"I thought I was going to die": Experiences of COVID-19 patients managed at home in Uganda.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2023
Historique:
received: 07 11 2022
accepted: 16 11 2023
medline: 12 12 2023
pubmed: 12 12 2023
entrez: 12 12 2023
Statut: epublish

Résumé

In Uganda, approximately 170,000 confirmed COVID-19 cases and 3,630 deaths have been reported as of January 2023. At the start of the second COVID-19 wave, the Ugandan health system was overwhelmed with a sudden increase in the number of COVID-19 patients who needed care, and the Ministry of Health resorted to home-based isolation and care for patients with mild to moderate disease. Before its rollout, the COVID-19 home-based care strategy had neither been piloted nor tested in Uganda. To explore the experiences of COVID-19 patients managed at home in Uganda. This was a qualitative study that was conducted to explore the lived experiences of COVID-19 patients managed at home. The study was carried out among patients who presented to three hospitals that were designated for treating COVID-19 patients in Uganda. COVID-19 patients diagnosed at these hospitals and managed at home were followed up and contacted for in-depth telephone interviews. The data were analysed using thematic content analysis with the aid of NVIVO 12.0.0 (QRS International, Cambridge, MA). Participants experienced feelings of fear and anxiety: fear of death, fear of losing jobs, fear of infecting loved ones and fear of adverse events such as loss of libido. Participants also reported feelings of loneliness, hopelessness and depression on top of the debilitating and sometimes worsening symptoms. In addition to conventional medicines, participants took various kinds of home remedies and herbal concoctions to alleviate their symptoms. Furthermore, COVID-19 care resulted in a high economic burden, which persisted after the COVID-19 illness. Stigma was a major theme reported by participants. Participants recommended that COVID-19 care should include counselling before testing and during and after the illness to combat the fear and stigma associated with the diagnosis. Another recommendation was that health workers should carry out home visits to patients undergoing home-based care and that COVID-19 treatment should be free of charge. COVID-19 home-based care was associated with fear, anxiety, loneliness, depression, economic loss and stigma. Policymakers should consider various home-based follow-up strategies and strengthen counselling of COVID-19 patients at all stages of care.

Sections du résumé

BACKGROUND BACKGROUND
In Uganda, approximately 170,000 confirmed COVID-19 cases and 3,630 deaths have been reported as of January 2023. At the start of the second COVID-19 wave, the Ugandan health system was overwhelmed with a sudden increase in the number of COVID-19 patients who needed care, and the Ministry of Health resorted to home-based isolation and care for patients with mild to moderate disease. Before its rollout, the COVID-19 home-based care strategy had neither been piloted nor tested in Uganda.
OBJECTIVE OBJECTIVE
To explore the experiences of COVID-19 patients managed at home in Uganda.
METHODS METHODS
This was a qualitative study that was conducted to explore the lived experiences of COVID-19 patients managed at home. The study was carried out among patients who presented to three hospitals that were designated for treating COVID-19 patients in Uganda. COVID-19 patients diagnosed at these hospitals and managed at home were followed up and contacted for in-depth telephone interviews. The data were analysed using thematic content analysis with the aid of NVIVO 12.0.0 (QRS International, Cambridge, MA).
RESULTS RESULTS
Participants experienced feelings of fear and anxiety: fear of death, fear of losing jobs, fear of infecting loved ones and fear of adverse events such as loss of libido. Participants also reported feelings of loneliness, hopelessness and depression on top of the debilitating and sometimes worsening symptoms. In addition to conventional medicines, participants took various kinds of home remedies and herbal concoctions to alleviate their symptoms. Furthermore, COVID-19 care resulted in a high economic burden, which persisted after the COVID-19 illness. Stigma was a major theme reported by participants. Participants recommended that COVID-19 care should include counselling before testing and during and after the illness to combat the fear and stigma associated with the diagnosis. Another recommendation was that health workers should carry out home visits to patients undergoing home-based care and that COVID-19 treatment should be free of charge.
CONCLUSION CONCLUSIONS
COVID-19 home-based care was associated with fear, anxiety, loneliness, depression, economic loss and stigma. Policymakers should consider various home-based follow-up strategies and strengthen counselling of COVID-19 patients at all stages of care.

Identifiants

pubmed: 38085728
doi: 10.1371/journal.pone.0295113
pii: PONE-D-22-30668
pmc: PMC10715664
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0295113

Informations de copyright

Copyright: © 2023 Nakireka et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Références

BMC Public Health. 2021 Dec 11;21(1):2257
pubmed: 34895189
Am J Public Health. 2005 Jan;95(1):53-9
pubmed: 15623859
J Behav Med. 2009 Aug;32(4):371-9
pubmed: 19308716
Asian J Psychiatr. 2020 Apr;50:102014
pubmed: 32240958
Issues Ment Health Nurs. 2013 Mar;34(3):150-7
pubmed: 23477435
Anesth Analg. 2020 Jul;131(1):86-92
pubmed: 32243287
BMJ. 2021 Aug 9;374:n1909
pubmed: 34373252
Lancet. 1998 Sep 26;352(9133):1054-5
pubmed: 9759769
Am J Trop Med Hyg. 2021 Jan;104(1):39-44
pubmed: 33258438
Diabetes Metab Syndr. 2021 Sep-Oct;15(5):102206
pubmed: 34298272
PLoS One. 2018 Nov 28;13(11):e0206595
pubmed: 30485311
J Patient Exp. 2021 Apr 12;8:23743735211007359
pubmed: 34179418
Int J Infect Dis. 2020 Jul;96:517-518
pubmed: 32464272
Int J Environ Res Public Health. 2020 Mar 06;17(5):
pubmed: 32155789
Health Expect. 2022 Apr;25(2):513-521
pubmed: 34224643
Front Public Health. 2022 Feb 03;9:778026
pubmed: 35186867
Global Health. 2020 Nov 25;16(1):114
pubmed: 33239041
Asian J Psychiatr. 2020 Oct;53:102187
pubmed: 32512532
BMJ. 2020 Jul 1;370:m2575
pubmed: 32611571
Am J Infect Control. 2022 Jul;50(7):809-819
pubmed: 35121042
Comput Human Behav. 2021 Jan;114:106524
pubmed: 32836728
Rev Cardiovasc Med. 2020 Dec 30;21(4):561-564
pubmed: 33388000
Singapore Med J. 2020 Jul;61(7):350-356
pubmed: 32241071
Eur Respir J. 2020 Sep 10;56(3):
pubmed: 32675205
BMC Public Health. 2020 May 6;20(1):625
pubmed: 32375725
Health (London). 2022 Nov;26(6):702-719
pubmed: 33287564
J Clin Epidemiol. 2020 Nov;127:198-201
pubmed: 32603686
Int J Health Policy Manag. 2014 Dec 02;4(1):55-6
pubmed: 25584356
Ann Behav Med. 2013 Dec;46(3):256-7
pubmed: 23843080
AIDS. 2008 Aug;22 Suppl 2:S67-79
pubmed: 18641472

Auteurs

Susan Nakireka (S)

Department of Internal Medicine, Mengo Hospital, Kampala, Uganda.
Department of Internal Medicine, Uganda Christian University, School of Medicine, Mukono, Uganda.

David Mukunya (D)

Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, Uganda.
Department of Research, Nikao Medical Center, Kampala, Uganda.

Crescent Tumuhaise (C)

Department of Medicine, Our Lady Health of the Sick, Nkozi Hospital, Mpigi, Uganda.

Ronald Olum (R)

Department of Medicine, St. Francis Hospital Nsambya, Kampala, Uganda.
School of Public Health, Makerere University, Kampala, Uganda.

Edith Namulema (E)

Department of Internal Medicine, Mengo Hospital, Kampala, Uganda.
Department of Internal Medicine, Uganda Christian University, School of Medicine, Mukono, Uganda.

Agnes Napyo (A)

Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, Uganda.
Department of Public Health, Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda.

Quraish Serwanja (Q)

Department of Programmes, Relief International, Khartoum, Sudan.

Prossie Merab Ingabire (PM)

Department of Medicine, St. Francis Hospital Nsambya, Kampala, Uganda.

Asad Muyinda (A)

Department of Medicine, Jinja Regional Referral Hospital, Jinja, Uganda.

Felix Bongomin (F)

Department of Medical Microbiology, Faculty of Medicine, Gulu University, Gulu, Uganda.

Milton Musaba (M)

Department of Obstetrics and Gynecology, Faculty of Health Sciences, Busitema University, Mbale, Uganda.

Vivian Mutaki (V)

Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, Uganda.

Ritah Nantale (R)

Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, Uganda.

Phillip Akunguru (P)

Department of Medicine, Moroto Hospital, Moroto, Uganda.

Rozen Ainembabazi (R)

Department of Medicine, Jaro Hospital, Wakiso, Uganda.

Derrick Nomujuni (D)

Department of Medicine, Mulago Hospital, Kampala, Uganda.

William Olwit (W)

Department of Radiology, Uganda Cancer Institute, Kampala, Uganda.

Aisha Nakawunde (A)

Department of Medicine, St. Francis Hospital Nsambya, Kampala, Uganda.

Specioza Nyiramugisha (S)

Department of Programmes, Relief International, Khartoum, Sudan.

Pamela Mwa Aol (PM)

Department of Pediatrics, Lacor Hospital, Gulu, Uganda.

Joseph Rujumba (J)

Department of Pediatrics and Child Health, School of Medicine, Makerere University, Kampala, Uganda.

Ian Munabi (I)

Department of Anatomy, School of Medicine, Makerere University, Kampala, Uganda.

Sarah Kiguli (S)

Department of Pediatrics and Child Health, School of Medicine, Makerere University, Kampala, Uganda.

Classifications MeSH