Browsing by Author "Hemler, Elena C."

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    Covid-19 preventive practices, psychological distress, and reported barriers to healthcare access during the pandemic among adult community members in sub-Saharan Africa: a phone survey
    (American Society of Tropical Medicine and Hygiene, 2022) Assefa, Nega; Abdullahi, Yasir Y.; Hemler, Elena C.; Lankoande, Bruno; Madzorera, Isabel; Wang, Dongqing; Ismail, Abbas; Chukwu, Angela; Workneh, Firehiwot; Mapendo, Frank; Millogo, Ourohire; Abubakari, Sulemana Watara; Febir, Lawrence Gyabaa; Lyatuu, Isaac; Dianou, Kassoum; Baernighausen, Till; Soura, Abdramane; Asante, Kwaku Poku; Smith, Emily; Vuai, Said; Worku, Alemayehu; Killewo, Japhet; Mwanyika-Sando, Mary; Berhane, Yemane; Sie, Ali; Tajudeen, Raji; Oduola, Ayo; Fawzi, Wafaie W.
    The COVID-19 pandemic has had serious negative health and economic impacts in sub-Saharan Africa. Continuous monitoring of these impacts is crucial to formulate interventions to minimize the consequences of COVID-19. This study surveyed 2,829 adults in urban and rural sites among five sub-Saharan African countries: Burkina Faso, Ethiopia, Nigeria, Tanzania, and Ghana. Participants completed a mobile phone survey that assessed self-reported sociodemographic, COVID-19 preventive practices, psychological distress, and barriers to healthcare access. A modified Poisson regression model was used to estimate adjusted prevalence ratios (aPRs) and 95% CIs to investigate potential factors related to psychological distress and barriers to reduced healthcare access. At least 15.6% of adults reported experiencing any psychological distress in the previous 2 weeks, and 10.5% reported that at least one essential healthcare service was difficult to access 2 years into the pandemic. The majority of participants reported using several COVID-19 preventive methods, with varying proportions across the sites. Participants in the urban site of Ouagadougou, Burkina Faso (aPR: 2.29; 95% CI: 1.74–3.03) and in the rural site of Kintampo, Ghana (aPR: 1.68; 95% CI: 1.21–2.34) had a higher likelihood of experiencing any psychological distress compared with those in the rural area of Nouna, Burkina Faso. Loss of employment due to COVID-19 (aPR: 1.77; 95% CI: 1.47–2.11) was also associated with an increased prevalence of psychological distress. The number of children under 5 years in the household (aPR: 1.23; 95% CI: 1.14–1.33) and participant self-reported psychological distress (aPR: 1.83; 95% CI: 1.48–2.27) were associated with an increased prevalence of reporting barriers to accessing health services, whereas wage employment (aPR: 0.67; 95% CI: 0.49–0.90) was associated with decreased prevalence of reporting barriers to accessing health services. Overall, we found a high prevalence of psychological distress and interruptions in access to healthcare services 2 years into the pandemic across five sub-Saharan African countries. Increased effort and attention should be given to addressing the negative impacts of COVID-19 on psychological distress. An equitable and collaborative approach to new and existing preventive measures for COVID-19 is crucial to limit the consequences of COVID-19 on the health of adults in sub-Saharan Africa.
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    COVID-19 vaccine hesitancy and its determinants among Sub-Saharan African adolescents
    (PLOS, 2022) Wang, Dongqing; Chukwu, Angela; Mwanyika-Sando, Mary; Abubakar, Sulemana Watara; Assef, Nega; Madzorera, Isabel; Hemler, Elena C.; Ismai, Abbas; Lankoande, Bruno; Mapendo, Frank; Millogo, Ourohire´; Workneh, Firehiwot; Azemraw, Temesgen; Febir, Lawrence Gyabaa; James, Christabel; Tinkasimile, Amani; Asant, Kwaku Poku; Baernighausen, Till; Berhane, Yemane; Killewo, Japhet; Oduola, Ayoade M. J.; Sie, Ali; Smith, Emily R.; Soura, Abdramane Bassiahi; Raj, Tajudeen; Vuai, Said; Fawzi, Wafaie W.
    COVID-19 vaccine hesitancy among adolescents poses a challenge to the global effort to control the pandemic. This multi-country survey aimed to assess the prevalence and determinants of COVID-19 vaccine hesitancy among adolescents in sub-Saharan Africa between July and December 2021. The survey was conducted using computer-assisted telephone interviewing among adolescents in five sub-Saharan African countries, Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania. A rural area and an urban area were included in each country (except Ghana, which only had a rural area), with approximately 300 adolescents in each area and 2662 in total. Sociodemographic characteristics and perceptions and attitudes on COVID-19 vaccines were measured. Vaccine hesitancy was defined as definitely not getting vaccinated or being undecided on whether to get vaccinated if a COVID-19 vaccine were available. Log-binomial models were used to calculate the adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for associations between potential determinants and COVID-19 vaccine hesitancy. The percentage of COVID-19 vaccine hesitancy was 14% in rural Kersa, 23% in rural Ibadan, 31% in rural Nouna, 32% in urban Ouagadougou, 37% in urban Addis Ababa, 48% in rural Kintampo, 65% in urban Lagos, 76% in urban Dar es Salaam, and 88% in rural Dodoma. Perceived low necessity, concerns about vaccine safety, and concerns about vaccine effectiveness were the leading reasons for hesitancy. Healthcare workers, parents or family members, and schoolteachers had the greatest impacts on vaccine willingness. Perceived lack of safety (aPR: 3.52; 95% CI: 3.00, 4.13) and lack of effectiveness (aPR: 3.46; 95% CI: 2.97, 4.03) were associated with greater vaccine hesitancy. The prevalence of COVID-19 vaccine hesitancy among adolescents is alarmingly high across the five sub-Saharan African countries, especially in Tanzania. COVID-19 vaccination campaigns among sub-Saharan African adolescents should address their concerns and misconceptions about vaccine safety and effectiveness.
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    Determinants of COVID-19 vaccine readiness and hesitancy among adults in sub-Saharan Africa
    (PLOS Global Public Healt, 2023) Abubakari, Sulemana Watara; Workneh, Firehiwot; Asante, Kwaku Poku; Hemler, Elena C.; Madzorera, Isabel; Wang, Dongqing; Ismai, Abbas; Nega Assefa; Azemraw, Temesgen; Lankoande, Bruno; Nuhu, Abdul Razak; Chukwu, Angela; Mapendo, Frank; Millogo, Ourohiré; Olufemi, Adedokun A.; Okpara, Daniel; Boudo, Valentin; Mwanyika-Sando, Mary; Berhane, Yemane; Baernighause, Till; Oduola, Ayoade; Vuai, Said; Sie, Ali; Soura, Abdramane; Killewo, Japhet; Tajudeen, Raji; Fawz, Wafaie W.; Smith, Emily R.
    There is very limited data on the extent and determinants of COVID-19 vaccine hesitancy among adults living in sub-Saharan Africa since the global roll-out of vaccines began in 2021. This multi-country survey sought to investigate COVID-19 vaccine hesitancy and other predictors of readiness to get vaccinated. We conducted surveys among adults residing in nine urban and rural areas in Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania in late 2021. Log binomial regression models were used to identify prevalence and factors associated with vaccine hesitancy and beliefs around COVID-19 misinformation. We completed a total of 2,833 interviews. Among all respondents, 9% had never heard of a COVID-19 vaccine, 12% had been vaccinated, and 20% knew someone else who had been vaccinated. The prevalence of vaccine hesitancy varied by country (Ethiopia 29%, Burkina Faso 33%, Nigeria 34%, Ghana 42%, Tanzania 65%), but not by rural or urban context. People who did not think the vaccine was safe or effective, or who were unsure about it, were more likely to be vaccine hesitant. Those who reported they did not have a trusted source of information about the vaccine (aPR: 1.25, 95% CI: 1.18,1.31) and those who thought the vaccine would not be made available to them within the year were more likely to be vaccine hesitant. Women were more likely to be vaccine hesitant (aPR: 1.31, 95% CI: 1.19,1.43) and believe COVID-19 falsehoods (aPR: 1.05, 95% CI: 1.02,1.08). The most commonly believed falsehoods were that the vaccine was developed too fast and that there was not enough information about whether the vaccine was effective or not. Educational campaigns targeted at misinformation and tailored to suit each country are recommended to build trust in COVID-19 vaccines and reduce hesitancy.
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    School-based nutrition programs for adolescents in Dodoma, Tanzania: a situation analysis
    (SAGE, 2021) Rector, Collete; Afifa, Nadhira Nuraini; Gupta, Varun; Ismail, Abbas; Mosha, Dominic; Katalambula, Leonard K.; Vuai, Said; Young, Tara; Hemler, Elena C.; Wang, Dongqing; Fawzi, Wafaie W.
    Tanzania has a double burden of malnutrition, including a high prevalence of undernutrition and an increasing prevalence of overweight and obesity among adolescents. Schools present a valuable opportunity to reach a large section of the country’s adolescent population with nutrition-oriented interventions. The objective of this study was to assess the current state of adolescent school nutrition interventions in Dodoma, Tanzania, with emphasis on 3 potential school-based nutrition interventions, school vegetable gardens, school meals, and education (on nutrition, agriculture, and water, sanitation, and hygiene). Focus group discussions were conducted with several regional and district-level governmental stakeholders, including health, education, and agricultural officers. Ten public secondary schools were visited, and interviews with school administrators, teachers, students, and parents were conducted. All stakeholders interviewed supported interventions to improve school-based nutrition, including school gardens, school feeding, and nutrition education. All 10 schools visited had some experience providing school meals, but parents’ contributions were essential for the program’s sustainability. Most schools visited had land available for a school garden program, but water availability could be challenging during certain times of the year. The teachers interviewed expressed that the curriculum on nutrition education was highly theoretical and did not allow students to practice the knowledge and skills they learned in the classroom. The current school-based approach to tackling the double burden of adolescent malnutrition in Dodoma is localized and ad hoc. To leverage the potential of schools as a platform for nutrition interventions, integrated and policy-mandated interventions are needed.