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Background: The impact of COVID-19 on mental health has been continuously reported, especially among healthcare workers. In the literature, anxiety and depressive symptoms are not uncommon in infected individuals. However, there is little data on these psychological events in healthcare professionals. Objective(s): To determine the prevalence and associated factors of anxiety and depressive symptoms in healthcare workers infected by COVID-19. Method(s): This is a cross-sectional study conducted among healthcare workers at Farhat Hached University Hospital infected by COVID 19. A self-administered questionnaire was used to collect data on the socio-professional and medical characteristics of the participants. Anxiety and depressive symptoms were assessed by the Hospital Anxiety and Depression Scale (HAD-S). Result(s): A total of 477 confirmed COVID-19 in healthcare workers were included in this study (85.9%). The mean age of the participants was 39.9 +/-10.8 years. Women represented 78.2%. The majority of the infected participants were nurses (32.1%). The paucisymptomatic form of the disease was the most frequent (73.8%). After returning to work, 62.7% of the participants retained residual symptoms and 15.5% experienced stigma reactions from their colleagues. The overall prevalence of anxiety and depressive symptoms were 25.4% and 19.1%, respectively. These identified problems were significantly interrelated. Furthermore, residual symptoms and duration of confinement predicted anxiety symptomatology, while female gender and symptomatic clinical form of COVID-19 were significantly associated with depressive symptomatology. Conclusion(s): The psychological events of COVID-19 are frequent among healthcare workers. Thus, systematic screening and early management of psychological disorders are necessary to preserve the human resources of the health sector.
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Background Psychological and social factors related to work activity can improve or deteriorate the physical and mental health of employees. Since the COVID-19 pandemic, the psychological well-being of workers has been strongly affected. Particularly, jobs with isostrain characterized by high work demands and low work control, coupled with low social support, place employees at highest risk for poor mental health. We aimed to assess the factors associated with isostrain among employees in the tourism sector in Sousse. Methods A cross-sectional study was conducted between September and November 2020 among tourism workers belonging to 12 hotels and restaurants in Sousse, Tunisia, using a self-administered questionnaire. ‘Isostrain’ was assessed using the Karasek questionnaire. ‘Isostrain’ is a situation where there is a combination of ‘jobstrain’ (‘tension at work') and low social support (score below the median of the group). SPSS 20 software was used to analyze the data. Results A total of 226 workers were included. The mean age was 38.2 ± 9.6 years. The sex ratio was 2.7. The majority of employees (64.8%) were working at workplace during COVID-19 lockdown. The prevalence of isostrain was 5.4%. Isostrain was reported by 5.7% of women (p = 1). All workers older than 50 years did not have isostrain (p = 0.6). Moreover, isostrain was found among 6.6% of workers with less than 5 years of work experience (p = 0.4), 4.8% of married employees (p = 0.7), and 7.6% of employees with a university education (p = 0.53). Conclusions Isostrain can affect employees in the tourism sector. Social support should be promoted among workers to ensure good mental health. Key messages • Prevalence of isostrain in tourism sector of Sousse during COVID-19 pandemic is quite high. • Preventive strategies of mental health should be promoted at workplace in Tunisia.
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Introduction In early 2021, Tunisia implemented a national COVID-19 strategy of vaccination aimed at disease elimination. In this study, we aimed to investigate the characteristics of the breakthrough COVID-19 infection in the governorate of Sousse, Tunisia. Methodology We conducted a cross-sectional study including all post-vaccination COVID-19 cases from March 2021 to August 2021. We collected data via 15-minute telephonic call interviews. We estimated the specific incidence rates (SIR) of confirmed cases by vaccine type and expressed them as cases per 100 000 inhabitants. Statistical analyzes were carried out using anonymous and codified Excel tables and SPSS 20. Results Overall, we included 618 cases of breakthrough COVID-19 infection. The majority were female (sex-ratio=0.8), and the average age of the overall cases was 55.7±14.5 years (range:19-91). Nearly half (49%) of participants had comorbidities, 19.6% were healthcare workers, and 17.9% were smokers. The majority of cases (70%) received at least one dose of Pfizer vaccine followed by CORONAVAC (15.6%;n = 96). Nevertheless, we found a higher incidence rate of COVID-19 among those vaccinated with SPUTNIK V (SIR=1551.2) followed by SINOPHARM (SIR=823.7). Fifty-eight percent of patients reported a poor adhesion to preventive measures, whereas 38.6% reported high respect for the preventive measures. COVID-19 infection led to hospitalization in 8.1% of cases, hospitalization in intensive care units in 2.1% of cases, and death in 1.8% of cases. Conclusions The findings of our study highlight the low rate of severe cases of COVID-19 among the vaccinated population. Furthermore, we found a discrepancy in the effectiveness of vaccines in the prevention of transmission potential. Yet, many factors could influence the transmission and the severity of COVID-19 breakthrough infection from one region to another. Key messages • low rate of severe cases of COVID-19 among the vaccinated population. • discrepancy in the effectiveness of vaccines in the prevention of transmission potential.
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Background The COVID-19 disease has a spectrum ranging from asymptomatic infection to multi-organ dysfunction. Most patients with mild symptoms are isolated at home until recovery. However, compliance with home-quarantine and recovery are not warranted especially in developed countries where health capacity is poor. The purpose of the current study is to evaluate compliance with home-quarantine and the prognosis of COVID-19 among a cohort of patients isolated at home in the Governorate of Sousse, Tunisia. Methods Prospective longitudinal study of three months was led among a cohort of 375 patients with COVID-19 isolated at home. Participants were randomly selected from the new declared cases in the governorate of Sousse. Data were collected using a pre-established and pre-tested questionnaire administered during phone calls interviews with trained medical doctors. Results The median age of participants was 40.0 (IQR: 29.75-54.25) years. Females represented 60% of them. The average duration between close contact with symptomatic person and onset of symptoms was 4.01(±1.9) days. The most commonly reported symptoms were asthenia (51.7%), smell disturbance (50.4%), myalgia (41.9%) and ageusia (40.8%). Thirty two (8.5%) participants required hospitalization and 4 (1.0%) were transferred to intensive care units.The median delay for recovery was 18 days (IQR 17.1-18.9). Otherwise, 95 (25.4%) declared not respecting the quarantine and 111 (29.6%) of participants transmitted the infection to their family members. Conclusions Complications and intra-family transmission are frequent among COVID-19 patients isolated at home in Sousse. Accelerating the implementation of the Tunisian telemedicine law would provide a cost-effective solution for this problem. Key messages Isolation at home of COVID-19 patients should be associated with close monitoring by health professionals. Individual prevention measures should be reinforced among patients isolated at home to limit intra-family spread of COVID-19.
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Introduction: Seasonal influenza vaccination of healthcare workers (HCWs) is recommended in order to protect themselves and patients. During the COVID-19 pandemic, several studies highlighted the benefit of Influenza vaccination in reducing COVID-19 burden especially in developing countries. However, Influenza vaccination coverage among HCWs is unknown in the majority of these countries. Objectives: To investigate the acceptance of Influenza vaccination during the COVID-19 pandemic among Tunisian HCWs. Methods: An online cross-sectional study was led between the 7th and the 21th of January 2021 among 493 Tunisian health professionals. A pre-established and pre-tested questionnaire recorded in a free Google form was self-administrated to participants anonymously. The generated online Google Sheet was uploaded and exported to the Statistical Package for the Social Sciences 10.0 software for analysis. Results: The mean age of participants was 37.4 (± 9.5) years. The males/females ratio was 0.38.The rates of influenza vaccine acceptance were: 68% among medical doctors, 65.7% among pharmacists, 55.8% among paramedical professionals and 50% among dental surgeons. Working in the public sector and having a chronic condition predicted more acceptance of influenza vaccine with adjusted odds ratio of 1.9 (95% CI: 1.3-3.9) and 2.1 (95% CI: 1.3-3.5) respectively. Having been infected by the SARS-COV2 predicted fewer acceptances with and adjusted odds ratio of 0.3 (95% CI: 0.1-0.7). Conclusion: More attention should be paid to Tunisian paramedical professionals and dental surgeons in order to increase influenza vaccine uptake among them. Involving HCWs in the national information campaign about COVID-19 and Influenza vaccination would ensure more vaccines acceptance among them.
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Introduction: Health professionals are the leaders of the war against the SARS-COV2 pandemic. Their adherence to the vaccination against this new virus is crucial to ensure a sufficient coverage in the community. Objectives: To evaluate hesitancy towards SARS-COV2 vaccines among the Tunisian health professionals and their use of information sources about these vaccines. Methods: A cross-sectional study was led online between the 7th and the 21th of January 2021 among Tunisian health professionals. A number of at least 460 participants were required. Data were collected anonymously using a pre-established and pre-tested questionnaire recorded in a free Google form. Results: A total of 493 responses were obtained. The mean age of participants was 37.4 (± 9.5) years. Females represented 70.2% of participants. The rate of hesitancy towards COVID-19 vaccines was 51.9%. Lack of information about the COVID19 vaccines was reported by 81.7% of participants. Social media were the most used source of information by them (66.9%) while 7.9% of them used the national information site for health professionals. Use of social media more than two hours per day was positively associated with hesitancy towards vaccination against SARS-COV2 with an OR of 2.5 (95% CI: 1.5-4.2) contrary to the use of the national website for information for health professionals which was negatively associated with hesitancy with an OR of 0.5 (95% CI:0.2-0.9). Conclusion: The current information strategy should be reinforced in Tunisia. Social media may represent a good channel for disseminating valid messages and tackling misinformation. Engaging health care professionals in social media to counter the vaccine related misinformation would boost the national information strategy.
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Introduction: Healthcare personnel (HCP) are at the frontline of the COVID-19 pandemic and are recognized as a priority target group for COVID-19 vaccines. However, the acceptance or refusal of vaccination among HCP is debated. Objectives: To investigate the prevalence and the predictors of COVID-19 vaccination refusal among Tunisian HCP. Methods: A cross sectional study was conducted using an anonymous online survey among Tunisian HCP from 7 to 21th of January 2021. Primary endpoints were the intention to decline vaccination against COVID-19 if a vaccine was available. Logistic regression analysis was used to assess the factors associated with the intention to decline the COVID-19 vaccination. Results: Of the 546 responses, 493 were retrieved. Among included HCP, 292 (59.2%) were physicians, 53 (10.8%) were paramedical personnel, 70 (14.2%) were pharmacists and 78 (15.8%) were dentists. Overall, 62 of 493 HCP (12.6%) stated their intention to refuse vaccination. Logistic regression analysis revealed that being aged more than 40 years-old was a predictor of COVID-19 vaccination refusal among HCP with an adjusted odds ratio (AOR) of 2 (95%CI: 1.2-3.6). A history of vaccination against influenza during the current season and the use of television as a source of information about COVID-19 vaccination predicted a lower risk of refusing COVID-19 vaccination with AORs of 0.2(95%CI: 0.1-0.4) and 0.5 (95%CI: 0.3-0.8) respectively. Conclusion: The current information campaign about COVID-19 vaccination should be reinforced among Tunisian HCP. Older ones may be involved in this campaign as leaders. The use of the official media seems to be a good communication channel for this campaign.
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Introduction: The covid19 pandemic has been associated with significant challenges for Healthcare workers (HCWs) due to the high risk to be infected. Inadequate attitudes among HCWs can directly influence practices and lead to spread of disease in the healthcare-settings. Objectives: To assess the attitudes of the Tunisian HCWs towards the COVID-19 disease and the perception of preventive measures in the worksite. Methods: This cross-sectional healthcare-setting study of HCWs in private sector, Tunisia, was conducted during the last quarter of 2020, from September to December 2020. Two-stage cluster sample was performed for needed sample size of 399 participants. For the data collection we used a pretested self-administered questionnaire. sociodemographic characters, psychosocial data, perception of preventive measure implementation in the worksite and attitudes towards COVID19 were recorded. The data analysis was performed using SPSS software 20. Results: A total of 506 HCWs were enrolled in the study with a mean age of 33.8 ± 8.4 years. The sex-ratio was 0.33. About 63% (n = 314) of the participants were afraid to contract the COVID19 infection and 93% (n = 461) were frightened of transmetting the virus to their families. More than half of the HCWs declared that they washed hands regularly and weared masks more frequently than the previous infection wave. Nearly 91% of HCWs respected the social distanciation. Three in four respondents (74%) totally agreed that preventive measures were implemented and 62% claimed that the responsibles at the worksite take care of the employees' health. the majority of HCWs (99%) respected the preventive measures and declared that the clinics' responsibles will support them in infection case. Conclusion: HCWs reported in this study a high rate of positive perceptions and attitudes towards the preventive measures to slow down the COVID19 spreading. Adequate attitudes represent a key component for HCWs' well-being as part of public health measures during this pandemic.
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Introduction: Until now, there is no specific treatment to beat the COVID-19 disease. Regarding the scarcity of vaccines, compliance with collective and individual preventive measures remain the most important weapon against this new disease in developed countries. Objectives: To assess compliance with collective and individual preventive measures among COVID-19 patients before and during home quarantine in the governorate of Sousse. Methods: A prospective longitudinal study of three months was led among a cohort of 375 patients with COVID-19 isolated at home. Participants were randomly selected from the new declared cases in the governorate of Sousse during November 2020. Data were collected using a pre-established and pre-tested questionnaire administered during phone calls interviews with trained medical doctors. The frequency of the compliance with hygiene measures was evaluated using a five item scale with the following possible responses: (“do not remember”;“never”;“sometimes”;“often” and “all the time”). Results: A total of 375 participants were included. The median age of participants was 40.0 (IQR: 29.75-54.25) years. Females represented 60% of them. Among participants, 359 (95.7%) consider that social distancing is an efficient collective preventive action. Before the COVID-19 infection episode, this measure was not easy to respect for 121 (32.3%) participants. Besides, compliance all the time with mask wearing, coughing into the elbow and hand hygiene were reported by 49.1%, 41.9% and 58.9% of participants respectively. Otherwise, during the confinement, 95 (25.4%) participants declared not respecting the quarantine and 111 (29.6%) participants transmitted the infection to their family members. Conclusion: The current national awareness compaign should be reinforced in Tunisia in order to enhance compliance with collective and individual preventive measures. Use of social media, involving leaders and enforcing the law may increase people's adherence to hygiene rules.