Acceptance of COVID-19 vaccine among sub-Saharan Africans (SSA): a comparative study of residents and diasporan dwellers.

BACKGROUND: The COVID-19 vaccines are being rolled out across all the sub-Saharan Africa (SSA) countries, with countries setting targets for achieving full vaccination rates. The aim of this study was to compare the uptake of, resistance and hesitancy to the COVID-19 vaccine between SSA locally residents and in the diasporan dwellers. METHODS: This was a cross-sectional study conducted using a web and paper-based questionnaire to obtain relevant information on COVID-19 vaccine acceptance. The survey items included questions on demography, uptake and planned acceptance or non-acceptance of the COVID-19 vaccines among SSAs. Multinomial logistic regression was used to determine probabilities of outcomes for factors associated with COVID-19 vaccination resistance and hesitancy among SSA respondents residing within and outside Africa. RESULTS: Uptake of COVID-19 vaccines varied among the local (14.2%) and diasporan (25.3%) dwellers. There were more locals (68.1%) who were resistant to COVID-19 vaccine. Participants' sex [adjusted relative risk (ARR) = 0.73, 95% CI: 0.58 - 0.93], education [primary/less: ARR = 0.22, CI:0.12 - 0.40, and bachelor's degree: ARR = 0.58, CI: 0.43 - 0.77]), occupation [ARR = 0.32, CI: 0.25-0.40] and working status [ARR = 1.40, CI: 1.06-1.84] were associated with COVID-19 vaccine resistance among locals. Similar proportion of local and diasporan dwellers (~ 18% each) were hesitant to COVID-19 vaccine, and this was higher among health care workers [ARR = 0.25, CI: 0.10 - 0.62 and ARR = 0.24, CI:0.18-0.32, diaspora and locals respectively]. After adjusting for the potential confounders, local residents aged 29-38 years [ARR = 1.89, CI: 1.26-2.84] and lived in East Africa [ARR = 4.64, CI: 1.84-11.70] were more likely to report vaccine hesitancy. Knowledge of COVID vaccines was associated with hesitancy among local and diasporan dwellers, but perception was associated with vaccine resistance [ARR = 0.86,CI: 0.82 - 0.90] and hesitancy [ARR = 0.85, CI: 0.80 - 0.90], only among the local residents. CONCLUSIONS: Differences exist in the factors that influence COVID-19 vaccine acceptance between local SSA residents and thediasporan dwellers. Knowledge about COVID-19 vaccines affects the uptake, resistance, and hesitancy to the COVID-19 vaccine. Information campaigns focusing on the efficacy and safety of vaccines could lead to improved acceptance of COVID-19 vaccines.

Habitual visual acuity and visual acuity threshold demands in Nigerian school classrooms.

This study was designed to estimate the burden of blindness and vision impairment in school children, and to determine the proportion of students meeting the visual acuity (VA) demand for their classrooms. From 148 primary and secondary school classrooms in Edo State, Nigeria, the habitual distance and near VA of over 2000 students were measured. Values obtained were compared with the calculated distance VA demand and actual near VA demand for their classrooms. Measures used to calculate the VA demand were working distance and smallest text size on learning materials, at both distance and near. We also determined the relationship between age and calculated VA demand and the effect of factors such as school ownership and school type on the VA  demand. Habitual distance vision impairment was found in 0.8% of pupils, including 2 (0.10%) who met the WHO criteria for blindness. The average VA demand at the furthest and nearest sitting position to the board was 0.21 ± 0.23 and 0.65 ± 0.33LogMAR, respectively. Near working distance of students ranged from 15.00 to 37.20 cm, and the near VA demand as well as actual near VA demand (using a 2.5 times acuity reserve) was 0.60 ± 0.17 and 0.20 ± 1.7LogMAR, respectively. LogMAR VA demand increased (size of print decreases) with increasing age, at both distance (r = - 0.549, p = 0.070) and near (r = - 0.921, p < 0.0001). The VA demand at maximum distance and the actual near VA demand differed significantly by school ownership and between primary and secondary schools. Most students had VA better, but up to 11% of students per class had VA poorer than their classroom demands. Although the majority of students had better VA than their classroom demands, for students with reduced vision, learning could be negatively impacted. It is important to continually screen students for vision impairment and ensure prompt referral and treatment. These findings have implications for managing vision problems in children, as well as enabling appropriate classroom arrangements for those with vision impairment.

Analysis of Perception, Reasons, and Motivations for COVID-19 Vaccination in People with Diabetes across Sub-Saharan Africa: A Mixed-Method Approach.

Diabetes mellitus (DM) is associated with severe COVID-19 infection and complications. This study assesses COVID-19 vaccine acceptance and hesitancy in people with DM, and explores the reasons for not being vaccinated. This was a web-based cross-sectional survey using a mixed-method approach conducted in March-May 2021, corresponding to most Sub-Saharan African (SSA) countries' early vaccine rollout period. Participants were those aged ≥18 years with self-reported DM in 11 Sub-Saharan African (SSA) countries. Responses to comments on the reasons for vaccine hesitancy and facilitators for vaccine uptake were analyzed. Of the 73 participants with DM, 65.8% were males, older than 35 years (86.3%), had postsecondary education (90%), and a significant proportion were from South Africa (39.7%), Nigeria (28.8%) and Ghana (13.7%). At the time of this study, 64.4% experienced COVID-19 symptoms, 46.6% were tested for COVID-19, of which 19.2% tested positive. Few participants (6.8%) had received a COVID-19 vaccination, 65.8% were willing to take the vaccine when it becomes available in their country, while 26.0% either refused or remained hesitant towards taking the vaccine. The main identified reasons for not taking the vaccine were: advice from religious leaders; concerns about the safety, effects, and efficacy of the vaccines; mistrust of the pharmaceutical companies producing the vaccines and the process of production; the conspiracy theories around the vaccines; and the personal belief of the participants regarding vaccination. However, participants stated they would take the vaccine if they were more educated about it, received positive feedback from those vaccinated, were rewarded for taking the vaccine, or if vaccination became a condition for travel and employment. In conclusion, this study shows that the uptake of the COVID-19 vaccine was very low in this high-risk group. Efforts to increase the uptake of COVID-19 vaccines among people with diabetes are imperative, such as the provision of education and relevant information.