{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T23:27:01Z","timestamp":1781220421618,"version":"3.54.1"},"reference-count":71,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","license":[{"start":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T00:00:00Z","timestamp":1673395200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,11]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>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\u20133.03) and in the rural site of Kintampo, Ghana (aPR: 1.68; 95% CI: 1.21\u20132.34) 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\u20132.11) 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\u20131.33) and participant self-reported psychological distress (aPR: 1.83; 95% CI: 1.48\u20132.27) were associated with an increased prevalence of reporting barriers to accessing health services, whereas wage employment (aPR: 0.67; 95% CI: 0.49\u20130.90) 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.<\/jats:p>","DOI":"10.4269\/ajtmh.22-0349","type":"journal-article","created":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T15:31:06Z","timestamp":1670859066000},"page":"124-136","source":"Crossref","is-referenced-by-count":7,"title":["COVID-19 Preventive Practices, Psychological Distress, and Reported Barriers to Healthcare Access during the Pandemic among Adult Community Members in Sub-Saharan Africa: A Phone Survey"],"prefix":"10.4269","volume":"108","author":[{"given":"Nega","family":"Assefa","sequence":"first","affiliation":[{"name":"College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasir Y.","family":"Abdullahi","sequence":"additional","affiliation":[{"name":"College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena C.","family":"Hemler","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population, Harvard T.H. 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