Breastfeeding practices among adolescent mothers and associated factors in Bangladesh (2004-2014)

Optimal breastfeeding practices among mothers have been proven to have health and economic benefits, but evidence on breastfeeding practices among adolescent mothers in Bangladesh is limited. Hence, this study aims to estimate breastfeeding indicators and factors associated with selected feeding practices. The sample included 2554 children aged 0–23 months of adolescent mothers aged 12–19 years from four Bangladesh Demographic and Health Surveys collected between 2004 and 2014. Breastfeeding indicators were estimated using World Health Organization (WHO) indicators. Selected feeding indicators were examined against potential confounding factors using univariate and multivariate analyses. Only 42.2% of adolescent mothers initiated breastfeed-ing within the first hour of birth, 53% exclusively breastfed their infants, predominant breastfeeding was 17.3%, and 15.7% bottle-fed their children. Parity (2–3 children), older infants, and adolescent mothers who made postnatal check-up after two days were associated with increased exclusive breastfeeding (EBF) rates. Adolescent mothers aged 12–18 years and who watched television were less likely to delay breastfeeding initiation within the first hour of birth. Adolescent mothers who delivered at home (adjusted OR = 2.63, 95% CI:1.86, 3.74) and made postnatal check-up after two days (adjusted OR = 1.67, 95% CI: 1.21, 2.30) were significantly more likely to delay initiation breast-feeding within the first hour of birth. Adolescent mothers living in the Barisal region and who lis-tened to the radio reported increased odds of predominant breastfeeding, and increased odds for bottle-feeding included male infants, infants aged 0–5 months, adolescent mothers who had eight or more antenatal clinic visits, and the highest wealth quintiles. In order for Bangladesh to meet the Sustainable Development Goals (SDGs) 2 and 3 by 2030, breastfeeding promotion programmes should discourage bottle-feeding among adolescent mothers from the richest households and promote early initiation of breastfeeding especially among adolescent mothers who delivered at home and had a late postnatal check-up after delivery

Differences in perceived risk of contracting SARS-CoV-2 during and after the lockdown in Sub-Saharan African countries

This study investigated risk perception of contracting and dying of SARS-CoV-2 in sub-Sahara Africa during and after the lockdown periods. Two online surveys were conducted one year apart, with participants 18 years and above living in sub-Sahara Africa or the diaspora. Each survey took four weeks. The first survey was taken from 18 April to 16 May 2020, i.e., during the lockdown. The second survey was taken from 14 April to 14 May 2021, i.e., after the lockdown. A cross-sectional study using adopted and modified questionnaires for both surveys were distributed through online platforms. Question about risks perception of contracting and dying of SARS-CoV-2 were asked. The Helsinki declaration was applied, and ethical approvals were obtained. Total responses for both surveys, i.e., both during and after the lockdown, was 4605. The mean age was similar in both surveys (18–28 years). The mean risk perception scores were higher after lockdown by 3.59%. Factors associated with risk perception of COVID-19 were survey period, age group, region of residence, and occupation. Non-health care workers had a lower risk perception of COVID-19. This first comparative study on the level of risk perception of Africans during and after the lockdown shows that one in every three and every four persons in sub-Sahara Africa felt at high risk of contracting COVID-19 and thought they could die from contracting the same, respectively

Public awareness and perception towards COVID-19 in sub-saharan African countries during the lockdown

Background: The coronavirus disease (COVID-19) outbreak has caused a universal health crisis resulting in significant morbidities and mortalities particularly among high-risk groups. This study sought to determine regional factors associated with knowledge and attitude towards COVID-19 mitigation practices and risk perception of contracting the disease in Sub-Saharan African (SSA) countries. Methods: A cross-sectional anonymous online study was conducted among 1970 participants between April and May 2020, during the lockdown in many SSA countries. Recruitment of participants was via WhatsApp, Facebook and emails using authors’ networks. The outcome variables were KAP (knowledge, attitudes and practice) of COVID-19 and analysis of variance (ANOVA) with post hoc test was run to assess the level of KAP by four regions in SSA. Simple and multiple linear regression (MLR) analyses were performed to examine factors associated with the outcome measures in the four SSA regions. Results: Mean knowledge (P=0.707) and risk perception (P=0.904) scores by four regions in SSA did not differ significantly. However, the mean attitude score was higher among West Africans compared with Southern (P=0.019) and Central Africans (P=0.003). MLR analysis revealed that among those living in West (adjusted coefficient β=-0.83 95% CI: -1.19, -0.48) and Southern Africa (β=-0.91 95% CI: -1.42, -0.40), having a primary or secondary education was associated with a decrease in knowledge scores while not being worried about COVID-19 decreased risk perception scores across the four SSA regions(West [β=-6.57, 95% CI: -7.53, -5.62], East [β=-6.24: 95% CI: -8.34,-4.15], Central [β=-6.51, 95% CI: -8.70, -4.31], and Southern Africa [β=-6.06: 95% CI: -7.51, -4.60]). Except among Southern Africans, participants who practiced self-isolation had positive attitude towards COVID-19. Conclusion: Future research on health education regarding COVID-19 or a future related pandemic in SSA should target people with lower education, those who do not self-isolate, those living in Southern and Western Africa and not worried about contracting COVID-19

Analysis of perception, reasons, and motivations for COVID-19 vaccination in people with diabetes across Sub-Saharan Africa : a mixed-method approach

Diabetes mellitus (DM) is associated with severe COVID-19 infection and complications. This study assesses COVID-19 vaccine acceptance and hesitancy in people with DM, and explores the reasons for not being vaccinated. This was a web-based cross-sectional survey using a mixed-method approach conducted in March–May 2021, corresponding to most sub-Saharan African (SSA) countries’ early vaccine rollout period. Participants were those aged ≥18 years with self-reported DM in 11 Sub-Saharan African (SSA) countries. Responses to comments on the reasons for vaccine hesitancy and facilitators for vaccine uptake were analyzed. Of the 73 participants with DM, 65.8% were males, older than 35 years (86.3%), had postsecondary education (90%), and a significant proportion were from South Africa (39.7%), Nigeria (28.8%) and Ghana (13.7%). At the time of this study, 64.4% experienced COVID-19 symptoms, 46.6% were tested for COVID-19, of which 19.2% tested positive. Few participants (6.8%) had received a COVID-19 vaccination, 65.8% were willing to take the vaccine when it becomes available in their country, while 26.0% either refused or remained hesitant towards taking the vaccine. The main identified reasons for not taking the vaccine were: advice from religious leaders; concerns about the safety, effects, and efficacy of the vaccines; mistrust of the pharmaceutical companies producing the vaccines and the process of production; the conspiracy theories around the vaccines; and the personal belief of the participants regarding vaccination. However, participants stated they would take the vaccine if they were more educated about it, received positive feedback from those vaccinated, were rewarded for taking the vaccine, or if vaccination became a condition for travel and employment. In conclusion, this study shows that the uptake of the COVID-19 vaccine was very low in this high-risk group. Efforts to increase the uptake of COVID-19 vaccines among people with diabetes are imperative, such as the provision of education and relevant information

COVID-19 in Sub-Saharan African countries : association between compliance and public opinion

Background: The outbreak of coronavirus disease (COVID-19) has created a global public health crisis and non-compliance with public health measures to contain the infection poses a challenge to Sub-Saharan African governments. This study investigated the associations between compliance and public opinion on COVID-19 public health containment measures across selected SSA countries. Method: Anonymous online cross-sectional survey was administered to 1779 adults (18 years and older) during the mandatory lockdown period in most African countries (April 18 - May 16, 2020). Respondents were recruited via Facebook, WhatsApp, and authors' networks. Data on participants’ socio-demographics, their opinions regarding the precautionary measures against COVID-19, and their compliance with preventive measures were collected. Multiple logistic regression analysis was used to examine the association between compliance and public opinions about COVID-19. Results: Respondents who did not think that public health authorities in their countries were doing enough to control the C0VID-19 outbreak were more likely to attend crowded places (aOR 1.75, 95% CI 1.30-2.35). Those who thought COVID-19 would not remain in their countries (aOR 0.48, 95% CI 0.24 - 0.96) and those who thought self-isolation is not needed during the pandemic (aOR 0.29, 95% CI 0.13 - 0.65) were less likely to encourage others to comply with the strategies put in place to prevent the spread of the disease. Participants who thought the COVID-19 outbreak was dangerous and those wearing medical masks were found to wash their hands with soap under running water. Conclusion: The study showed that public opinion influenced the compliance of individuals to public health measures for containment and mitigation of COVID-19. There is a need to improve compliance by the public

International research collaboration during the pandemic: Team formation, challenges, strategies and achievements of the African Translational Research Group

This paper discusses multidisciplinary international research collaboration team formation during the COVID-19 pandemic, challenges faced, strategies adopted, achievements and dynamics in the implementation of research on Coronavirus disease-2019 (COVID-19), by the African Translational Research Group (ATReG). The paper also discusses the lessons learnt and future opportunities for global collaborative research. In-depth virtual interviews were conducted with consenting members of ATReG. Questions were designed to provide rich, deep, and insightful opinions, lived experiences and perspectives of ATReG group members on group formation, challenges, strategies and achievements. Interview data was transcribed and analysed thematically, and the results were presented with important quotations presented. The ATReG consisted of English (n = 13) and French (n = 1) speaking sub-Saharan African (SSA) researchers who specialise in public health, epidemiology, optometry, information technology, supply chain management, psychiatry, community health, general medical practice, nutrition and biostatistics. Most members of the group reported an informal but well-coordinated structure of the group. Formed during the pandemic, all group meetings were held online, and many members are yet to meet each other in person. The group collected data from Africans and published 10 peer reviewed journal articles on COVID-19 within two years. It presented in international conferences, engaged with the media and the public and was awarded a national competitive funding in Nigeria all of which which contributed to career progression and academic promotion of some members. There have been challenges in sustaining the research collaboration and maintaining productivity. Challenges include difficulties meeting deadlines and obtaining funding for research activities. However, these challenges have been addressed through a collaborative problem-solving approach. The study found the need for operational and methodological flexibility, centralised coordination, and established funding sources as being essential for long term sustainability and performance of the group. The ATReG’s objective of providing useful data on COVID-19 and generating useful knowledge about COVID-19 in SSA has been achieved. In such a multi-disciplinary international collaborative team relaiant on the online medium to operate, the experiences and challenges can be a model for learning for researchers intending to form international multidisciplinary collaborative groups. Nonetheless, there are still many important areas of research which ATReG will continue to pursue

Misinformation About COVID-19 in Sub-Saharan Africa: Evidence from a Cross-Sectional Survey

Misinformation about coronavirus disease 2019 (COVID-19) is a significant threat to global public health because it can inadvertently exacerbate public health challenges by promoting spread of the disease. This study used a convenience sampling technique to examine factors associated with misinformation about COVID-19 in sub-Saharan Africa using an online cross-sectional survey. A link to the online self-administered questionnaire was distributed to 1,969 participants through social media platforms and the authors' email networks. Four false statements—informed by results from a pilot study—were included in the survey. The participants' responses were classified as “Agree,” “Neutral,” and “Disagree.” A multinomial logistic regression was used to examine associated factors. Among those who responded to the survey, 19.3% believed that COVID-19 was designed to reduce world population, 22.2% thought the ability to hold your breath for 10 seconds meant that you do not have COVID-19, 27.8% believed drinking hot water flushes down the virus, and 13.9% thought that COVID-19 had little effect on Blacks compared with Whites. An average of 33.7% were unsure whether the 4 false statements were true. Multivariate analysis revealed that those who thought COVID-19 was unlikely to continue in their countries reported higher odds of believing in these 4 false statements. Other significant factors associated with belief in misinformation were age (older adults), employment status (unemployed), gender (female), education (bachelor's degree), and knowledge about the main clinical symptoms of COVID-19. Strategies to reduce the spread of false information about COVID-19 and other future pandemics should target these subpopulations, especially those with limited education. This will also enhance compliance with public health measures to reduce spread of further outbreaks

Knowledge, attitude and practice of hospital waste disposal among cleaners in a tertiary health institution in Plateau State, Nigeria

Background: Hospital waste disposal has become an important public health concern especially in low and middleincome countries.  Health hazards could occur where there are inadequate and improper techniques in handling these wastes. The aim of this study was to assess the knowledge, attitude and practice of hospital waste disposal among cleaners in a tertiary hospital of Plateau State, Nigeria.Method: This was a cross-sectional study carried out among 206 cleaners. Data was collected using a semi-structured interviewer-administered questionnaire. Knowledge, attitude and practice were all graded and scored. Analysis was done using Epi Info version 3.5.4 at a confidence level of 95% and pvalue of < 0.05.Results: The mean age of respondents was 36.9 ± 9.5 years. The highest level of education was secondary school among 110 (54%) of them and 169 (82%) had been working for =10 years. Knowledge, attitude and practice was good among 83 (41%), 203 (98%) and 17 (8.3%) of respondents respectively. Knowledge grade and previous training were found to have a statistically significant relationship with practice on biomedical waste disposal (p < 0.05).Conclusion: The study revealed a lack of knowledge and poor practice of hospital waste disposal among hospital cleaners though with most having a good attitude. The hospital needs to train and retrain hospital cleaners, adopt and enforce guidelines specific for their use on medical waste disposal

Knowledge, attitudes, and perceptions of COVID-19 among healthcare and non-healthcare workers in Sub-Saharan Africa : a web-based survey

Due to the current COVID-19 pandemic and associated high mortality in sub-Saharan Africa, there is panic amongst healthcare workers because of the higher risk of being infected. This study compared knowledge, attitudes, and perceptions of COVID-19 among healthcare workers (HCWs) and non-healthcare workers (non-HCWs) and examined common associated factors. A web-based cross-sectional study of 1,871 respondents (430 HCWs and 1,441 non-HCWs) was conducted while lockdown measures were in place in 4 regions of sub-Saharan Africa. Data were obtained using a validated self-administered questionnaire via an online survey platform. Mean scores were calculated and summarized using a t test for both groups. Multivariate linear regression analysis was conducted to assess the unadjusted (B) and adjusted coefficients (b) with a confidence interval (CI) of 95%. The mean scores were slightly higher among HCWs than non-HCWs, but not statistically significant. Being worried about contracting COVID-19 was the only common factor associated with knowledge, attitudes, and perceptions between the 2 groups. Knowledge of COVID-19 was associated with attitudes and perceptions between the 2 groups. Other significant associated factors were: the sub-Saharan Africa region, ages 29 to 38 years (b = .32; 95% CI, 0.04 to 0.60 for knowledge among non-HCWs), education (b = -.43; 95% CI, -0.81 to -0.04; and b = -.95; 95% CI, -1.69 to -0.22, for knowledge among non-HCWs and HCWs, respectively), practice of self-isolation (b = .71; 95% CI, 0.41 to 1.02 for attitude among non-HCWs and HCWs (b = .97; 95% CI, 0.45 to 1.49), and home quarantine due to COVID-19, in both groups. Policymakers and healthcare providers should consider these factors when targeting interventions during COVID-19 and other future pandemics