Is social media, as a main source of information on COVID-19, associated with perceived effectiveness of face mask use? Findings from six sub-Saharan African countries.

BACKGROUND: The use of face masks as a public health approach to limit the spread of coronavirus disease 2019 (COVID-19) has been the subject of debate. One major concern has been the spread of misinformation via social media channels about the implications of the use of face masks. We assessed the association between social media as the main COVID-19 information source and perceived effectiveness of face mask use. METHODS: In this survey in six sub-Saharan African countries (Botswana, Kenya, Malawi, Nigeria, Zambia and Zimbabwe), respondents were asked how much they agreed that face masks are effective in limiting COVID-19. Responses were dichotomised as 'agree' and 'does not agree'. Respondents also indicated their main information source including social media, television, newspapers, etc. We assessed perceived effectiveness of face masks, and used multivariable logistic models to estimate the association between social media use and perceived effectiveness of face mask use. Propensity score (PS) matched analysis was used to assess the robustness of the main study findings. RESULTS: Among 1988 respondents, 1169 (58.8%) used social media as their main source of information, while 1689 (85.0%) agreed that face masks were effective against COVID-19. In crude analysis, respondents who used social media were more likely to agree that face masks were effective compared with those who did not [odds ratio (OR) 1.29, 95% confidence interval (CI): 1.01-1.65]. This association remained significant when adjusted for age, sex, country, level of education, confidence in government response, attitude towards COVID-19 and alternative main sources of information on COVID-19 (OR 1.33, 95%CI: 1.01-1.77). Findings were also similar in the PS-matched analysis. CONCLUSION: Social media remains a viable risk communication channel during the COVID-19 pandemic in sub-Saharan Africa. Despite concerns about misinformation, social media may be associated with favourable perception of the effectiveness of face masks.

COVID-19 risk perception among residents of seven sub-Saharan African countries: socio-demographic correlates and predicted probabilities.

INTRODUCTION: as the COVID-19 pandemic rages on, sub-Saharan Africa remains at high risk given the poor adherence to pandemic control protocols. Misconceptions about the contagion may have given rise to adverse risk behaviours across population groups. This study evaluates risk perception among 2,244 residents of seven countries in sub-Saharan Africa (Botswana, Kenya, Malawi, Nigeria, Tanzania, Zambia and Zimbabwe) in relation to socio-demographic determinants. METHODS: an online survey was conducted via social media platforms to a random sample of participants. Risk perception was evaluated across six domains: loss of income, food scarcity, having a relative infected, civil disorder, criminal attacks, or losing a friend or relative to COVID-19. A multivariable ordinal logistic regression was conducted to assess socio-demographic factors associated with the perceived risk of being affected by COVID-19. RESULTS: 595 (27%) respondents did not consider themselves to be at risk, while 33% perceived themselves to be at high risk of being affected by the pandemic with respect to the six domains evaluated. Hospital-based workers had the highest proportional odds (3.5; 95%CI: 2.3-5.6) high perceived risk. Teenage respondents had the highest predictive probability (54.6%; 95% CI: 36.6-72.7%) of perceiving themselves not to be at risk of being affected by COVID-19, while Zambia residents had the highest predictive probability (40.7%; 95% CI: 34.3-47.0%) for high-risk perception. CONCLUSION: this study reveals the need to increase awareness of risks among socio-demographic groups such as younger people and the unemployed. Targeted risk communication strategies will create better risk consciousness, as well as adherence to safety measures.

Vertical HIV transmission in perinatally-exposed infants in South-Rift region of Kenya: a retrospective cross sectional study.

BACKGROUND: Despite proven efficacy of the prevention mother-to-child transmission of HIV strategy, its adoption in Africa has remained slow. In Kenya, its effectiveness remain unknown. The aim of this study was to assess the effectiveness of a prevention of mother-to-child transmission program in Kenya. METHODS: This retrospective cross-sectional study analyzed 2,642 records of HIV-exposed infants who had a deoxyribonucleic acid polymerase chain reaction test done. The main outcome measure was HIV vertical transmission rates, stratified by i) infant age at diagnosis, ii) maternal prophylaxis and iii) infant mode of feeding. The characteristics of the infants who tested positive were compared to those who tested negative using Chi-square and Wilcoxon-Ranksum test. Bivariate and multivariate logistic regression analyses were conducted to establish associations and explore relationship between covariates and HIV transmission. RESULTS: One thousand and one hundred nineteen (42.4%) infants had dried blood spot samples taken for HIV deoxyribonucleic acid polymerase chain reaction test within the first 6 weeks of age. Median age at diagnosis for HIV-positive infants was 4 months (IQR 1.5-9) while that of HIV-negative infants was 2 months (IQR 1.5-6). In total, 1,906 (72.1%) infants received prophylactic antiretrovirals. Infants whose mothers received prophylaxis had significantly lower vertical transmission rate (6.7%) compared to those whose mothers did not receive prophylaxis (24.0%), (OR 0.23, p < 0.001). When adjusted for feeding option and infant's age at diagnosis, the odds of transmission among women who received prophylaxis was 76% lower than that of women who did not receive any prophylaxis (OR 0.2 p < 0.001). 1,368 infants less than 6 months of age, 67.3%) were exclusively breastfed, 214 (10.5%) were replacement fed, and 164 (8.1%) mixed fed. Mixed feeding was associated with increased risk of HIV transmission (OR 2.7, p = 0.007). 67% of children older than 6 months were breastfed and had higher HIV transmission rate compared to those who were not breastfed (OR 2.3, p = 0.006). CONCLUSIONS: The recorded rate of 9.3%, suggest the interventions implemented at the study sites were moderately effective, more so when provided early. Program performance will improve should the 12.8% of pregnant women who did not receive antiretroviral prophylaxis are reached.