Adherence to COVID-19 preventive measures and associated factors among pregnant women in Ghana

Psychological and psychosocial determinants of COVID-related handwashing behaviours: A systematic review

Background

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has resulted in illness, deaths and societal disruption on a global scale. Societies have implemented various control measures to reduce transmission of the virus and mitigate its impact. Individual behavioural changes are crucial to the successful implementation of these measures. One commonly recommended measure to limit risk of infection is frequent handwashing. It is important to identify those factors that can predict the uptake and maintenance of handwashing.

Objectives

We aimed to identify and synthesise the evidence on malleable psychological and psychosocial factors that determine uptake and adherence to handwashing aimed at reducing the risk of infection or transmission of COVID-19.

Search Methods

We searched various literature sources including electronic databases (Medline ALL, Child Development & Adolescent Studies, ERIC, PsycInfo, CINAHL and Web of Science), web searches, conference proceedings, government reports, other repositories of literature and grey literature. The search strategy was built around three concepts of interest including (1) context (terms relating to COVID-19), (2) behaviour of interest and (3) terms related to psychological and psychosocial determinants of COVID Health-Related Behaviours and adherence or compliance with handwashing, to capture malleable determines. Searches capture studies up until October 2021.

Selection Criteria

Eligibility criteria included observational studies (both retrospective and prospective) and experimental studies that measure and report malleable psychological and psychosocial determinants and handwashing at an individual level, amongst the general public. Screening was supported by the Cochrane Crowd. Titles and abstracts were screened against the eligibility criteria by three independent screeners. Following this, all potentially relevant studies were screened at full-text level by the research team. All conflicts between screeners were resolved by discussion between the core research team.

Data Collection and Analysis

All data extraction was managed in EPPI-Reviewer software. All eligible studies, identified through full-text screening were extracted by one author. We extracted data on study information, population, determinant, behaviour and effects. A second author checked data extraction on 20% of all included papers. All conflicts were discussed by the two authors until consensus was reached.We assessed methodological quality of all included studies using an adapted version of the Joanna Briggs Institute Quality appraisal tool for cross-sectional studies.

Main Results

Our initial searches yielded 23,587 results, of which 56 studies were included in this review. The included studies were cross sectional in design, came from 22 countries and had a combined sample of 199,376 participants. The vast majority of studies had samples from the general public, with eight of the studies focusing on specific samples. All included studies considered people over the age of 18. The quality of the majority of the studies was good (n = 30 rated low risk of bias), with 8 rated high risk of bias, predominately due to lack of reporting of recruitment, sample characteristics and methodology. Thirty-four studies were included in the narrative synthesis and 28 in the meta-analysis.Findings indicated that emotions about COVID-19 (worry [0.381, confidence interval [CI] = 0.270-0.482, I 2 = 92%) and anxiety (0.308, CI = 0.154-0.448, I 2 = 91%]), knowledge of COVID-19 (0.323, CI = 0.223-0.417, I 2 = 94%), and perceived social norms (0.303, CI = 0.184-0.413, I 2 = 92%) were among the malleable determinants most associated with handwashing. Perceived severity (0.006, CI = -0.011-0.023) and susceptibility of COVID-19 (0.041, CI = -0.034 to 0.115) had little to no effect on handwashing behaviour.

Authors' Conclusions

Understanding the effects of various malleable determinants on COVID-related handwashing can aid in the development and implementation of interventions and public health campaigns to promote handwashing behaviour in potential new waves of COVID-19 or other respiratory infections. Emotions about COVID, knowledge of COVID and perceived social norms warrant further consideration in future research and policy.

COVID-19 vaccination in low and middle-income countries: Creating a sustainable roadmap for promoting public health intervention

The Coronavirus Disease 2019 (COVID-19) pandemic is a global public health threat ravaging the health systems. In low and middle-income countries (LMICs), COVID-19 and several other challenges concurrently worsen the health outcome indicators. Interestingly, vaccines have been identified as the most reliable and cost-effective public health intervention, and the governments in LMICs have instituted an array of plans to ensure every eligible person gets vaccinated. However, there is still considerable apathy around the use of the available COVID-19 vaccines in LMICs which is impeding the fight against the COVID-19 pandemic. In this paper, we explore the multiple interrelated factors behind low COVID-19 vaccination coverage in LMICs. It is therefore recommended that the governments in LMICs embrace multicomponent and wide-ranging strategies. This should involve utilising community-based approaches such as community pharmacy-led vaccination to promote community access to COVID-19 vaccines and to revive trust in national health authorities by offering population-specific, target-driven, transparent, and timely communication to the community who they serve about the safety and efficacy of the COVID-19 vaccine. Communication strategies should be tailored to reflect diverse political orientations as this can enhance vaccine acceptance. Additionally, local political parties and representative should be engaged in broad alliances to facilitate community mobilisation and support for vaccination campaigns. Also, relevant Nongovernmental Organisations and Community-based Organisations should institute programs at the grassroots that incorporate the gatekeepers to the community aimed at influencing population behaviour regarding COVID-19 vaccine hesitancy. Besides, the public health department in the ministry of health in LMICs should create more awareness, through social and mass media, particularly in the rural, semi-urban, and slum communities about the pivotal role of vaccination. Thus, we opined that these strategies will help LMICs achieve the COVID-19 vaccination target and further reposition the healthcare systems, and promote other public health interventions now and in the future.

Assessing factors associated with compliance to preventive measures of COVID-19 in Rwanda: a cross-sectional community survey

OBJECTIVE

To assess the level of compliance with COVID-19 preventive measures and compliance-associated factors in the Rwanda community.

DESIGN

Cross-sectional study.

SETTINGS

Country-wide community survey in Rwanda.

PARTICIPANTS

4763 participants were randomly sampled following the sampling frame used for the recent Rwanda Demographic Health Survey. Participants were aged between 22 years and 94 years.

OUTCOMES

The participants' compliance with three preventive measures (wearing a face mask, washing hands and social distancing) was the main outcome.

METHODS

From 14 February 2022 to 27 February 2022, a cross-sectional survey using telephone calls was conducted. Study questionnaires included different questions such as participants' demographics and compliance with COVID-19 preventives measures. Verbal consent was obtained from each participant. The compliance on three main preventive measures (wearing a mask, washing hands and social distancing) were the main outcomes. Univariate and multivariable logistic regression analyses were performed to evaluate factors associated with compliance (age, gender, level of education, socioeconomic status).

RESULTS

Compliance with the three primary preventive measures (washing hands 98%, wearing a mask 97% and observing social distance 98%) was at a rate of 95%. The respondents' mean age was 46±11 SD (range 22-98) years. In addition, 69% were female and 86% had attended primary education. Bivariate and regression analyses indicated a significant association among the three primary preventive measures (p<0.05). The results showed factors associated significantly between the different models (p<0.05): proper mask use and social distancing in the hand washing model; hand washing, social distancing, avoiding handshakes and not attending gatherings in the proper mask use model; hand washing and avoiding handshakes in the social distancing model.

CONCLUSION

Compliance with the three key preventive measures against COVID-19 was high in the Rwandan community and these measures were interdependent. Therefore, the importance of all three measures should be emphasised for effective disease control.

Pre-vaccination seroprevalence of SARS-CoV-2 antibodies in the Volta Region, Ghana

Objectives

Before administration of the first dose of the AstraZeneca 2019 SARS-CoV-2 vaccine to selected prioritized groups in the Volta regional capital of Ghana, we determined the pre-vaccination status of prospective recipients and established the baseline exposure status 1 year after the first case was reported.

Methods

After informed consent, blood samples were collected for the detection of SARS-CoV-2 immunoglobulin (Ig) M/IgG antibodies using rapid diagnostic test kits. A total of 409 individuals (mean age 27 years) consented and participated in the study, comprising 70% students and others were health staff and educators who presented themselves for vaccination.

Results

The overall exposure rate of SARS-CoV-2 was 12.7% (95% confidence interval [CI] 9.6-16.3). The prevalence of SARS-CoV-2 IgM and IgG were 4.2% (95% CI 2.4-6.6) and 5.6% (95% CI 3.6-8.3), respectively. IgM and IgG were detected in 2.9% (95% CI 1.5-5.1) of the respondents. The exposure rates were higher in participants over 40 years old (15.5%). Participants without a history of COVID-19-like symptoms had an exposure rate of 13.0% and those without any chronic diseases was 13.2%.

Conclusion

Pre-vaccination exposure was relatively low and underscored the need for vaccination i to increase protection in communities and disease outcomes.

The psychosocial experiences of pregnant women in the early stages of the COVID-19 pandemic: A retrospective qualitative study

BACKGROUND

Pregnant women are among the most vulnerable and suffer the most during pandemics, according to earlier studies. Pregnant women had to seek healthcare for both themselves and their unborn child(ren) in the wake of the COVID-19 pandemic, which was unprecedented. Pregnant women's psychosocial experiences during pandemics are crucial since they both directly and indirectly affect the course of pregnancy and childbirth. The study therefore sought to explore the psychosocial experiences of pregnant women during the COVID-19 pandemic.

METHODS

In this retrospective qualitative study, 15 nursing mothers who were attending a postnatal clinic at the Kwame Nkrumah University of Science and Technology (KNUST) hospital in Ghana were recruited. Individual interviews were conducted with mothers who were pregnant between March and December 2020. The audio-recorded interviews were transcribed verbatim and inductively analysed into themes.

RESULTS

Nursing mothers were aged 25-30 years and had infants ranging from 5 months to 15 months. Thirteen (13) were married and two were single. Two (2) major themes and five (5) subthemes emerged from the study. The unpleasant feelings connected to the potential for contracting COVID-19 and experiencing stress were described by the theme, "Fear and Stress". Participants' social experiences (support from significant others), alterations in daily routine and the economic impact because of the pandemic were presented as the "Socioeconomic impact".

CONCLUSION

Pregnant women go through several challenges during pregnancy such as perceived stress and anxiety. These are likely to heighten during a pandemic, as presented in the study. They therefore need emotional and psychosocial support in such uncertain times to improve outcomes of pregnancy.

Potential risk factors for cardiovascular diseases and associated sociodemographic characteristics: A cross-sectional evaluation of a large cohort of women living with HIV in north-central Nigeria

Males have a higher prevalence of cardiovascular (CVD) risk factors such as alcohol use, hypercholesterolemia, hypertension, obesity, and smoking based on limited data available from two tertiary health centers in Nigeria. Increasing age and lower educational level influence smoking among the same population in northeastern and northwestern Nigeria. Specifically in women living with HIV (WLHIV), the association between demographic characteristics and CVD risk factors has not been described. In a multi-center cross-sectional study, we documented the association of sociodemographic characteristics with potential CVD risk factors among a large cohort of WLHIV attending five treatment sites in north-central Nigeria. This was a cross-sectional study among 5430 women of reproductive age who received antiretrovirals at five selected treatment sites in Benue State, Nigeria. We performed multivariable regression of sociodemographic characteristics on potential cardiovascular risk factors, namely, smoking, alcohol consumption, and contraceptive use. We found participants' mean age was 33.2 (standard deviation: 6.1) years. Prevalence of smoking, alcohol consumption, and contraceptive use were 0.6%, 11%, and 7% respectively. Older WLHIV (≥ 40 years) had a negative association with contraceptive use (aOR: 0.58, 95%CI: 0.42-0.81). Being educated WLHIV had a positive association with contraceptive use (aOR: 1.34, 95%CI: 1.02-1.76) and a negative association with tobacco smoking (aOR: 0.37, 95%CI: 0.16-0.83). Being a farmer had a negative association with alcohol consumption (aOR: 0.43, 95%CI: 0.35-0.52) and contraceptive use (aOR: 0.61, 95%CI: 0.48-0.76). Compared to being married, being in a single relationship had positive association with alcohol consumption (aOR: 1.30, 95%CI: 1.08-1.56) while parenting was associated with 165% higher odds of contraceptive use (aOR: 2.65, 95%CI: 1.73-4.06). In conclusion, the low prevalence of smoking exists among women living with HIV on antiretroviral treatment. Older age, farming and being married are potential deterrents to lifestyle risk factors for cardiovascular diseases among this population. To improve HIV-related treatment efforts and outcomes, implementing interventions aimed at lifestyle behavioral modification among this population has the potential to reduce cardiovascular disease risks.

Sociodemographic and clinical predictors for COVID-19 preventive measures compliance among pregnant women in Saudi Arabia: a multicenter study

OBJECTIVE

To assess the levels of adherence among pregnant women to the basic COVID-19 preventive measures, and to analyze the effect of risk perception and sociodemographic and clinical factors on adherence.

METHOD

A multicenter, cross-sectional study was conducted at the obstetrics clinics of 50 primary care centers selected using a multistage sampling method. An online-administered, structured questionnaire was used to collect self-reported levels of adherence to four basic preventive measures against COVID-19, along with perceived COVID-19 severity, infectiousness, and harmfulness to the baby, besides sociodemographic and clinical data including obstetrical and other medical history.

RESULTS

A total of 2460 pregnant women were included with a mean (SD) age of 30.21 (6.11) years. Levels of self-reported compliance were highest for hand hygiene (95.7%), followed by social distancing (92.3%), masking (90.0%), and avoidance of contact with a COVID-19 infected person (70.3%). Perceived COVID-19 severity and infectiousness, and harmfulness to the baby were observed in 89.2%, 70.7%, and 85.0% of the participants, respectively, and were variably associated with compliance to preventive measures. Analysis of sociodemographic factors highlighted the significance of education and economic status in determining adherence to preventive measures, which represents a potential inequity in the risk of COVID-19 infection.

CONCLUSION

This study highlights the importance of patients' education to enable functional perception of COVID-19 that promotes self-efficacy, besides investigating the specific social determinants of health to tackle inequalities in terms of prevention efficiency and the subsequent health outcomes.

Perceptions about COVID-19 preventive measures among Ghanaian women

Though the advent of COVID-19 vaccines has significantly reduced severe morbidity and mortality, infection rates continue to rise. Therefore, adhering to COVID-19 preventive measures remains essential in the fight against the pandemic, particularly in Africa, where vaccination rates remain low. However, the perceived risk associated with COVID-19 and public education and awareness campaigns has waned over time. COVID-19 vaccine hesitancy is consistently high among women globally. This study, therefore, assessed the facilitators, and barriers to adherence to COVID-19 preventive measures. A qualitative descriptive study was conducted among Ghanaian women. Twenty-seven in-depth interviews were conducted with women in the Greater Accra and Ashanti regions. All interviews were audio-recorded and transcribed verbatim into English. The data were analysed using NVivo 10 software. While some participants found the use of face masks as the easiest, others found it as the most difficult. In addition, institutional and policy decisions such as access to water and the use of public transport impacted individual level adherence to preventive measures. In conclusion, the fight against COVID-19 is not over; hence public education and the provision of facilities that would enhance compliance with preventive measures should continue to be prioritised.

SARS-CoV-2 Infection-Blocking Immunity Post Natural Infection: The Role of Vitamin D

OBJECTIVE AND AIM

The extent of the protection against SARS-CoV-2 conferred by natural infection is unclear. Vitamin D may have a role in the interplay between SARS-CoV-2 infection and the evolving acquired immunity against it. We tested the correlation between baseline 25(OH) D content and both the reinfection rate and the anti-spike protein antibody titer following COVID-19 infection. Methods A retrospective observational survey that included a large convalescent COVID-19 population of subjects insured by the Leumit HMO was recorded between 1 February 2020 and 30 January 2022. Inclusion criteria required at least one available 25(OH)D level prior to enlistment. The association between 25(OH)D levels, the rate of breakthrough infection, and the anti-spike protein antibody titer was evaluated. Results A total of 10,132 COVID-19 convalescent subjects were included, of whom 322 (3.3%) sustained reinfection within a one-year follow-up. In the first 8 months after recovery, the reinfected patients were characterized by a higher incidence of low 25(OH)D levels (<30 ng/mL, 92% vs. 84.8%, p < 0.05), while during the following three months, the incidence of low 25(OH)D levels was non-significantly higher among PCR-negative convalescent subjects compared to those reinfected (86% vs. 81.7, p = 0.15). By multivariate analysis, age > 44 years (OR-0.39, 95% CI: 0.173-0.87, p = 0.02) and anti-spike protein antibody titer > 50 AU/mL (0.49, 95% CI: 0.25-0.96, p = 0.04) were inversely related to reinfection. No consistent correlation with vitamin D levels was observed among the 3351 available anti-spike protein antibody titers of convalescent subjects. However, the median anti-spike protein antibody titers tended to increase over time in the vitamin D-deficient group. Conclusion Higher pre-infection 25(OH)D level correlated with protective COVID-19 immunity during the first 8 months following COVID-19 infection, which could not be explained by anti-spike protein antibody titers. This effect dissipated beyond this period, demonstrating a biphasic 25(OH)D association that warrants future studies.

Correlation between Baseline 25(OH) Vitamin D Levels and Both Humoral Immunity and Breakthrough Infection Post-COVID-19 Vaccination

Objective: Vaccines against COVID-19 induce specific antibodies whose titer is perceived as a reliable correlate of protection. Vitamin D confers complex regulatory effects on the innate and adaptive immunity. In this study, we explored a plausible impact of baseline vitamin D content on achieved immunity following COVID-19 vaccination. Methods: A retrospective observational study comprising 73,254 naïve subjects insured by the Leumit Health Service HMO, who were vaccinated between 1 February 2020 and 30 January 2022, with one available vitamin D level prior to vaccination, was performed. The association between 25(OH) vitamin D levels, SARS-CoV-2 antibody titer, and post-vaccination PCR results were evaluated. Results: Of the study population, 5026 (6.9%) tested positive for COVID-19. The proportion of low 25(OH)D levels (<30 ng/mL) was significantly higher in the PCR-positive group (81.5% vs. 79%, p < 0.001). Multivariate analysis showed a higher incidence of breakthrough infection among non-smokers [1.37 (95% CI 1.22−1.54, p < 0.001)] and lower incidences among subjects with sufficient 25(OH)D levels (>30 ng/mL) [0.87 (95% CI 0.79−0.95, p—0.004)], hyperlipidemia [0.84 (95% CI 0.76−0.93, p < 0.001], depression [OR-0.87 (95% CI: 0.79−0.96, p < 0.005], socio-economic status >10 [0.67 (95% CI 0.61−0.73, p < 0.001)], and age >44 years. SARS-CoV-2 antibody titers were available in 3659 vaccinated individuals. The prevalence of antibody titers (<50 AU) among PCR-positive subjects was 42% compared to 28% among PCR-negative subjects (p < 0.001). Baseline 25(OH)D levels showed an inverse relation to total antibody titers. However, no association was found with an antibody titer <50 AU/mL fraction. Conclusion Baseline 25(OH)D levels correlated with the vaccination-associated protective COVID-19 immunity. Antibody titers <50 AU/mL were significantly linked to breakthrough infection but did not correlate with 25(OH)D levels.

Adherence to COVID-19 preventive measures in Sub-Saharan Africa during the 1st year of the pandemic: Pooled analysis of the International Citizen Project on COVID-19 (ICPCovid) surveys

Introduction

While most governments instituted several interventions to stall the spread of COVID-19, little is known regarding the continued observance of the non-pharmaceutical COVID-19 preventive measures particularly in Sub-Saharan Africa (SSA). We investigated adherence to these preventive measures during the initial 6 months of the COVID-19 outbreak in some SSA countries.

Methods

Between March and August 2020, the International Citizen Project on COVID-19 consortium (www.icpcovid.com) conducted online surveys in six SSA countries: Benin, Cameroon, Democratic Republic of Congo, Mozambique, Somalia, and Uganda. A five-point individual adherence score was constituted by scoring respondents' observance of the following measures: mask use, physical distancing, hand hygiene, coughing hygiene, and avoiding to touch one's face. Community behaviors (going to public places, traveling during the pandemic) were also assessed. Data were analyzed in two time periods: Period 1 (March-May) and Period 2 (June-August).

Results

Responses from 26,678 respondents were analyzed (mean age: 31.0 ± 11.1 years; 54.1% males). Mean individual adherence score decreased from 3.80 ± 1.37 during Period 1, to 3.57 ± 1.43 during Period 2; p < 0.001. At the community level, public events/places were significantly more attended with increased travels during Period 2 compared to Period 1 (p < 0.001). Using linear mixed models, predictors of increased individual adherence included: higher age (Coef = 0.005; 95% CI: 0.003-0.007), female gender (Coef = 0.071; 95% CI: 0.039-0.104), higher educational level (Coef = 0.999; 95% CI: 0.885-1.113), and working in the healthcare sector (Coef = 0.418; 95% CI: 0.380-0.456).

Conclusion

Decreasing adherence to non-pharmaceutical measures over time constitutes a risk for the persistence of COVID-19 in SSA. Younger persons and those with lower education levels constitute target groups for improving adherence to such measures.

Psychological impact of coronavirus disease (COVID-19) on health professions students at the University of Zambia: a cross-sectional study

Introduction

the coronavirus disease 2019 (COVID-19) has negatively impacted the mental health of students across the globe. In Zambia, little is known about the psychological impacts of COVID-19 on healthcare students. This study assessed the psychological impact of COVID-19 on health professions students at the University of Zambia.

Methods

this cross-sectional study was conducted from August 2021 to October 2021. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). The multivariable logistic regression model was used to identify the factors associated with anxiety and depression among the participants. Data were analysed using Stata 16.1.

Results

of the 452 students, 57.5% were female, with the majority aged between 19 and 24 years. Overall, 65% (95% CI: 60.5-69.4) experienced anxiety, while 86% (95% CI: 82.7-89.3) experienced depression. Participants whose income was affected were more likely to experience anxiety (aOR; 2.09, 95% CI: 1.29-3.37) and depression (aOR; 2.87, 95% CI: 1.53-5.38). Anxiety was associated with difficulty in observing the COVID-19 preventive measures (aOR; 1.84, 95% CI: 1.21-2.81). Being depressed was associated with having a chronic condition (aOR; 3.98, 95% CI: 1.67-9.50) or a relative or friend who died from COVID-19 (aOR: 1.98, 95% CI: 1.06-3.70).

Conclusion

many students experienced anxiety and depression during the COVID-19 third wave of infections. This calls for mitigation measures because continued anxiety and depression can affect the academic performance of students. Fortunately, most of the associated factors are modifiable and can easily be targeted when formulating interventions to reduce anxiety and depression among students.

Adherence to face mask use during the COVID-19 pandemic among women seeking antenatal care in Kinshasa, Democratic Republic of Congo: a facility-based cross-sectional study

OBJECTIVES

To describe face mask use among pregnant women seeking antenatal care (ANC) in Kinshasa, Democratic Republic of Congo and to identify factors associated with masking adherence in this population.

DESIGN

Facility-based cross-sectional study nested within a prospective cohort study.

SETTING

Random sample of 10 health facilities, including 5 primary health centers and 5 secondary facilities or hospitals.

PARTICIPANTS

A total of 934 pregnant women aged 18 years or above with a gestational age of at least 32 weeks were consecutively surveyed from 17 August 2020 to 31 January 2021.

PRIMARY AND SECONDARY OUTCOME MEASURES

We estimated the proportions of pregnant women wearing a face mask and masking correctly (ie, over the mouth and nose), and assessed their knowledge regarding the COVID-19 pandemic. Multivariable logistic regression was employed to identify factors associated with overall and correct face mask use.

RESULTS

Overall, 309 (33.1%) women wore a mask during the interview after their antenatal appointments, but only 33 (10.7%) wore a mask correctly. The odds of masking and correct mask use were significantly higher among women who had their ANC visit in a facility that provided COVID-19 care. Additionally, women who experienced COVID-19-like symptoms in the past 6 months had higher odds of wearing a mask correctly compared with those reporting no recent symptoms. Although 908 (97.2%) women were aware of the COVID-19 pandemic, only 611 (67.3%) thought that COVID-19 was circulating locally in Kinshasa.

CONCLUSION

Overall and correct face mask adherence levels were low among pregnant women attending ANC in Kinshasa. Our study highlights the need for improving adherence to correct face mask use in order to help control the spread of COVID-19 within Kinshasa alongside other control measures, like vaccination.

Effect of restrictions imposed due to COVID-19 pandemic on the antenatal care and pregnancy outcomes: a prospective observational study from rural North India

OBJECTIVES

To assess the difficulties faced by the pregnant women in seeking appropriate antenatal care due to the restrictions imposed during the COVID-19 pandemic; assess the difficulties encountered during delivery and postpartum period; the suitability of the teleconsultation services offered; effect of COVID-19 infection on pregnancy outcomes and the effect of restrictions on the nutrition profile of the pregnant women.

DESIGN

Prospective observational study.

SETTING AND PARTICIPANTS

We included 1374 pregnant women from the rural areas of three districts of Punjab, India registered at government health centres before the implementation of lockdown due to the COVID-19 pandemic on 24 March 2020.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was the difficulties faced by the women during their pregnancies due to restrictions imposed during the lockdown. The secondary outcomes included the effect of COVID-19 infections on pregnancy outcomes, satisfaction from the telemedicine services and restrictions on the nutrition profile of the pregnant women.

RESULTS

One-third of the women (38.4%) considered their last pregnancy unplanned. Women faced difficulties due to the restrictions in getting adequate nutrition (76.5%), accessing transportation facilities (35.4%), consultations from doctors (22.4%) or getting an ultrasonography scan (48.7%). One-fifth (21.9%) of women could not access safe abortion services. Only 3.6% of respondents ever took any teleconsultation services offered by the government. Most of them felt unsatisfied compared with routine visits (77.5%). COVID-19-infected women were primarily asymptomatic (76.1%), but there was a high incidence of preterm birth (42.8%). Frontline workers could visit 64.3% of the women in the postpartum period despite restrictions.

CONCLUSIONS

Lockdown compromised the antenatal care in our study area while the frontline workers attempted to minimise the inconvenience. Telemedicine services did not prove to be of many benefits to pregnant women and should only work as a supplement to the existing protocols of antenatal care.

Assessment of practice of Covid-19 preventive measures and associated factors among residents in Southern, Ethiopia

INTRODUCTION

Coronavirus (Covid-19) is a respiratory disease mostly affecting old aged and those with comorbidities. Due to resource constraints in developing countries, control of Covid-19 was based on preventive measures. However, there is variation in adherence to these precautionary measures from place to place among communities. Therefore, this study assessed the practice of Covid-19 preventive measures and associated factors among residents of Southern, Ethiopia.

METHODS

A community-based cross-sectional study was employed on residents of Southern, Ethiopia. Interviewer administered questionnaire was used to collect data from households through systematic random sampling methods. Data was entered, coded, and analyzed using STATA version 16. Logistic regression analysis was used to explore the association between outcome variables and predictor variables. Finally, the interpretation of Adjusted Odds ratio (AOR) with 95% Confidence Interval (CI) and p-value was done for statistically significant factors of Covid-19 preventive measures practice.

RESULTS

The proportion of residents who had good practice of Covid-19 preventive measures was 31.3% (95% CI: 26.5, 36.1). Out of 364 residents, 264 (72.5%) used facemasks, 218 (59.9%) washed their hands frequently, 167 (45.9%) practiced social distancing, 135 (37.1%) stayed at home, 75 (18.1%) avoided handshaking and 228 (62.6%) used hand sanitizer. Following government directions (AOR = 225; 95% CI: 68.6, 738), good knowledge about Covid-19 (AOR = 3.47; 95% CI: 1.12, 10.73), having access to water supply (AOR = 2.92; 95% CI: 1.05, 8.18), belief towards protectiveness of preventive measure (AOR = 3.53; 95% CI: 1.08, 11.61) and chronic illness (AOR = 5.09; 95% CI: 1.44, 17.96) were significantly associated with practice of Covid-19 preventive measures.

CONCLUSION

In this study, the proportion of residents practicing Covid-19 preventive measures was low. Having comorbidity, following government directions, knowledge about Covid-19 and access to water supply were significantly associated with Covid-19 preventive measures practice. Therefore, government and all concerned stakeholders should increase the accessibility of infrastructure and provide continuous awareness creation campaigns regarding Covid-19 mode of transmission, sign and symptom, and protectiveness of Covid-19 preventive measures. Moreover, dissemination of teaching aids using local languages and close monitoring of community compliance to Covid-19 preventive measures is crucial.

Compliance with COVID-19 Preventive Measures and Associated Factors Among Women Attending Antenatal Care at Public Health Facilities of Debre Berhan Town, Ethiopia

BACKGROUND

Coronavirus disease-2019 (COVID-19) is a highly contagious and cause for the death of many people worldwide. Due to physiological immunosuppressive state and mechanical alteration, pregnant women are at a higher risk of severe illness and adverse maternal and fetal outcomes from COVID-19 than non-pregnant women. Compliance with the preventive measures is essential to control COVID-19 related consequences. Therefore, this study aimed to assess compliance with COVID-19 preventive measures among pregnant women attending antenatal care at public facilities of Debre Berhan town, Ethiopia.

METHODS

A facility-based cross-sectional study was conducted from May 1 to 30, 2021 among 402 pregnant mothers. Data were collected via a face-to-face interviewer-administered questionnaire. Then, entered into Epi-Data version 4.6 and exported to SPSS version 25 for data analysis. In multivariable logistic regression analysis, variables with p < 0.05 were declared as statistically significant and the strength of statistical association was measured by adjusted odds ratio (AOR) and 95% confidence interval (CI).

RESULTS

Of the total 396 participants, 222 (56.1%) of women had a good compliance with COVID-19 preventive measures. Maternal age (25-34 years) [AOR: 1.926; 95% CI (1.084, 3.421)] and (≥35 years) [AOR: 3.018; 95% CI (1.53, 5.952)], husband educational status [AOR: 3.68; 95% CI (1.55, 8.737)], had current chronic disease [AOR: 2.516; 95% CI (1.297, 4.883)], and knowledge [AOR: 5.484; 95% CI (3.057, 9.838)] were significant predictors to have good compliance with COVID-19 preventive measures.

CONCLUSION

Although COVID-19 is a global and national agenda, compliance towards its preventive measures was not sufficient enough. Therefore, scale-up the community awareness via media campaign is crucial which will eventually improve compliance. Furthermore, those women who had no pre-existing chronic diseases and those in the young age group should be given special consideration.