Abstract
The unpredictability of the COVID-19 pandemic can induce psychological distress in individuals. We investigated perceived stressors, prevalence of psychological distress and suicidal ideation, and predictors of psychological distress among adults during the COVID-19 pandemic in Eswatini. This study was a cross-sectional, population-based household telephone survey of 993 conveniently sampled adults (18+ years) from all the four administrative regions of Eswatini. Data were collected between 9 June and 18 July 2020 during the first wave of the COVID-19 pandemic, when the country was under a partial lockdown. COVID-19-related psychological distress was assessed using the Kessler 6-item Psychological Distress Scale (K6). We performed weighted modified Poisson regression analyses to identify significant predictors of moderate/severe psychological distress (K6 scores: ≥5). The weighted prevalences of moderate (K6 scores: 5–12) and severe psychological distress (K6 scores: ≥13) were 41.7% and 5.4%, respectively. Participants reported several perceived COVID-19-related stressors, including worries and fears of the contagion-specific death, serious need for food and money, and concerns about loss of income or business. The weighted prevalence of suicidal ideation was 1.5%. Statistically significant predictors of increased risk for moderate/severe psychological distress included living in the Hhohho and Manzini regions; feeling not well informed about COVID-19; feeling lonely; having received COVID-19 food or financial relief from the government; feeling burdened by the lockdown; being married; and being youth (18–24 years). The results call for the government to urgently augment the provision of mental health services during the pandemic. Mental health practitioners and programs may use several stressors and risk factors identified in this study to inform interventions and government policies aimed at reducing psychological distress induced by the pandemic.
Highlights
Compared to those living in the Lubombo region, those living in the Hhohho and Manzini regions had increased risks of moderate/severe psychological distress, with adjusted risk ratios (ARRs) of 1.63 and 1.42, respectively, holding the other covariates constant in the model
Those who did not feel well informed about COVID-19 had a significantly increased risk of moderate/severe psychological distress with an ARR of 1.59 than those who felt well informed about the disease, holding the other covariates constant in the model
The prevalence of suicidal ideation was 1.5%. We found that those who lived in the Hhohho and Manzini regions, who felt not well informed about COVID-19, who felt lonely, who received COVID-19 food or financial relief from the government, who felt burdened by the lockdown, and who were married, as well as the youth had increased risks of moderate/severe psychological distress during the pandemic
Summary
The novel coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing global health emergency. 2021, there had been more than 175.3 million confirmed cases of COVID-19 globally, including more than 3.7 million deaths, of which more than 3.6 million of the global cases were from Africa, including 89,674 deaths [1]. In Eswatini, which is a small, landlocked, lower–middle-income country in Southern Africa with a population of about 1.1 million [2], the first case of COVID-19 was reported by the Ministry of Health (MoH) on 13 March 2020. By 13 June 2021, there had been 18,736 confirmed COVID-19 cases, including 676 deaths.
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