背景:2019年冠状病毒病(COVID-19)大流行是一种新发展的疾病,其应对措施在很大程度上取决于个人防护措施(PPM)的实践和遵守情况。
目的:本系统评价旨在研究非洲国家对COVID-19PPMs的知识和实践,正如已发表的文献中所记录的那样。
方法:对Scopus进行了系统搜索,PubMed,和WebofScience数据库使用适当的关键字和预定义的资格标准来选择相关研究。只有基于人群的原创性研究(包括定性、定量,和混合方法研究)在非洲完成,并以英语出版。筛选过程和数据提取根据PROSPERO(CRD42022355101)中的预注册方案进行,并遵循PRISMA(系统评价和荟萃分析的首选报告项目)指南。使用混合方法评估工具评估纳入研究的质量。主题分析用于系统地将研究总结为四个预定义的领域:i)关于PPM的知识和感知,ii)口罩使用,iii)社会/身体距离,和iv)洗手/卫生,包括他们各自的水平和相关因素。
结果:共纳入了12个非洲国家的58项研究,这些都是在2019年至2022年之间发布的。非洲社区,包括各种人口群体,对COVID-19PPM的知识和实践水平各不相同,缺乏个人防护设备(PPE)(主要是口罩),副作用(在医护人员中)是依从性差的主要原因。在几个非洲国家,洗手/卫生率特别低,特别是在城市贫民和贫民窟居民中,主要障碍是缺乏安全和清洁的水。各种认知(知识和感知),社会人口和经济因素与COVID-19PPMs的使用有关。此外,在区域层面上有明显的研究不平等,东非贡献了36.2%,西非20.7%,北非17.2%,南部非洲6.9%,也没有来自中非的单一国家研究。尽管如此,纳入研究的总体质量总体良好,因为他们满足了大多数质量评估标准。
结论:需要提高当地生产和供应PPE的能力。考虑各种认知,人口和社会经济差异,特别关注最脆弱的人,对于包容性和更有效的应对大流行战略至关重要。此外,需要更多关注和参与社区行为研究,以充分了解和解决当前非洲大流行的动态。
背景:研究方案已在PROSPERO(CRD420223555101)中注册。
With COVID-19 being a newly evolving disease, its response measures largely depend on the practice of and compliance with personal protective measures (PPMs).
This systematic
review aimed to examine the knowledge and practice of COVID-19 PPMs in African countries as documented in the published literature.
A systematic search was conducted on the Scopus, PubMed, and Web of Science databases using appropriate keywords and predefined eligibility criteria for the selection of relevant studies. Only population-based original research studies (including qualitative, quantitative, and mixed methods studies) conducted in Africa and published in the English language were included. The screening process and data extraction were performed according to a preregistered protocol in PROSPERO (CRD42022355101) and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Thematic analysis was used to systematically summarize the studies into 4 predefined domains: knowledge and perception of PPMs, mask use, social and physical distancing, and handwashing and hand hygiene, including their respective levels and associated factors.
A total of 58 studies across 12 African countries were included, published between 2019 and 2022. African communities, including various population groups, had varying levels of knowledge and practice of COVID-19 PPMs, with the lack of personal protective equipment (mainly face masks) and side effects (among health care workers) being the major reasons for poor compliance. Lower rates of handwashing and hand hygiene were particularly noted in several African countries, especially among low-income urban and slum dwellers, with the main barrier being the lack of safe and clean water. Various cognitive (knowledge and perception), sociodemographic, and economic factors were associated with the practice of COVID-19 PPMs. Moreover, there were evident research inequalities at the regional level, with East Africa contributing 36% (21/58) of the studies, West Africa contributing 21% (12/58), North Africa contributing 17% (10/58), Southern Africa contributing 7% (4/58), and no single-country study from Central Africa. Nonetheless, the overall quality of the included studies was generally good as they satisfied most of the quality assessment criteria.
There is a need to enhance local capacity to produce and supply personal protective equipment. Consideration of various cognitive, demographic, and socioeconomic differences, with extra focus on the most vulnerable, is crucial for inclusive and more effective strategies against the pandemic. Moreover, more focus and involvement in community behavioral research are needed to fully understand and address the dynamics of the current pandemic in Africa.
PROSPERO International Prospective Register of Systematic Reviews CRD42022355101; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022355101.