Frequency and correlates of anxiety symptoms during the COVID-19 pandemic in low- and middle-income countries: A multinational study

Abstract

Objective Studies have documented the significant direct and indirect psychological, social, and economic consequences of the Coronavirus disease 2019 (COVID-19) in many countries but little is known on its impact in low- and middle-income countries (LMICs) already facing difficult living conditions and having vulnerable health systems that create anxiety among the affected populations. Using a multinational convenience sample from four LMICs (DR Congo, Haiti, Rwanda, and Togo), this study aims to explore the prevalence of anxiety symptoms and associated risk and protective factors during the COVID-19 pandemic. Methods A total of 1267 individuals (40.8% of women) completed a questionnaire assessing exposure and stigmatization related to COVID-19, anxiety, and resilience. Analyses were performed to examine the prevalence and predictors of anxiety. Results Findings showed a pooled prevalence of 24.3% (9.4%, 29.2%, 28.5%, and 16.5% respectively for Togo, Haiti, RDC, and Rwanda, x 2 = 32.6, p < .0001). For the pooled data, exposure to COVID-19 ( β = 0.06, p = .005), stigmatization related to COVID-19 ( β = 0.03, p < .001), and resilience ( β = −0.06, p < .001) contributed to the prediction of anxiety scores. Stigmatization related to COVID-19 was significantly associated to anxiety symptoms in all countries ( β = 0.02, p < .00; β = 0.05, p = .013; β = 0.03, p = .021; β = 0.04, p < .001, respectively for the RDC, Rwanda, Haiti, and Togo). Conclusions The findings highlight the need for health education programs in LMICs to decrease stigmatization and the related fears and anxieties, and increase observance of health instructions. Strength-based mental health programs based on cultural and contextual factors need to be developed to reinforce both individual and community resilience and to address the complexities of local eco-systems.

Prevalence and correlates of depression during the COVID-19 pandemic and the major role of stigmatization in low- and middle-income countries: A multinational cross-sectional study

“…Although we have not identified any studies on the association between COVID-19-related stigmatization and mental health problems in LMICs, various articles published since the beginning of the pandemic have alerted this issue ( Jung and Jun, 2020 ; Zhai and Du, 2020 ). In addition, we have observed the same pattern for anxiety symptoms ( Cénat et al., 2021b ). Moreover, studies on Ebola and HIV have extensively documented the role of stigmatization in predicting mental health problems ( Cénat et al., 2020d , 2020b ; Obilade, 2015 ).…”

The Impact of Demographics, Life and Work Circumstances on College and University Instructors’ Well-Being During Quaranteaching

“…Confinement and social and physical distancing can additionally exacerbate the negative symptoms and require additional relevant individual resources in order to re-establish the balance and protect wellbeing. A body of research from the COVID-19 pandemic has accordingly identified numerous stressors and risk factors for mental health, spanning but not limited to fear of or actually getting infected (Bo et al, 2020;Nguyen et al, 2020;Rogers et al, 2020), inadequate information as well as excessive consumption of negative information from social media (Gao et al, 2020), the experience of quarantine (Lei et al, 2020), infection and/or death of loved ones, stigma, social isolation and loneliness, frustration, boredom, job/wage losses and associated financial insecurities (Brooks et al, 2020;Cénat et al, 2020Cénat et al, , 2021bNicola et al, 2020), among others. Not surprisingly, studies have reported increased levels of anxiety (Lee et al, 2020;Lei et al, 2020;Moghanibashi-Mansourieh, 2020), distress (Hao et al, 2020;Mazza et al, 2020), post-traumatic stress (Bo et al, 2020;Liu et al, 2020), depression (Lei et al, 2020;Nguyen et al, 2020), insomnia , and other dimensions of psychological impact (Ahmed et al, 2020;Cao et al, 2020;Moccia et al, 2020;Xiong et al, 2020;Cénat et al, 2021a,b;Huang and Zhao, 2021) in pandemicaffected populations.…”

Sleep and Resilience during the COVID-19 Pandemic

“…Healthcare workers in particular have faced tremendous stress during the COVID-19 pandemic due to a range of factors, such as increased workload, long working hours, high work intensity, emotional demands, and increased risk of infection. As a result, the prevalence of sleep problems, especially insomnia, have significantly increased for healthcare workers during the pandemic [64][65][66]. As the pandemic continued to unfold during the first year and the number of cases and deaths continued to rise, the impact on sleep among healthcare workers became undeniable [66].…”