Self-reported delays in care-seeking in West Africa during the first wave of the COVID-19 pandemic

Conboy, Natalie E.; Nickow, Andre; Awoonor-Williams, John Koku; Hirschhorn, Lisa R.

doi:10.1186/s12913-023-09812-x

Cited by 4 publications

References 61 publications

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Impact of COVID-19 on the management of hypertension: a perspective on disease severity, service use patterns and expenditures from Ghana’s health insurance claims data

Fenny,

Otieku,

Owusu Achiaw

et al. 2024

J Hum Hypertens

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Hypertension is a leading cause of morbidity in Ghana and other sub-Saharan African countries, but management has historically suffered from the fragility of health systems in these countries. This has been exacerbated by the COVID-19 pandemic and its associated measures. Our study examines and quantifies the effect of the pandemic on the management of hypertension in Ghana by determining changes in disease severity and presentation, as well as changes in health service use patterns and expenditures. We used cross-sectional data to perform an impact evaluation of COVID-19 on hypertension management before and during the pandemic. We employed statistical tests including t-tests, z-tests, and exact Poisson tests to estimate and compare hypertension episode intensity and related claim expenditures before and during the pandemic using medical claims data from Ghana’s National Health Insurance Authority database. The study duration includes a 12-month reference/pre-pandemic period (March 2019–February 2020) relative to the target/pandemic period (March 2020–February 2021). We observed that although there was a 20% reduction in the number of hypertension claimants in the pandemic year, there was an increase in hypertension severity as measured by the number of hypertension episodes per claimant. There was also an 18.64% or $22.88 (95% CI: $21–$25, p = 0.01042) increase in the average cost per hypertension claimant in the pandemic year. The increase in episodes per claimant had the largest financial impact on the average cost per claimant. The findings from our studies are relevant for future policymaking and strategy implementation for hypertension control in Ghana.

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Impact of COVID-19 on the management of hypertension: a perspective on disease severity, service use patterns and expenditures from Ghana’s health insurance claims data

Fenny,

Otieku,

Owusu Achiaw

et al. 2024

J Hum Hypertens

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Undermining the Translational Potential of Clinical Research With Adolescents and Young Adults: Differential Enrollment in Randomized Clinical Trials During COVID-19

Perin,

Anders,

Barfield

et al. 2024

Sexual Trans Dis

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Background COVID-19 stay-at-home orders and research restrictions halted recruitment and follow-up of clinical research patients. While clinical research has resumed, it is an open question whether research participation has returned to levels similar to those before COVID-19. Methods We utilized data from the TECH-PN (NCT# NCT03828994) study, a single-center RCT enrolling 13-25-year-olds with mild-moderate pelvic inflammatory disease (PID) receiving ambulatory care. We examined enrollment patterns before COVID-19 and during/after COVID-19 among those assessed for eligibility by estimating the average rate of recruitment visits for each period. We focused on this monthly rate by pandemic status, the length of stay (LOS) by pandemic status, as well as the relationship between the LOS and patient demographics. Descriptive analyses were conducted, including Student’s t-test to compare rates between time periods and a Chi-square test to compare the proportion refusing enrollment. Results The monthly enrollment rate during/post-pandemic was significantly lower than before COVID-19 (4.8 per month compared to 7.4 per month, p < 0.001). However, eligible participants' age, race, and insurance type were similar pre- and during/post-pandemic. Among eligible patients, LOS for receiving PID care was slightly increased, from a median of 5.4 hours to 6.4 hours (p = 0.650), and the rate of refusal to participate among those eligible was similar (23% versus 27%, p = 0.362). There was a similar number of ineligible patients due to inpatient admissions during both periods. Conclusion COVID-19 pandemic restrictions negatively impacted recruitment into this RCT. Enrollment differences may reflect ongoing perceptions of restrictions in care access or a hesitancy to use health services. More research is needed to stabilize access to ambulatory STI/PID care and access to clinical trials.

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The Role of Mass Media on Malaria Care-Seeking Behavior: Insights from the Nigeria Malaria Indicator Survey 2021

Atwijukiire,

Ikwara,

Angut

2023

Preprint

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Background Malaria remains a global health crisis, and ending this crisis demands support and action of all people around the world. Sub-Saharan Africa bears the heaviest brunt, with children under five being the most affected. Mass media campaigns play a pivotal role in increasing awareness, promoting malaria care-seeking behavior, and advancing prevention efforts. Methods Secondary data analysis of the 2021 Nigeria Malaria Indicator Survey (NMIS) scrutinized malaria care-seeking behavior among women aged 15–49 who had children with a fever in the previous two weeks. Employing a two-stage sampling strategy, data were collected from 568 clusters spanning both urban and rural areas. Descriptive statistics, bivariate, and logistic regression tests were utilized to assess the role of mass media on malaria care-seeking behavior. Results The majority of participants resided in rural areas (74.5%), were aged 25–29 (29.2%), lacked formal education (47.5%), and adhered to the Islamic faith (63.9%). Many households lacked basic media tools, with 62% lacking radios, 66.7% lacking TVs, and 86.4% not having access to newspapers or magazines. Only 57.9% of participants reported not having seen or heard any malaria-related messages. 38.5% did not seek malaria treatment when their children had a fever, and 68.1% delayed seeking care for two or more days. Respondents who used the internet before the last 12 months were 1.7 times more likely to seek malaria care (AOR = 1.717, 95%CI:1.020–2.889). Conclusion This study delves into the intricate interplay between mass media exposure, and malaria care-seeking behaviors in Nigeria. The stark limitations in access to mass media hinder access to malaria information and malaria care-seeking behaviors. These findings indicate a gap in the roles of mass media on malaria care seeking. To better understand the factors limiting the availability of information on malaria through the media, more research is required.

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Self-reported delays in care-seeking in West Africa during the first wave of the COVID-19 pandemic

Cited by 4 publications

References 61 publications

Impact of COVID-19 on the management of hypertension: a perspective on disease severity, service use patterns and expenditures from Ghana’s health insurance claims data

Impact of COVID-19 on the management of hypertension: a perspective on disease severity, service use patterns and expenditures from Ghana’s health insurance claims data

Undermining the Translational Potential of Clinical Research With Adolescents and Young Adults: Differential Enrollment in Randomized Clinical Trials During COVID-19

The Role of Mass Media on Malaria Care-Seeking Behavior: Insights from the Nigeria Malaria Indicator Survey 2021

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