ABSTRACT
The COVID-19 vaccines are being rolled out across all the Sub-Saharan Africa (SSA) countries, with countries setting targets for achieving full vaccination rates. The aim of this study was to compare the uptake of, resistance and hesitancy to the COVID-19 vaccine between SSA locally residents and in the diaspora. This was a cross-sectional study conducted using a web and paper-based questionnaire to obtain relevant information on COVID-19 vaccine acceptance. The survey items included questions on demography, uptake and planned acceptance or non-acceptance of the COVID-19 vaccines among SSAs. Multinomial logistic regression was used to determine probabilities of outcomes for factors associated with COVID-19 vaccination resistance and hesitancy among SSA respondents residing within and outside Africa. Uptake of COVID-19 vaccines varied among the local (14.2%) and diaspora (25.3%) residents. There was more resistance to COVID-19 vaccine among locals (68.1%) and across the sociodemographic variables of sex [ adjusted Relative Risk (ARR) =0.73, 95% CI; 0.58 - 0.93], primary/less [ARR =0.22, 95% CI; 0.12 - 0.40] and bachelors degree [ARR =0.58, 95% CI; 0.43 - 0.77] educational levels, occupation [ARR =0.32, 95% CI; 0.25 - 0.40] and working status [ARR =1.40, 95%CI; 1.06 - 1.84]. COVID-19 vaccine hesitancy was almost similar between locals and diasporas (17.7% and 17.8% respectively) significant only among healthcare workers [ARR =0.46, 95% CI; 0.16 - 1.35] in the diaspora after adjusting for the variables. Similarly, knowledge and perception of COVID-19 vaccine among locals were substantial, but only perception was remarkable to resistance [ARR =0.86, 95% CI; 0.82 - 0.90] and hesitancy [ARR =0.85, 95% CI; 0.80 - 0.90] of the vaccine. Differences exist in the factors that influence COVID-19 vaccine acceptance between local SSA residents and those in the diaspora. Knowledge about COVID-19 vaccines affects the uptake, resistance, and hesitancy to the COVID-19 vaccine. Information campaigns focusing on the efficacy and safety of vaccines could lead to improved acceptance of COVID-19 vaccines.
ABSTRACT
Mental health and emotional responses to the effects of COVID-19 lockdown in sub-Saharan Africa (SSA) are of serious public health concern and may negatively affect the mental health status of people. Hence, this study assessed the prevalence of mental health symptoms as well as emotional reactions among sub-Saharan Africans (SSAs) and associated factors among SSAs during the COVID-19 lockdown period. This was a web-based cross-sectional study on mental health and emotional features from 2005 respondents in seven SSA countries. This study was conducted between 17 April and 17 May 2020 corresponding to the lockdown period in most SSA countries. Respondents aged 18 years and above and the self-reported symptoms were feeling anxious, being worried, angry, bored and frustrated. These were the main outcomes and were treated as dichotomous variables. Univariate and multivariate logistic regression analyses were used to identify the factors associated with these symptoms. We found that over half (52.2%) of the participants reported any of the mental health symptoms and the prevalence of feeling bored was 70.5% followed by feeling anxious (59.1%), being worried (57.5%), frustrated (51.5%) and angry (22.3%) during the COVID-19 pandemic. Multivariate analysis revealed that males, those aged >28 years, those who lived in Central and Southern Africa, those who were not married, the unemployed, those living with more than six persons in a household, had higher odds of mental health and emotional symptoms. Similarly, people who perceived low risk of contracting the infection, and those who thought the pandemic would not continue after the lockdown had higher odds of mental health and emotional symptoms. Health care workers had lower odds for feeling angry than non-healthcare workers. During the COVID-19 lockdown periods in SSA, about one in two participants reported mental health and emotional symptoms. Public health measures can be effectively used to identify target groups for prevention and treatment of mental health and emotional symptoms. Such interventions should be an integral component of SSA governments' response and recovery strategies of any future pandemic.
Subject(s)
COVID-19/psychology , Mental Health , Pandemics , Adolescent , Adult , Africa South of the Sahara , Communicable Disease Control , Cross-Sectional Studies , Emotions , Female , Humans , Internet , Male , Middle Aged , Prevalence , Young AdultABSTRACT
Background: The unprecedented outbreak of coronavirus disease (COVID-19) drastically spread worldwide, resulting in extraordinary measures put in place in various countries including Sub Saharan Africa (SSA) countries. Objective: To assess the factors associated with compliance with the public health measures imposed by various SSA countries. Method: Cross sectional study using self-administered surveys distributed on social media platforms between April 18th and May 16th, 2020, corresponding with the mandatory lockdown period in most SSA countries. Multivariate analysis examined the associated factors. Results: The prevalence of hand hygiene, quarantine, self isolation practices, wearing of face mask and attending large gatherings during COVID-19 were 94%, 39%, 31%, 64% and 14%, respectively. In multivariate models, older age 49+ years: adjusted OR 2.13, 95%CI 1.22,3.71), females (OR 1.41,95%CI 1.03,1.93), Central African countries (OR 3.73,95%CI 2.02,6.87) were associated with wearing face mask. Living alone (aOR 1.52,95%CI 1.04,2.24) during the lockdown was associated with avoiding large gatherings including religious events. Female respondents (aOR 1.61, 95%CI 1.30, 2.00), married (aOR 1.71,95%CI 1.33,2.21) and unemployed (aOR 1.62,95%CI 1.25,2.09) SSAs were more likely to practice self-quarantine measures. Conclusion: The low prevalence of mitigation practices suggest the need for targeted education campaign programs to sensitise the population.
