Effect of stigma on COVID-19 cases management at the treatment unit of the Yaounde Central Hospital, Cameroon

C. Kouanfack, K. Kuathe, A. Zemsi, S. Zemsi, A. Edingue, E. Youm, A. Nangmo, M. Sanou, E. Sobngwi, J. Fouda, J. Ateudjieu
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Abstract

Background: The coronavirus pandemic coronavirus disease-19 (COVID-19) has affected the whole world, causing the lives of many victims. Africa has recorded more than a million cases and Cameroon around 18,600 cases (August 2020) since the first case was notified. The rapid spread of this disease (among other factors) could have contributed to creating a situation of fear and stigma among affected populations. It is, therefore, necessary to identify the characteristics of this stigma and its effect on the case management of this disease. Materials and Methods: We carried out a cross-sectional study with positive COVID-19 people at the Central Hospital of Yaoundé, Cameroon, from May 2020 to June 2020. A questionnaire adapted from the stigma index of persons living with human immunodeficiency virus and from the SAPHORA-MCO 2009 guide was administered to participants. Results: Among 138 patients with confirmed COVID-19 infection during the study, 134 (97%) accepted the study, 115 (85.8%) reported auto-stigmatisation, 29 (22%) indicated having been stigmatised by the community and 20 (15%) by medical personnel. Auto-stigmatisation increased the risk of seeking care late (odds ratio [OR] = 3.4 with a confidence interval [CI] of 0.99–11.5; P = 0.049), unlike stigma by the community, which tended to result in early care seeking, but not significantly (OR = 0.6 with a CI of 0.26–1.66; P = 0.479). Conclusion: Stigma is highly prevalent among patients affected by COVID-19. Action should be taken to address stigma to increase the overall adherence to disease control strategies.
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耻辱对喀麦隆雅温得中心医院治疗部门COVID-19病例管理的影响
背景:冠状病毒大流行冠状病毒病-19 (COVID-19)已影响全球,造成许多受害者的生命。自通报首例病例以来,非洲已记录了100多万例病例,喀麦隆约有1.86万例(2020年8月)。这种疾病的迅速蔓延(除其他因素外)可能在受影响人群中造成一种恐惧和耻辱的局面。因此,有必要确定这种耻辱的特征及其对该病病例管理的影响。材料和方法:我们于2020年5月至2020年6月在喀麦隆雅温得中心医院对COVID-19阳性人群进行了横断面研究。根据人类免疫缺陷病毒感染者的耻辱指数和SAPHORA-MCO 2009年指南对参与者进行了问卷调查。结果:在研究期间确诊的138例COVID-19感染患者中,134例(97%)接受研究,115例(85.8%)报告自我污名,29例(22%)报告被社区污名,20例(15%)被医务人员污名。自污名化增加了晚求医的风险(优势比[OR] = 3.4,可信区间[CI]为0.99-11.5;P = 0.049),与社区的污名化不同,污名化倾向于导致早期寻求护理,但并不显著(OR = 0.6, CI为0.26-1.66;P = 0.479)。结论:耻辱感在新冠肺炎患者中普遍存在。应采取行动解决耻辱感问题,以加强对疾病控制战略的总体遵守。
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