Published date: Jul 09 2020

Journal Title: Sudan Journal of Medical Sciences

Issue title: SJMS Special Issue 2020: Competing with COVID-19 in Sudan

Pages: 54-70

DOI: 10.18502/sjms.v15i5.7136

Muna Mohamed Elaminmonalameen2@gmail.comMD community Medicine, MD Dermatology, MSC medical education, Assistant professor and head department of community medicine, Acting faculty dean

Salih Boushra Hamzasalihboushra@gmail.comOmdurman Islamic University

Yassin Abdelrahim Abdallayasinabdo96@yahoo.comOmdurman Islamic University

Ahmed Alsayed Mohammed Mustafaahmedngu91@gmail.comOmdurman Islamic University

Mosab Abbas Altayebmosab.ebs12@gmail.comOmdurman Islamic University

Maria Adam Mohammed Mariaadammero@gmail.comOmdurman Islamic University

Radi Tofaha AlhusseiniRadi.tuffaha1995@gmail.comAlzaiem Alazhari university

Mohamed Fathelrahman Mohammed AbassMo7mday@gmail.comMRCPCH, MD pediatrics and child health, MSc Biochemistry, Assistant professor department of pediatrics Omdurman Islamic University

Background: The 2019 novel corona virus (COVID-19) is highly contagious with pandemic transmission, so it is associated with severe health problems and high public anxiety, with healthcare community speculation to be the most distressed because they were at the highest risk of infection. This study aimed to investigate the psychological impact on frontline medical staff in Khartoum state, Sudan, during the COVID‑19 outbreak between January and March 2020

Material and Methods: Patient Health questionnaire-9 (PHQ-9), generalized anxiety Disorders (GAD-7) scale and the revised impact of event scale (IES-R) were used to assess the depression, anxiety and psychological impact of COVID-19 on participants respectively, by an online questionnaire, analyzed by the statistical package for social science (SPSS) version 24.

Results: PHQ-9 depression Scale showed that 72% have some degree of depression with mild depression being the most common seen in 96 (24.2%), severe depression was found to be more among age group between 45-65 and was associated with working in the emergency room (ER), p value was 0.03.The post-traumatic stress disorder among our participants was assessed by the IES-R scale which revealed 67 (16.9%) having mild PTSD, 32 (8.1%) having moderate PTSD,75 (18.9%) having severe PTSD while with statistical association with male gender with (P value= 0.16), age group of 45-65 (P value= 0.03), working in the respiratory wards (P value of 0.039) and history of contact with a positive case of COVID 19, (P value= 0.0001). We used GAD 7anxiety score showed mild anxiety in 32 participants (23.2%) moderate anxiety in 53 (13.4%) and severe anxiety 66 (16.7%).

Conclusion: These findings highlight the importance of vigor organizational support in predicting and managing health workers symptoms of burnout, and the working conditions they face during novel times of crisis.

Keywords: COVID-19, Psychological impact, Health workers, Sudan, GAD-7, PHQ-9, IES-R

1. Maunder R, Hunter J, Vincent L, et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ 2003;168:1245–51.

2. Phelan AL, Katz R, Gostin LO. The novel coronavirus originating in Wuhan, China: challenges for global health governance. JAMA 2020; published online Jan 30. DOI:10.1001/jama.2020.1097.

3. World Health Organization. Novel Coronavirus - China Disease Outbreak News. https://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/.

4. Kalichman SC, Simbayi L. Traditional beliefs about the cause of AIDS and AIDS-related stigma in South Africa. AIDS Care 2004; 16: 572–58.

5. McAlonan GM, Lee AM, Lee AM, et al. Immediate and sustained psychological impact of an emerging infectious disease outbreak on health care workers. Can J Psychiatry Rev 2007;52:241–7.

6. Tiong WW, Koh GCH. Ethical considerations in the review of Singapore’s H1N1 pandemic response framework in 2009. Ann Acad Med Singapore 2013;42:246–50.

7. Chong MY, Wang WC, Hsieh WC, et al. Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital. Br J Psychiatry 2004;185:127–133.

8. Sim K, Chua HC. The psychological impact of SARS: a matter of heart and mind. CMAJ 2004;170(5):811– 812.

9. World Health Organization. Summary table of SARS cases by country, 1November 2002—2007 August 2003. Geneva (CH): WHO; 2003.

10. SARS Commission. Spring of fear, volumes 1, 2 and 3. Toronto (ON): SARS Commission (Canada); 2006.

11. Naushad VA, Bierens JJ, Nishan KP, et al. A systematic review of the impact of disaster on the mental health of medical responders. Prehospital Disaster Med 2019;34:632–43.

12. Hall RCW, Hall RCW, Chapman MJ. The 1995 Kikwit Ebola outbreak: lessons hospitals and physicians can apply to future viral epidemics. Gen Hosp Psychiatry 2008;30:446–52.

13. Tucci V, Moukaddam N, Meadows J, Shah S, Galwankar SC, Kapur GB. The forgotten plague: psychiatric manifestations of Ebola, Zika, and emerging infectious diseases. J Glob Infect Dis 2017;9:151–6.

14. Müller N. Infectious diseases and mental health. In: Sartorius N, Holt RIG, Maj M, editors. Key Issues in Mental Health. Basel: S. KARGER AG; 2014;99–113. Available at: https://www.karger.com/Article/ FullText/365542. Accessed on 8 March 2020.

15. Sim K, Huak Chan Y, Chong PN, Chua HC, Wen Soon S. Psychosocial and coping responses within the community health care setting towards a national outbreak of an infectious disease. J Psychosom Res 2010;68:195–202.
16. Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health 2020;17:1729.

17. Maunder R, Hunter J, Vincent L, et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ 2003;168(10):1245-51.

18. Dwosh HA, Hong HH, Austgarden D, Herman S, Schabas R. Identification and containment of an outbreak of SARS in a community hospital. CMAJ 2003;168(11):1415-20.

19. Mackay B. SARS: “a domino effect through entire system.” CMAJ 2003;16(10):1308.

20. Cluster of severe acute respiratory syndrome cases among protected healthcare workers — Toronto, Canada, April 2003. 2003;52(19):433-6.
Available: www.cdc.gov/mmwr/preview/mmwrhtml/mm5219a1.htm (accessed
2003 Oct 15).

21. Epi-update: interim report on the SARS outbreak in the Greater Toronto Area, Ontario, Canada. Ottawa: Health Canada; 2003. Available: www.hc-sc.gc.ca/pphb-dgspsp/sars-sras/pef-dep/gta-20030424_e.html (accessed 2003 Oct 15).

22. Patrick DM. The race to outpace severe acute respiratory syndrome (SARS). CMAJ 2003;168(10):1265-6.

23. Wu P, Fang Y, Quan Z, et al. The Psychological Impact of the SARS Epidemic on Hospital Employees in China: Exposure, Risk Perception, and Altruistic Acceptance of Risk. The Canadian Journal of Psychiatry 2009;54(5):303-311.

24. Barbisch D, Koenig KL, Shih FY. Is there a case for quarantine? Perspectives from SARS to Ebola. Disaster Med Public Health Prep 2015;9:547–53.

25. Manuell M-E, Cukor J. Mother Nature versus human nature: public compliance with evacuation and quarantine. Disasters 2011;35:417–42.

26- Bai T, Hospital W U, Chen J, Chen J, Liu X, Wang D, Jin Y and He M 2020 The Lancet Psychiatry Multiple risk factors of depression and anxiety in medical staffs : a cross-sectional study at the outbreak of SARS-CoV-2 in China.

27- Kang L, Ma S, Chen M, Yang J, Wang Y, Li R, Yao L, Bai H, Cai Z, Xiang Yang B, Hu S, Zhang K, Wang G, Ma C and Liu Z 2020 Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study Brain. Behav. Immun. Online: http://www.sciencedirect.com/science/article/pii/S0889159120303482.

28- Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, Wu J, Du H, Chen T and Li R 2020 Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019;3:1–12.

29- Tan B Y Q, Chew N W S, Lee G K H, Jing M, Goh Y, Yeo L L L, Zhang K, Chin H-K, Ahmad A, Khan F A, Shanmugam G N, Chan B P L, Sunny S, Chandra B, Ong J J Y, Paliwal P R, Wong L Y H, Sagayanathan R, Chen J T, Ying Ng A Y, Teoh H L, Ho C S, Ho R C and Sharma V K 2020 Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore Ann. Intern. Med. Online: https://doi.org/10.7326/M20-1083.

30- Min S, Sub W, Cho A, Kim T and Kyung J. Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients Compr. Psychiatry 2018;87:123–7 Online: https://doi.org/10.1016/j.comppsych.2018.10.003.

31- Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R.S., Choo, F.N., Tran, B., Ho,
R., Sharma, V.K., Ho, C., A Longitudinal Study on the Mental Health of General Population during the COVID-19 Epidemic in China, Brain, Behavior, and Immunity (2020), doi: https://doi.org/10.1016/j.bbi.2020.04.028.

32- Zhu Z, Ph D, Xu S, Ph D, Wang H, Med M, Liu Z and Ph D 2020 COVID-19 in Wuhan : Immediate Psychological Impact on 5062 Health Workers medRxiv.

33- Simonds AK, Sokol DK. Lives on the line? Ethics and practicalities of duty of care in pandemics and disasters. EurRespir J 2009;34:303–309.

34- Cai H, Tu B, Ma J, Chen L, Fu L, Jiang Y and Zhuang Q 2020 Psychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 2020 During the Outbreak of Coronavirus Disease 2019 (COVID‑19) in Hubei, China. Med. Sci. Monit. Int. Med. J. Exp. Clin. Res. 26 e924171.