-3.31, P = 0.01). The majority of people received their information regarding COVID-19 from one source (radio) (OR = 1.55). Conclusion: Where and how the rural market vendors get their information and education level are vital in breaking COVID 19 infection circle in line with WHO guidelines. Therefore, sources of information and education level played a key role in molding their knowledge and practices. However, the level of knowledge on COVID 19 among our respondents was not linked with phone internet connectivity.