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Supplementary File: Table S1: Overview of attendance of infection prevention and control training in member countries, May 2020-December 2021. Table S2: Overview of in-country capacity building of infection prevention and control training in member countries, May 2020-December 2021. Figure S1: IPC in country Capacity building(21-25 February 2020. 36 countries were trained, and 80 participants were trained). Figure S2: English Webinar Participants by Location. 48 AU Countries are represented in the webinars. Among the 7 countries, not represented include Chad, Central African Republic, Angola, Libya, Cabo Verde, Equatorial Guinea, Eritrea. In attendance, 48 non-AU countries were represented. Figure S3: French Webinar Participants by Location. 37 AU Countries are represented in the English webinars. Among the 18 Francophone countries, 03 countries were not represented include, Cabo Verde, Equatorial Guinea, and Seychelles. In attendance, 15 non-AU countries were represented. Figure S4: All Webinar Participants by Location. 50 AU Countries are represented in the webinars. Among the 5 countries, not represented include Angola, Libya, Cabo Verde, Equatorial Guinea, Eritrea. In attendance, 53 non-AU countries were represented. Table S3: Overall number of registrants per series. Figure S5: Overview of weekly number of registrants per series. Figure S6: Number of peak live viewers per webinar. Recorded webinars are uploaded on zoom cloud and You Tube and distributed for a total of 3,616 views.

The African continent has some of the world’s lowest COVID-19 vaccination rates. While the limited availability of vaccines is a contributing factor, COVID-19 vaccine hesitancy among health care providers (HCP) is another factor that could adversely affect efforts to control infections on the continent. We sought to understand the extent of COVID-19 vaccine hesitancy among HCP, and its contributing factors in Africa. We evaluated COVID-19 vaccine hesitancy among 1,499 HCP enrolled in a repeated cross-sectional telephone survey in Burkina Faso, Ethiopia, Nigeria, Tanzania and Ghana. We defined COVID-19 vaccine hesitancy among HCP as self-reported responses of definitely not, maybe, unsure, or undecided on whether to get the COVID-19 vaccine, compared to definitely getting the vaccine. We used Poisson regression models to evaluate factors influencing vaccine hesitancy among HCP. Approximately 65.6% were nurses and the mean age (±SD) of participants was 35.8 (±9.7) years. At least 67% of the HCP reported being vaccinated. Reasons for low COVID-19 vaccine uptake included concern about vaccine effectiveness, side effects and fear of receiving unsafe and experimental vaccines. COVID-19 vaccine hesitancy affected 45.7% of the HCP in Burkina Faso, 25.7% in Tanzania, 9.8% in Ethiopia, 9% in Ghana and 8.1% in Nigeria. Respondents reporting that COVID-19 vaccines are very effective (RR:0.21, 95% CI:0.08, 0.55), and older HCP (45 or older vs.20-29 years, RR:0.65, 95% CI: 0.44,0.95) were less likely to be vaccine-hesitant. Nurses were more likely to be vaccine-hesitant (RR 1.38, 95% CI: 1.00,1.89) compared to doctors. We found higher vaccine hesitancy among HCP in Burkina Faso and Tanzania. Information asymmetry among HCP, beliefs about vaccine effectiveness and the endorsement of vaccines by the public health institutions may be important. Efforts to address hesitancy should address information and knowledge gaps among different cadres of HCP and should be coupled with efforts to increase vaccine supply.

The COVID-19 pandemic has had serious negative health and economic impacts in sub-Saharan Africa. Continuous monitoring of these impacts is crucial to formulate interventions to minimize the consequences of COVID-19. This study surveyed 2,829 adults in urban and rural sites among five sub-Saharan African countries: Burkina Faso, Ethiopia, Nigeria, Tanzania, and Ghana. Participants completed a mobile phone survey that assessed self-reported sociodemographics, COVID-19 preventive practices, psychological distress, and barriers to healthcare access. A modified Poisson regression model was used to estimate adjusted prevalence ratios (aPRs) and 95% CIs to investigate potential factors related to psychological distress and barriers to reduced healthcare access. At least 15.6% of adults reported experiencing any psychological distress in the previous 2 weeks, and 10.5% reported that at least one essential healthcare service was difficult to access 2 years into the pandemic. The majority of participants reported using several COVID-19 preventive methods, with varying proportions across the sites. Participants in the urban site of Ouagadougou, Burkina Faso (aPR: 2.29; 95% CI: 1.74–3.03) and in the rural site of Kintampo, Ghana (aPR: 1.68; 95% CI: 1.21–2.34) had a higher likelihood of experiencing any psychological distress compared with those in the rural area of Nouna, Burkina Faso. Loss of employment due to COVID-19 (aPR: 1.77; 95% CI: 1.47–2.11) was also associated with an increased prevalence of psychological distress. The number of children under 5 years in the household (aPR: 1.23; 95% CI: 1.14–1.33) and participant self-reported psychological distress (aPR: 1.83; 95% CI: 1.48–2.27) were associated with an increased prevalence of reporting barriers to accessing health services, whereas wage employment (aPR: 0.67; 95% CI: 0.49–0.90) was associated with decreased prevalence of reporting barriers to accessing health services. Overall, we found a high prevalence of psychological distress and interruptions in access to healthcare services 2 years into the pandemic across five sub-Saharan African countries. Increased effort and attention should be given to addressing the negative impacts of COVID-19 on psychological distress. An equitable and collaborative approach to new and existing preventive measures for COVID-19 is crucial to limit the consequences of COVID-19 on the health of adults in sub-Saharan Africa.

COVID-19 vaccine hesitancy among adolescents poses a challenge to the global effort to control the pandemic. This multi-country survey aimed to assess the levels and determinants of COVID-19 vaccine hesitancy among adolescents in sub-Saharan Africa between July and December 2021. The survey was conducted using computer-assisted telephone interviewing among adolescents in five sub-Saharan African countries, Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania. A rural area and an urban area were included in each country (except Ghana, which only had a rural area), with approximately 300 adolescents in each area and 2803 in total. Sociodemographic characteristics and perceptions and attitudes on COVID-19 vaccines were measured. Vaccine hesitancy was defined as definitely not getting vaccinated or being undecided on whether to get vaccinated if a COVID-19 vaccine were available. Log-binomial models were used to calculate the adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for associations between potential determinants and COVID-19 vaccine hesitancy. The percentage of COVID-19 vaccine hesitancy was 15% in rural Kersa, 24% in rural Ibadan, 31% in rural Nouna, 33% in urban Ouagadougou, 37% in urban Addis Ababa, 48% in rural Kintampo, 64% in urban Lagos, 76% in urban Dar es Salaam, and 88% in rural Dodoma. Perceived low necessity, concerns about vaccine safety, and concerns about vaccine effectiveness were the leading reasons for hesitancy. Healthcare workers, parents or family members, and schoolteachers had the greatest impacts on vaccine willingness. Perceived lack of safety (aPR: 3.61; 95% CI: 3.10, 4.22) and lack of effectiveness (aPR: 3.59; 95% CI: 3.09, 4.18) were associated with greater vaccine hesitancy. The levels of COVID-19 vaccine hesitancy among adolescents are alarmingly high across the five sub-Saharan African countries, especially in Tanzania. COVID-19 vaccination campaigns among sub-Saharan African adolescents should address their concerns and misconceptions about vaccine safety and effectiveness.

Background Functional National Public Health Institutes (NPHIs) are critical for effective surveillance, outbreak detection and response, provision of specialized diagnostic services, research and capacity building to guide health policies and strategies through science and data. Many countries in Africa lack fully functioning NPHIs and remain ill-prepared to respond to public health threats with the required speed and agility. Objective The main objective of this study was to map and generate information on the status of NPHI establishment in Africa, understand the legal frameworks used by the countries to establish NPHIs, and describe the different models of NPHIs in the continent. Methods A semi-structured questionnaire was administered online by the Africa CDC between 18 July 2021 and 26 May 2022. Data was collated, filtered and analyzed using Microsoft Excel and Arc GIS for mapping of NPHI establishment status by country. Informed consent was obtained from all participating institutions. Result Of the 55 African Union Member States, 40 (72.7%) responded to the online survey. Among the Members States that responded, 12 reported being fully-established, 17 indicated that they were at an advanced stage, six (6) have started the process, and five (5) reported as not having a plan to develop a NPHI. Among the fully-established and at advanced stage NPHIs, 17 (58.6%) are autonomous and semi-autonomous, three (10.3%) are a network of institutions, and nine (31%) are structured as a departments under the Ministries of Health. The most common functions of NPHsI are Research (26), Surveillance and Disease Intelligence (24), Epidemic Preparedness and Response (24), Workforce Development (19), Public Health Informatics (15), and Health Promotion (10). Conclusion Success in building strong health systems in Africa requires countries to have strong Public Health Institutions. Thus, more efforts are required from the Africa CDC, African Union Member States and development partners to advocate and support the strengthening and the establishment of new NPHIs.

Health and climatic changes have been linked for centuries. Viruses, bacteria, fungi and parasites are sensitive to environmental conditions including ambient temperature, humidity, smog, and other climatic factors like exposure to sunlight. Viral respiratory tract infections such as seasonal influenza are known to become epidemic primarily during cold weather conditions influenced also by population density and travel patterns. The winter months in China are from November to March. The SARS-CoV-1 outbreak commenced in Guangdong Province, in November 2002 and the SARS-CoV-2 outbreak in Wuhan in early December 2019. Understanding how the emergence and spread of COVID-19 could be affected by climatic conditions may be an important aspect for disease control. As of August 4th 2020, 18 142 718 confirmed cases and 691 013 deaths have been reported to the WHO from all continents [...].

Background: Iodine deficiency can cause brain damage and/or cognitive impairment in children. It is preventable and of public health concern. After sixteen years of universal salt iodization in Nigeria, we undertook this study in north-western Nigeria to determine: prevalence of iodine deficiency in school children, any relationship between iodine deficiency, goiter and intelligence quotient and iodine content of table salt from their households. Methodology: A cross-sectional study of school children aged 6-12 years. Data was collected using structured questionnaire. Enrolled children had physical examination and anthropometric measurements. Presence of goiter was clinically assessed using criteria jointly recommended by WHO, UNICEF and ICCIDD. Intelligence quotient was assessed using the Draw-A-Man test. Specimen of urine was obtained from each child and table salt specimen from their homes. Atomic absorption spectrophotometry was used to analyze urinary iodine in μg/L. Iodine content of salt was semi-quantitatively analyzed. Results: A total of 544 children were studied. Their mean age (±1SD) was 9.5 ± 2.0 years. Median urinary iodine excretion (UIE) level was 148 μg/L. Forty-seven (8.6%) children had goiter. Three hundred and seventy- six (69.1%) children had normal body build. Of 118 (21.7%) children with adequate iodine status, 18 (15.3%) were stunted; a similar proportion in iodine deficient children. One hundred and thirty-four (57.0%) of 235 iodine-deficient children and 67 (56.8%) of 118 iodine-sufficient children had normal Intelligence Quotient. All household table salts contained iodine. Conclusion: There was no relationship between nutritional status and Iodine status; iodine status and intelligence quotient in study children.