COVID-19 Health Care Behaviour in The Gambia: a cross-sectional survey of 205 adults who went through mandatory institutional quarantine

  1. Penda Johm
  2. Oluwatosin Nkereuwem
  3. Aji-Matty Manjang
  4. Omar Ceesay
  5. Lamin Leigh
  6. Amie Ceesay
  7. Mustapha Bittaye
  8. Adeyemi Roberts
  9. Buba Manjang
  10. Sana Sambou
  11. Sainey Sanneh
  12. Lamin Saidy
  13. Binta Saidy
  14. Beate Kampmann

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Abstract

Background

To control the spread of the novel Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome novel Coronavirus-2 (SARS-CoV-2), countries around the world subsequently implemented several public health measures, including the adoption of mandatory institutional quarantine for close contacts. This study explored the experiences of individuals who underwent institutional quarantine in The Gambia to inform government measures to increase its effectiveness and reduce its associated negative impacts.

Methods

Questionnaires were administered via mobile phone call with data collectors calling and directly recording participant responses on a tablet in an electronic online form developed in REDCap (Research Electronic Data Capture). The questionnaire contained questions on COVID-19 related knowledge, health care behaviour, attitudes, perceptions and stigma. Data were analysed using STATA v.13 (Stata Corp, College Station, TX, USA).

Results

In total, 205 adults who observed the mandatory institutional quarantine were interviewed. There was varied knowledge of COVID-19 causes, spread, symptoms, diagnosis, treatment, and severity. Participants believed the purpose of quarantine was monitoring for signs and symptoms of coronavirus disease, testing for SARS-CoV-2, separation from the community, and protection from coronavirus disease. While a majority reported positive experiences while in quarantine, some expressed prominent dissatisfaction related to the essential services and quality of care provided. Different forms of stigma were also experienced before, during and after the quarantine experience.

Conclusion

This study provides important information on quarantine experiences in The Gambia during the global COVID-19 pandemic. The Ministry of Health in The Gambia and other countries could improve the experience of quarantined individuals by consistently providing psychosocial support, compensation for loss of earnings, and timely provision of SARS-CoV-2 test results. Furthermore, stigma experiences and practices should be addressed during and after individuals stay in quarantine via the provision of psychosocial support.

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  1. ScreenIT

    SciScore for 10.1101/2021.11.17.21266451: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethical considerations: This study received approval from the Gambia Government/MRC Joint Ethics Committee (Ref. 22271) on the 11th of August 2020 and the London School of Hygiene & Tropical Medicine (LSHTM) Observational/Interventions Research Ethics Committee (Ref. 22271) on the 17th of August 2020.
    Consent: The survey had an introductory text stating the survey was completely anonymous, and consent was implied by respondents agreeing to participate and completing the survey.
    Sex as a biological variableAccording to The Gambia Multiple Indicator Cluster Survey (MICS) 2018 (12), the percentage of women and men aged 15-24 years who were able to read a short simple statement about everyday life or who attended secondary or higher education was 64.3 and 68.0 respectively.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data collection: Questionnaires were administered via mobile phone calls with participant responses recorded on a tablet in an electronic online form developed in REDCap (Research Electronic Data Capture) and hosted at the Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine (MRCG at LSHTM) in the Gambia.
    REDCap
    suggested: (REDCap, RRID:SCR_003445)
    Data were analysed using STATA v.
    STATA
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Study strengths and limitations: One of the key strengths of this study was carrying out interviews via mobile phone call guided by our REDCap questionnaire displayed on tablets. This method seemed most appropriate over traditional face-to-face interviewing due to the rise of new cases at the time and government COVID-19 preventive mandates such as social/physical distancing. Our chosen method ensured we generated rapid first-hand evidence and helped us save on travel costs. Another key strength of our study was conducting interviews soon after participants left quarantine to minimise their recall bias after changing environment. It is important to note that our study population does not represent the diverse demographics of The Gambia and not every person who went through institutional quarantine was included. Most of our participants were Gambian males who are more likely to travel than women during the pandemic and therefore were more frequently identified for institutional quarantine. Our chosen methods of phone call surveys reduced our opportunity to take note of participants’ nonverbal communication. We did not explore the stigma experience of associative stigma, meaning any stigma experienced by family or friends of those who went through institutional quarantine as they were not the cohort of focus in our study.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  2. Version published to 10.1101/2021.11.17.21266451v2 on medRxiv
  3. Version published to 10.1101/2021.11.17.21266451v1 on medRxiv