Abstract

The emergence of the COVID-19 global pandemic has had a major impact on the Health care- seeking behaviors of patients with COVID-19 symptoms. The surge in the number of new cases of COVID-19 detected in Cameroon led to the preventive measures enacted to curb the spread of the virus; these measures have been linked with poor mental health outcomes. We assessed the health care- seeking behaviours and the impact of COVID-19 preventive measures on depression and anxiety among survivors of COVID-19 at the Buea Regional Hospital

The study design was an unmatched case- control study: 1 case to 2 controls with the cases being 76 COVID-19 survivors and 169 controls from outpatient consultations of the Buea Regional Hospital. Data was collected by an online Google form and self-administered questionnaire which consisted of the following sections: sociodemographic data, COVID-19 risk factors assessment, health care seeking behaviours and its determinants, , assessment of anxiety and depression and  determinants of anxiety and depression . We used the HADS (Hospital Anxiety and Depression Scale) to assess anxiety and depression related symptoms through a set of 14 questions; 7 questions each for both mental health disorder.

The mean age for our participants was 32.89±13.17years. With regards to Health care -seeking behaviours 78.9 vs 75.1% sought care from the hospital and 25 vs 5.9% called to inform relatives at the onset of the illness among the cases and controls respectively; also as regards reasons for not seeking care from the health facility 40.8 vs 9.5% reported the symptoms not to be severe as a reason while 22.4 vs 13 % reported fear of stigmatization among the cases and controls respectively. Survivors of COVID-19 were about 12 times significantly more likely to seek modern medication as a treatment for their disease (OR 11.96, 95% CI: 6.25-22.90, p=0.001). The survivors of COVID-19 were 7 times significantly more likely to get medications from the treatment center of the health facility (OR 7.16, 95% CI: 3.68-13.93, p=0.001).

Survivors of COVID-19 presented with significantly higher mean scores for depression compared to the controls (7.74±3.93 vs. 4.01±4.48, p=0.001). Survivors of COVID-19 presented with significantly higher mean scores for anxiety compared to the controls (6.84±3.87 vs. 3.10±3.75, p=0.001). Participants who wore face masks were 3 times more likely to be anxious and depressed than those who did not. Participants who lost a loved one due to COVID-19 and those who were separated from spouse/relation following quarantine were 6 and 5 times more likely to be depressed than participants who didn’t undertake this measures. Those who were separated from spouse/relation and those who missed out on routine activities were also 5 and 6 times more likely to have anxiety symptoms.

The findings of this study indicate that a significant proportion of study participants had appropriate health -seeking behaviour and taking modern medications from the COVID-19 center (hospital) as measures to tackle their illness state of being infected with COVID-19 and hence better population health outcome.

The study confirms the negative psychological impact of wearing face masks and quarantine as COVID-19 preventive measures on the COVID-19 survivors hence indicating the need for psychosocial support as part of management and follow-up for these patients.

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