Examining Psychosocial Factors and Community Mitigation Practices to Limit the Spread of COVID-19: Evidence from Nigeria

Assessing COVID-19 Pandemic-Era Vaccine Uptake and Adherence to Prevention Measures: A Comparative Analysis Among Men and Women Using Lot Quality Assurance Sampling in Central Uganda

Aim

This study examined citizens' knowledge and compliance with COVID-19 standard operating procedures (SOPs), vaccine acceptance and hesitancy, and factors that could influence these behaviors.

Methods

The study that utilised the Lot Quality Assurance Sampling (LQAS) approach was conducted in eight districts of Central Uganda; Kiboga, Kyankwanzi, Mubende, Kasanda, Mityana, Luwero, Nakaseke, and Nakasongola districts. Each district was divided into five supervision areas (SAs). Data were collected from 19 respondents per SA, focusing on women aged 15-49 years and men aged 15 years and above. A satisfactory performance for study indicators was determined by the LQAS decision rules.

Results

There was high awareness of COVID-19, with 98.2% of women and 99.3% of men having heard of the pandemic. However, knowledge of at least four COVID-19 preventive measures was low, reported by only 45.4% of women and 48.6% of men. Adherence to social distancing measures in the previous 24 hours was modest, with 67.2% of men and 66.5% of women complying. There was a pronounced lack of hand hygiene, with only 24.8% of women and 19.0% of men frequently washing their hands or using hand sanitizer. COVID-19 vaccine uptake was relatively high for the first dose, with 83.5% of women and 83.0% of men receiving at least one dose. However, full vaccination coverage was low, at 37.5% for women and 41.5% for men. A hesitancy to get vaccinated was driven by fear of side effects, misinformation, doubts about vaccine effectiveness, long distances and queues, and beliefs that vaccines cause infertility.

Conclusion

While awareness of COVID-19 was high, knowledge of preventative measures was lacking. The low vaccination rates highlight barriers to uptake. A tailored, trust-based messaging approach through community leaders was recommended to address these gaps. Inter-district and inter-SA disparities indicated the need for localized interventions.

Impact of Covid -19 incidence rate and government-initiated risk communication measures on individual's NPI practices

BACKGROUND

Non-pharmaceutical interventions (NPI) are the most widely recognized public health measures recognized globally to prevent the spread of Covid-19. NPIs' effectiveness may depend on the type, combination of applied interventions, and the level of proper public compliance with the NPIs. The expected outcome of behavioural practices varies relative to the intervention duration.

OBJECTIVES

This study aimed to assess the trend of community compliance to NPI with Covid-19 incidence and government-initiated interventions, and its variation by residence and sociodemographic characteristics of people.

METHODS

A weekly non-participatory field survey on individuals' NPI practices was observed from the 41st epidemiological week of October 5th, 2020, to the 26th epidemiological week of July 4th, 2021, a total of 39 weeks. The survey covered all 14 regional and national capital cities in Ethiopia. Data collection for the three NPI behaviours (i.e., respiratory hygiene, hand hygiene, and physical distance) was managed weekly at eight public service locations using the Open Data Kit (ODK) tool. The Covid- 19 incidence data and public health measures information from August 3rd, 2020 to July 4th, 2021 were obtained from the Ethiopian Public Health Institute (EPHI).

RESULTS

More than 180,000 individuals were observed for their NPI practice, with an average of 5,000 observations in a week. About 43% of the observations were made in Addis Ababa, 56% were male and 75% were middle age group (18-50 years). The overall level of NPI compliance was high at the beginning of the observation then peaked around the 13th- 15th epidemiological weeks then declined during the rest of the weeks. The peak NPI compliance periods followed the high Covid-19 death incidence and government-initiated intensive public health measures weeks. Respiratory hygiene had the highest compliance above 41% whereas hand hygiene was the lowest (4%). There was a significant difference between residents of the capital city and regional cities in their level of compliance with NPI. Females comply more than males, and individuals had increased NPI compliance at the bank service and workplaces compared to those in the transport services at P = 0.000.

CONCLUSION

An increased level of compliance with NPI was observed following intensive government-initiated Covid-19 prevention measures and an increased Covid-19 death incidence. Therefore, the intensity of government-initiated risk communication and public advocacy programs should be strengthened, possibly for similar respiratory disease pandemics in the future.

Leveraging lessons from the COVID-19 pandemic to strengthen low-income and middle-income country preparedness for future global health threats

Although the global COVID-19 pandemic response was quick to develop medical countermeasures, it failed to fully prevent morbidity and mortality in high-income countries and low-income and middle-income countries (LMICs). As new variants and post-COVID-19 condition continue to emerge and affect health systems and economies, the full human and economic cost is yet to be felt. We should now learn from these shortcomings and implement more inclusive and equitable frameworks to prevent and respond to outbreaks. This Series offers specific learnings from COVID-19 vaccination campaigns and non-pharmaceutical interventions, highlighting the need for resilient, inclusive, and equitable health systems. Taking action to rebuild trust and invest in resilient local manufacturing capacity, supply chains, regulatory frameworks, and placing LMIC voices at the centre of decision making will help to ensure preparedness for future threats. It is time to move beyond mere talk of learning and implementing lessons and instead take action towards a more resilient future.

The effect of non-pharmaceutical interventions on COVID-19 outcomes: A heterogeneous age-related generalisation of the SEIR model

Successive generalisations of the basic SEIR model have been proposed to accommodate the different needs of the organisations handling the SARS-CoV-2 epidemic and the assessment of the public health measures adopted and named under the common umbrella of Non-Pharmaceutical Interventions (NPIs). So far, these generalisations have not been able to assess the ability of these measures to avoid infection by the SARS-CoV-2 and thus their contribution to contain the spread of the disease. This work proposes a new generalisation of SEIR model and includes a heterogeneous and age-related generation of infections that depends both on a probability that a contact generates the transmission of the disease and a contact rate. The results show (1) thanks to the universal wearing of facial coverings, the probability that a contact provokes the transmission of the disease was reduced by at least 50% and (2) the impact of the other NPI is so significant that otherwise Portugal would have gone into a non-sustainable situation of having 80% of its population infected in the first 300 days of the pandemic. This situation would have led to a number of deaths almost twenty times higher than the number that was actually recorded by December 26th, 2020. Moreover, the results suggest that even if the requirement of universal wearing of facial coverings was adopted sooner jointly with closing workplaces and resorting to teleworking would have postponed the peak of the incidence, altought the epidemic path would have result in a number of infections hardly managed by the National Health System. Complementary, results confirm that (3) the health authorities adopted a conservative approach on the criteria to consider an infected individual not infective any longer; and (4) the most effective NPIs and stringency levels either impacting on self-protection against infection or reducing the contacts that would eventually result in infection are, in decreasing order of importance, the use of Facial coverings, Workplace closing and Stay at home requirements.