RESUMO
During the COVID-19 pandemic in Kenya, 5,311 handwashing stations were distributed by the National Business Compact Coalition (NBCC) to help combat the virus. This study evaluated 316 of these stations across five counties, assessing functionality, usability, and accessibility. Quantitative data, including spot checks and surveys, revealed that 83.9% of the evaluated stations were functional, with paid caretakers, which is associated with higher functionality rates. Qualitative insights underscored challenges such as inadequate signage and limited soap and water availability, particularly affecting individuals with disabilities. Despite initial success, only 61% of stations remained functional 6-8 months post-distribution, often due to relocation by caretakers. Future distributions should prioritize long-term support for caretakers to sustain station functionality. This study highlights the importance of ongoing monitoring and support for public handwashing facilities in pandemic response efforts.
Assuntos
COVID-19 , Desinfecção das Mãos , Pandemias , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Quênia/epidemiologia , Estudos Transversais , Pandemias/prevenção & controle , SARS-CoV-2/isolamento & purificaçãoRESUMO
The global emergence of coronavirus disease 2019 (COVID-19) posed unprecedented challenges, jeopardizing decades of progress in healthcare systems, education, and poverty eradication. While proven interventions such as handwashing and mass vaccination offer effective means of curbing COVID-19 spread, their uptake remains low, potentially undermining future pandemic control efforts. This systematic review synthesized available evidence of the factors influencing vaccine uptake and handwashing practices in Kenya, Uganda, and Tanzania in the context of COVID-19 prevention and control. We conducted an extensive literature search across PubMed, Science Direct, and Google Scholar databases following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Out of 391 reviewed articles, 18 were eligible for inclusion. Some of the common barriers to handwashing in Kenya, Uganda, and Tanzania included lack of trust in the government's recommendations or messaging on the benefits of hand hygiene and lack of access to water, while some of the barriers to vaccine uptake included vaccine safety and efficacy concerns and inadequate awareness of vaccination sites and vaccine types. Enablers of handwashing practices encompassed hand hygiene programs and access to soap and water while those of COVID-19 vaccine uptake included improved access to vaccine knowledge and, socio-economic factors like a higher level of education. This review underscores the pivotal role of addressing these barriers while capitalizing on enablers to promote vaccination and handwashing practices. Stakeholders should employ awareness campaigns and community engagement, ensure vaccine and hygiene resources' accessibility, and leverage socio-economic incentives for effective COVID-19 prevention and control. Clinical trial registration: [https://clinicaltrials.gov/], identifier [CRD42023396303].
Assuntos
COVID-19 , Desinfecção das Mãos , Humanos , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Quênia , Tanzânia , Uganda , ÁguaRESUMO
Introduction: Coronavirus Disease 2019 (COVID-19) presents a massive challenge in Africa due to overwhelmed and underresourced health systems, as well as the existing burden of communicable and non- communicable diseases. Self-inoculation may occur when an individual touches their mucous membrane following direct contact between their hands and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-contaminated surfaces. Therefore, handwashing can be used along with COVID-19 vaccines to reduce the spread of SARS-CoV-2 and the burden of COVID-19. We were interested in investigating the levels of handwashing and vaccine uptake to control and prevent COVID-19 in Kenya, Uganda and Tanzania using a systematic review and meta-analysis. Methods: We searched PubMed, African Index Medicus and African Journals Online for studies published since inception to 31st January 2023. We included all studies that assessed: the levels of COVID-19 vaccine acceptance and hesitance as indicators of vaccine uptake; and studies on the levels of handwashing to prevent and control COVID-19 in Kenya, Uganda and Tanzania. Study findings were synthesized by meta-analysis to get the pooled effect measure. Three studies were synthesized qualitatively due to high level of heterogeneity in effect measure precluding a quantitative meta-analysis. Results: Our search identified 128 articles of which 17 studies with 18,305 participants and 622 vaccination sites were reviewed with 14 of them being meta-analyzed. This systematic review and meta-analysis reports high levels of COVID-19 vaccine acceptance and handwashing in Kenya, Uganda and Tanzania at 67% (95% CI: 55, 78) and 88% (95% CI: 73, 97), respectively. Vaccine hesitance among the participants was low at 31% (95% CI: 15, 49). Discussion: Despite their importance in the control and prevention of COVID-19, some countries do not implement handwashing and vaccination effectively. There is a need for public health strategies to raise awareness about the importance of handwashing and the uptake of the COVID-19 vaccine. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, PROSPERO ID CRD42023394698.