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1.
Disease Surveillance ; 37(6):850-854, 2022.
Article in Chinese | CAB Abstracts | ID: covidwho-2055474

ABSTRACT

Objective: To understand the epidemiological characteristics and explore source of infection of coronavirus disease 2019 (COVID-19) cases imported through an inbound air flight from Kenya to Guangzhou, China.

2.
Economic Journal of Development Issues ; 29(30):59-80, 2020.
Article in English | GIM | ID: covidwho-2054875

ABSTRACT

This study assesses the COVID-19 and its shocks on macro-economic variables in Nepalese economy based on the secondary data sets of macroeconomics variable pre- and post-COVID-19 by applying descriptive statistical methods. The growth of COVID-19 is unpredictably spreading all over the world. Its hot spot has been in the South Asia, particularly in Delhi and Nepal. Its correlation between COVID 19 cases and per capita GDP is positive. In South Asia, its growth rate is higher than its recovery indicating inefficiency of health system. Similarly, its shocks are so strong to influence trend, pattern and structure of macro-economic variables. Economic growth declined at 0.1percent in 2020 with falling outputs of agriculture, industry and service sectors. Unemployment rate reaches at 27.8 percent from 11.4 percent. The poor population increased by 7.47 percent. Besides, residential income and household income has fallen along with sharp decline in labor and remittance income. Lastly, its negative implication is found in foreign exchange reserve and balance of payment, trade and revenue. Thus, the COVID-19 and its shocks are undesired fluctuations and impose implications in Nepalese economy. Therefore, Nepal should improve health care system and vaccine availability for reducing the effects of pandemic and the lockdown for stability and recovery of the economy and also for welfare of the poor.

3.
Africa Health ; 43(3):10-11, 2021.
Article in English | CAB Abstracts | ID: covidwho-2046311

ABSTRACT

In Africa, there is frequently an extreme need for nurses and other healthcare professionals. Overcrowding, a lack of administrative oversight, and a lack of resources are all problems in health settings. Health professionals may develop psychological damage referred to as "insufficient resource trauma" as a result of these difficulties, which can lower morale and motivation. Such trauma reduces the standard of treatment provided and causes professional "burn-out," a problem that has become more significant in the wake of the SARS-CoV-2 pandemic. One of the nurses who received training in PSBH-N in 2006 was promoted to the position of MoH Nursing Director by 2019. This nurse reflected on her personal experience and said, "The nurses trained in PSBH are among the top nurses in the country today," when she learned of the new PSBH training for MoH QAU employees. In order to train all 877 registered nurses and 373 licensed practical nurses (LPNs) in the nation during the following three to five years, the director requested that LeBoHA host PSBH-N workshops. The countrywide rollout's training and evaluation are now under progress. Priority setting may result from centralized, "top-down," problem-solving techniques that are not always appropriate for the district. A poll of healthcare professionals in South African hospitals revealed that administrators of hospitals were regarded as effective leaders if their leadership style encouraged engagement and problem-solving. An emphasis on a decentralised and egalitarian (equity-fostering) approach, where problem-solving is the duty of all health workers, is emphasized in a national quality assurance plan that includes PSBH.

4.
Forced Migration Review ; 67:33-35, 2021.
Article in English | CAB Abstracts | ID: covidwho-2046152

ABSTRACT

Significant variations in access to fundamental public health services during the COVID-19 epidemic have been revealed by recent study conducted in a number of different nations. States have an obligation to apply what they have learned from the present pandemic to remove existing obstacles. In many aspects, the COVID-19 pandemic fostered cooperation across nations and within communities in an effort to address dangers to the public's health and lessen the socioeconomic effects of the virus. Some good practices have emerged as a result of extensive advocacy and engagement with governments by a variety of actors. These include expanding free access to COVID-19 testing, treatment, and vaccines for all migrants, regardless of status, and allowing stranded migrants and those without visas to access basic services. They must consider the impact of this extraordinary situation and global public health emergency on those who continue to face barriers to accessing basic services, such as COVID-19 vaccines, as well as how this intersects with both individual and public health, even though these policy developments are to be welcomed, championed, and replicated. Public health initiatives could be jeopardized by enduring access impediments as well as fresh difficulties brought on by movement restrictions and lockdowns. National Red Cross and Red Crescent Societies conducted the study in eight nations: Australia, Colombia, Egypt, Ethiopia, the Philippines, Sudan, Sweden, and the UK (and data from the Sahel region was also taken into consideration). The findings suggest that, in order to end the pandemic and guarantee that everyone has the chance to receive assistance in a respectful and supportive manner, inclusive approaches for connecting with and supporting migrants and refugees must be incorporated into national and local pandemic preparedness, response, and recovery plans. Public health hazards will persist if inclusive policies are not accompanied by operational guidelines to overcome barriers in practice.

5.
Forced Migration Review ; 67:26-28, 2021.
Article in English | CAB Abstracts | ID: covidwho-2045404

ABSTRACT

Building a robust healthcare system is dependent on infection prevention and control (IPC), which is also essential during pandemics. In late 2020, a multi-country assessment was conducted, and it revealed serious issues that need to be fixed. Poor infection prevention and control (IPC) infrastructure and practices during the Ebola outbreaks in West Africa in 2014 to 2015 and the Democratic Republic of the Congo in 2019 resulted in high numbers of health-care worker infections and decreased use of health services because of people's fear of transmission. The International Rescue Committee (IRC) created a baseline set of IPC criteria for COVID-19 based on their experience with Ebola in an effort to facilitate quick IPC advancements at healthcare facilities serving people impacted by violence and displacement. The main tenets of this basic package for IPC are on personnel and responsibility, expertise and application, and resources and infrastructure. The administered facilities by IRC perform better generally than those by MOH and other partners, it is crucial to mention. The reason for this discrepancy is that IRC can more readily make modifications in facilities that it directly maintains than in facilities that it merely supports. This should show that even under the most challenging situations, it is possible to put appropriate IPC procedures in place. Members of the World Health Assembly (WHA) decided to enhance WASH services in healthcare facilities in four resolutions that were enacted in 2019. 2 Member states likewise urged nations to improve IPC, particularly in the WASH industry, in order to guarantee the greatest standards of universal healthcare. IPC is still given too little priority despite these international agreements.

6.
Central African Journal of Medicine ; 67(1/6):14-18, 2021.
Article in English | CAB Abstracts | ID: covidwho-2045204

ABSTRACT

Background: Anxiety is one of the commonest mental health challenges facing medical students. Levels of anxiety have not been estimated among medical students in Zambia. Objectives: To estimate the prevalence of anxiety disorders and its associated factors among pre-clinical students during the COVID-19 pandemic in the Copperbelt province of Zambia. Materials and Methods: A sample size of 398 students was sampled using a 1 in 2 systematic random sampling technique. The Zung's Self-rating Anxiety Scale (SAS) was used to determine levels of anxiety. Adjusted Odds Ratios (AOR) and their 95% Confidence Interval (CI) are reported.

7.
Forced Migration Review ; 67:29-33, 2021.
Article in English | CAB Abstracts | ID: covidwho-2044773

ABSTRACT

In the face of COVID-19, innovation, adaptation, and learning from experience have all been crucial to meeting the needs of those who have been displaced. In order to respond to this new disease, the humanitarian community had to get familiar with COVID-19. It was understood from the beginning that basic hygiene precautions, such adequate handwashing, could aid in preventing its transmission. However, a lot of displacement settings lack the infrastructure needed to put household and community-level infection prevention and control (IPC) measures into place. They might also have inadequate governance structures for overseeing and maintaining WASH services. Some of the hardest-to-reach populations are found in displacement contexts like Ethiopia, Somalia, and South Sudan, where people lack the resources to defend themselves and deal with health threats. Disease vulnerability may be exacerbated by overcrowding and restricted access to proper WASH facilities. In the meantime, xenophobia and stigma can develop due to the fear surrounding COVID-19 as well as the dissemination of false information. As new information became available and lessons were discovered, IOM teams operating in these environments had to modify their Risk Communication and Community Engagement (RCCE) and IPC efforts. Any disaster response has traditionally included funding for capacity building for hygiene promotion to strengthen local responses, but COVID-19 demanded more localisation because of the absence of international travel. It demonstrated how supporting local structures can help solidify hygiene promotion capacities while obviating the requirement for a high degree of international assistance in the event of future outbreaks by highlighting considerable local capacity and willingness in some communities.

8.
Cancer Epidemiology, Biomarkers & Prevention ; 30(7 Suppl):4-114, 2021.
Article in English | CAB Abstracts | ID: covidwho-2044470

ABSTRACT

These proceedings contains 114 articles that discuss building toward resilient health systems as the main topic of the first ASGCR plenary. Speakers stressed the significance of collaborations, adaptation, and innovation while highlighting crucial gaps that have appeared in the face of serious threats and emergencies like COVID-19, climate change, and political shifts. In order to close the gap between research and practice in cancer prevention and control in LMICs, this workshop covered evidence-based and cutting-edge solutions. The sometimes transient nature of many programs and initiatives was discussed, along with the difficulties of sustainability in the face of conflicting priorities and dangers to reliable health systems. Nevertheless, even as it discussed past failings, the event also recognised significant gains and started a conversation about resilient building patterns. The second plenary addressed equality in international cancer research, acknowledging the inequalities in the field's translational capacity. Research in LMICs has frequently led to important advances in cancer science, such as the early Burkitt lymphoma treatment trials in Uganda and the human papillomavirus immunisation trials in Costa Rica. The LMIC groups who contributed to these triumphs have frequently not received the rewards of this progress fairly. Inequities in cancer between high-income countries (HIC) and low- and middle-income countries (LMICs) also lead to research that fails to take into account the entire scientific worth of studies carried out in LMICs as well as the worldwide burden of disease. Established power imbalances that are frequently related to funding sources can hinder the development of HIC's career and local knowledge. To ensure the translation of research findings, suggestions included multisectoral stakeholder engagement across entire health systems, such as finance and education, as well as proper humility and listening on the part of HIC researchers and funders. Additionally, the chance for two-way information exchange and learning, respecting local knowledge, and developing trust to ensure successful relationships were noted. In turn, successful collaborations and active community involvement were considered as the way to effectively translate and disseminate research findings.

9.
PLoS Global Public Health ; 2(8), 2022.
Article in English | CAB Abstracts | ID: covidwho-2039243

ABSTRACT

The enforcement of the coronavirus disease (COVID-19) pandemic restrictions disrupted health services delivery and currently, there is a limited understanding regarding measures employed by health facilities to ensure delivery of human immunodeficiency virus (HIV) services amidst the interruptions. We, therefore, designed a qualitative study to explore the measures for continuity of HIV services during the COVID-19 pandemic restrictions in Kampala, Uganda. This study was conducted at six large primary health care facilities in the Kampala Metropolitan area. Qualitative data were collected from anti-retroviral therapy (ART) focal persons and lay health workers namely linkage facilitators and peer mothers through key informant interviews (KIIs). Overall, 14 KIIs were performed, 10 with lay health workers and 4 with ART focal persons. Data were audio-recorded, transcribed verbatim, and analyzed using the content approach, and the results were presented as themes along with participant quotations. Five themes emerged to describe measures for continuity of HIV services. The measures included: (1) leveraging the use of mobile phone technology to support ART adherence counseling, psychosocial care, and reminders concerning clinic appointments and referrals;(2) adoption of novel differentiated service delivery models for ART like the use of motorcycle taxis and introduction of an individualized ART delivery model for patients with non-disclosed HIV status;(3) scale-up of existing differentiated service delivery models for ART, namely multi-month dispensing of antiretroviral drugs (ARVs), fast-track ARV refill, home-based ARV refill, peer ART delivery, use of community pharmacy model, and community client-led ART delivery model;and, (4) reorientation of health facility functioning to the COVID-19 pandemic restrictions characterized by the use of nearby health facilities for ARV refill and viral load monitoring, transportation of healthcare providers and flexible work schedules and reliance on shift work. We found several measures were adopted to deliver HIV care, treatment, and support services during the COVID-19 pandemic restrictions in Kampala, Uganda. We recommend the scale-up of the new measures for service continuity in the post-COVID-19 period.

10.
PLoS Global Public Health ; 2(8), 2022.
Article in English | CAB Abstracts | ID: covidwho-2039226

ABSTRACT

The Joint External Evaluation (JEE) assesses national capacities to implement the International Health Regulations (IHR). Previous studies have found that higher JEE scores are associated with fewer communicable disease deaths. But given the impact of COVID-19 in many countries, including those believed to have developed IHR capacities, the validity of the JEE for pandemic preparedness has been questioned. We constructed univariable and multivariable linear regression models to investigate the relationship between JEE scores and (i) deaths from communicable diseases before the pandemic and (ii) deaths from COVID-19. We adjusted for country differences in age, health system access, national wealth, health expenditure, democratic governance, government restrictions, pre-pandemic tourist arrivals and testing capacity (estimated by test positivity rates). For COVID-19 deaths, we calculated cumulative deaths per 100,000 at 3, 6 and 12 months into the pandemic. A total of 91 countries were included, with a median JEE score of 50%. On multivariable linear regression the association between JEE scores and log COVID-19 deaths was significant and positive at 3 months (ss 0.05, p = 0.02), becoming statistically non-significant, at 6 (ss 0.02, p = 0.27) and 12 months (ss -0.03, p = 0.19), while the association with log communicable disease deaths was significant and negative (ss -0.03, p = 0.003). A higher Stringency Index was significantly associated with higher log COVID-19 deaths at 3 (ss 0.04, p = 0.003) and 6 (ss 0.04, p = 0.001) months, but not at 12 months (ss 0.02, p = 0.08). Higher test positivity rates were associated with higher log COVID-19 deaths at all time points, at least partially attenuating the positive association between Stringency Index and log COVID-19 deaths. While universal health coverage indices (ss -0.04 p<0.001) and international tourist arrivals were associated with log communicable disease deaths (ss 0.02, p = 0.002), they were not associated with log COVID-19 deaths. Although the same tool is used to assess capacities for both epidemics and pandemics, the JEE may be better suited to small outbreaks of known diseases, compared to pandemics of unknown pathogens.

11.
Boletin de Malariologia y Salud Ambiental ; 61(Edicion Especial II 2021):26-34, 2021.
Article in Spanish | GIM | ID: covidwho-2034459

ABSTRACT

Introduction: SARS-CoV2 infection with severe clinical manifestations has been associated with a decrease in plasma hemoglobin levels. This suggests the need to understand the impact that anemia has in the clinical outcomes of patients with COVID-19.

12.
Journal of Bhutan Studies ; 42:1-43, 2020.
Article in English | GIM | ID: covidwho-2034320

ABSTRACT

When COVID-19 first emerged in late-2019 in Wuhan, China, without adequate containment, the virus and the economic shock waves that followed quickly spread across the world, leaving few countries unaffected by the contagion. COVID-19 quickly escalated into an ongoing and widespread global crisis, placing acute pressure on prevailing economic systems, governance structures, development institutions and health systems not experienced since the Spanish flu of 1918. In doing so, it crippled economies and ruptured trajectories of globalization and development, with a myriad of negative impacts as well as unintended positive effects such as reduced carbon emissions. As the pandemic continues to unfold, the responses of individual nation-states and sub-national regions have been both varied and divergent.

13.
American Journal of Primatology ; 84(4/5), 2022.
Article in English | CAB Abstracts | ID: covidwho-2033684

ABSTRACT

This special issue consists of 17 papers dealing with issues animal health (captive and wild primates), environmental health (rain forests and mountain areas), and human health (the role of religion in One Health, lessons from the Hanuman langur (Semnopithecus entellus) and other human-non-human primate interactions,and Covid-19).

14.
CGIAR Research Program on Policies, Institutions, and Markets ; 2022.
Article in English | CAB Abstracts | ID: covidwho-2033653

ABSTRACT

This report highlights the achievements in 2021 of the CGIAR Research Program on Policies, Institutions, and Markets (PIM). PIM had a productive final year centered on synthesizing and packaging findings to consolidate the program's legacy while continuing to respond to demand related to the impacts of COVID-19 and preparing the transition to the new CGIAR portfolio. Among other achievements, PIM findings and engagement contributed to Myanmar's response to COVID-19, South Africa's policies on resilience to climate change, Tunisia's policies for pastoral development, a reform of Nigeria's national agricultural research system, Ghana's fish seed and farm certification system, gender strategies for three agricultural value chains in Honduras, and genome editing guidelines for the agricultural sector in four African countries. PIM research informed policy documents of FAO, IFAD, One CGIAR, the UK Government, the World Bank and the World Food Programme. PIM tools enabled more equitable co-management of 76 protected areas in Peru and informed World Bank social protection projects.

15.
HPS Weekly Report ; 55:41, 2021.
Article in English | CAB Abstracts | ID: covidwho-2033648

ABSTRACT

This article is based on a recommendation from an ongoing pilot programme in Ghana, Kenya and Malawi that has reached more than 800,000 children since 2019, with key findings: (1) The vaccine introduction is feasible, improves health and saves lives, with good and equitable coverage of RTS,S seen through routine immunisation systems. This has occurred even in the context of the COVID-19 pandemic, (2) RTS,S has increased equity in access to malaria prevention, with data from the pilot programme showing that more than two-thirds of children in the three pilot programme countries, who do not sleep under a bednet, have benefitted from the RTS,S vaccine, (3) To date, more than 2.3 million doses of the vaccine have been administered in three African countries, with a favourable safety profile, (4) In areas where the vaccine has been introduced, there has been no decrease in the use of insecticide-treated nets, uptake of other childhood vaccinations, or health seeking behaviour for febrile illness, (5) A reduction of 30% in deadly severe malaria, even when introduced in areas where insecticide-treated nets are widely used and there is good access to diagnosis and treatment, and (6) Modelling estimates that the vaccine is cost-effective in areas of moderate to high malaria transmission. Therefore, this recommendation includes funding decisions from the global health community for broader rollout, and country decision-making on whether to adopt the vaccine as part of national malaria control strategies.

16.
Journal of Henan Normal University Natural Science Edition ; 49(6):199-208, 2022.
Article in English | CAB Abstracts | ID: covidwho-2026899

ABSTRACT

As the major source of information, social media has outpaced mainstream news channels. In these information overloaded days, differentiating rumors from facts is crucial and difficult. This study aims to explore the respondents' perception of the reasons for spreading rumors related to the Coronavirus on social media. Furthermore, it seeks to look at the respondents' perception of the ways of combating fake news related to the Coronavirus on social media. Lastly, the study attempts to know to what extent the respondents are satisfied with the performance of the media institutions in dealing with the Coronavirus. A cross-sectional survey design was used with a non-probability sample to explore the respondents' perceptions of the above-mentioned aims. A total of 1274 self-selected cases from Bahrain, Egypt, Iraq, Jordan, Morocco, Oman, Saudi Arabia, Sudan, and the United Arab Emirates were investigated. The study finds that all respondents agree with the reasons listed in the survey about spreading rumors related to the Coronavirus on social media, except for the reasons of lacking transparency on behalf of the Ministry of Health and other official bodies and lacking accurate information about the Coronavirus. Moreover, the study confirms the respondents' beliefs that all listed ways effectively combat fake news related to the Coronavirus on social media. Furthermore, the study finds that the respondents are satisfied with the performance of the media institutions in dealing with the Coronavirus in their countries. With these findings, the study significantly contributes to the literature. It may assist various parties, such as the government and media organizations, in making the proper decision to combat the spread of rumors via social media.

17.
Bangladesh Journal of Veterinary Medicine ; 20(1):17-24, 2022.
Article in English | CAB Abstracts | ID: covidwho-2026591

ABSTRACT

Background: Poultry and livestock are a leading sub-sector of agriculture, playing an important role to fulfill the protein requirements of the human diet and contributing to the national economy in Bangladesh. This sub-sector is often vulnerable due to frequent outbreaks of diseases in animals and unrest situations worldwide that hamper earning a profit up to the expected mark. Due to pandemic COVID-19, the Bangladesh government was bound to announce a countrywide lockdown and periodical restriction of movement in March 2020 to minimize the spread of the infection. This study aimed to evaluate the impact of COVID-19 on poultry and livestock health.

18.
Zoonoses ; 1(3):1-6, 2021.
Article in English | CAB Abstracts | ID: covidwho-2025740

ABSTRACT

The COVID-19 pandemic has already affected human society for more than 1.5 years. As of August 8, 2021, this pandemic had caused more than 203 million infected and 4.3 million deaths worldwide. As an RNA virus, SARS-CoV-2 is prone to genetic evolution, thus resulting in development of mutations over time. Numerous variants of SARS-CoV-2 have been described globally, four of which are considered variants of concern (VOCs) by the WHO: Alpha (B.1.1.7), Beta (B.1.351), Gamma (P1) and Delta (B.1.617.2). The Delta VOC was first reported in India in December of 2020 and has since affected approximately 130 different countries and regions. Herein, the spatiotemporal spread of the Delta VOC during April to July 2021 in 20 selected countries with available data were analyzed. The prevalence of the Delta VOC sequences was maintained at low levels in the beginning of April, increased rapidly in the following 3 months and is now becoming the predominant viral strain in most regions of the world. We also discuss the effects of the Delta VOC on transmissibility, clinical severity and vaccine effectiveness according to the latest data. The Delta VOC has greater transmissibility and risk of hospitalization than the ancestral SARS-CoV-2 strains and the other three VOCs. The Delta VOC places partially or unvaccinated sub-populations at high risk. Currently authorized vaccines, regardless of vaccine type, still have reliable effectiveness against symptomatic infections and hospitalizations due to the Delta VOC.

19.
PLoS Global Public Health ; 2(7), 2022.
Article in English | CAB Abstracts | ID: covidwho-2021495

ABSTRACT

Pneumonia is a major killer of children younger than five years old. In resource constrained health facilities, the capacity to diagnose severe pneumonia is low. Therefore, it is important to identify technologies that improve the diagnosis of severe pneumonia at the lowest incremental cost. The objective of this study was to conduct a health economic evaluation of standard integrated management of childhood illnesses (IMCI) guideline alone and combined use of standard IMCI guideline and pulse oximetry in diagnosing childhood pneumonia. This is a cluster-randomized controlled trial conducted in health centres in southern Ethiopia. Two methods of diagnosing pneumonia in children younger than five years old at 24 health centres are analysed. In the intervention arm, combined use of the pulse oximetry and standard IMCI guideline was used. In the control arm, the standard IMCI guideline alone was used. The primary outcome was cases of diagnosed severe pneumonia. Provider and patient costs were collected. A probabilistic decision tree was used in analysis of primary trial data to get incremental cost per case of diagnosed severe pneumonia. The proportion of children diagnosed with severe pneumonia was 148/928 (16.0%) in the intervention arm and 34/876 (4.0%) in the control arm. The average cost per diagnosed severe pneumonia case was USD 25.74 for combined use of pulse oximetry and standard IMCI guideline and USD 17.98 for standard IMCI guideline alone. The incremental cost of combined use of IMCI and pulse oximetry was USD 29 per extra diagnosed severe pneumonia case compared to standard IMCI guideline alone. Adding pulse oximetry to the diagnostic toolkit in the standard IMCI guideline could detect and treat one more child with severe pneumonia for an additional investment of USD 29. Better diagnostic tools for lower respiratory infections are important in resource-constrained settings, especially now during the COVID-19 pandemic.

20.
PLoS Global Public Health ; 2(6), 2022.
Article in English | CAB Abstracts | ID: covidwho-2021487

ABSTRACT

As of March 2022, the COVID-19 vaccination rate in Chad approximated 1%. There are no published reports of COVID-19 vaccine hesitancy or beliefs in Chad. We aimed to study COVID-19 vaccine acceptance and hesitancy among community members, patients, and health care workers in urban Chad. We recruited a prospective convenience sample of adult patients, community members, and healthcare workers from N'Djamena, Chad between August-October 2021. Participants completed a 15-minute, 25-question survey instrument exploring demographic, social, and clinical variables related to COVID-19 and an adapted WHO SAGE Vaccine Hesitancy Survey. Primary outcomes were vaccine acceptance and vaccine hesitancy. Regression models were fit to assess associations between Vaccine Hesitancy Scale (VHS) scores, ranging from 10 (least hesitant) to 50 (most hesitant) points, and pre-selected variables of interest. An inductive thematic analysis was used to analyze the qualitative vaccine hesitancy responses. Of 508 participants (32% female;mean age 32 years), 162 were patients, 153 were community members, and 193 were healthcare workers. COVID-19 vaccine acceptance was significantly higher among patients (67%) than community members (44%) or healthcare workers (47%), p < .001. The average VHS score was 29 points (patients = 27.0, community members = 28.9, healthcare workers = 29.4), and more than one-third of participants were classified as highly vaccine hesitant (score >30 points). Knowing someone who died from COVID-19, believing local healthcare workers support vaccination, trusting the government, having a higher socioeconomic status (i.e. having electricity), and reporting medical comorbidities were each associated with less vaccine hesitancy (all p < .05). The vaccine concerns most frequently endorsed were: vaccine side effects (48%), efficacy (38%), safety (34%), concerns about the pharmaceutical industry (27%), and lack of government trust (21%). Four main themes arose from qualitative vaccine hesitancy responses (n = 116): education, trust, clinical concerns, and misinformation and false beliefs. Overall, COVID-19 vaccine acceptance was low, including among health care workers, and reasons for vaccine hesitancy were broad. We detail the most commonly reported concerns of urban Chadians for receiving the COVID-19 vaccine;we also identify subgroups most likely to endorse vaccine hesitancy. These analyses may inform future vaccination outreach campaigns in N'Djamena.

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