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Background: The coronavirus disease (COVID-19) outbreak has caused a universal health crisis resulting in significant morbidities and mortalities particularly among high-risk groups. This study sought to determine regional factors associated with knowledge and attitude towards COVID-19 mitigation practices and risk perception of contracting the disease in Sub-Saharan African (SSA) countries. Methods: A cross-sectional anonymous online study was conducted among 1970 participants between April and May 2020, during the lockdown in many SSA countries. Recruitment of participants was via WhatsApp, Facebook and emails using authors’ networks. The outcome variables were KAP (knowledge, attitudes and practice) of COVID-19 and analysis of variance (ANOVA) with post hoc test was run to assess the level of KAP by four regions in SSA. Simple and multiple linear regression (MLR) analyses were performed to examine factors associated with the outcome measures in the four SSA regions. Results: Mean knowledge (P=0.707) and risk perception (P=0.904) scores by four regions in SSA did not differ significantly. However, the mean attitude score was higher among West Africans compared with Southern (P=0.019) and Central Africans (P=0.003). MLR analysis revealed that among those living in West (adjusted coefficient β=-0.83 95% CI: -1.19, -0.48) and Southern Africa (β=-0.91 95% CI: -1.42, -0.40), having a primary or secondary education was associated with a decrease in knowledge scores while not being worried about COVID-19 decreased risk perception scores across the four SSA regions(West [β=-6.57, 95% CI: -7.53, -5.62], East [β=-6.24: 95% CI: -8.34,-4.15], Central [β=-6.51, 95% CI: -8.70, -4.31], and Southern Africa [β=-6.06: 95% CI: -7.51, -4.60]). Except among Southern Africans, participants who practiced self-isolation had positive attitude towards COVID-19. Conclusion: Future research on health education regarding COVID-19 or a future related pandemic in SSA should target people with lower education, those who do not self-isolate, those living in Southern and Western Africa and not worried about contracting COVID-19.

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.

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 diaspora. 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 diaspora (25.3%) residents. There was more resistance to COVID-19 vaccine among locals (68.1%) and across the sociodemographic variables of sex [adjusted Relative Risk (ARR) =0.73, 95% CI; 0.58 – 0.93], primary/less [ARR =0.22, 95% CI; 0.12 – 0.40] and bachelor’s degree [ARR =0.58, 95% CI; 0.43 – 0.77] educational levels, occupation [ARR =0.32, 95% CI; 0.25 - 0.40] and working status [ARR =1.40, 95%CI; 1.06 - 1.84]. COVID-19 vaccine hesitancy was almost similar between locals and diasporas (17.7% and 17.8% respectively) significant only among healthcare workers [ARR =0.46, 95% CI; 0.16 – 1.35] in the diaspora after adjusting for the variables. Similarly, knowledge and perception of COVID-19 vaccine among locals were substantial, but only perception was remarkable to resistance [ARR =0.86, 95% CI; 0.82 – 0.90] and hesitancy [ARR =0.85, 95% CI; 0.80 – 0.90] of the vaccine. Conclusions: Differences exist in the factors that influence COVID-19 vaccine acceptance between local SSA residents and those in the diaspora. 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.

Background Vaccination remains the most powerful weapon against the emergence of new variants of coronavirus (COVID-19). However, false information about COVID-19 vaccines through various platforms including social media remain a major threat to global public health. The study examined the impact of information sources on COVID-19 vaccine hesitancy and resistance in sub-Saharan Africa (SSA). Methods A validated web-based questionnaire was administered in French and English to 2572 participants from sub-Saharan African (SSA) countries including Cameroon, Ghana, Kenya, Mozambique, Nigeria, South Africa, Tanzania, who were aged 18 years and over. An e-link to the survey was disseminated via emails and posted on social media platforms (Facebook and WhatsApp). The COVID-19 vaccination status (vaccinated, hesitancy and resistance) and their association with sources of information (mainstream media and social media) were assessed by conducting multinomial logistic regression analyses. Results The prevalence of vaccine resistance and hesitancy in SSA was higher among social media users (72.2 and 84.5%) and those that watched TV (73.0 and 79.7%), but lower among newspaper readers (42.5 and 36.7%) respectively, during the pandemic. Multivariate analysis revealed that Southern and Central African respondents were more likely rely on TV for information, women and those who smoke were more likely to rely on friends and family members for information during the pandemic. Lower education (primary education or less) was associated with lower likelihood of social media use for COVID-19 related information compared with postgraduate qualification (aOR 0.36, 95%CI 0.20, 0.62). Resistance to COVID-19 vaccination was associated with reliance families and friends (aOR 1.44, 95%CI = 1.08, 1.93), watching TV (aOR 1.54, 95%CI = 1.11, 2.14) and social media use (adjusted odds ratio aOR 2.93, 95%CI = 2.10, 4.09), which was also associated with vaccine hesitancy (aOR 1.46, 95%CI = 1.15, 1.85) among the respondents. Conclusions Our study showed that reliance on social media and television had the strongest impact on vaccine hesitancy. However, further research and investments are needed to improve the availability of reliable healthcare information in these channels to protect people and empower them to make appropriate choices about their health.

Background Vaccination remains the most powerful weapon against the emergence of new variants of coronavirus (COVID-19). However, false information about COVID-19 vaccines through various platforms including social media remains a major threat to global public health. This study examined the impact of information sources on COVID-19 vaccine hesitancy and resistance in sub-Saharan Africa (SSA). Methods A validated web-based cross-sectional study was conducted from 14 March to 16 May 2021, and was administered in both French and English to 2572 participants aged 18 years and over. Data on sociodemographic characteristics, medical and vaccination history, and the information sources (mainstream media and social media) used by the participants during the pandemic were obtained. There were three main outcomes: The vaccinated group were those who responded in the affirmation (Yes) to the question of whether they have been vaccinated against COVID-19. Those who responded ‘not sure’ or ‘no’ to the question were then asked if they were willing to be vaccinated when the vaccine became available in their home countries. The responses to this follow-up question were used to derive the second and third outcome variables of ‘vaccine hesitancy’ and ‘vaccine resistance’, respectively. A series of logistic regression analyses were used to examine the impact of information sources on the three main outcomes. Results The prevalence of COVID-19 vaccine hesitancy among the participants was lowest among newspaper readers (42%) and highest among TV (72%) and social media users (73%). The prevalence of COVID-19 vaccine-resistance was also lowest among newspaper readers (37%) but highest among social media users (87%). Multivariate analyses revealed that compared to those who did not use these information sources, SSA participants who relied on the radio (aOR 0.83, 95%CI = 0.70, 0.99), TV (aOR 0.80, 95%CI = 0.65, 0.97) and social media (aOR 0.79, 95%CI = 0.65, 0.97) for information during the pandemic were less likely to be hesitant towards taking the vaccines. However, social media users (aOR 2.13, 95%CI = 1.62, 2.80), those who watched TV (aOR 1.40, 95%CI =1.08, 1.80), relied on healthcare workers (HCWs: aOR 1.32, 95%CI = 1.07, 1.63) and families/friends (aOR 1.31, 95%CI = 1.06, 1.61) for COVID-19 related information during the pandemic were more likely to resist taking the COVID vaccines in this study. Participants who relied on the newspaper for information during the pandemic were less likely to resist the vaccines (aOR 0.77, 95%CI = 0.62, 0.95) compared to non-readers of a newspaper. Conclusion We found that all six information sources except radio were strong predictors of the resistance towards COVID-19 vaccination. Further research on how these channels can be used to improve the availability of reliable healthcare information is needed. Investments in these resources will protect people and empower them to make appropriate choices about their health.

This paper discusses multidisciplinary international research collaboration team formation during the COVID-19 pandemic, challenges faced, strategies adopted, achievements and dynamics in the implementation of research on Coronavirus disease-2019 (COVID-19), by the African Translational Research Group (ATReG). The paper also discusses the lessons learnt and future opportunities for global collaborative research. In-depth virtual interviews were conducted with consenting members of ATReG. Questions were designed to provide rich, deep, and insightful opinions, lived experiences and perspectives of ATReG group members on group formation, challenges, strategies and achievements. Interview data was transcribed and analysed thematically, and the results were presented with important quotations presented. The ATReG consisted of English ( n = 13) and French ( n = 1) speaking sub-Saharan African (SSA) researchers who specialise in public health, epidemiology, optometry, information technology, supply chain management, psychiatry, community health, general medical practice, nutrition and biostatistics. Most members of the group reported an informal but well-coordinated structure of the group. Formed during the pandemic, all group meetings were held online, and many members are yet to meet each other in person. The group collected data from Africans and published 10 peer reviewed journal articles on COVID-19 within two years. It presented in international conferences, engaged with the media and the public and was awarded a national competitive funding in Nigeria all of which which contributed to career progression and academic promotion of some members. There have been challenges in sustaining the research collaboration and maintaining productivity. Challenges include difficulties meeting deadlines and obtaining funding for research activities. However, these challenges have been addressed through a collaborative problem-solving approach. The study found the need for operational and methodological flexibility, centralised coordination, and established funding sources as being essential for long term sustainability and performance of the group. The ATReG’s objective of providing useful data on COVID-19 and generating useful knowledge about COVID-19 in SSA has been achieved. In such a multi-disciplinary international collaborative team relaiant on the online medium to operate, the experiences and challenges can be a model for learning for researchers intending to form international multidisciplinary collaborative groups. Nonetheless, there are still many important areas of research which ATReG will continue to pursue.

BACKGROUND: The outbreak of coronavirus disease (COVID-19) has created a global public health crisis and non-compliance with public health measures to contain the infection poses a challenge to Sub-Saharan African governments. This study investigated the associations between compliance and public opinion on COVID-19 public health containment measures across selected SSA countries. METHOD: Anonymous online cross-sectional survey was administered to 1779 adults (18 years and older) during the mandatory lockdown period in most African countries (April 18 - May 16, 2020). Respondents were recruited via Facebook, WhatsApp, and authors' networks. Data on participants’ socio-demographics, their opinions regarding the precautionary measures against COVID-19, and their compliance with preventive measures were collected. Multiple logistic regression analysis was used to examine the association between compliance and public opinions about COVID-19. RESULTS: Respondents who did not think that public health authorities in their countries were doing enough to control the C0VID-19 outbreak were more likely to attend crowded places (aOR 1.75, 95% CI 1.30-2.35). Those who thought COVID-19 would not remain in their countries (aOR 0.48, 95% CI 0.24 - 0.96) and those who thought self-isolation is not needed during the pandemic (aOR 0.29, 95% CI 0.13 - 0.65) were less likely to encourage others to comply with the strategies put in place to prevent the spread of the disease. Participants who thought the COVID-19 outbreak was dangerous and those wearing medical masks were found to wash their hands with soap under running water. CONCLUSION: The study showed that public opinion influenced the compliance of individuals to public health measures for containment and mitigation of COVID-19. There is a need to improve compliance by the public.