The Impact of COVID-19 on Hospital Attendance and Perceived Stigmatization Towards Individuals with COVID-19 Like Symptoms in Buea Municipality, Cameroon

Abstract

Objectives: The outbreak of COVID-19 has brought about fear and uncertainty resulting to stigmatization and discrimination towards those with COVID-19 like symptoms as well as influence the patient influx to health facilities and the health-seeking behaviour of the population. This study assessed the health-seeking behaviour, hospital attendance, and the level of stigmatization of the population towards individuals with COVID-19 like symptoms. Methods: This was a cross-sectional community and hospital-based study carried out to assess hospital attendance, perceived stigmatization and population health-seeking behaviour during the COVID-19 pandemic in the Buea Municipality. The trend in the patients' influx in the COVID-19 treatment centre and other health facilities was assessed from March to June 2020 and compared with corresponding months in 2019. The stigmatization data was collected using a modified 12-items stigma scale. The data was analyzed with SPSS version 26. Results: The hospital attendance decreased in the COVID-19 treatment centre from April to June 2020 by -38.3% and increased in non-COVID-19 treatment health facilities by over 70%. Of the 570 participants for the community survey, 322 (56.5%) reported to go for auto medication if they developed COVID-19 symptoms. Individuals with COVID-19 like symptoms experienced moderate (59.1%) to severe (33.9%) perceived stigmatization. Perceived stigmatization was significantly higher (χ 2 =14.56, p=0.001) in participants who reported not willing to go to the hospital during the pandemic. Conclusion: The hospital turnout experienced a drop in the COVID-19 treatment centre and an increase in other health facilities. There was high perceived stigmatization towards people with COVID-19 like symptoms, which probably accounted for the population refusal to seek treatment in the COVID-19 treatment center and to resort to auto medication.

Healthcare- Seeking Behaviours and the Impact of Covid-19 preventive Measures on Anxiety and Depression among Survivors of Covid-19 at the Buea Regional Hospital Cameroon: A Case Control Study

“…Symptoms not being severe and fear of stigmatization were the major reasons of not seeking care from the hospital. The plausible explanation could be due to the fact that a great majority of the cases in our study were asymptomatic patients who literally had no life threatening symptoms hence felt no need for hospital consultation; also we recruited patients at the peak of the pandemic when there was still a lot of myths about COVID-19 with patients having COVID-19 symptoms being regarded as those who were going to die soon and would be neglected this findings are in line with that of Tendengfor et al, [12].…”

“…With the occurrence of a global pandemic of this nature associated with fear of the outcome when one gets infected the Health seeking behaviour could be greatly hampered ; the outbreak of the SARS in Hong Kong that occurred in 2003 was associated with a lot of hospital avoidance [9]. The mental or brain health impacts of the COVID-19 pandemic are evident in Cameroon [10], but the impact of the preventive measures on mental health is still not well understood .Many studies have examined healthcare utilization using Andersen's behavioral models, where various multidimensional factors determine healthcare-seeking behaviors of people including predisposing factors (age, gender, ethnic, cultural, social), enabling factors (financial, insurance coverage, healthcare accessibility, healthcare availability), and need factors (health perceptions, medical conditions) [11].The first case of COVID-19 was reported in Buea south west region of Cameroon in the early days of April 2020 associated with a lot of misinformation, fear and stigmatization towards individuals who tested positive for COVID-19 [12].The majority of cases diagnosed from the lone treatment center in the early months of the pandemic were mainly asymptomatic cases and studies have proven that this group of persons are carriers and there is a possibility of transmitting and infecting the population [13]. Systematic reviews have reported expected psychological and mental health problems due to the outbreak of COVID-19, such as stress, anxiety, depressive symptoms, insomnia, denial, stigma ,anger and fear [14].…”