Maryan Abdullahi Sh. Nur

Background: Antiretroviral Therapy is an effective method against HIV, reducing mortality and opportunistic infections. In Somalia, high rates of these infections and low adherence to therapy have been reported. However, factors contributing to non-adherence remain unidentified. Therefore, The study aims to assess the magnitude of antiretroviral therapy non-adherence and identify associated factors for individuals living with HIV in Mogadishu, Somalia. Methodology: A hospital-based cross-sectional study was conducted using a questionnaire containing socio-demographic, behavioral, familial, psychosocial, clinical, and laboratory characteristics. Antiretroviral Therapy adherence was assessed by quantifying the number of prescribed pills taken in the past month. Those who adhered to ≥95% of the prescribed Antiretroviral Therapy drugs were considered adherent to Antiretroviral Therapy. Logistic regression was used to identify factors associated with Antiretroviral Therapy non-adherence at significance levels of p < 0.05. Results: Out of 453 participants, the magnitude of non-adherence to ART among people living with HIV in Mogadishu, Somalia, was 138 (30.5%) with its 95% CI: 26.3–34.9. The predominant reasons for missing ART were forgetting (7.3%), transportation issues (5.5%), side effects and being busy with other commitments (4.4%), stigma (3.8%), and ART facilities being distant from home (2.6%). In multivariable logistic regression, living alone (AOR=1.81, 95%CI:1.182–2.782), perceived stigma (AOR=3.19, 95%CI:1.784–5.720), smoking cigarettes (AOR=2.96, 95%CI:1.759–5.003), and living with a co-morbid chronic disease (AOR=1.80, 95%CI:1.155–2.813) were factors associated with ART non-adherence among people living with HIV in Mogadishu, Somalia. Conclusion: Individuals living with HIV in Mogadishu, Somalia suffer sub-optimal adherence to ART. Priority should be given to strategically addressing the needs of those living alone and individuals with co-morbid chronic conditions, eliminating HIV stigma, and discouraging substance abuse.

Introduction: Somalia is among the countries with a high burden of human papillomavirus (HPV) infection in Sub-Saharan Africa. In 2022, 660,000 infections are reported among women globally, out of which 350,000 died from the disease. Most of the studies on HPV reported from Somalia are based on cytologic analysis which is a subjective and suboptimal assessment. The recent World Health Organization (WHO) guidelines for HPV recommend DNA-based testing as a better alternative to the traditional pap smear test. Methodology: This study was undertaken to determine the prevalence of HPV based on the preferred HPV DNA assay on cervical samples of women of reproductive age in Mogadishu, Somalia. The HPV DNA detection was carried out using real-time quantitative polymerase chain reaction (RT-PCR) assays to identify high-risk oncogenic HPV16, HPV18, and other high-risk HPV types. Results: Overall, 31.7% (60/189) of cervical samples were positive for HPV DNA. Out of this, 19.6% were high risk-HPV (hrHPV), 13.8% were HPV16, and 5.3% were HPV18. Moreover, age, income and education level were found to be significant risk factors for HPV infection. Conclusions: These results provide further proof that HPV continues to be a serious public health challenge in Somalia with the risk of progressing to fatal cervical cancer.

Background: Pregnant women exhibit COVID-19 vaccine hesitancy due to concerns regarding potential risks to their babies, doubts about vaccine efficacy, and limited access to information. Therefore, this study aims to estimate COVID-19 vaccine uptake and factors associated with pregnant women in Mogadishu, Somalia. Methods: A cross-sectional study was conducted on pregnant women using a questionnaire covering socio-demographic information, pregnancy-related characteristics, perceptions about the COVID-19 vaccine, and vaccination status. Univariable and multivariable logistic regression analyses were utilized to identify factors associated with the outcome variable. Results: Among the 400 pregnant women who participated in this study, 26.8% had received a COVID-19 vaccine dose, with only 14.9% receiving it during pregnancy. Reasons for not receiving the vaccine included a lack of information about the vaccine (47.4%), concerns about its adverse effects on personal health (33.8%), misconceptions regarding impacts on fertility or menstrual cycles (14.3%), belief in the vaccine’s inefficacy (3.4%), and fears about adverse effects on their fetus. In multivariable logistic regression, pregnant women with a history of chronic diseases (AOR=3.27, 95% CI=1.992– 6.145), those who perceived themselves at risk of contracting COVID-19 (AOR=3.81, 95% CI=2.11– 5.10), those who believed that the vaccine was accessible to them (AOR=4.34, 95% CI=2.915– 6.165), and those who discussed the COVID-19 vaccine with their healthcare provider (AOR=3.91, 95% CI=2.123– 7.878) were more likely to receive the COVID-19 vaccine compared to their counterparts. Conclusion: Pregnant women in Mogadishu, Somalia, face challenges with sub-optimal covid-19 vaccine uptake. Implementations should improve awareness of COVID-19 risks and facilitate discussions between healthcare providers and pregnant women. In addition, efforts to provide reliable information about the vaccine, alleviate concerns about its adverse effects, and dispel misconceptions about fertility, menstrual cycles, efficacy, and foetal impact are crucial.

Healthcare workers (HCWs) are one of the most vulnerable groups for contracting COVID-19 and dying as a result of it. Over 10,000 HCWs in Africa have been infected with COVID-19, according to the World Health Organization, making it a substantial occupational health threat for HCWs. To that end, Somalia’s Ministry of Health has ordered that all healthcare personnel obtain the COVID-19 vaccination to safeguard themselves and the community they serve. In this investigation, we aimed to assess the COVID-19 vaccination coverage and its associated factors among healthcare workers in Somalia. A cross-sectional study was employed to examine COVID-19 vaccination coverage among healthcare personnel in Somalia. The data were obtained via an online questionnaire supplied by Google forms between December 2021 and February 2022, where a total of 1281 healthcare workers from the various federal states of Somalia were recruited. A multinomial regression analysis was used to analyse the factors associated with COVID-19 vaccine uptake. Overall, 1281 HCWs participated (630 females, 651 males) with a mean age and standard deviation of 27.7 years ± 7.1. The overall vaccine coverage was 37.4%. Sex, age, the state of residency, education level, specialization, hospital COVID-19 policy, vaccine availability at the centre, COVID-19 treatment centre, and health facility level were the factors that influenced the COVID-19 vaccine uptake among health professionals in Somalia. Male healthcare employees were 2.2 times (odds ratio-OR = 2.2; confidence interval-CI: 1.70, 2.75, p < 0.001) more likely than female healthcare workers to be fully vaccinated. The survey discovered that the COVID-19 vaccine coverage among health professionals was quite low, with the major contributing factors being accessibility, security challenges and literary prowess. Additional efforts to enhance vaccination uptake are needed to improve the COVID-19 vaccination coverage.

Objective Recent investigations have revealed that COVID-19 during pregnancy substantially increases the risk of harmful outcomes for mothers and neonates, including preterm death and stillbirth as well as severe maternal morbidity and mortality. Hence, the urgent need to understand the prevalence rate and level of awareness about COVID-19 (SARS-CoV-2 virus infection) and the practice of preventive measures against the disease among pregnant women in Somalia. This study aims to determine the prevalence of COVID-19 among pregnant women seeking antenatal care in the Benadir region (Mogadishu) of Somalia and to assess their knowledge and preventive practices towards COVID-19. Setting A hospital-based cross-sectional study involving two major referral maternity hospitals in Mogadishu, Somalia. Participants Pregnant women seeking antenatal services were included in our study. Methods A total of 477 blood samples were collected from pregnant women attending the two referral hospitals in Mogadishu and screened for COVID-19. The participants were subjected to questionnaire interviews where their detailed history and practice of prevention against COVID-19 were evaluated. Results The results showed that 175 (36.7%) were positive while 302 (63.3%) samples were negative for SARS-CoV-2 virus antibodies. Also, out of the 141 pregnant women who had two children or less, 19.4% were positive for IgG/IgM antibodies. Participants who had close contact with patients with COVID-19 were significantly associated for testing positive with a p value 0.0001. Students, teachers, employed people and individuals reported COVID-19 like symptoms were all associated with COVID-19 seropositivity outcomes. Conclusion Pregnant women and those with commorbidies should be given special preventive care and health education about COVID-19 transmission.