Reactivation of Surgical Campaigns after the Covid Pandemic: Surgeons in Action with Hernia International Foundations in 2022

Aim: The Cirujanos en Accion and Hernia International foundations carried out their own and collaborative surgical campaigns in developing countries. In 2020 and 2021 the programme had to be suspended due to Covid. In 2022 we restarted our actions, analysed the difficulties of reactivation and described the campaigns that had been carried out and those that had to be delayed. Material/ Methods: We describe the 9 campaigns of Surgeons in Action, our own and in collaboration with Hernia International and our own campaign to the region of Naborno Karabakh, planned for September and cancelled 24 hours before departure due to the resurgence of armed conflict. An analysis is made of volunteers, places, type (adults or children or mixed), collaborations with other foundations, patients operated and procedures done according to pathologies, integration with local staff with exchange of knowledge. Result(s): Made in 8 countries (Benin, Camerun, Gambia (2), Kenya, Liberia, Mozambique, Tanzania, Sierra Leone) and postponed in one country, the Naborno Karabakh region of Armenia. 85 volunteers (25 general and 10 paediatric surgeons, 19 anaesthetists, 3 intensivists, 23 nurses, 5 audiovisuals);local staff;1144 patients (473 children, 671 adults), 1325 procedures for various pathologies (hernias, goitres, hydroceles, undescendend testis, soft tissue tumours, etc.) Conclusion(s): 9 campaigns have been carried out successfully and new locations have been opened with a good projection for the coming years, and we have experienced difficulties with the cancellation of a mega-campaign in an area with geopolitical conflicts - to be taken into account in the future.

Circulation of respiratory viruses during the COVID-19 pandemic in The Gambia

Background: In many countries, non-pharmaceutical interventions to limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission resulted in significant reductions in other respiratory viruses. However, similar data from Africa are limited. We explored the extent to which viruses such as influenza and rhinovirus co-circulated with SARS-CoV-2 in The Gambia during the COVID-19 pandemic. Methods: Between April 2020 and March 2022, respiratory viruses were detected using RT-PCR in nasopharyngeal swabs from 1397 participants with influenza-like illness. An assay to detect SARS-CoV-2 and a viral multiplex RT-PCR assay was used as previously described to detect influenza A and B, respiratory syncytial virus (RSV) A and B, parainfluenza viruses 1-4, human metapneumovirus (HMPV), adenovirus, seasonal coronaviruses (229E, OC43, NL63) and human rhinovirus. Result(s): Overall virus positivity was 44.2%, with prevalence higher in children <5 years (80%) compared to children aged 5-17 years (53.1%), adults aged 18-50 (39.5%) and >50 years (39.9%), p<0.0001. After SARS-CoV-2 (18.3%), rhinoviruses (10.5%) and influenza viruses (5.5%) were the most prevalent. SARS-CoV-2 positivity was lower in children <5 (4.3%) and 5-17 years (12.7%) than in adults aged 18-50 (19.3%) and >50 years (24.3%), p<0.0001. In contrast, rhinoviruses were most prevalent in children <5 years (28.7%), followed by children aged 5-17 (15.8%), adults aged 18-50 (8.3%) and >50 years (6.3%), p<0.0001. Four SARS-CoV-2 waves occurred, with 36.1%-52.4% SARS-CoV-2 positivity during peak months. Influenza infections were observed in both 2020 and 2021 during the rainy season as expected (peak positivity 16.4%-23.5%). Peaks of rhinovirus were asynchronous to the months when SARS-CoV-2 and influenza peaked. Conclusion(s): Our data show that many respiratory viruses continued to circulate during the COVID-19 pandemic in The Gambia, including human rhinoviruses, despite the presence of NPIs during the early stages of the pandemic, and influenza peaks during expected months.Copyright: © 2023 Jarju S et al.

GAMBIA: Opposition Protest

B This first rally in decades offers hope for democracy. b Hundreds of Gambians marched through the capital Banjul on March 10th in what was believed to be the first opposition protest permitted in the former dictatorship for nearly three decades. The petition also highlighted the high cost of living and a swathe of financial scandals including Covid-19 funding and a Gambia Ports Authority embezzlement scandal. In a statement, the UDP Youth Wing described the police decision to grant the march as a "positive development" that it hoped would mark "a turning point in the political landscape". [Extracted from the article] Copyright of Africa Research Bulletin: Political, Social & Cultural Series is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Vaccine network design to maximize immunization coverage

PurposeThe COVID-19 pandemic has forced countries to consider how to reach vulnerable communities with extended outreach services to improve vaccination uptake. The authors created an optimization model to align with decision-makers' objective to maximize immunization coverage within constrained budgets and deploy resources considering empirical data and endogenous demand.Design/methodology/approachA mixed integer program (MIP) determines the location of outreach sites and the resource deployment across health centers and outreach sites. The authors validated the model and evaluated the approach in consultation with UNICEF using a case study from The Gambia.FindingsResults in The Gambia showed that by opening new outreach sites and optimizing resource allocation and scheduling, the Ministry of Health could increase immunization coverage from 91.0 to 97.1% under the same budget. Case study solutions informed managerial insights to drive gains in vaccine coverage even without the application of sophisticated tools.Originality/valueThe research extended resource constrained LMIC vaccine distribution modeling literature in two ways: first, endogenous calculation of demand as a function of distance to health facility location enabled the effective design of the vaccine network around convenience to the community and second, the model's resource bundle concept more accurately and flexibly represented complex requirements and costs for specific resources, which facilitated buy-in from stakeholders responsible for managing health budgets. The paper also demonstrated how to leverage empirical research and spatial analysis of publicly available demographic and geographic data to effectively represent important contextual factors.

Stress and coping in the face of COVID-19: A qualitative inquiry into early pandemic experiences and psychological wellbeing of health workers in Burkina Faso, Senegal, and The Gambia.

COVID-19 represented an unprecedented challenge for health workers around the world, resulting in strong concerns about impacts on their psychological wellbeing. To inform on-going support and future preparedness activities, this study documented health workers' experiences, wellbeing, and coping throughout the first wave of the pandemic, in Burkina Faso, Senegal, and The Gambia. We collected data from 68 primarily clinical staff from the COVID-19 treatment, maternity, and emergency departments in 13 purposely hospitals and laboratories across the three countries. Following in-depth interviews via zoom (mid-May to September 2020), we regularly followed up via WhatsApp until the end of 2020. We used a mixed deductive and inductive coding approach, and a framework matrix to organize and analyse the material. All respondents initially assessed the situation as stressful and threatening. Major emotional reactions included fear of own infection, fear of being a risk to loved ones, guilt, compassion, and anxiety regarding the future. Many suffered from feeling left alone with the emerging crisis and feeling unvalued and unappreciated, particularly by their governments and ministries of health. Conversely, health workers drew much strength from support and valuation by direct supervisors and team members, and in part also by patients. We observed important heterogeneity between places of work and individual backgrounds. Respondents coped with the situation in various ways, particularly with strategies to manage adverse emotions, minimize infection risk and fortifying health, and find meaning in the adverse circumstances. Coping strategies were primarily grounded in own resources rather than institutional support. Over time, the situation normalised and fears diminished for most respondents. With a view towards emergency preparedness, our findings underline the value of participation and transparent communication, institutional support, and routine training to foster health workers' psychological preparedness, coping skill set, and resilience more generally.

Circulation of respiratory viruses during the COVID-19 pandemic in The Gambia

Background: In many countries, non-pharmaceutical interventions to limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission resulted in significant reductions in other respiratory viruses. However, similar data from Africa are limited. We explored the extent to which viruses such as influenza and rhinovirus co-circulated with SARS-CoV-2 in The Gambia during the COVID-19 pandemic. Method(s): Between April 2020 and March 2022, respiratory viruses were detected using RT-PCR in nasopharyngeal swabs from 1397 participants with influenza-like illness. An assay to detect SARS-CoV-2 and a viral multiplex RT-PCR assay was used as previously described to detect influenza A and B, respiratory syncytial virus (RSV) A and B, parainfluenza viruses 1-4, human metapneumovirus (HMPV), adenovirus, seasonal coronaviruses (229E, OC43, NL63) and human rhinovirus. Result(s): Overall virus positivity was 44.2%, with prevalence higher in children <5 years (80%) compared to children aged 5-17 years (53.1%), adults aged 18-50 (39.5%) and >50 years (39.9%), p<0.0001. After SARS-CoV-2 (18.3%), rhinoviruses (10.5%) and influenza viruses (5.5%) were the most prevalent. SARS-CoV-2 positivity was lower in children <5 (4.3%) and 5-17 years (12.7%) than in adults aged 18-50 (19.3%) and >50 years (24.3%), p<0.0001. In contrast, rhinoviruses were most prevalent in children <5 years (28.7%), followed by children aged 5-17 (15.8%), adults aged 18-50 (8.3%) and >50 years (6.3%), p<0.0001. Four SARS-CoV-2 waves occurred, with 36.1%-52.4% SARS-CoV-2 positivity during peak months. Influenza infections were observed in both 2020 and 2021 during the rainy season as expected (peak positivity 16.4%-23.5%). Peaks of rhinovirus were asynchronous to the months when SARS-CoV-2 and influenza peaked. Conclusion(s): Our data show that many respiratory viruses continued to circulate during the COVID-19 pandemic in The Gambia, including human rhinoviruses, despite the presence of NPIs during the early stages of the pandemic, and influenza peaks during expected months.Copyright © 2022 Jarju S et al.

Quantifying excess mortality during the COVID-19 pandemic in 2020 in The Gambia: a time-series analysis of three health and demographic surveillance systems.

OBJECTIVES: Estimates for COVID-19-related excess mortality for African populations using local data are needed to design and implement effective control policies. METHODS: We applied time-series analysis using data from three health and demographic surveillance systems in The Gambia (Basse, Farafenni, and Keneba) to examine pandemic-related excess mortality during 2020, when the first SARS-CoV-2 wave was observed, compared to the pre-pandemic period (2016-2019). RESULTS: Across the three sites, average mortality during the pre-pandemic period and the total deaths during 2020 were 1512 and 1634, respectively (Basse: 1099 vs 1179, Farafenni: 316 vs 351, Keneba: 98 vs 104). The overall annual crude mortality rates per 100,000 (95% CI) were 589 (559, 619) and 599 (571, 629) for the pre-pandemic and 2020 periods, respectively. The adjusted excess mortality rate was 8.8 (-34.3, 67.6) per 100,000 person-month with the adjusted rate ratio (aRR) = 1.01 (0.94,1.11). The age-stratified analysis showed excess mortality in Basse for infants (aRR = 1.22 [1.04, 1.46]) and in Farafenni for the 65+ years age group (aRR = 1.19 [1, 1.44]). CONCLUSION: We did not find significant excess overall mortality in 2020 in The Gambia. However, some age groups may have been at risk of excess death. Public health response in countries with weak health systems needs to consider vulnerable age groups and the potential for collateral damage.

COVID-19 and Changes in Intentions to Migrate from The Gambia

The COVID-19 pandemic has resulted in border closures in many countries and a sharp reduction in overall international mobility. However, this disruption of legal pathways to migration has raised concerns that potential migrants may turn to irregular migration routes as a substitute. We examine how the pandemic has changed intentions to migrate from The Gambia, the country with the highest pre-pandemic per-capita irregular migration rates in Africa. We use a large-scale survey conducted in 2019 and 2020 to ask about changes in intentions to migrate to Europe and to neighbouring Senegal. We find that youth say that the pandemic has reduced the intention to migrate to both destinations, with approximately one-third of young males expressing less intention to migrate. The largest reductions in migration intentions are for individuals who were unsure of their intent pre-pandemic and for poorer individuals who are no longer able to afford the costs of migrating at a time when these costs have increased and their remittance income has fallen. Nevertheless, despite these decreases in intentions, the overall desire to migrate the backway to Europe remains high, highlighting the need for legal migration pathways to support migrants and divert them from the risks of backway migration.

Diagnosis and genomic characterization of SARSCOV- 2 in a Senegalese laboratory of public sector

Introduction/ Background: In Senegal, several labs are involved in COVID-19 diagnosis but only a few have the capacity of genomic sequencing, especially in the public sector. The aim of this study was to describe the contribution of a public health laboratory in COVID-19 diagnosis and molecular epidemiology of SARS-COV-2 in Senegal. Methods: From nasopharyngeal swabs collected from COVID- 19 patients, viral RNA was extracted and an RT-PCR was carried out to detect SARS-COV-2 genes using different kits targeting ORF1ab and N genes using Dan-An Gene Co (LTD of Sun-Yat-Sen University) and Sansure Bio Tech Inc or RdRp and N gene with Abbot Real-Time RT-PCR kit. Genomic characterization of SARS-COV-2 strains were carried out on a subset of positive samples collected from the 3 waves by sequenced using MinIon Oxford Nanopore technology. Results: From July 2020 to Sept 2021, 7988 COVID-19 suspected patients or travelers were tested at Laboratoire de Bacteriologie- Virologie (LBV) of Aristide Le Dantec hospital, an University Teaching Hospital. Among them, 964 patients were positive to SARS-COV-2 giving a positivity rate of 12%. Thereafter, 115 (11.9%) were sequenced including 32, 40, and 43 from the first, second, and third waves, respectively. The most detected variants of the first wave were B.1.1.420 (23%). For the second wave, B.1.1.420 (27.5%) and B.1.1.7 (35%) were the most detected. For the third wave, 42 sequences were Delta variant (B.1.617), and one from 19A clade. Impact: The results of this study highlight the need to enlarge the sequencing capacity to laboratories from the public sector in Senegal, especially university teaching hospitals as they may contribute efficiently to COVID -19 response. Conclusion: Despite the low number of positive samples, the LBV through this experience has proven its capacity to contribute to the national response of the COVID-19 pandemic and in genomic characterization of SARSCOV- 2 in the country. It was also a very good opportunity for a technology transfer from IRESSEF and MCR-Gambia.

Field performance of a rapid antigen detection test for SARS-CoV-2 (COVID-19 Ag Respi-Strip) in two West African settings

Introduction/ Background: The COVID pandemic continues to devastate the world population since January 2020. RDTs are a key tool for COVID-19 response. We evaluated the performance of a commercially available SARSCoV- 2 antigen RDT for the screening of suspect cases of COVID-19 in two West African countries, Burkina Faso and The Gambia. Methods: The study was implemented between September 2020 and September 2021 in Burkina Faso (Bobo- Dioulasso) and The Gambia (West Coast division). Patients presenting with COVID-19 symptoms (WHO case definition, August 2020) were systematically screened for COVID-19 by RDT and diagnostic PCR and enrolled in a 6-month prospective follow-up study. Oro- and nasopharyngeal (OP/NP) swabs were collected from suspected case and the RDT performed within <8h of collection. The sensitivity and specificity of the RDT- with and without universal transport medium (UTM), were analyzed against COVID-19 diagnostic PCR and the positiveand negative predictive values were also estimated. Results: Between September 2020 and March 2021, a total of 478 patients were screened with 263 from Burkina Faso and 215 from The Gambia. From these, 118 COVID-19 positive by PCR were enrolled in the cohort (Burkina Faso: 92;The Gambia: 26). Specificity was 100% for samples from UTM, but sensitivity was 24%. When stratifying the analysis to patients with Ct values ≤ 30 and ≤ 25, the sensitivity was 44% and 65%, respectively. Sensitivity on samples with buffer only was 71% and specificity 100%. On samples with buffer only and Ct values ≤ 34, RDT sensitivity and specificity were 100%. Impact: The COVID-19 Ag Respi Strip represents a rapid, reliable, and affordable triage tool for clinically suspect COVID-19 cases in Africa allowing for the timely isolation and management of COVID-19 patients before PCR confirmation. Conclusion: The RDT performs much better as a point of care test without UTM using the direct swab method. A newer version of the RD (COVID-19 Ag K-Set) with improved sensitivity could be assessed in the future.

Temporal dynamics of SARS-COV-2 viral load and related antibodies in West African patients: the COVADIS cohort

Introduction/ Background: The COVID-19 pandemic continues to challenge the world's population though morbidity and mortality seems to be lower in West Africa than in other parts of the world. We set up a cohort of COVID-19 patients to determine the dynamics of SARS-CoV-2 viral load and related antibodies in West Africa. Methods: The study was carried out in Burkina Faso and The Gambia between Sep2020 and Sep 2021. Symptomatic patients confirmed by RT-PCR were invited into a 6-month follow-up with weekly up to day 28, then months 3 and 6. A 4-plex qRT-PCR was used to detect the N and E genes of SARS-CoV-2, and a multiplex serological assay for the detection of antibodies against SARS-CoV-2 Spike (S) and Nucleocapsid (NC) protein as well as other seasonal corona viruses. Analysis used mixed models allowing for a random intercept on subject and considering non-linear pattern of antibodies overtime adjusting for confounders. Results: 114 COVID-19 patients were recruited (88 in Burkina Faso and 26 in The Gambia). Preliminary results show rapidly decreasing viral loads while the S & NC antibodies increased overtime peaking around day 21 since diagnosis. Though antibodies gradually decline after day 21, the relative gains in antibodies from day 0 were sustained even at day 90, particularly for the S protein. The estimated mean antibody titer (log10) rose from 3.66 (95% CI: 3.58 - 3.73) at admission to 4.11 (95% CI: 4.03 - 4.19) at day 21, then declined to 3.83 (95% CI: 3.75 - 3.91) at day 90. Impact: The COVID Luminex platform constitutes a powerful tool to accurately measure exposure to SARS-CoV-2 at population level, and to explore the relationship between SARS-CoV-2 antibody response and antibodies against other human seasonal coronaviruses viruses and/or other tropical pathogens. Conclusion: Our preliminary data suggest a rapid decline in viral load among SARS-CoV-2 patients while their serological response is sustained for weeks. The COVID Luminex platform constitutes a powerful tool measuring exposure to SARS-CoV-2, explore the relationship between SARS-CoV-2 antibody response and antibodies against other seasonal coronaviruses viruses and tropical pathogens.

How have health systems in Gambia, Senegal and Burkina Faso managed COVID-19 from May 2020 to September 2021?

Introduction/ Background: Known for their weakness, health systems in West Africa have been the subject of pessimistic predictions. We were interested in understanding how the Senegalese, Gambian and Burkinabe health systems have coped with the shock of the pandemic. Methods: We conducted interviews with 75 doctors, nurses, midwives, and other medical personnel working in four selected healthcare institutions per country. We also interviewed six healthcare managers in charge of coordinating COVID-19 activities in each of the three countries, including a nation-wide COVID-19 decision-maker, a COVID-19 treatment centre coordinator and a COVID-19 testing laboratory manager. We used the theory of resilient health systems (Fridell et al., 2020) to analyse our data. Results: Health professionals reported leadership support. Solidarity between colleagues improves the working environment although the working conditions are difficult. To cope with the lack of training, health professionals go to colleagues or to the Internet. The availability and quality of Personal protective equipments varies between countries and services. COVID-19 treatment centre and laboratory staff felt more protected within their department than outside it, whereas maternal health workers.. About delivery services, the first patients were taken care of with a lot of pressure because of providers lack's of experience. In addition, health professionals find themselves playing the role of carer in their absence. Impact: This study shows that health systems in West Africa, although weak and often under-resourced, have a workforce capable of using the resources available to deal with the shock of a pandemic. Conclusion: Human resources of health are strong and committed, despite difficult working conditions with insufficient preparation, providers have drawn on their own resources to train themselves to the point of taking over the role of the carer.

COVID-19 vaccinations in The Gambia: efforts, challenges, and future directions.

On March 11, 2020, the novel coronavirus disease (COVID-19) was declared a pandemic. Since the declaration, countries have implemented response measures to stop the spread of the virus, while multiple vaccines combatting the virus have also been developed. However, vaccine rollout and providing vaccine access has been very challenging in many African countries, including The Gambia. This article briefly assesses the efforts and challenges facing The Gambia´s COVID-19 vaccine rollout and implementation. The article also provides recommendations that policymakers and program implementers can use to address the low COVID-19 vaccination rate in The Gambia. It is based on a narrative review of existing literature on COVID-19 vaccination efforts and challenges in The Gambia.

Mobile Big Data in the fight against COVID-19

In this editorial, Guest Editors Richard Benjamins (Telefónica), Jeanine Vos (GSMA), and Stefaan Verhulst (Data & Policy Editor-in-Chief) draw insights from a set of peer-reviewed, open access articles in a Data & Policy special collection dedicated to the use of Telco Big Data Analytics for COVID-19.

Pro-poor and inclusive growth in West Africa

PurposeThis paper focuses on three key metrics of poverty, income distribution and employment to ascertain the pro-poor and inclusive-growth position of the western African region. The roles of governance structures and their interactive effects are also accommodated to capture the peculiarity of the region.Design/methodology/approachThe paper employs fixed and dynamic models.FindingsEvidence suggests that growth is pro-poor, although virtually all governance indicators are sterile in stimulating poverty reduction. The authors observe that health and education spending coupled with trade-openness stimulate pro-poor growth potentials, whereas conflicts culminate the pervasiveness of poverty in the region. By empirically answering the question of how inclusive is economic growth through the lens of income-distribution and employment, the authors show that growth has been exclusive as per-capita-GDP growth rather dampens income shared by the poorest 20%. Also, it is observed that growth has not been inclusive as the jobless-growth argument remains valid while high inequality further exacerbates unemployment in the region. It is further shown that governance has been generally weak in propelling inclusive growth except where the institutional-component of governance stimulates inclusive growth through improvement in equality and labor employability.Originality/valueThe study jointly examines the metrics of poverty, income distribution and employment to ascertain growth pro-poorness and inclusivity which are key for the achievement of African-union (AU) agenda 2063. The study captures cross-sectional dependence among selected countries which previous studies ignored.

RETHINKING THE RENEWAL AND INTERNATIONALISATION OF UNIVERSITY OF THE GAMBIA IN THE POST-COVID-19 ERA

The central question grappled with in this paper is: How can the University of The Gambia (UTG) be renewed in the post-Covid-19 era in a way that will enable it to reclaim its space in the international higher education landscape? To answer this question, this conceptual paper relies on document study, interdisciplinary discourse analysis and an insiders' perspective. It is argued that the present and future state of UTG can best be understood when located within a historical and international context. While Covid-19 has ruined the academic project at UTG, the establishment of this institution remains a noble idea which deserves to be applauded. With targeted funding and other forms of support especially from the government of Gambia, UTG is well poised to renew and reclaim its space in the international higher education landscape. Theoretically, these recommendations are distilled from the major findings of the research of this paper which has been shaped largely by the decision making approach.

Forecasting Daily New Covid-19 Cases in the Gambia Using the Artificial Neural Networks

In this research paper, the ANN approach was applied to analyze daily new COVID-19 cases in Gambia. The employed data covers the period 1 January 2020 to 31 December 2020 and the out-of-sample period ranges over the period 1 January 2021 to 31 May 2021. The residuals and forecast evaluation criteria (Error, MSE and MAE) of the applied model indicate that the model is stable in forecasting daily COVID-19 in the Gambia. The results of the study indicate that Gambia is likely to witness another wave of infections over the period 1 January 2021 and 31 May 2021 as indicated by the out of sample forecasts . Therefore the government is encouraged to continue practicing WHO guidelines on prevention and control of COVID-19.

Intense and Mild First Epidemic Wave of Coronavirus Disease, The Gambia.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is evolving differently in Africa than in other regions. Africa has lower SARS-CoV-2 transmission rates and milder clinical manifestations. Detailed SARS-CoV-2 epidemiologic data are needed in Africa. We used publicly available data to calculate SARS-CoV-2 infections per 1,000 persons in The Gambia. We evaluated transmission rates among 1,366 employees of the Medical Research Council Unit The Gambia (MRCG), where systematic surveillance of symptomatic cases and contact tracing were implemented. By September 30, 2020, The Gambia had identified 3,579 SARS-CoV-2 cases, including 115 deaths; 67% of cases were identified in August. Among infections, MRCG staff accounted for 191 cases; all were asymptomatic or mild. The cumulative incidence rate among nonclinical MRCG staff was 124 infections/1,000 persons, which is >80-fold higher than estimates of diagnosed cases among the population. Systematic surveillance and seroepidemiologic surveys are needed to clarify the extent of SARS-CoV-2 transmission in Africa.

Examining the perceptions and behaviors of Gambian adults in response to COVID-19 social mitigation strategies.

The objective of this study was to examine the perceptions and behaviors of Gambian adults in response to COVID-19 social mitigation strategies. An online survey of 200 respondents was conducted. The survey inquired about respondents´ motivation to comply with a social distancing strategy and their ability to adopt 3 recommended social distancing strategies (avoiding public transport without wearing facemask, avoiding public gatherings and self-isolation). Respondents were also asked about the level of trust they had in the information about COVID-19 from the government and their confidence in the handling of the COVID-19 situation by the authorities. Fifty two percent (52%) of respondents reported that they would be motivated to comply with a social distancing strategy because they believed it is the right thing to do. Avoiding public transport without wearing facemask (n=154, 78.9%), followed by avoiding public gatherings (n=143, 73.3%) were considered to have high to very high capacity to adopt ratings among respondents. Whereas, only (n=132, 68.7%) thought that their ability to self-isolate, would be high to very high. Only (n=87, 44.2%) stated that they have high to very high level of trust in the information about COVID-19 from the government. The rest, (n=110, 55.8%) ranked their trust level as intermediate, low, very low or don´t know. Majority of respondents (n=114, 58.7%) disagreed to strongly disagreed that the authorities are doing a good job in handling the COVID-19 situation. These findings can be used to improve adoption of COVID-19 mitigation strategies and ensure trust and confidence in response efforts.