COVID-19 In sub-Saharan Africa Research Articles

A systematic review and meta-analysis of compassion fatigue among healthcare professionals before and during COVID-19 in Sub-Saharan Africa.

Compassion fatigue is a significant concern globally, particularly in Sub-Saharan Africa, where the COVID-19 pandemic exacerbated existing challenges, placing unprecedented strain on healthcare professionals. This study systematically estimated the prevalence of compassion fatigue among healthcare professionals before and during COVID-19 in Sub-Saharan Africa. A systematic review was conducted using keywords in PubMed, ScienceDirect, Google Scholar, and grey literature, covering all literature published between 2012 and December 30, 2023. The search team independently conducted study selection, quality assessments, data extractions, and analysis of all included studies. The systematic review, reported following PRISMA guidelines, included 11 studies. The results show that the pooled overall prevalence of compassion fatigue in Sub-Saharan Africa was 70% (95% CI: 57-82, I2 = 88.37%). The highest prevalence was found in Eastern Africa at 74% (95% CI: 55-93, I2 = 94.40%), compared to 64% in Southern Africa (95% CI: 49-79, I2 = 59.01%). Nurses reported the highest rates of compassion fatigue at 80% (95% CI: 57-100, I2 = 34.77%), followed by general healthcare professionals at 59% (95% CI: 22-97, I2 = 94.11%) and nursing students at 50% (95% CI: 35-64, I2 = 0.00%). Before COVID-19, the overall prevalence of compassion fatigue was 66% (95% CI: 41-91, I2 = 27%). During COVID-19, this increased to 74% (95% CI: 63-85, I2 = 88.73%). Our results indicate that nearly 3 in 4 healthcare professionals in Sub-Saharan Africa experience compassion fatigue, and this prevalence increased due to the pandemic. The high prevalence underscores the importance of addressing and mitigating compassion fatigue to support the mental health and emotional well-being of healthcare professionals dedicated to helping others in challenging circumstances. Systematic registration: PROSPERO. REG No: CRD42023449462.

Evaluation of COVID-19 antigen rapid diagnostic tests for self-testing in Lesotho and Zambia.

The use of antigen rapid tests (Ag-RDTs) for self-testing is an important element of the COVID-19 control strategy and has been widely supported. However, scale-up of self-testing for COVID-19 in sub-Saharan Africa is still insufficient and there is limited evidence on the acceptability of self-testing and agreement between Ag-RDT self-testing and Ag-RDT testing by professional users. A joint collaboration (Botnar Research Centre for Child Health-European & Developing countries Clinical Trials Partnership)was established between Lesotho and Zambia to address these gaps in relation to Ag-RDT self-testing and contribute to increasing its use in the region. A cross-sectional study was conducted with qualitative and quantitative data analysis. Firstly, 14 in-depth cognitive interviews (5 in Zambia and 9 in Lesotho) were performed to assess the participants' understanding of the instructions for use (IFU) for self-testing. In a second step, evaluation of test agreement between Ag-RDT self-testing and Ag-RDT testing by professional user using SD Biosensor STANDARD Q COVID-19 Ag-RDT was performed. In Zambia, usability and acceptability of self-testing were also assessed. Cognitive interviews in Lesotho and Zambia showed overall good understanding of IFU. In Zambia, acceptability of self-testing was high, though some participants had difficulties in conducting certain steps in the IFU correctly. Agreement between Ag-RDT self-test and Ag-RDT by professional users in Lesotho (428 participants) and Zambia (1136 participants) was high, 97.3% (403/414, 95% CI: 95.3-98.7) and 99.8% (1116/1118, 95% CI: 99.4-100) respectively. Findings from this study support the use of Ag-RDT self-testing within COVID-19 control strategies in sub-Saharan Africa, contributing to increase the testing capacity and access in hard-to reach settings.

COVID-19 immune signatures in Uganda persist in HIV co-infection and diverge by pandemic phase

Little is known about the pathobiology of SARS-CoV-2 infection in sub-Saharan Africa, where severe COVID-19 fatality rates are among the highest in the world and the immunological landscape is unique. In a prospective cohort study of 306 adults encompassing the entire clinical spectrum of SARS-CoV-2 infection in Uganda, we profile the peripheral blood proteome and transcriptome to characterize the immunopathology of COVID-19 across multiple phases of the pandemic. Beyond the prognostic importance of myeloid cell-driven immune activation and lymphopenia, we show that multifaceted impairment of host protein synthesis and redox imbalance define core biological signatures of severe COVID-19, with central roles for IL-7, IL-15, and lymphotoxin-α in COVID-19 respiratory failure. While prognostic signatures are generally consistent in SARS-CoV-2/HIV-coinfection, type I interferon responses uniquely scale with COVID-19 severity in persons living with HIV. Throughout the pandemic, COVID-19 severity peaked during phases dominated by A.23/A.23.1 and Delta B.1.617.2/AY variants. Independent of clinical severity, Delta phase COVID-19 is distinguished by exaggerated pro-inflammatory myeloid cell and inflammasome activation, NK and CD8+ T cell depletion, and impaired host protein synthesis. Combining these analyses with a contemporary Ugandan cohort of adults hospitalized with influenza and other severe acute respiratory infections, we show that activation of epidermal and platelet-derived growth factor pathways are distinct features of COVID-19, deepening translational understanding of mechanisms potentially underlying SARS-CoV-2-associated pulmonary fibrosis. Collectively, our findings provide biological rationale for use of broad and targeted immunotherapies for severe COVID-19 in sub-Saharan Africa, illustrate the relevance of local viral and host factors to SARS-CoV-2 immunopathology, and highlight underemphasized yet therapeutically exploitable immune pathways driving COVID-19 severity.

Population and reproductive health dynamics under COVID-19 in Sub-Saharan Africa: Insights from scientific evidence

Population and reproductive health dynamics under COVID-19 in Sub-Saharan Africa: Insights from scientific evidence

Demand and supply of adolescent and young adult’s sexual and reproductive health services during COVID-19 in sub-Saharan Africa: A scoping review

The COVID-19 pandemic and its associated containment strategies have significantly impacted the logistics of supplying sexual and reproductive health (SRH) services to adolescents and young adults (AYA) in sub-Saharan Africa (SSA). Studies conducted in the region indicate an increase in sexual activity, particularly among young people, during the pandemic. However, the impact of these changes on their utilization of SRH services remains unclear. This scoping review aims to synthesize the available evidence on the impact of COVID-19 on the SRH behavior and service utilization of AYA. This review focuses on examining the demand and supply of SRH for AYA during the COVID-19 lockdown period (January 2020 – December 2021). Following the Arksey & O’Malley (2005) procedure and the Joanna Briggs Institute (JBI) Reviewer’s Manual (2020), the review encompasses comprehensive search strategies, analysis, and reporting of results. The search for relevant articles was conducted across various databases, including Medline Complete, Africa-Wide, SocINDEX, Academic Search Complete (all through EBSCOhost), Public Health, Social Science & Sociology databases, the Middle East & Africa Database (all through ProQuest), and Web of Science. Articles published between January 2020 and December 2021 were included in this review. The studies discussed in this review shed light on the discrepancies in the demand for and supply of SRH services during the COVID-19 pandemic, exposing a substantial gap in addressing the specific SRH needs of AYA. This review also examines the strategies adopted by countries in SSA to mitigate these effects. Several countries in SSA demonstrated resilience as health providers fulfilled their role, while AYA sought alternatives to mitigate the shortage in the supply chain for SRH services and commodities, often resorting to alternative medicine. The findings underscore the urgency of further research to address the risks imposed by COVID-19 on the utilization of SRH services by AYA in SSA. The evidence presented in this review can inform strategic efforts to ensure the availability and accessibility of SRH services for AYA during any unforeseen emergency or future pandemic.

COVID-19 in Sub-Saharan Africa: Impacts on land, governance, and livelihoods

This paper focuses on the impacts of COVID-19 on livelihoods, land access and governance in rural and peri-urban selected areas of Sub-Saharan Africa. Crises are usually expected to be worse for citizens in developing countries since most of their economic activities are in the informal sector, and access to the social protection programs is often limited and exclusionary. Those vulnerable and marginalized are often those who are hit the hardest and who struggle the most to recover after crises. The COVID-19 pandemic is no exception. Extended lockdowns have put livelihoods under stress, underlying patterns of fragile livelihoods and inequality. There are also particular vulnerabilities with regards to land access and livelihoods of vulnerable populations. Our case studies document how the pandemic has affected livelihoods through several mechanisms relating to land access, including distress sales due to economic hardships and exacerbating land conflicts due to increased pressure on land and increasing trends of urban-to-rural migration. We reflect on how households act and react when faced with shocks and how this affects not only their current access to livelihood assets but might undermine their options for the future. In addition, a range of other effects were identified in our case studies that we expect to negatively impact livelihood recovery.

Clinical epidemiology of COVID-19 among hospitalized children in rural western Kenya.

The epidemiology of pediatric COVID-19 in sub-Saharan Africa and the role of fecal-oral transmission in SARS-CoV-2 are poorly understood. Among children and adolescents in Kenya, we identify correlates of COVID-19 infection, document the clinical outcomes of infection, and evaluate the prevalence and viability of SARS-CoV-2 in stool. We recruited a prospective cohort of hospitalized children aged two months to 15 years in western Kenya between March 1 and June 30 2021. Children with SARS-CoV-2 were followed monthly for 180-days after hospital discharge. Bivariable logistic regression analysis was used to identify the clinical and sociodemographics correlates of SARS-CoV-2 infection. We also calculated the prevalence of SARS-CoV-2 detection in stool of confirmed cases. Of 355 systematically tested children, 55 (15.5%) were positive and were included in the cohort. The commonest clinical features among COVID-19 cases were fever (42/55, 76%), cough (19/55, 35%), nausea and vomiting (19/55, 35%), and lethargy (19/55, 35%). There were no statistically significant difference in baseline sociodemographic and clinical characteristics between SARS-CoV-2 positive and negative participants. Among positive participants, 8/55 (14.5%, 95%CI: 5.3%-23.9%) died; seven during the inpatient period. Forty-nine children with COVID-19 had stool samples or rectal swabs available at baseline, 9 (17%) had PCR-positive stool or rectal swabs, but none had SARS-CoV-2 detected by culture. Syndromic identification of COVID-19 is particularly challenging among children as the presenting symptoms and signs mirror other common pediatric diseases. Mortality among children hospitalized with COVID-19 was high in this cohort but was comparable to mortality seen with other common illnesses in this setting. Among this small set of children with COVID-19 we detected SARS-CoV-2 DNA, but were not able to culture viable SARs-CoV-2 virus, in stool. This suggests that fecal transmission may not be a substantial risk in children recently diagnosed and hospitalized with COVID-19 infection.

The Double-Edged Sword Effect of Social Media on COVID-19 in Sub-Saharan Africa

The COVID-19 pandemic has entered its third year ravaging the lives of people worldwide. During the pandemic, social media usage has increased significantly, as people seek not only for educative information about COVID-19 but also for platforms to collectively respond to the outbreak. An increase in traffic to websites and government sources has significantly contributed to an overall increase in internet usage during the pandemic. On a positive note, social media is being used by the scientific community as an ally to enhance research coordination and quickly disseminate crucial information about COVID-19 across geographical boundaries and time zones. However, a major problem with social media has been the spread of “infodemic” or widespread misinformation about treatment and vaccines for the virus. The COVID-19 “infodemic” led to an increase in vaccine hesitancy, panic, fear and confusion in people and it is amplifying rumours and questionable information. Consequently, the objective of this review is to look at the role of social media as a tool for the good, the bad and the ugly in the ongoing fight against COVID-19.

Application of the socio-ecological model in the efforts to end COVID-19 in Sub-Saharan Africa: The challenges and success stories.

The Novel Coronavirus (COVID-19) was detected in December 2019 in the Hubei Province of China. Also known as 2019-nCoV, the outbreak was declared a pandemic by the World Health Organization (WHO) in March 2020. The WHO thus proposed country and technical guidelines in responding to the COVID-19 pandemic. This paper reviewed the preparedness of sub-Saharan African (SSA) countries in ending the pandemic through the adoption of the WHO guidelines. The Socio-Ecological Model was adopted as a conceptual framework in conducting our analysis. We realized that while striving to implement the WHO guidelines, a plethora of microsystem, mesosystem, exosystem, macrosystem, and chronosystem factors make it difficult for SSA countries to achieve the desired results aimed at halting the spread of the virus. SSA countries may, therefore, not be able to end the COVID-19 pandemic soon. We recommend various interventions including short- and long-term loan facilities from donor agencies, decentralization of COVID-19 testing to sub-national levels, and increased community engagement to improve risk communication and adherence to public health measures to end the spread of COVID-19 in SSA.

Maternal COVID-19 infection and associated factors: A cross-sectional study.

Since the declaration of COVID-19 as a global pandemic, several studies have been conducted to examine associated factors. However, few studies have focused on pregnant women infected with COVID-19 in sub-Saharan Africa. Therefore, this study investigated the prevalence and factors associated with COVID-19 infection among pregnant women at the Levy Mwanawasa University Teaching Hospital and Women and Newborn Hospital of the University Teaching Hospitals in Lusaka, Zambia. A cross-sectional study was conducted between March and July 2021. Women were recruited as they presented for antenatal care. Data was collected using a structured questionnaire to capture variables of interest (socio-demographic, clinical and obstetric). COVID-19 diagnosis was made using a nasopharyngeal swab by PCR test. Multivariable logistic regression was used to control for confounding and calculate the odds ratios for each explanatory variable and respective 95% confidence intervals. The study enrolled 352 participants with a mean (standard deviation [SD]) age of 30.1 years (5.6). One hundred thirty of 352 (36.9%; 95% CI: 31.9 to 42.2) participants had a confirmed positive SARS-CoV-2 test result. At univariable analysis, factors associated with COVID-19 were increased gestational age, education status and maternal HIV serostatus. Women with a secondary level of education were less likely to have COVID-19 infection than those with a primary level of education (AOR = 0.23, 95% CI: 0.09-0.63). On the other hand, a one-week increase in gestational age was associated with higher odds of COVID-19 infection (AOR = 1.03, 95% CI: 1.01-1.06). The results showed that the prevalence of COVID-19 infection among pregnant women was 36.9% and was associated with increased gestational age and a lower level of education. To mitigate adverse maternal outcomes, there is a need to screen for COVID-19 strictly and broadly monitor prenatal women presenting for healthcare.

Trends in fertility intentions and contraceptive practices in the context of COVID-19 in sub-Saharan Africa: insights from four national and regional population-based cohorts

ObjectivesStudies in several sub-Saharan geographies conducted early in the COVID-19 pandemic suggested little impact on contraceptive behaviours. Initial results may mask widening disparities with rising poverty, and changes to women’s...

Risk factors for mortality in COVID-19 patients in sub-Saharan Africa: A systematic review and meta-analysis.

Mortality rates of coronavirus-2019 (COVID-19) disease continue to increase worldwide and in Africa. In this study, we aimed to summarize the available results on the association between sociodemographic, clinical, biological, and comorbidity factors and the risk of mortality due to COVID-19 in sub-Saharan Africa. We followed the PRISMA checklist (S1 Checklist). We searched PubMed, Google Scholar, and European PMC between January 1, 2020, and September 23, 2021. We included observational studies with Subjects had to be laboratory-confirmed COVID-19 patients; had to report risk factors or predictors of mortality in COVID-19 patients, Studies had to be published in English, include multivariate analysis, and be conducted in the sub-Saharan region. Exclusion criteria included case reports, review articles, commentaries, errata, protocols, abstracts, reports, letters to the editor, and repeat studies. The methodological quality of the studies included in this meta-analysis was assessed using the methodological items for nonrandomized studies (MINORS). Pooled hazard ratios (HR) or odds ratios (OR) and 95% confidence intervals (CI) were calculated separately to identify mortality risk. In addition, publication bias and subgroup analysis were assessed. Twelve studies with a total of 43598 patients met the inclusion criteria. The outcomes of interest were mortality. The results of the analysis showed that the pooled prevalence of mortality in COVID-19 patients was 4.8%. Older people showed an increased risk of mortality from SARS-Cov-2. The pooled hazard ratio (pHR) and odds ratio (pOR) were 9.01 (95% CI; 6.30-11.71) and 1.04 (95% CI; 1.02-1.06), respectively. A significant association was found between COVID-19 mortality and men (pOR = 1.52; 95% CI 1.04-2). In addition, the risk of mortality in patients hospitalized with COVID-19 infection was strongly influenced by chronic kidney disease (CKD), hypertension, severe or critical infection on admission, cough, and dyspnea. The major limitations of the present study are that the data in the meta-analysis came mainly from studies that were published, which may lead to publication bias, and that the causal relationship between risk factors and poor outcome in patients with COVID-19 cannot be confirmed because of the inherent limitations of the observational study. Advanced age, male sex, CKD, hypertension, severe or critical condition on admission, cough, and dyspnea are clinical risk factors for fatal outcomes associated with coronavirus. These findings could be used for research, control, and prevention of the disease and could help providers take appropriate measures and improve clinical outcomes in these patients.

The Paradox of COVID-19 in Sub-Saharan Africa: Why it is More Unethical Not to Investigate Low Dose Radiotherapy for COVID-19.

An accumulating body of evidence shows that various ethnicities are differentially affected by SARS-COV-2 infection. Moreover, some evidence shows that due to the vaccine inequity and millions of people living with HIV, a major catastrophe could occur in African countries that possibly affects the whole world. Given the possibility that Neanderthal genes confer a slight increase in susceptibility, this difference, at least to some extent, might possibly decrease the risk of the emergence of new SARS-CoV-2 variants among black people in Africa. Recent studies show less death and fewer cases among the ethnic group classified as “Black Africans”. Although Neanderthal DNA might explain some differences in morbidity and mortality of COVID-19, a multitude of confounders complicate things to where drawing definite conclusions is hard or even impossible. Using selective-pressure-free treatments (e.g. low dose radiotherapy) for COVID-19 pneumonia would be of crucial importance everywhere, but particularly in sub-Saharan Africa, where “long COVID” in millions of people with HIV paves the road for the more frequent emergence of new variants.

Private Savings and COVID-19 in Sub-Saharan Africa

Private Savings and COVID-19 in Sub-Saharan Africa

Unmet contraceptive needs and unintended pregnancies among adolescent girls amid COVID-19 in sub-Saharan Africa and the importance of accurate, reliable and real-time data

COVID-19 in sub-Saharan Africa (SSA) has had a significant negative impact on issues such as the reproductive health of young girls. One of the consequences of the pandemic is a shortage of contraceptives and devices due to supply chain disruptions. The concern is that due to a lack of data, it is unclear how much these restrictions have impacted contraceptive use among youth from sub-Saharan Africa during COVID-19. Thousands of Kenyan schoolgirls have become pregnant due to the lockdown. It was recently reported from Gauteng, one of the South African provinces, that between April 2020 and March 2021 there were over 23,000 teenage pregnancies, with 934 girls aged 10 to 14 giving birth. This opinion piece aims to stimulate discussion on these issues while also addressing the issue of the importance of data for studying contraceptive use and teenage pregnancy in the face of hard-hit pandemics such as the COVID-19 pandemic in SSA.

An Overview of COVID-19 in Sub-Saharan Africa: the Transmissibility,Pathogenicity, Morbidity and Mortality so far

An Overview of COVID-19 in Sub-Saharan Africa: the Transmissibility,Pathogenicity, Morbidity and Mortality so far

Overcoming Data Sparsity: A Machine Learning Approach to Track the Real-Time Impact of COVID-19 in Sub-Saharan Africa

The COVID-19 crisis has had a tremendous economic impact for all countries. Yet, assessing the full impact of the crisis has been frequently hampered by the delayed publication of official GDP statistics in several emerging market and developing economies. This paper outlines a machine-learning framework that helps track economic activity in real time for these economies. As illustrative examples, the framework is applied to selected sub-Saharan African economies. The framework is able to provide timely information on economic activity more swiftly than official statistics.

Assessment of Clinical Outcomes Among Children and Adolescents Hospitalized With COVID-19 in 6 Sub-Saharan African Countries

Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. This cohort study was a retrospective record review of data from 25 hospitals in the Democratic Republic of the Congo, Ghana, Kenya, Nigeria, South Africa, and Uganda from March 1 to December 31, 2020, and included 469 hospitalized patients aged 0 to 19 years with SARS-CoV-2 infection. Age, sex, preexisting comorbidities, and region of residence. An ordinal primary outcome scale was used comprising 5 categories: (1) hospitalization without oxygen supplementation, (2) hospitalization with oxygen supplementation, (3) ICU admission, (4) invasive mechanical ventilation, and (5) death. The secondary outcome was length of hospital stay. Among 469 hospitalized children and adolescents, the median age was 5.9 years (IQR, 1.6-11.1 years); 245 patients (52.4%) were male, and 115 (24.5%) had comorbidities. A total of 39 patients (8.3%) were from central Africa, 172 (36.7%) from eastern Africa, 208 (44.3%) from southern Africa, and 50 (10.7%) from western Africa. Eighteen patients had suspected (n = 6) or confirmed (n = 12) multisystem inflammatory syndrome in children. Thirty-nine patients (8.3%) died, including 22 of 69 patients (31.9%) who required intensive care unit admission and 4 of 18 patients (22.2%) with suspected or confirmed multisystem inflammatory syndrome in children. Among 468 patients, 418 (89.3%) were discharged, and 16 (3.4%) remained hospitalized. The likelihood of outcomes with higher vs lower severity among children younger than 1 year expressed as adjusted odds ratio (aOR) was 4.89 (95% CI, 1.44-16.61) times higher than that of adolescents aged 15 to 19 years. The presence of hypertension (aOR, 5.91; 95% CI, 1.89-18.50), chronic lung disease (aOR, 2.97; 95% CI, 1.65-5.37), or a hematological disorder (aOR, 3.10; 95% CI, 1.04-9.24) was associated with severe outcomes. Age younger than 1 year (adjusted subdistribution hazard ratio [asHR], 0.48; 95% CI, 0.27-0.87), the presence of 1 comorbidity (asHR, 0.54; 95% CI, 0.40-0.72), and the presence of 2 or more comorbidities (asHR, 0.26; 95% CI, 0.18-0.38) were associated with reduced rates of hospital discharge. In this cohort study of children and adolescents hospitalized with COVID-19 in sub-Saharan Africa, high rates of morbidity and mortality were observed among infants and patients with noncommunicable disease comorbidities, suggesting that COVID-19 vaccination and therapeutic interventions are needed for young populations in this region.

Mathematical modeling of COVID-19 pandemic in the context of sub-Saharan Africa: a short-term forecasting in Cameroon and Gabon.

In this paper, we propose and analyse a compartmental model of COVID-19 to predict and control the outbreak. We first formulate a comprehensive mathematical model for the dynamical transmission of COVID-19 in the context of sub-Saharan Africa. We provide the basic properties of the model and compute the basic reproduction number $\mathcal {R}_0$ when the parameter values are constant. After, assuming continuous measurement of the weekly number of newly COVID-19 detected cases, newly deceased individuals and newly recovered individuals, the Ensemble of Kalman filter (EnKf) approach is used to estimate the unmeasured variables and unknown parameters, which are assumed to be time-dependent using real data of COVID-19. We calibrated the proposed model to fit the weekly data in Cameroon and Gabon before, during and after the lockdown. We present the forecasts of the current pandemic in these countries using the estimated parameter values and the estimated variables as initial conditions. During the estimation period, our findings suggest that $\mathcal {R}_0 \approx 1.8377 $ in Cameroon, while $\mathcal {R}_0 \approx 1.0379$ in Gabon meaning that the disease will not die out without any control measures in theses countries. Also, the number of undetected cases remains high in both countries, which could be the source of the new wave of COVID-19 pandemic. Short-term predictions firstly show that one can use the EnKf to predict the COVID-19 in Sub-Saharan Africa and that the second vague of the COVID-19 pandemic will still increase in the future in Gabon and in Cameroon. A comparison between the basic reproduction number from human individuals $\mathcal {R}_{0h}$ and from the SARS-CoV-2 in the environment $\mathcal {R}_{0v}$ has been done in Cameroon and Gabon. A comparative study during the estimation period shows that the transmissions from the free SARS-CoV-2 in the environment is greater than that from the infected individuals in Cameroon with $\mathcal {R}_{0h}$ = 0.05721 and $\mathcal {R}_{0v}$ = 1.78051. This imply that Cameroonian apply distancing measures between individual more than with the free SARS-CoV-2 in the environment. But, the opposite is observed in Gabon with $\mathcal {R}_{0h}$ = 0.63899 and $\mathcal {R}_{0v}$ = 0.39894. So, it is important to increase the awareness campaigns to reduce contacts from individual to individual in Gabon. However, long-term predictions reveal that the COVID-19 detected cases will play an important role in the spread of the disease. Further, we found that there is a necessity to increase timely the surveillance by using an awareness program and a detection process, and the eradication of the pandemic is highly dependent on the control measures taken by each government.

Adopting population-based interventions towards sustaining child health services in the midst of COVID-19 in sub-Saharan Africa: application of the socio-ecological model.

Child health services remain one of the most cost-effective strategies in reducing child mortality which is still disturbingly high in sub-Saharan Africa (SSA). Efforts by governments and other stakeholders in response to the COVID-19 pandemic have inadvertently disrupted the provision of other essential health services including those focusing on children. This comes at the backdrop of the World Health Organization´s guidelines for countries to sustain priority services while fighting the COVID-19 pandemic. Underpinned by the Socio-Ecological Model (SEM), we propose population-based interventions which could help in sustaining child health services in the midst of COVID-19 in SSA. At the intrapersonal and interpersonal levels, educating mothers during routine community outreach services, during child welfare clinics, and in church/mosques could be useful. Education and sensitization of male partners could also be an important intervention. At the institutional and community levels, we recommend the allocation of more funds to other essential health services including child health services. The training and deployment of more general nurses, community health nurses/officers, and public health officers is imperative. The provision and adherence to COVID-19 preventive protocols at health facilities are also recommended at these levels. At the public policy level, insurance and tax relief packages for frontline professionals providing child health services and micro-credit facilities at reduced interest rates for women could be implemented towards sustaining the utilisation of child health services.