Factors associated with COVID-19 infections and mortality in Africa: a cross-sectional study using publicly available data

IntroductionThe current COVID-19 pandemic is a global threat. This elicits questions on the level of preparedness and capacity of health systems to respond to emergencies relative to other parts of the world.MethodsThis cross-sectional study uses publicly available core health data for 53 African countries to determine risk factors for cumulative COVID-19 deaths and cases per million in all countries in the continent. Descriptive statistics were determined for the indicators, and a negative binomial regression was used for modelling the risk factors.ResultsIn sub-Saharan Africa, an increase in the number of nursing and midwifery personnel decreased the risk of COVID-19 deaths (p=0.0178), while a unit increase in universal healthcare (UHC) index of service coverage and prevalence of insufficient physical activity among adults increased the risk of COVID-19 deaths (p=0.0432 and p=0.0127). An increase in the proportion of infants initiating breast feeding reduced the number of cases per million (p<0.0001), while an increase in higher healthy life expectancy at birth increased the number of cases per million (p=0.0340).ConclusionDespite its limited resources, Africa’s preparedness and response to the COVID-19 pandemic can be improved by identifying and addressing specific gaps in the funding of health services delivery. These gaps impact negatively on service delivery in Africa, which requires more nursing personnel and increased UHC coverage to mitigate the effects of COVID-19.

Download Full-text

Correlation between prevalence and socio-demographic, knowledge and risk factors of soil transmitted helminthiases: cross-sectional study among primary school-going children in Rarieda, Kenya

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20202965 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2455

Author(s):

Stephen Onyango Arwa ◽

Dominic Mogere ◽

David Musoke

Keyword(s):

Risk Factors ◽

Primary School ◽

Ethical Issues ◽

Statistical Significance ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Primary School Children ◽

Sectional Study ◽

Cross Sectional ◽

Soil Transmitted Helminthiasis

Background: Soil transmitted helminthiasis, classified as neglected tropical diseases are among the most common infections worldwide with greatest numbers occurring in Sub-Saharan Africa, Americas, China and East Asia. Globally, over two billion people are infected with school-age children bearing the greatest burdens. Transmission is through eggs present in human faeces. They are infections of public health importance as they cause among others, nutritional impairment, diarrhoea and intestinal obstruction. Prevention involves deworming, health education and sanitation.Methods: The study was carried out in Rarieda, Kenya in 2018. Study participants were primary school children of ages seven to fifteen. Cross sectional study design was used and the data was analyzed using Statistical Package for Social Sciences. All the ethical issues were adhered to as per the International standards.Results: The study established that prevalence of soil transmitted helminthiasis was high in areas where the risk factors associated with the infections were high. Pupils who were more knowledgeable on soil transmitted helminthiases were less infected. Younger pupils were more infected than older pupils. Lastly, the prevalence of these infections varied with gender of the pupils, and geographical location from where the pupils came from.Conclusions: Correlation between prevalence of soil transmitted helminthiases and risk factors, and between presence of toilets and level of hygiene practice were positive, r=0.90 and 0.93 respectively; while correlation between prevalence of soil transmitted helminthiases and knowledge was negative, r=-0.75. Values of the correlations were of statistical significance at p<0.05.

Download Full-text

Determinants of knowledge, attitudes, and practices of front-line health workers during the first wave of COVID-19 in Africa: a multi-center online cross-sectional study

10.21203/rs.3.rs-1164116/v1 ◽

2021 ◽

Author(s):

Larrey Kasereka Kamabu ◽

Hervé Monka Lekuya ◽

Richard Newton Iranya ◽

Bienvenu Muhindo Kasusula ◽

Franck Katembo Sikakulya ◽

...

Keyword(s):

Health Workers ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Sectional Study ◽

Front Line ◽

African Countries ◽

Cross Sectional ◽

Poor Knowledge ◽

Attitude And Practice ◽

Good Attitude

Abstract Background: During its first wave of COVID-19 infection in sub-Saharan Africa, there was insufficient understanding of the pandemic among front-line health care professionals that has led to a misidentification, and mistreatment of affected patients, with a potential risk of contracting and spreading the disease. This study was carried out to determine the Knowledge, attitude, and practices (KAP) of front-line health workers (HWs) towards COVID-19 in Africa and their related factors.Methods: This was a multi-centers online cross-sectional study conducted over a 3-months study-period using a google survey link among front lines HWs involved in the COVID-19 response in 26 African countries. Chi-square test & logistic regression were used in the bivariate and multivariate analysis respectively to assess determinants of KAP. Statistical analysis was done using STATA version 16; all tests were two-sided with 95% confidence interval. Results: Five hundred and seventeen (517, 96.3%) consented to participate in this study from 26 African countries; 289 (55.9%) were male and 228 (44.1%) female. Overall, most of HWs, 379 (73.3%) showed poor knowledge about COVID-19 infection and preventive measures. In contrast, majority of them showed good attitude (89%) and practice (90.3%) towards prevention of COVID-19 infections. Knowledge varied among countries; Uganda had the greatest number of HWs with good knowledge. (OR = 28.09, p <0.0001) followed by Ghana (OR=10.92, p=0.001) and DRC (OR: 4.59, p=0.015). The cadre of HWs also influenced knowledge; doctors were the most knowledgeable as compared to other cadres (OR: 3.4, p= 0.005). Additionally, knowledge increased with increasing HWs’ education level (p=0.011).Attitude and practice were both influenced by HWs country of workplace (p=0.05 & p< 0.0001 respectively) and their cadre (p = 0.025 & p < 0.0001 respectively).Conclusions: Majority of the front-line HWs in the African region had an overall good attitude and practice towards COVID-19 infection and practice measures despite relatively poor Knowledge. The KAP is influenced by HWs country of workplace, their cadre and level of education.

Download Full-text

Prevalence and correlates of traditional risk factors for cardiovascular disease in a Nigerian ART-naive HIV population: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2017-019664 ◽

2018 ◽

Vol 8 (7) ◽

pp. e019664 ◽

Cited By ~ 5

Author(s):

Udeme E Ekrikpo ◽

Effiong E Akpan ◽

John U Ekott ◽

Aminu K Bello ◽

Ikechi G Okpechi ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Density Lipoprotein ◽

Integrated Approach ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Sectional Study ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Cross Sectional

ObjectivesHIV infection environment presents a classic example of the interplay between infectious diseases and non-communicable diseases (NCDs). Traditional cardiovascular disease (CVD) risk factors abound in the HIV population even before initiation of antiretrovirals (ARVs) and predispose them to the development of stroke and myocardial infarction. This work focuses on determining the prevalence of traditional CVD risk factors among ARV-naive HIV individuals in southern Nigeria.MethodsThis was a cross-sectional study of ARV-naive patients initiating care at the University of Uyo Teaching Hospital HIV clinic cohort to determine the prevalence and correlates of hypertension, diabetes mellitus (DM), obesity and dyslipidaemia.ResultsThe sample consisted of 4925 assessed for hypertension, 5223 for obesity, 1818 for DM and 926 for dyslipidaemia. Hypertension prevalence was 26.7% (95% CI 25.5% to 28.0%) with a male preponderance (p=0.02). DM was found in 5.6% (95% CI 4.5% to 6.7%), obesity in 8.3% (95% CI 7.6% to 9.1%) and dyslipidaemia in 29.1% (95% CI 26.1% to 32.1%) with a high prevalence of low high-density lipoprotein-c (42.6%). Hypertension was independently associated with age (OR 1.04 (95% CI 1.03 to 1.05), p<0.001) and body mass index (BMI) (OR 1.06 (95% CI 1.03 to 1.08), p<0.001), obesity with age (OR 1.02 (95% CI 1.01 to 1.03), p<0.001), male gender (OR 0.38 (95% CI 0.29 to 0.49), p<0.001) and CD4 count (OR 2.63 (95% CI 1.96 to 3.53), p<0.001) while dyslipidaemia was associated with BMI (OR 1.05 (95% CI 1.01 to 1.10), p=0.03).ConclusionThe prevalence of traditional CVD risk factors is high in this ART-naive HIV population. An integrated approach of HIV and NCD screening/treatment may be relevant for centres in sub-Saharan Africa.

Download Full-text

Potential Risk Factors for Length of Hospitalization in COVID-19 Patients: A Cross-sectional Study

Health Scope ◽

10.5812/jhealthscope.115575 ◽

2021 ◽

Vol 10 (4) ◽

Author(s):

Elaheh Talebi-Ghane ◽

Salman Khazaei ◽

Leili Tapak ◽

Ali Reza Soltanian ◽

Saeed Bashirian ◽

...

Keyword(s):

Risk Factors ◽

Length Of Stay ◽

Potential Risk ◽

Negative Binomial ◽

Cross Sectional Study ◽

Medical Laboratory ◽

Sectional Study ◽

Cross Sectional ◽

Hospital Beds ◽

Potential Risk Factors

Background: Identifying the potential risk factors of the length of stay in hospital (LOSH) in COVID-19 patients could help the health system meet future demand for hospital beds. Objectives: This study aimed to determine the factors affecting the length of stay in hospital in COVID-19 patients in Hamadan, the west of Iran. Methods: This cross-sectional study recruited 512 hospitalized COVID-19 patients in Hamadan city. Demographic, clinical, and medical laboratory characteristics of the patients and their survival status were assessed by a checklist. Univariate and multiple negative binomial regressions were used by Stata 12. Results: The median hospitalization length for COVID-19 patients was five days (range: 0 to 47). In the discharged patients, the adjusted incidence rate ratios (95% CI) of LOSH for females, rural residents, patients with a history of diabetes and cardiovascular disease, SPO2 less than 88%, prothrombin time higher than 13 s, platelet count lower than 130 × 1000 µL, blood sugar higher than 105 mg/dL, and intensive care unit experience were 1.16 (1.03, 1.44), 1.22 (1.03, 1.44), 1.43 (1.07, 1.92), 1.41 (1.23, 1.61), 0.82 (0.71, 0.93), 1.32 (1.11, 1.56), 1.18 (1.03, 1.36), and 1.85 (1.59, 2.17) compared to their references, respectively. Conclusions: Our study added new insight into LOSH determining factors that could be used for future planning in combating the need for hospital beds. The present study revealed that some demographic, social, and clinical variables could increase the IRR of a more extended hospital stay.

Download Full-text

Psychological distress among Ethiopian migrant returnees who were in quarantine in the context of COVID-19: institution-based cross-sectional study

BMC Psychiatry ◽

10.1186/s12888-021-03429-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kassahun Habtamu ◽

Yekoyealem Desie ◽

Mulat Asnake ◽

Endirias Gina Lera ◽

Temesgen Mequanint

Keyword(s):

Psychological Distress ◽

Depressive Symptoms ◽

Negative Binomial ◽

Addis Ababa ◽

Negative Binomial Regression ◽

Cross Sectional Study ◽

Anxiety Symptoms ◽

Sectional Study ◽

Cross Sectional ◽

Stress Symptoms

Abstract Background In association with the novel coronavirus (SARS-CoV-2) disease 2019 (COVID-19) pandemic, many numbers of Ethiopian migrants are returning to their home country, and they are required to stay in mandatory quarantine centers. This results in severe disruptions of life routines, social isolation, and loss of freedom. Studies on psychological distress among Ethiopian migrant returnees in the context of COVID-19 are scarce. This study aimed to investigate the prevalence of psychological distress and associated factors among migrant returnees who were in quarantine during the time of COVID-19. Methods A cross-sectional study was conducted with 405 migrant returnees recruited from quarantine centers in Addis Ababa. We developed a structured questionnaire to collect data on sociodemographic, migration related, quarantine related and COVID-19 related characteristics of participants. We used the 21 item Depression, Anxiety and Stress Scale to assess psychological distress. Univariate and multivariable negative binomial regression models were fitted to assess the association between exposure variables with depression, anxiety and stress separately. Results A little more than half of the participants (55%) had depressive symptoms; around half had anxiety symptoms (48.9%) and more than a third (35.6%) experienced symptoms of stress. We found significantly higher prevalence of anxiety (ARR = 0.59; 95% CI = 0.39, 0.91) and depressive symptoms (ARR = 0.56; 95% CI = 0.39, 0.81) among women than men. Fear of discrimination after the quarantine was significantly associated with depressive (ARR = 0.76; 95% CI = 0.63, 0.92) and anxiety symptoms (ARR = 0.77; 95% CI = 0.62, 0.97). Experiencing COVID-19 like symptoms is associated with depressive (ARR = 0.40; 95% CI = 0.25, 0.65), anxiety (ARR = 0.35; 95% CI = 0.20, 0.62) and stress symptoms (ARR = 0.43; 95% CI = 0.28, 0.66). Have no a plan of what to do after the quarantine (ARR = 1.30; 95% CI = 1.09, 1.54) was significantly associated with increasing stress scores. Conclusions We found a very high prevalence of depressive, anxiety and stress symptoms among Ethiopian migrant returnees who were in quarantine due to the COVID-19 pandemic. Screening, integration of mental health services with other socioeconomic and psychosocial services, and effective and efficient referral may be useful to address the burden of psychological distress in this group.

Download Full-text

Clinical and Inflammatory Features of Exacerbation-Prone Asthma: A Cross-Sectional Study Using Multidimensional Assessment

Respiration ◽

10.1159/000510793 ◽

2020 ◽

pp. 1-13

Author(s):

Min Feng ◽

Xin Zhang ◽

Wen Wen Wu ◽

Zhi Hong Chen ◽

Brian G. Oliver ◽

...

Keyword(s):

Severe Asthma ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Cross Sectional Study ◽

Upper Respiratory Tract ◽

Sectional Study ◽

Cross Sectional ◽

Multidimensional Assessment ◽

Sputum Eosinophils ◽

Adjusted Rate

Background: Reducing asthma exacerbations is a major target of current clinical guidelines, but identifying features of exacerbation-prone asthma (EPA) using multidimensional assessment (MDA) is lacking. Objective: To systemically explore the clinical and inflammatory features of adults with EPA in a Chinese population. Methods: We designed a cross-sectional study using the Severe Asthma Web-based Database from the Australasian Severe Asthma Network (ASAN). Eligible Chinese adults with asthma (n = 546) were assessed using MDA. We stratified patients based on exacerbation frequency: none, few (1 or 2), and exacerbation prone (≥3). Univariate and multivariable negative binomial regression analyses were performed to investigate features associated with the frequency of exacerbations. Results: Of 546 participants, 61.9% had no exacerbations (n = 338), 29.6% had few exacerbations (n = 162), and 8.4% were exacerbation prone (n = 46) within the preceding year. EPA patients were characterized by elevated blood and sputum eosinophils but less atopy, with more controller therapies but worse asthma control and quality of life (all p < 0.05). In multivariable models, blood and sputum eosinophils (adjusted rate ratio = 2.23, 95% confidence interval = [1.26, 3.84] and 1.67 [1.27, 2.21], respectively), FEV1 (0.90 [0.84, 0.96]), bronchodilator responsiveness (1.16 [1.05, 1.27]), COPD (2.22 [1.41, 3.51]), bronchiectasis (2.87 [1.69, 4.89]), anxiety (2.56 [1.10, 5.95]), and depression (1.94 [1.20, 3.13]) were found. Further, upper respiratory tract infection (1.83 [1.32, 2.54]) and food allergy (1.67 [1.23, 2.25]) were at high risk of asthma symptom triggers. Conclusion: EPA is a clinically recognizable phenotype associated with several recognizable traits that could be addressed by targeted treatment.

Download Full-text

Burden of depressive symptoms and non-alcohol substance abuse; and their association with alcohol use and partner violence: a cross-sectional study in four sub-Saharan Africa countries

Global Mental Health ◽

10.1017/gmh.2018.22 ◽

2018 ◽

Vol 5 ◽

Cited By ~ 3

Author(s):

F. Bajunirwe ◽

S. Maling ◽

H.-O. Adami ◽

I. O. Ajayi ◽

J. Volmink ◽

...

Keyword(s):

Risk Factors ◽

Substance Abuse ◽

Depressive Symptoms ◽

Alcohol Use ◽

Partner Violence ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Sectional Study ◽

Cross Sectional ◽

Sub Saharan

In sub-Saharan Africa, there are limited data on burden of non-alcohol substance abuse (NAS) and depressive symptoms (DS), yet potential risk factors such as alcohol and intimate partner violence (IPV) are common and NAS abuse may be the rise. The aim of this study was to measure the burden of DS and NAS abuse, and determine whether alcohol use and IPV are associated with DS and/or NAS abuse. We conducted a cross-sectional study at five sites in four countries: Nigeria (nurses), South Africa (teachers), Tanzania (teachers) and two sites in Uganda (rural and peri-urban residents). Participants were selected by simple random sampling from a sampling frame at each of the study sites. We used a standardized tool to collect data on demographics, alcohol use and NAS use, IPV and DS and calculated prevalence ratios (PR). We enrolled 1415 respondents and of these 34.6% were male. DS occurred among 383 (32.3%) and NAS use among 52 (4.3%). In the multivariable analysis, being female (PR = 1.49, p = 0.008), NAS abuse (PR = 2.06, p = 0.02) and IPV (PR = 2.93, p < 0.001) were significantly associated with DS. Older age [odds ratio (OR) = 0.31, p < 0.001)], female (OR = 0.48, p = 0.036) were protective of NAS but current smokers (OR = 2.98, p < 0.001) and those reporting IPV (OR = 2.16, p = 0.024) were more likely to use NAS. Longitudinal studies should be done to establish temporal relationships with these risk factors to provide basis for interventions.

Download Full-text

Effect of weather on GP home visits: a cross-sectional study

British Journal of General Practice ◽

10.3399/bjgp19x702257 ◽

2019 ◽

Vol 69 (683) ◽

pp. e430-e436 ◽

Cited By ~ 2

Author(s):

Olaoluwa Oyawoye ◽

Louise Marston ◽

Melvyn Jones

Keyword(s):

Negative Binomial ◽

Home Visits ◽

Negative Binomial Regression ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Temporal Variables ◽

Binomial Regression ◽

Day Of The Week ◽

The Uk

BackgroundGPs in the UK conduct >13 million home visits each year. The visits, which are resource intensive, are usually to the frailest patients who are least resilient to adverse weather.AimTo explore the relationship between meteorological variables (temperature, rainfall, sunshine) and temporal variables (day of the week, season) with GP home visits (HVs).Design and settingA cross-sectional study using data provided by Herts Urgent Care for its GP acute in-hours visiting service and UK Meteorological (Met) Office weather data for the Herts & South East region of the UK.MethodThe association between the number of GP HVs and weather and temporal variables was explored using univariable and multivariable negative binomial regression.ResultsThere was a significant 0.4% decrease in HVs per degrees Celsius increase in minimum temperature (incidence rate ratio [IRR] 0.996, 95% confidence interval [CI] = 0.993 to 0.999), and a 0.4% decrease per hour increase in sunshine (IRR 0.996, 95% CI = 0.992 to 1.000), as well as significant decreases in weekday HVs compared with Mondays (Thursday IRR 0.824, 95% CI = 0.790 to 0.859). There were 6.2% fewer HVs in summer compared with winter (IRR 0.938, 95% CI = 0.902 to 0.975). Multivariable negative binomial regression showed non-significant relationships between meteorological variables and HVs, but a significant day-of-the-week relationship.ConclusionGP HVs increased on cold days and fell on sunnier days. The effect sizes were small so it is unlikely that there is any clinically significant effect of weather on HVs in this acute GP visit setting. A tentative conclusion might also be that GPs in this system can deliver care to frail housebound patients in most weather conditions.

Download Full-text

Individual, maternal and household risk factors for anaemia among young children in sub-Saharan Africa: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2017-019654 ◽

2018 ◽

Vol 8 (5) ◽

pp. e019654 ◽

Cited By ~ 18

Author(s):

Peter P Moschovis ◽

Matthew O Wiens ◽

Lauren Arlington ◽

Olga Antsygina ◽

Douglas Hayden ◽

...

Keyword(s):

Risk Factors ◽

Young Children ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Sectional Study ◽

Cross Sectional ◽

Sub Saharan

Download Full-text

PRRSV: Risikofaktoren und Herdenprävalenz in Deutschland

Tierärztliche Praxis Ausgabe G Großtiere / Nutztiere ◽

10.1055/a-0867-8990 ◽

2019 ◽

Vol 47 (02) ◽

pp. 132-132

Author(s):

Sebastian Ganz

Keyword(s):

Risk Factors ◽

Cross Sectional Study ◽

Respiratory Syndrome Virus ◽

Sectional Study ◽

Cross Sectional ◽

Klinische Symptome

Nathues C, Janssen E, Duengelhoef A et al. Cross-sectional study on risk factors for Porcine Reproductive and Respiratory Syndrome virus sow herd instability in German breeding herds. Acta Vet Scand 2018; 60 (1): 1–8 In mit PRRSV (Porcine Reproductive and Respiratory Syndrom Virus) infizierten Schweinebeständen zeigen die Tiere oftmals ernsthafte klinische Symptome. Die Schwere der Symptomatik hängt von der Virulenz der jeweiligen Virusstämme ab. Deshalb ist die Impfung gegen diesen Erreger sinnvoll und wird empfohlen, auch wenn sie nicht immer klinische Fälle verhindert bzw. das Virus vollends eliminiert. Aufgrund dessen rückt die Prävention durch Verbesserung der innerbetrieblichen Abläufe zunehmend in den Fokus. Um solche Maßnahmen erfolgreich etablieren zu können, ist es wichtig, den epidemiologischen Status der Herde und mögliche Risikofaktoren zu kennen. Ziel der Studie war deshalb, die Prävalenz der Infektion in Sauenbetrieben in Norddeutschland zu eruieren und verschiedene Arbeitsabläufe hinsichtlich des Risikos der Erregerverbreitung zu untersuchen.

Download Full-text