Experiences of Persons in COVID-19 Institutional Quarantine in Uganda: A Qualitative Study

Abstract

Background Quarantine has been adopted as a key public health measure to support the control of the Coronavirus disease (COVID-19) pandemic in many countries including Uganda. Uganda adopted institutional quarantine for individuals suspected of exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to be placed in institutions like hotels and/or hostels of institutions for at least 14 days. This study explored experiences of individuals who underwent institutional quarantine in Uganda to inform measures to increase its effectiveness and reduce its associated negative impact.Methods We conducted a qualitative description using in-depth interviews with 20 purposively selected individuals who had spent time in institutional quarantine facilities. These were mainly phone-based interviews that were audio recorded and transcribed verbatim. Electronic data coding was conducted using Atlas.ti 7 software. Thematic content analysis was used to synthesize the findings with similar codes grouped to form sub-themes and ultimately study themes. The findings are presented thematically with typical participant quotes.Results Study participants spent between 14 to 25 days in institutional quarantine. Four themes emerged describing the experiences of study participants during institutional quarantine, which determined whether participants’ experiences were positive or negative. These themes were: quarantine environment including facility related factors, compliance with COVID-19 measures; quarantine management factors of entity paying the costs, communication, days spent in quarantine; individual factors including attitude towards quarantine, fears during and post-quarantine and coping mechanisms; and linkage to other services such as health care and post-quarantine follow-up. Conclusion The planning, management and implementation of the quarantine process is a key determinant of the experiences of individuals who undergo the measure. To improve the experience of quarantined individuals and reduce its associated negative impact, the pre-quarantine process should be better managed to comply with standards, quarantined persons should be provided as much information as possible, their quarantine duration should kept short and costs of the process ought to be minimized. Furthermore, quarantine facilities should be assessed for suitability and monitored to comply with guidelines while avenues for access to healthcare for the quarantined need to be established and any potential stigma addressed.

COVID-19 Health Care Behaviour in The Gambia: a cross-sectional survey of 205 adults who went through mandatory institutional quarantine

“…Looking at facility related factors during quarantine, there was prominent dissatisfaction reported by most of our participants regarding the facility environment, specifically cleanliness and the services provided, specifically meals. Our findings are similar to the experiences of persons in COVID-19 institutional quarantine in Uganda (26). In The Gambia, all quarantine related costs were covered by the government and therefore our study participants were not financially burdened with the cost of accommodation, food, testing and certification.…”

“…"It was painful leaving my family behind; horrible; traumatised; like a prison." (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) Gambian man, identified via contact tracing)…”