Vaccination against the novel coronavirus is one of the most effective strategies for combating the global Coronavirus disease (COVID-19) pandemic. However, vaccine hesitancy has emerged as a major obstacle in several regions of the world, including Africa. The objective of this rapid review was to summarize the literature on COVID-19 vaccine hesitancy in Africa.We searched Scopus, Web of Science, African Index Medicus, and OVID Medline for studies published from January 1, 2020, to March 8, 2022, examining acceptance or hesitancy towards the COVID-19 vaccine in Africa. Study characteristics and reasons for COVID-19 vaccine acceptance were extracted from the included articles.A total of 71 articles met the eligibility criteria and were included in the review. Majority (n = 25, 35%) of the studies were conducted in Ethiopia. Studies conducted in Botswana, Cameroun, Cote D'Ivoire, DR Congo, Ghana, Kenya, Morocco, Mozambique, Nigeria, Somalia, South Africa, Sudan, Togo, Uganda, Zambia, Zimbabwe were also included in the review. The vaccine acceptance rate ranged from 6.9 to 97.9%. The major reasons for vaccine hesitancy were concerns with vaccine safety and side effects, lack of trust for pharmaceutical industries and misinformation or conflicting information from the media. Factors associated with positive attitudes towards the vaccine included being male, having a higher level of education, and fear of contracting the virus.Our review demonstrated the contextualized and multifaceted reasons inhibiting or encouraging vaccine uptake in African countries. This evidence is key to operationalizing interventions based on facts as opposed to assumptions. Our paper provided important considerations for addressing the challenge of COVID-19 vaccine hesitancy and blunting the impact of the pandemic in Africa. 

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COVID-19 vaccine hesitancy in Africa: a scoping review

ABSTRACT Pregnancy is an independent risk factor for severe covid-19. Vaccination is the best way to reduce the risk for SARS-CoV-2 infection and limit its morbidity and mortality. The current recommendations from the World Health Organization, Centers for Disease Control and Prevention, and professional organizations are for pregnant, postpartum, and lactating women to receive covid-19 vaccination. Pregnancy specific considerations involve potential effects of vaccination on fetal development, placental transfer of antibodies, and safety of maternal vaccination. Although pregnancy was an exclusion criterion in initial clinical trials of covid-19 vaccines, observational data have been rapidly accumulating and thus far confirm that the benefits of vaccination outweigh the potential risks. This review examines the evidence supporting the effectiveness, immunogenicity, placental transfer, side effects, and perinatal outcomes of maternal covid-19 vaccination. Additionally, it describes factors associated with vaccine hesitancy in pregnancy. Overall, studies monitoring people who have received covid-19 vaccines during pregnancy have not identified any pregnancy specific safety concerns. Additional information on non-mRNA vaccines, vaccination early in pregnancy, and longer term outcomes in infants are needed. To collect this information, vaccination during pregnancy must be prioritized in vaccine research.

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Covid-19 vaccination in pregnancy

Objective:Ethiopia is planning to vaccinate 20% of its population against the coronavirus disease 2019 pandemic by the end of 2021—however, there is no single piece of evidence regarding pregnant w...

https://journals.sagepub.com/doi/pdf/10.1177/20503121211038454

Predictors of pregnant women's intention to vaccinate against coronavirus disease 2019: A facility-based cross-sectional study in southwest Ethiopia.

ABSTRACT Introduction Pregnant and breastfeeding women are at an increased risk of severe illness from COVID-19. Despite this, low vaccination coverages are reported in this population sub-group. Areas covered The purpose of this study is to estimate the proportion of pregnant and breastfeeding women expressing hesitation to the COVID-19 vaccine worldwide. Forty-six studies were included, selected from scientific articles available in three scientific databases between 1 January 2020 and 6 February 2022. The vaccine hesitation rate among pregnant and breastfeeding women was 48.4% (95%CI=43.4–53.4%). In a sub analysis by study period, it was 40.0% (95%CI=31.6–46.6%) considering surveys administered in 2020, 58.0% (95%CI=48.9–66.9%) considering surveys administered in the first semester of 2021, and 38.1% (95%CI=25.9–51.2%) considering surveys administered in the second semester of 2021. The main reasons for vaccine hesitation were lack of information about vaccination, opinion that the vaccine is unsafe, and fear of adverse events. Expert opinion Available evidence in the literature has shown that fighting vaccine resistance is harsh and too slow as a process, considering the rapidity and unpredictability of a pandemic. Health education should be provided in order to improve the willingness of the community, especially for those with lower levels of education.

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COVID-19 vaccination hesitancy in pregnant and breastfeeding women and strategies to increase vaccination compliance: a systematic review and meta-analysis

BackgroundSARS-CoV-2 vaccine has been recommended to pregnant women, but survey studies showed contrasting findings worldwide in relation to the willingness to accept vaccination during pregnancy.ObjectiveTo evaluate the evidence from the literature regarding the acceptance rate of the SARS-CoV-2 vaccine in pregnant and breastfeeding women.Study designWe performed a systematic review on the main databases (MEDLINE (PubMed), Scopus, ISI Web of Science) searching for all the peer-reviewed survey studies analyzing the eventual acceptance rate of the SARS-CoV-2 vaccine among pregnant and breastfeeding women. To combine data meta-analyses of proportions and pooled proportions with their 95% confidence intervals (CI) were calculated.Results15 studies including 25,839 women were included in the analysis. The proportion of women actually willing to be vaccinated during pregnancy is 49.1% (95% CI, 42.3–56.0), and the proportion of breastfeeding women is 61.6% (95% CI, 50.0–75.0).ConclusionThe cumulative SARS-CoV-2 vaccine acceptance rate among pregnant women appears still low. Vaccinal campaign are urgently needed to drive more confidence into the vaccine to help reducing the spread of the infection and the possible consequences during pregnancy. 

http://www.ejog.org/article/S0301211521009994/pdf

Worldwide beliefs among pregnant women on SARS-CoV-2 vaccine: a systematic review

Background Prisons and detention centers in Ethiopia lack adequate hand washing, personal protective equipment, and quarantine areas As a result, they are vulnerable to the expansion of the COVID-19 pandemic Despite its high risk for the COVID-19 pandemic, no study has been made to assess the preparedness and readiness in prison institutions and detention centers Methods A cross-sectional study design mixed with a qualitative approach was conducted from May 1 to June 30, 2020 A total of four prison institutions and 17 detention centers were included in the study A simple random sampling technique was employed to select the institutions The data were entered into the EpiData and exported to SPSS Windows version 22 for data management and analysis Descriptive statistics was employed for the quantitative section and content analysis was used to analyze the qualitative data Results Five out of 17 detention centers and three out of four prison facilities did not fulfill the standards related to human rights Almost all detention centers and prison facilities did not implement recommended activities of risk assessment and management of COVID-19 In addition, none of the prison facilities and detention centers had quick access to laboratory tests for suspected cases Neither the prison facilities nor the detention centers had a contingency plan for the COVID-19 pandemic Moreover, all staff working in prison facilities and detention centers mentioned that training regarding COVID-19 had not yet been given However, in all prisons and detention centers, preventive measures such as physical distancing, utilization of hand washing facilities, wearing masks, and keeping respiratory hygiene were not practiced

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Preparedness and Readiness Against COVID-19 Pandemic in Prison Institutions and Detention Centers in Southwest Ethiopia

Background: Road traffic accidents (RTAs) remain an important public health issue worldwide Psychoactive substance use is one of the main contributors to the occurrence of traffic accidents, and its use by truck drivers is a global problem Also, psychoactive substance use is a commonly observed behavior among truck drivers To the best of our knowledge, no evidence shows the prevalence and factors associated with psychoactive substance use among truck drivers in Ethiopia Therefore, this study was aimed at assessing the prevalence and factors associated with psychoactive substance use among truck drivers in Ethiopia Methods: A cross-sectional study was conducted among 400 systematically selected truck drivers at Modjo dry port in Ethiopia, from February 1 to March 1, 2018 The data were collected through face-to-face individual interviews using a structured questionnaire The collected data were entered into EpiData version 4200 and analyzed using SPSS version 20 Binary logistic regression analysis was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals The level of significance was declared at p value < 005 in the multivariable binary logistic regression analysis Results: Of the 400 truck drivers interviewed, the overall one-month self-reported prevalence of psychoactive substance use was 70% (n = 280) In the multivariable binary logistic regression analysis, aged 38 years and above (AOR = 040, 95% CI [023-069]), Christianity religion (AOR = 052, 95% CI [028-097]), college and university education (AOR = 347, 95% CI [127-947]), having a family size of 3 or more (AOR = 034, 95% CI [020-060]), having 6 or more hours spent sleeping at night (AOR = 046, 95% CI [028-075]), and rest breaks between driving (AOR = 213, 95% CI [114-397]) were significantly associated with psychoactive substance use Conclusion: The one-month prevalence of psychoactive substance use among truck drivers was remarkably high We can conclude that psychoactive substance use is a public health problem among truck drivers, which is a major threat to themselves and others on the road The sociodemographic and occupational factors are the factors associated with drivers' psychoactive substance use Therefore, devising health education and counseling program for drivers to tackle the problem plays paramount importance

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Psychoactive Substance Use and Its Associated Factors among Truck Drivers in Ethiopia.

Background Patient-centered care is a practice of caring for patients in ways that are valuable to the individual patient and families. Implementation of the practice is a common problem worldwide. In Ethiopia, the available information is limited and is largely skewed to certain dimensions of the practice. Objective To assess the patient-centered health care practice and associated factors among public and private general hospitals of Addis Ababa 2020. Methods An institution-based comparative cross-sectional study was conducted in two public, and seven private general hospitals located in Addis Ababa from April 08 to May 20, 2020. A multistage sampling technique was employed to select the study participants. Data were collected using an interviewer-administered structured questioner, then entered into Epi-data version 3.1, and finally analyzed using SPSS version 25. Multivariable logistic regression was used to identify independent predictors of clients' perceived patient-centered care. Statistical significance was declared at p-value <0.05 and adjusted odds ratio with 95% confidence interval. Results A total of 570 patients were involved with 99.8% response rate. About 49% (95% CI: 45.0-53.1) of patients rated the practice as good. It was 27.8% (95% CI: 22.5-33.1), and 70.2% (95% CI: 64.6-75.4) for public, and private hospitals, respectively Hospital type (AOR:0.21; 95% CI: 0.13-0.35), service easiness (AOR:3.3; 95% CI: 2.0-5.8), hospital attractiveness (AOR:2.3; 95% CI: 1.2,4.5), privacy to access care (AOR:2.0; 95% CI: 1.1,4.1), information on plan of care (AOR:2.3; 95% CI; 1.1,4.6), information on medication (AOR:3.1; 95% CI; 1.5,6.3), and perceived intimacy with the provider (AOR: 0.4; 95% CI;0.2,0.8) were the factors associated with the practice. Conclusion Even though providing patient-centered care has been the focus of quality improvement in Ethiopia, this study showed it is mostly being implemented from the traditional provider-centered approach and public hospitals were lower in practice than private hospitals.

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Patient-Centered Care and Associated Factors at Public and Private Hospitals of Addis Ababa: Patients’ Perspective

Introduction Good glycemic control and preventing early complications are the ultimate targets of diabetes management, which depends on patients’ adherence to regimens. Even though highly potent and effective medications have been developed and manufactured with astonishing advancement over the past few decades, excellent glycemic control has remained elusive. Objective This study aimed to assess the magnitude and factors associated with medication adherence among type 2 diabetes (T2D) patients on follow-up at Adama Hospital Medical College (AHMC) in East Ethiopia. Methods A hospital-based cross-sectional study was conducted among 245 T2D patients on follow-up at AHMC from March 1 to March 30, 2020. Medication adherence reporting scale-5 (MARS-5) was utilized to collect information regarding patients’ medication adherence. The data were entered and analyzed using SPSS (Statistical Package for Social Sciences) version 21. The level of significance was declared at a p-value of  < .05. Results Of the 245 respondents, the proportion of respondents who adhere to diabetes medication was 29.4%, 95% CI [confidence interval] (23.7%–35.1%). After adjusting for khat chewing and adherence to blood glucose testing as confounding factors, being married (AOR [adjusted odds ratio]  =  3.43, 95%CI [1.27–4.86]), government employee (AOR  =  3.75, 95%CI [2.12–7.37]), no alcohol drinking (AOR  =  2.25, 95%CI [1.32–3.45]), absence of comorbidity (AOR  =  1.49, 95%CI [1.16–4.32]), and having diabetes health education at health institution (AOR  =  3.43, 95%CI [1.27–4.86]) were the factors associated with good medication adherence. Conclusion The proportion of T2D patients who adhere to medication in the study area was remarkably low. The study also found that being married, government employee, no alcohol drinking, absence of comorbidity, and having diabetes health education at a health institution were the factors associated with good medication adherence. Therefore, imparting health education on the importance of diabetes medication adherence by health professionals at each follow-up visit should be considered. Besides, awareness creation programs regarding diabetes medication adherence should be considered using mass media (radio and television).

Nigusie Shifera

Papers

Predictors of pregnant women's intention to vaccinate against coronavirus disease 2019: A facility-based cross-sectional study in southwest Ethiopia.

Preparedness and Readiness Against COVID-19 Pandemic in Prison Institutions and Detention Centers in Southwest Ethiopia

Psychoactive Substance Use and Its Associated Factors among Truck Drivers in Ethiopia.

Patient-Centered Care and Associated Factors at Public and Private Hospitals of Addis Ababa: Patients’ Perspective

Medication Adherence and Contributing Factors Among Type 2 Diabetes Patients at Adama Hospital Medical College in Eastern Ethiopia