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A Descriptive-Multivariate Analysis of Community Knowledge, Confidence, and Trust in COVID-19 Clinical Trials among Healthcare Workers in Uganda.

ABSTRACT: Background-misinformation and mistrust often undermines community vaccine uptake, yet information in rural communities, especially of developing countries, is scarce. This study aimed to identify major challenges associated with coronavirus disease 2019 (COVID-19) vaccine clinical trials among healthcare workers and staff in Uganda. Methods-a rapid exploratory survey was conducted over 5 weeks among 260 respondents (66% male) from healthcare centers across the country using an online questionnaire. Twenty-seven questions assessed knowledge, confidence, and trust scores on COVID-19 vaccine clinical trials from participants in 46 districts in Uganda. Results-we found low levels of knowledge (i.e., confusing COVID-19 with Ebola) with males being more informed than females (OR = 1.5, 95% CI: 0.7-3.0), and mistrust associated with policy decisions to promote herbal treatments in Uganda and the rushed international clinical trials, highlighting challenges for the upcoming Oxford-AstraZeneca vaccinations. Knowledge, confidence and trust scores were higher among the least educated (certificate vs. bachelor degree holders). We also found a high level of skepticism and possible community resistance to DNA recombinant vaccines, such as the Oxford-AstraZeneca vaccine. Preference for herbal treatments (38/260; 14.6%, 95% CI: 10.7-19.3) currently being promoted by the Ugandan government raises major policy concerns. High fear and mistrust for COVID-19 vaccine clinical trials was more common among wealthier participants and more affluent regions of the country. Conclusion-our study found that knowledge, confidence, and trust in COVID-19 vaccines was low among healthcare workers in Uganda, especially those with higher wealth and educational status. There is a need to increase transparency and inclusive participation to address these issues before new trials of COVID-19 vaccines are initiated.

SUBMITTER: Kasozi KI

PROVIDER: S-EPMC8000597 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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A Descriptive-Multivariate Analysis of Community Knowledge, Confidence, and Trust in COVID-19 Clinical Trials among Healthcare Workers in Uganda.

Kasozi Keneth Iceland KI Laudisoit Anne A Osuwat Lawrence Obado LO Batiha Gaber El-Saber GE Al Omairi Naif E NE Aigbogun Eric E Ninsiima Herbert Izo HI Usman Ibe Michael IM DeTora Lisa M LM MacLeod Ewan Thomas ET Nalugo Halima H Crawley Francis P FP Bierer Barbara E BE Mwandah Daniel Chans DC Kato Charles Drago CD Kiyimba Kenedy K Ayikobua Emmanuel Tiyo ET Lillian Linda L Matama Kevin K Nelly Mak Shui Ching SC Onanyang David D Pius Theophilus T Nalumenya David Paul DP Ssebuufu Robinson R Rugambwa Nina Olivia NO Musoke Grace Henry GH Bardosh Kevin K Ochieng Juma John JJ Ssempijja Fred F Kyamanywa Patrick P Tumwine Gabriel G Alzahrani Khalid J KJ Welburn Susan Christina SC

Vaccines 20210312 3

Background-misinformation and mistrust often undermines community vaccine uptake, yet information in rural communities, especially of developing countries, is scarce. This study aimed to identify major challenges associated with coronavirus disease 2019 (COVID-19) vaccine clinical trials among healthcare workers and staff in Uganda. Methods-a rapid exploratory survey was conducted over 5 weeks among 260 respondents (66% male) from healthcare centers across the country using an online questionnai ...[more]

PMID: 33809269

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Project description:BackgroundMycetoma is an uncommon and neglected tropical disease in Uganda. We aimed to assess baseline knowledge and provide community health workers (CHWs) in Northern Uganda with knowledge to identify and refer presumptive mycetoma cases.MethodologyBetween March and August 2023, we conducted a concurrent triangulation mixed methods study among CHWs in Gulu and Pader districts on mycetoma. We conducted a 1 day in person training on mycetoma. Quantitative data were collected before (pretest), immediately (immediate posttest) and six months (6-month posttest) after the training and results compared using paired sample t test or one-way ANOVA. Qualitative data were collected using four focused group discussions, audio recorded, and analyzed using thematic content analysis.Principal findingsForty-five CHWs were enrolled, mostly male (66.7%, n = 30), with a median age of 36 years (IQR 29 43). Out of a total score of 18, the baseline mean knowledge score was 7±2.42, improving to 11±1.99 immediately posttest (p<0.001), and 10±2.35 at 6 months (p<0.001), without additional training. Significant knowledge improvements at 6 months were observed among female participants (p = 0.004), those aged 30 40 years (p = 0.031) or 40+ years (p = 0.035), and those with secondary education (p = 0.007). Over 6 months, CHWs screened 2,773 adults, identifying and referring 30 presumptive mycetoma cases. Qualitative findings revealed challenges and barriers to early identification and referral of mycetoma presumptive cases including limited knowledge, stigma, myths, lack of an indigenous name for mycetoma, delayed decision making, and transportation barriers.ConclusionsThis study highlights a significant knowledge gap among CHWs about mycetoma, with substantial improvement following training. The identification of presumptive cases by CHWs reflects their potential in community-based surveillance, emphasizing the need to integrate well-trained CHW to lead efforts for mycetoma surveillance and capacity building to enhance health outcomes in Uganda.

Project description:Background: Adequate information and knowledge about COVID-19 has been shown to induce the confidence and positive performance among healthcare workers (HCWs). Therefore, assessing the relationship between confidence in knowledge and associated factors among HCWs is vital in the fight against COVID-19. This paper investigates factors associated with HCWs' confidence in their overall knowledge about COVID-19 in South Africa in the early stages of the epidemic. Methods: Data utilized in this paper were from an online survey conducted among HCWs using a structured questionnaire on a data free online platform. The study population were all the medical fraternity in South Africa including medical and nurse practitioners as well as other healthcare professionals. Bivariate and multivariate logistic regression models were performed to examine the factors associated with confidence in HCWs' overall knowledge about COVID-19. Results: Overall, just below half (47.4%) of respondents indicated that they had confidence in their overall knowledge about COVID-19. Increased odds of having confidence in the knowledge about COVID-19 were significantly associated with being male [aOR = 1.31 95% CI (1.03-1.65), p < 0.05], having a doctorate degree [aOR = 2.01 (1.23-3.28), p < 0.05], being satisfied with the information about COVID-19 guidelines [aOR = 6.01 (4.89-7.39), p < 0.001], having received training in 6-8 areas [aOR = 2.54 (1.89-3.43), p < 0.001] and having received training in 9-11 areas [aOR = 5.33 (3.81-7.47), p < 0.001], and having already treated COVID-19 patients [aOR = 1.43 (1.08-1.90), p < 0.001]. Those who were highly concerned with the levels of training of HCWs [aOR = 0.47 (0.24-0.92), p < 0.05] had decreased odds of having confidence in their overall knowledge about COVID-19. Conclusion: This study sheds light on the importance of capacitating HCWs with knowledge and adequate relevant training as part of infection prevention control measures during pandemics. Future training and information sharing should be sensitive to knowledge gaps by age, gender, qualifications, professional categories, and experience.

Project description:BackgroundHealthcare workers (HCWs) are at high risk of acquiring SARS-CoV-2 and COVID-19 and may therefore be a suitable population for COVID-19 vaccine trials. We conducted a survey to evaluate willingness-to-participate in COVID-19 vaccine trials in a population of HCWs at three hospitals in Uganda.MethodsThe survey was conducted between September and November 2020. Using a standardised questionnaire, data were collected on socio-demographics, previous participation in health research, COVID-19 information sources, underlying health conditions, and willingness-to-participate in COVID-19 vaccine trials. Data were analysed descriptively and a binomial generalised linear model with a log link function used to investigate factors associated with unwillingness to participate.Results657 HCWs (female, 63%) were enrolled with a mean age of 33 years (Standard Deviation, 10). Overall willingness-to-participate was 70.2%. Key motivating factors for participation were: hope of being protected against COVID-19 (81.1%), altruism (73.3%), and the opportunity to get health care (26.0%). Selected hypothetical trial attributes reduced willingness-to-participate as follows: weekly-quarterly study visits over a 12-month period (70.2%-63.2%, P = 0.026); provision of approximately 50ml of blood at each study visit (70.2%-63.2%, P = 0.026); risk of mild-moderate local adverse reactions (70.2%-60.3%, P<0.001); chance of receiving candidate vaccine or placebo (70.2%-56.9%, P<0.001); and delay of pregnancy [Overall, 70.2%-57.1% P<0.001); Female, 62.8%-48.4% (P = 0.002); Male, 82.5%-71.5% (P = 0.003)]. Collectively, these attributes reduced willingness-to-participate from [70.2%-42.2% (P<0.001) overall; 82.5%-58.1% (P<0.001) in men; 62.8%-32.6% (P<0.001) in women]. Among individuals that were unwilling to participate, the commonest barriers were concerns over vaccine safety (54.6%) and fear of catching SARS-CoV-2 (31.6%). Unwillingness to participate was associated with being female (aRR 1.97, CI 1.46-2.67, P<0.001) and having university or other higher-level education (aRR 1.52, CI 1.05-2.2, P = 0.026).ConclusionsWillingness-to-participate in COVID-19 vaccine trials among HCWs in Uganda is high but may be affected by vaccine trial requirements and concerns about the safety of candidate vaccines.

Project description:IntroductionHealthcare facilities produce a variety of trash that, if handled improperly, could endanger the environment, the health of patients and clients, healthcare personnel, and the general public. Health staff have been given training on infection control and healthcare waste management. It is not apparent whether similar initiatives are taken for sanitary personnel, though. By evaluating sanitary workers' knowledge, attitudes, and practices about healthcare waste treatment in the Dodoma region of Tanzania, this study sought to clarify the situation.MethodsFrom March to August 2022 in Dodoma, Tanzania, a descriptive cross-sectional study using a quantitative methodology was conducted on 156 randomly chosen sanitary workers. The primary data collection instruments were structured questionnaires that were conducted by interviewers and a trash checklist that the research team created. Statistical Package for Social Sciences computer software was used to conduct a descriptive analysis of the data with a 95% confidence level and a 5% level of significance.ResultsThe average age was 28 ± 6.2 years, and there were 74.4% females. Of all of the health institutions under study, 78.4% of the generated medical waste was non-infectious, whereas 21.6% of it was infectious. The share of non-infectious and infectious healthcare waste created by regional referral hospitals was 43.5% and 13.2%, respectively. While 67.8% of sanitary workers believed that handling healthcare waste was not their problem and 63.6% of sanitary workers actually displayed subpar practices of handling healthcare waste, 74.4% of sanitary workers had low understanding about handling healthcare waste. Their procedures for handling medical waste were substantially influenced by the kind of healthcare facility, sex, education, job experience, knowledge, and attitude (p < 0.05).ConclusionSanitary staff members had limited understanding and thought they were less concerned with gathering, moving, and storing medical waste. To provide the highest level of health safety, national health policy and facility-based interventions must support and fund participatory waste management training that is tailored to the sociodemographic profiles of sanitary employees.

Project description:BackgroundVillage health workers (VHWs) can serve as a valuable resource to address public health needs in resource-limited settings such as Uganda. However, the successful implementation of VHW programs can be limited by poor acceptability among community members. Kisoro District Hospital (KDH) in Kisoro District, Uganda operates a VHW program and, at the time of the study, was expanding its services to 11 additional villages.ObjectiveThe objective of this study was to evaluate community perceptions of VHWs in villages of Kisoro District with no prior exposure to the KDH VHW program in order to improve community acceptance when expanding the program to additional villages.MethodsWe administered surveys to 658 community members from 11 villages to evaluate their perceptions of VHWs prior to receiving VHW services. Additionally, we conducted focus group discussions among 97 participants to explore perceptions of VHWs in further depth.FindingsCommunity members were generally accepting of VHWs. They preferred that VHWs provide both curative and preventive services across a broad range of health domains as opposed to a single disease. Expectations of the responsibilities of a VHW were influenced by agricultural occupational and household responsibilities, particularly for women. Participants expressed a preference to be actively involved in the selection and oversight of VHWs and that VHWs receive compensation.Conclusions1) Community members' expectations of VHWs are shaped by environmental, cultural, and social factors. 2) Active community engagement in the VHW program is key. 3) Aligning a VHW program with community perceptions may improve acceptance, in turn influencing effectiveness and sustainability. These findings were used to expand the KDH VHW Program into the participating villages in a manner consistent with community preferences. Our findings may provide guidance on enhancing the uptake of community-based VHW programs for VHW stakeholders and policymakers in other settings.

Dataset Information

A Descriptive-Multivariate Analysis of Community Knowledge, Confidence, and Trust in COVID-19 Clinical Trials among Healthcare Workers in Uganda.

Publications

A Descriptive-Multivariate Analysis of Community Knowledge, Confidence, and Trust in COVID-19 Clinical Trials among Healthcare Workers in Uganda.

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