An unprecedented infodemic has been witnessed to create massive damage to human society. However, it was not thoroughly investigated. This systematic review aims to (1) synthesize the existing literature on the causes and impacts of COVID-19 infodemic; (2) summarize the proposed strategies to fight with COVID-19 infodemic; and (3) identify the directions for future research. A systematic literature search following the PRISMA guideline covering 12 scholarly databases was conducted to retrieve various types of peer-reviewed articles that reported causes, impacts, or countermeasures of the infodemic. Empirical studies were assessed for risk of bias using the Mixed-Methods Appraisal Tool. A coding theme was iteratively developed to categorize the causes, impacts, and countermeasures found from the included studies. Social media usage, low level of health/eHealth literacy, and fast publication process and preprint service are identified as the major causes of the infodemic. Besides, the vicious circle of human rumor-spreading behavior and the psychological issues from the public (e.g., anxiety, distress, fear) emerges as the characteristic of the infodemic. Comprehensive lists of countermeasures are summarized from different perspectives, among which risk communication and consumer health information need/seeking are of particular importance. Theoretical and practical implications are discussed and future research directions are suggested.

The causes, impacts and countermeasures of COVID-19 “Infodemic”: A systematic review using narrative synthesis

http://www.clinicalmicrobiologyandinfection.com/article/S1198743X22001677/pdf

Impact of COVID-19 and malaria coinfection on clinical outcomes: a retrospective cohort study

Introduction: It is well-recognized that containing COVID-19 successfully is determined by people’s prevention measures which are related to their knowledge, attitudes, and practices (KAP). This perception has attracted attention in low- and middle-income countries (LMIC) due to their fragile health systems and economies. The objective of this study was to understand how residents in Malawi perceived COVID-19, to determine the factors related to KAP. Methods: A semi-structured questionnaire was used for the data collection. A field-based survey was conducted among adult residents in Lilongwe, Malawi. Descriptive statistic, linear regression, the Chi-square test, and Pearson’s correlation statistics were used for data analysis. Results: A total of 580 questionnaires were involved. The mean knowledge, attitude, and practice (KAP) scores were 10 (SD = ±3, range: 3–19), 16 (SD = ±4, range: 5–25), and 2 (SD = ±1, range: 0–5), respectively. Lack of money and resources (39%) was the biggest challenge for people who practice prevention measures. Among the participants, the radio (70%) and friends/family (56%) were the main sources of information. A higher economic status was associated with better KAP. Conclusions: A low level of KAP was detected among the population. The people faced challenges regarding a lack of necessary preventive resources and formal information channels. The situation was worse considering vulnerable population who had low economic status. Further all-round health education is urgently needed along with providing adequate health supplies and ensuring proper information management.

https://www.mdpi.com/1660-4601/18/8/4090/pdf

Knowledge, Attitudes, and Practices Related to COVID-19 Among Malawi Adults: A Community-Based Survey.

To examine changes in vaccination of children younger than 1 year during the coronavirus disease 2019 (COVID-19) pandemic (March 2020-August 2021) in Haiti, Lesotho, Liberia and Malawi.We used data from health management information systems on vaccination of children aged 12 months or younger in districts supported by Partners In Health. We used data from January 2016 to February 2020 and a linear model with negative binomial distribution to estimate the expected immunization counts for March 2020-August 2021 with 95% prediction intervals, assuming no pandemic. We compared these expected levels with observed values and estimated the immunization deficits or excesses during the pandemic months.Baseline vaccination counts varied substantially by country, with Lesotho having the lowest count and Haiti the highest. We observed declines in vaccination administration early in the COVID-19 pandemic in Haiti, Lesotho and Liberia. Continued declines largely corresponded to high rates of COVID-19 infection and discrete stock-outs. By August 2021, vaccination levels had returned to close to or above expected levels in Haiti, Liberia and Lesotho; in Malawi levels remained below expected.Patterns of childhood immunization coverage varied by country over the course of the pandemic, with significantly lower than expected vaccination levels seen in one country during subsequent COVID-19 waves. Governments and health-care stakeholders should monitor vaccine coverage closely and consider interventions, such as community outreach, to avoid or combat the disruptions in childhood vaccination.Étudier les changements en matière de vaccination des enfants âgés de moins d’un an durant la pandémie de maladie à coronavirus 2019 (COVID-19) en Haïti, au Lesotho, au Liberia et au Malawi, entre mars 2020 et août 2021.Nous avons utilisé les données issues des systèmes d'information pour la gestion de la santé et portant sur la vaccination des enfants de moins de 12 mois, dans les districts soutenus par l'association Partners In Health. Nous nous sommes appuyés sur des données collectées entre janvier 2016 et février 2020, ainsi que sur un modèle linéaire avec distribution binomiale négative, afin d'estimer les chiffres d'immunisation attendus pour la période allant de mars 2020 à août 2021 en appliquant des intervalles de prévision de 95%, en supposant qu'il n'y ait pas eu de pandémie. Enfin, nous avons comparé ces prévisions avec les valeurs observées, puis calculé les excédents ou déficits en la matière pendant les mois de pandémie.Les chiffres de vaccination initiaux étaient très différents d'un pays à l'autre, le Lesotho enregistrant le plus faible taux et Haïti, le plus élevé. Nous avons constaté une diminution de l'administration des vaccins au début de la pandémie de COVID-19 en Haïti, au Lesotho et au Liberia. Les baisses continues correspondaient à des niveaux élevés d'infection à la COVID-19 et à des ruptures de stock distinctes. En août 2021, les taux de vaccination avaient repris un cours normal ou supérieur à la norme en Haïti, au Liberia et au Lesotho; au Malawi, ils sont restés inférieurs aux résultats escomptés.Les schémas de couverture vaccinale infantile ont varié en fonction des pays tout au long de la pandémie, avec des taux de vaccination nettement inférieurs aux prévisions dans l'un des pays durant les vagues successives de COVID-19. Les gouvernements et acteurs du secteur de la santé devraient surveiller attentivement la couverture vaccinale et envisager des interventions telles que la sensibilisation communautaire s'ils souhaitent éviter ou mettre fin aux interruptions dans la vaccination des enfants.Analizar los cambios en la vacunación de los niños menores de 1 año durante la pandemia de la coronavirosis de 2019 (COVID-19) (entre marzo de 2020 y agosto de 2021) en Haití, Lesotho, Liberia y Malawi.Se emplearon datos de los sistemas de información de gestión sanitaria sobre la vacunación de niños de 12 meses o menos en los distritos que reciben apoyo de Partners In Health. Se usaron datos de enero de 2016 a febrero de 2020 y un modelo lineal con distribución binomial negativa para estimar las cifras de inmunización esperadas para el periodo de marzo de 2020 a agosto de 2021 con intervalos de predicción del 95 %, suponiendo que no hay pandemia. Se compararon estos niveles esperados con los valores observados y se estimaron los déficits o excesos de inmunización durante los meses de la pandemia.El número de vacunas de referencia varió bastante según el país, siendo Lesotho el que tuvo el número más bajo y Haití el más alto. Se observó una disminución en la administración de vacunas al principio de la pandemia de la COVID-19 en Haití, Lesotho y Liberia. Las disminuciones continuas fueron en gran medida consecuencia de las altas tasas de infección por la COVID-19 y a la escasez de existencias. En agosto de 2021, los niveles de vacunación se habían acercado o superado los niveles esperados en Haití, Liberia y Lesotho; en Malawi los niveles seguían siendo inferiores a los esperados.Los patrones de cobertura de la inmunización infantil variaron según el país en el transcurso de la pandemia, con niveles de vacunación mucho más bajos de lo esperado en un país durante las siguientes oleadas de la COVID-19. Los gobiernos y las partes interesadas en la atención sanitaria deben supervisar de cerca la cobertura de la vacunación y contemplar intervenciones, como la divulgación en la comunidad, para evitar o superar las interrupciones de la vacunación infantil.فحص التغييرات في تطعيم الأطفال الذين تقل أعمارهم عن سنة واحدة خلال جائحة مرض فيروس كورونا 2019 (كوفيد 19) (مارس/آذار 2020 إلى أغسطس/آب 2021) في هايتي وليسوتو وليبيريا وملاوي.قمنا باستخدام بيانات من أنظمة معلومات الإدارة الصحية بخصوص تطعيم الأطفال الذين تصل أعمارهم إلى 12 شهرًا أو أقل في المناطق التي يدعمها شركاء في الصحة. استخدمنا البيانات من يناير (كانون الثاني) 2016 إلى فبراير (شباط) 2020، ونموذج خطي بتوزيع سالب ذي الحدين لتقدير أعداد التحصين المتوقعة للفترة من مارس (آذار) 2020 إلى أغسطس (آب) 2021، مع فواصل توقع بنسبة 95%، بافتراض عدم وجود جائحة. قمنا بمقارنة هذه المستويات المتوقعة بالقيم التي تمت ملاحظتها، وقمنا بتقدير أوجه القصور أو التجاوزات في التحصين خلال أشهر الجائحة.اختلفت أعداد التلقيح الأساسية بشكل كبير حسب الدولة، حيث سجلت ليسوتو أقل عدد، بينما سجلت هايتي الأعلى. ولاحظنا انخفاضات في إدارة التطعيم في وقت مبكر من جائحة كوفيد 19 في هايتي وليسوتو وليبيريا. وتتماشى الانخفاضات المستمرة إلى حد كبير مع المعدلات المرتفعة للإصابة بكوفيد 19، وحالات نفاد المخزون المستقلة. بحلول أغسطس (آب) 2021، عادت مستويات التطعيم إلى ما يقرب من المستويات المتوقعة أو أعلى منها في هايتي وليبيريا وليسوتو؛ بينما ظلت المستويات في ملاوي أقل من المتوقع.اختلفت أنماط تغطية تحصين الأطفال حسب الدولة خلال فترة الجائحة، مع مستويات تطعيم أقل من المتوقع بشكل ملحوظ في دولة واحدة خلال موجات كوفيد 19 التالية. يجب على الحكومات وأصحاب المصلحة في الرعاية الصحية القيام بمراقبة تغطية اللقاح عن كثب والنظر في التدخلات، مثل التوعية المجتمعية، لتجنب أو مكافحة الاضطرابات في تطعيم الأطفال.调查海地、莱索托、利比里亚、和马拉维在新型冠状病毒肺炎 (COVID-19) 疫情期间（2020 年 3 月至 2021 年 8 月）1 岁以下的儿童疫苗接种的变化情况。.我们使用了健康管理信息系统提供的由健康合作伙伴支持的地区 12 个月及以下儿童接种疫苗的数据。我们使用 2016 年 1 月至 2020 年 2 月的数据和负二项分布的线性模型，来估计 2020 年 3 月至 2021 年 8 月的疫苗接种剂数，假设没有疫情，预测区间为 95%。我们将这些预期水平与观察值进行了比较，并估计了疫情期间的免疫缺陷或免疫反应过度情况。.不同国家的基线疫苗接种计数差别很大，莱索托的疫苗接种计数最低，海地最高。我们观察到海地、莱索托和利比里亚在新型冠状病毒肺炎疫情早期疫苗接种率下降。这种持续下降在很大程度上与新型冠状病毒肺炎感染率高和离散性缺货有关。到 2021 年 8 月，海地、莱索托和利比里亚的疫苗接种水平已恢复到接近或高于预期水平；马拉维的接种水平仍低于预期水平。.在疫情期间，各国的儿童免疫接种覆盖模式各不相同，在随后新型冠状病毒肺炎的反复爆发中，一个国家的疫苗接种水平明显低于预期水平。政府和医疗卫生利益相关者应密切监测疫苗接种覆盖率，并考虑采取干预措施，如社区外联，以避免或应对儿童疫苗接种中断的问题。.Изучить изменения в вакцинации детей младше 1 года во время пандемии коронавирусной инфекции 2019 года (COVID-19) (март 2020 г. — август 2021 г.) в Гаити, Лесото, Либерии и Малави.Авторы использовали данные из информационных систем управления в области здравоохранения о вакцинации детей в возрасте 12 месяцев и младше в районах, которые получают поддержку от организации «Партнеры во имя здоровья». Авторы использовали данные с января 2016 г. по февраль 2020 г., а также линейную модель с отрицательным биномиальным распределением для оценки ожидаемого числа иммунизаций на март 2020 г. — август 2021 г. с 95%-ми интервалами прогнозирования при условии отсутствия пандемии. Авторы сравнили эти ожидаемые уровни с наблюдаемыми значениями и оценили дефицит или избыток иммунизации в месяцы пандемии.Исходные показатели вакцинации существенно различались в разных странах: самый низкий показатель был в Лесото, а самый высокий — в Гаити. В начале пандемии COVID-19 наблюдалось снижение уровня вакцинации в Гаити, Лесото и Либерии. Продолжающееся снижение в значительной степени соответствовало высоким показателям заражения COVID-19 и дискретным дефицитам. К августу 2021 г. в Гаити, Либерии и Лесото уровни вакцинации вернулись к ожидаемым уровням или превысили их. В Малави уровни остались ниже ожидаемых.На протяжении пандемии характер охвата детей иммунизацией отличался в разных странах, при этом в одной стране во время последующих волн COVID-19 уровень вакцинации был значительно ниже, чем ожидалось. Правительствам и заинтересованным сторонам в сфере здравоохранения следует внимательно следить за охватом вакцинацией и предусматривать информационно-просветительскую работу с населением во избежание сбоев в вакцинации детей или для противостояния таким сбоям. 

/pdf/childhood-immunization-during-the-covid-19-pandemic-1fmlcqd3.pdf

Childhood immunization during the COVID-19 pandemic: experiences in Haiti, Lesotho, Liberia and Malawi

BACKGROUND: Research about the coronavirus disease 2019 (COVID-19), its epidemiology and socio-economic impact on populations worldwide has gained attention. However, there is dearth of empirical knowledge in low- and middle-income settings about the pandemic's impact on survivors, particularly the tension of their everyday life arising from the experiences and consequences of stigma, discrimination and social exclusion, and how they cope with these behavioral adversities. METHODS: Realist qualitative approach drawing data from people clinically diagnosed positive of COVID-19, admitted into therapy in a designated treatment facility, and subsequently recovered and discharged for or without follow-up domiciliary care. In-depth interviews were conducted by maintaining a code book for identifying and documenting thematic categories in a progression leading to thematic saturation with 45 participants. Data were transcribed and coded deductively for broad themes at the start before systematically nesting emerging themes into the broad ones with the aid of NVivo 12 software. RESULTS: Everyday lived experiences of the participants were disrupted with acts of indirect stigmatization (against relatives and family members), direct stigmatization (labeling, prejudices and stereotyping), barriers to realizing full social life and discriminatory behaviors across socio-ecological structures (workplace, community, family, and social institutions). These behavioral adversities were associated with self-reported poor health, anxiety and psychological disorders, and frustrations among others. Consequently, supplicatory prayers, societal and organizational withdrawal, aggressive behaviors, supportive counseling, and self-assertive behaviors were adopted to cope and modify the adverse behaviors driven by misinformation and fearful perceptions of the COVID-19 and its contagious proportions. CONCLUSION: In the face of the analysis, social campaigns and dissemination of toolkits that can trigger behavior change and responsible behaviors toward COVID-19 survivors are proposed to be implemented by health stakeholders, policy and decision makers in partnership with social influencers, the media, and telecoms.

https://www.ijhpm.com/article_4093_ad94f9e94457b07d7c4f36d2fdb6fa29.pdf

Recovered but Constrained: Narratives of Ghanaian COVID-19 Survivors Experiences and Coping Pathways of Stigma, Discrimination, Social Exclusion and Their Sequels.

The world has witnessed rapid advancement and changes since the COVID-19 pandemic emerged in Wuhan, China. The significant changes experienced during these times remain unprecedented. The African continent has initiated significant responses to curb the spread of the pandemic. However, there is an increasing concern that rural Africa is facing serious challenges in their responses to the COVID-19 pandemic. This is due to the uncertainty if the populations are detached from or in synch with information on COVID-19. The findings reported here suggest that rural Africa is burdened with misinformation and infodemic regarding COVID-19 due to widespread misconceptions and anecdotal reports. It is, therefore, necessary to engage with community leaders to provide awareness campaigns in rural communities to ensure access to reliable information issued by local and international health authorities. It is pertinent to set up avenues that improve health literacy in communities in rural Africa as it is a major determinant of information assimilation.

/pdf/covid-19-misinformation-and-infodemic-in-rural-africa-1z2vfgz29a.pdf

COVID-19 Misinformation and Infodemic in Rural Africa.

Early marriage and its sad consequences to the girl child and socio-economic development of the nation has been an age-long issue being advocated against in many parts of Nigeria. At the onset of COVID-19, the teeming efforts to curb this issue almost got jeopardized with harsh economic situations in many households due to the lockdown and the willingness to marry off their girls to reduce this burden. Closure of schools and cases of sexual gender based violence also impacted the prevalence of early marriage during the pandemic in Nigeria. We also argue in this commentary that the pandemic has so much impacted on programs aimed at ending early marriage in the nation. Therefore, if serious and concerted efforts are not taken by relevant stakeholders, more girls will be at risk of early marriage and teenage pregnancy with their related health consequences. They will also be left behind in fulfilling their potentials and their aspirations cut off with early marriage, thus sustainable development cannot be achieved.

Early marriage and teenage pregnancy: The unspoken consequences of COVID-19 pandemic in Nigeria

Dear Editor, In recent years, e-cigarette use has become a global phenomenon, with many countries witnessing a surge in the number of its users [1]. The estimated number of e-cigarette users in 2018 was 58.1 million globally [1]. As the number of e-cigarette users continues to rise, there is also a growing interest on the phenomenon by the media [2] with portrayals from different persuasions and perspectives. In general, they are either presented negatively or positively. Positive in a sense of being a potential less harmful alternative to smoking, or explaining its increasing popularity, and negative in terms of the regulatory challenges they present and the seemingly bad consequences on the part of the users. Given that approximately 80% of the public relying on general media for health information, more than the percentage that rely on health care professionals, the media plays a key role in informing the public about its various health dimensions [3]. In this article, we discuss the portrayal of e-cigarettes in the news, its seeming implications and the need for balanced coverage. The debate over e-cigarette use continues among public health experts [4]. Some believe that e-cigarettes offer significant benefits to public health, such as being a less harmful alternative to traditional smoking, whereas others hold mixed opinions and strongly oppose their use [4]. This is why portrayal is quite dichotomous; and mostly leaning toward the extreme ends of the continuum. These opposing views and division is probably one reason why many countries have implemented regulations regarding the sale and use of e-cigarettes. For instance, the United States has introduced laws to restrict the marketing and sale of e-cigarettes to minors, whereas some countries, like Brazil and Singapore, have banned their sale altogether [5]. In countries like the United Kingdom, electronic cigarettes are considered to be 95% less harmful than traditional cigarettes, making them a safer alternative for smokers [6] thus portrayed as such by the media. The United Kingdom is an example of a country which has taken a more welcoming stance toward e-cigarette use as a tool for smoking cessation, with reputable public health agencies conducting independent research to scientifically validate their effectiveness. On the other hand, the World Health Organization (WHO) has a different stance by expressing its concern over the lack of regulation and potential health risks associated with e-cigarettes [7] in many countries. With the growing popularity of e-cigarettes, it is crucial to continue exploring and understanding both its potential benefits and at the same time risks to contribute to a well-informed public debate and discussion, at the same time addressing concerns related to their use. In countries where the media portrayal focuses on the negative aspects of e-cigarettes, there is potential silencing of voices of those who have had positive experiences using them. It is important to strive for a balanced view and to inform policy that does not dismiss the potential benefits of e-cigarettes as a smoking cessation aid. The media should allow for open discussion and research on e-cigarettes, rather than pushing a one-sided narrative. Different voices should be heard, without fear of being silenced, intimidated, or marginalized. The media remains to have a significant impact on the public's perception of electronic cigarettes, particularly in the context of African countries where little research is being done. The portrayal of e-cigarettes in the news can influence public opinion and shape government policies, as seen through the various policies countries have promulgated including banning or regulation. Moreover, the media remains a crucial source of information for individuals seeking guidance on health-related issues. It is imperative to understand how and why the media portrays electronic cigarettes in certain ways in African countries, as this could help inform public health interventions and policies. By analyzing news portrayals of e-cigarettes at an early stage of adoption and use, researchers can gain insight into the ways in which the media contribute and shape the ongoing debate over their regulation. Various media portrayals of electronic cigarettes have varying consequences, including public panic and policy-making that are not based on scientific evidence. The choice of news sources may influence how the issue is framed. A recent study comparing news coverage of e-cigarettes in the USA, United Kingdom, and Korea found that the most prominent argument in the USA and United Kingdom was that e-cigarettes are less harmful than combustible cigarettes, whereas Korean news focused on e-cigarette ingredients [8]. These differences may be due to regional differences in priorities and research. Research has shown that media coverage of electronic cigarettes tends to have emphasis on the opinions of government officials and lawmakers rather than those of health experts and electronic cigarette users [9]. As a result, news coverage may present a partial or skewed picture of the issue. This can lead to the sidelining of the views of vulnerable stakeholders, such as electronic cigarette users, who are not given an adequate platform to share their firsthand experiences with the benefits and negative consequences of using electronic cigarettes. News representation is often selective and influenced by political, economic, or ideological aims, according to some scholars. This suggests that people's perceptions of electronic cigarettes may be shaped more by the perspectives of social–political elites than the voices of consumers who have firsthand information about using electronic cigarettes. It is important for news coverage of electronic cigarettes to include a range of perspectives. Health news is more likely to use alarm frames than coping frames [10]. Health issues like diseases are often depicted as killers, plagues, or hostile combatants in war, which can cause fear and vulnerability to the public. The use of such frames is sometimes attributed to the media's desire to gain public attention and maximize profit. This may conflict with the journalistic norm of objectivity. A mixed frame that features both high alarm information and high coping information is most likely to promote public health effects. The portrayal of e-cigarettes in the news requires a balanced view of its risk and benefits. Although some media coverage may overemphasize the potential risks and negative consequences, other news outlets may focus solely on the benefits and downplay the potential harm. It is important for journalists and media organizations to seek a diverse range of perspectives and sources, including those of health experts and electronic cigarette users, to provide a comprehensive and accurate picture of this issue. The media must continue to inform public debate and policymaking on electronic cigarettes in a more balanced and objective manner. This paper was conceptualized by Chimwemwe Ngoma and developed by Chimwemwe Ngoma, Samar Mohamed Alhaj, Uchenna Frank Imo, and Gabriel Ilerioluwa Oke. Chimwemwe Ngoma was involved in data acquisition and data interpretation. Chimwemwe Ngoma, Samar Mohamed Alhaj, Yusuff Adebayo Adebisi, Uchenna Frank Imo, and Gabriel Ilerioluwa Oke were involved in the drafting of the work and revising it critically for important intellectual content. The authors received no funding to develop this paper. The authors have either previously or currently been recipients of tobacco harm reduction scholarships awarded by Knowledge-Action-Change, a public health organization with a specific focus on tobacco harm reduction. The views and opinions expressed in the contents of this paper are the sole responsibility of the authors, and should not, under any circumstances, be regarded as reflecting the positions of Knowledge-Action-Change. Yusuff Adebayo Adebisi is an Editorial Board member of Public Health Challenges and a coauthor of this article. To minimize bias, he was excluded from all editorial decision-making related to the acceptance of this article for publication. This paper did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors. None. This is a Letter to the Editor and all sources used have been properly cited. 

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/puh2.84

Samar Mohammed Alhaj

Papers

COVID-19 Misinformation and Infodemic in Rural Africa.

Early marriage and teenage pregnancy: The unspoken consequences of COVID-19 pandemic in Nigeria

Portrayal of electronic cigarettes in the news