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Psychological Impact of COVID-19 on Community Pharmacists: A Cross-Sectional Study in Lusaka District, Zambia

Article Information

Steward Mudenda1 *, Patrick Mainza1, Ruth Lindizyani Mfune2, Webrod Mufwambi1, Jimmy Hangoma3, Ronald Mutati Kampamba1, Tyson Lungwani Muungo1, Christabel Nang’andu Hikaambo1, Martin Kampamba1, Shafiq Mohamed4, Victor Daka2

1Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia

2Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia

3Department of Pharmacy, Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia

4Remedium Pharmaceuticals limited, Libowa Street No. 48, Salama Park, Lusaka, Zambia

*Corresponding author: Steward Mudenda, Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia.

Received: 08 November 2022; Accepted: 17 November 2022; Published: 23 November 2022

Citation: Steward Mudenda, Patrick Mainza, Ruth Lindizyani Mfune, Webrod Mufwambi, Jimmy Hangoma, Ronald Mutati Kampamba, Tyson Lungwani Muungo, Christabel Nang’andu Hikaambo, Martin Kampamba, Shafiq Mohamed, Victor Daka. Psychological Impact of COVID-19 on Community Pharmacists: A Cross-Sectional Study in Lusaka District, Zambia. Fortune Journal of Health Sciences 5 (2022): 579-587.

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Abstract

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has caused serious health problems globally. This has included increased psychological challenges among frontline healthcare workers (HCWs). Community pharmacists are critical in the fight against COVID-19 and in sensitising the public about vaccinations and other public health interventions. However, little is known about the psychological impact of COVID-19 and the acceptance of vaccinations among community pharmacists in Zambia. Therefore, this study assessed the psychological impact of COVID-19 among community pharmacists in Lusaka, Zambia.

Materials and Methods: This cross-sectional study was conducted among 188 community pharmacists from August to October 2021 using a structured questionnaire. Statistical Package for Social Sciences (SPSS) version 22.0 was used to analyse the data. The statistical significance was conducted at a 95% confidence level.

Results: Of the 188 participants, 108 (57.4%) were male, while 80 (42.6%) were female. Most of the participants were in the age group of 20−30 years (n=109, 58.0%). The study found that 36.7% of the participants experienced anxiety, while 50.5% experienced depression. Anxiety was associated with fear of dying from COVID-19 if one contracted it (p=0.001), fear of infecting loved ones if infected (p=0.003) and experiencing a traumatic event (p=0.036). Depression was associated with a fear of dying if one contracted COVID-19 (p=0.001). Overall, about 70.2% of the participants expressed willingness to receive the COVID-19 vaccine.

Conclusion: Community pharmacists experienced anxiety and depression due to the COVID-19 pandemic. Most of the community pharmacists were willing to receive the COVID-19 vaccine. There is a need for urgent interventions to address the mental health challenges of community pharmacists during pandemics.

Keywords

anxiety; community pharmacists; COVID-19 vaccine; depression; healthcare workers; vaccine hesitancy; mental health; psychological impact

anxiety articles; community pharmacists articles; COVID-19 vaccine articles; depression articles; healthcare workers articles; vaccine hesitancy articles; mental health articles; psychological impact articles

Article Details

1. Introduction

The coronavirus disease 2019 (COVID-19) is a disease caused by a Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that emerged in the seafood and poultry markets in the Chinese city of Wuhan in 2019 [1-4]. Since the report of the first case, the virus quickly spread and was declared a pandemic by the World Health Organization (WHO) on March 11th, 2020 [5-7]. The main clinical presentations of COVID-19 include sore throat, diarrhoea, vomiting, fever, shortness of breath, dry cough, persistent chest pain or pressure in the chest, sputum production, headache, respiratory failure, septic shock, confusion, and organ failure [8-10]. If COVID-19 is not managed appropriately, it may easily lead to death due to acute respiratory distress syndrome, ventilator-associated pneumonia, acute renal failure, acute respiratory injury, and septic shock [11].

The pandemic not only affects the physical health but also the mental well-being of individuals [12-15]. The mental health challenges of the COVID-19 pandemic are particularly of serious concern for healthcare workers (HCWs) due to their high risk of exposure during their work and also for being on the frontline of healthcare provision [16-20]. The challenging conditions imposed HCWs, such as longer working hours, leads to increased anxiety, stress, depressive symptoms, and the exacerbation of pre-existing mental illness [19, 21-23]. Additionally, changes in routine activities and lifestyle have contributed to mental health problems among HCWs during the pandemic [24]. Therefore, it is Important to provide support systems and mechanisms that promote the mental well-being of HCWs at workplaces during and after health emergencies [25, 26]. Alongside this, it is imperative to understand the psychological needs of HCWs to provide them with the appropriate tools and support to mitigate the negative effects of COVID-19 [27-29]. High levels of stress and anxiety decrease staff morale, lower work satisfaction levels, increase absenteeism and lower the quality of healthcare services given to patients [25, 30, 31]. The mental health of HCWs must be protected by learning from experiences from previous epidemics and the strategies used by affected countries [32]. This is also critical particularly in low-and-middle-income countries [5, 33]. This is because stigma and discrimination associated with mental health and gaps in mental health services prevent timely help-seeking behaviour and favourable outcomes in affected populations [34].

The COVID-19 vaccination may protect populations from the severe manifestation of the disease. Thus, acceptance of the vaccine is very critical for HCWs, including community pharmacists [35]. This is because HCWs are messengers of vaccine promotion to the general public and are involved in vaccine administration [36, 37]. Previous studies have reported different acceptance rates of COVID-19 vaccines among HCWs. A global survey of COVID-19 acceptance by Noushad et al. 2022 found that 69% of the HCWs accepted to be vaccinated, with HCWs from Brazil and Malaysia reporting the highest vaccine acceptance (97% and 98%, respectively) than those from Egypt (40%) (38). In Ethiopia, only 48% of HCWs were willing to be vaccinated [39]. With such variations in acceptance of COVID-19 vaccines, community pharmacists can help share information on the benefits of vaccinations and thus promote vaccine uptake [40-42]. Community pharmacists are very important in the fight against pandemics because they are readily available and accessible to the public [43, 44]. This puts them at a high risk of contracting COVID-19 [11, 45, 46]. Additionally, these pharmaceutical frontline workers have also experienced psychological distress associated with COVID-19 [47, 48]. In Zambia, there is little information on the psychological impact of COVID-19 and the acceptance of vaccinations among HCWs, including community pharmacists. Therefore, this study assessed the psychological impact of COVID-19 on community pharmacists in Lusaka, Zambia.

2. Materials and Methods

2.1 Study Design, site and Population

This was a descriptive cross-sectional study that was conducted among community pharmacists from August 2021 to October 2021. The study was done in Lusaka district of Lusaka province in Zambia. Lusaka district was chosen for the study as it was disproportionately affected by the COVID-19 pandemic and was registering the highest number of confirmed cases [49]. Lusaka district was also the first COVID-19 epicentre in Zambia and has the largest number of community pharmacists in the country. We included registered community pharmacies that are under the responsibility of registered pharmacists. The community pharmacists provided consent to be part of the study.

2.2 Sample size determination and sampling technique

Lusaka district had a total of 373 registered community pharmacies at the time of conducting the study [50]. A list of community pharmacies was generated and the sample size was determined using the Raosoft formula [51]. With no previous similar study done in Zambia, the sample size was estimated using a proportion of 50% at a 95% confidence level and a 5% margin of error. A 10% incomplete or non-response was taken into consideration. A sample size of 186 was determined. After sample size determination, a complete listing of the community pharmacies was done followed by simple random sampling.

2.3 Data Collection Tool

Data collection was conducted using adopted validated tools from previous studies. Anxiety was measured using the Generalized Anxiety Disorder (GAD) questionnaire [52]. This tool has been used to assess anxiety among HCWs during the COVID-19 pandemic [53, 54]. Depression was measured using the Patient Health Questionnaire (depression module) 9 (PHQ-9). This tool has also been used in other studies to assess depression levels among HCWs during the COVID-19 pandemic [53]. The data collection was conducted by the principal investigator and one data collector assistant. Responding to the questionnaire took an average of 15 to 30 minutes depending on the other activities that the community pharmacists were doing.

2.4 Data Analysis

The collected data were entered in Microsoft Excel 2013 and exported to Statistical Package for Social Sciences (SPSS) version 22 for analysis. All responses from the participants were described using frequencies and percentages. The chi-square test (or Fisher’s exact test when appropriate) was used to compare categorical variables. All statistical significance tests were conducted at a 95% confidence level (p=0.05). Based on the validated tool, a score of 1-4 indicates minimal depression, 5-9 indicates mild depression, 10-14 indicates moderate depression, 15-19 indicates moderately severe depression and 20-27 indicates severe depression [55].

2.5 Ethical approval

This study was approved by the University of Zambia Health Sciences Research Ethics Committee (UNZAHSREC), protocol ID: 202112030046. Informed consent from the participants was obtained, and they were made aware of the purpose, risks and benefits of participating in the study. During the data collection period, the recommended precautions to prevent contracting COVID-19 were adhered to.

3. Results

3.1 Sociodemographic characteristics of study participants

Overall, 188 participants completed the survey, of which 108 (57.4%) were male and 80 (42.6%) were female. Most of the participants, 58% (n = 109) were aged between 20 and 30 years. Among them, 73.4% (n = 138) were unmarried and the majority, 73.9% (n = 139) had worked for less than five (5) years, as shown in Table 1.

Table 1: Sociodemographic characteristics of study participants

Variable

Characteristics

Frequencies (n=188)

Percentage (%)

Sex

Female

80

42.6

Male

108

57.4

Age

20-30years

109

58

31-40years

71

37.8

>40years

8

4.3

Education

Bachelors

175

93.1

Masters/PhD

13

6.9

Marital status

Single

138

73.4

Married

50

26.6

Family type

Nuclear

136

72.3

Extended

52

27.7

Work experience

Up to 5years

139

73.9

More than 5 years

49

26.1

Living with a child less than 15 years

Yes

82

43.6

No

106

56.4

Living with the elderly (above 60 years)

Yes

20

10.6

No

168

89.4

History of medication for mental health

Yes

5

2.7

No

183

97.3

Experienced traumatic event

Yes

44

23.4

No

144

76.6

3.2 Work-related variables of study participants

The majority 106 (53.4%) of study participants reported that they lacked access to adequate protective equipment and that 133 (70.7%) lacked adequate staff testing equipment. Approximately 102 (54.3%) community pharmacists had attended to more than 20 COVID-19 patients. The majority (70.2%) of the participants would accept being vaccinated against COVID-19.

Table 2: Work-related variables of study participants and acceptance of the COVID-19 vaccine

Variable

Category

Frequency (n=188)

Percentage (100%)

Adequate Personal Protective Equipment (PPE)

Yes

82

43.6

No

106

53.4

Adequate testing for staff members

Yes

55

29.3

No

133

70.7

Number of COVID-19 patients treated

< 10

45

23.9

20-Oct

41

21.8

>20

102

54.3

Level of team spirit

Low

10

5.3

Medium

104

55.3

High

74

39.4

Felt torn between your desire to help patients and your desire to loved ones

None of the time

24

12.8

Sometimes

136

72.3

All the time

28

14.9

Aware of government incentives for HCWs

Yes

89

47.3

No

99

52.7

Working in an affected residential area

Yes

138

73.4

No

50

26.6

Change in regular job duty

Yes

153

81.4

No

35

18.6

Accept the risk of getting COVID-19 as part of the job

Yes

115

61.2

No

73

38.8

Would you accept to receive a COVID-19 vaccine?

Yes

132

70.2

No

56

29.8

3.3 Prevalence of anxiety and depression among Study Participants

Overall, 36.7% of the participants experienced symptoms of anxiety, of which 25% had mild, 10.1% moderate, and 1.6% severe anxiety. Slightly more than half of the participants (50.5%) had some symptoms of depression, of which 37.8% showed mild, 10.6% moderate, 1.6% moderately severe, and 0.5% severe levels of depression.

Table 3: Prevalence of anxiety and depression among participants (n=188)

Variable

Category

Frequencies

Percentage (%)

Anxiety (GAD-7)

0-4 Normal

119

63.3

5-9 Mild

47

25

10-14 Moderate

19

10.1

15-21 severe

3

1.6

Depression (PHQ-8 modified)

0-4 None

93

49.5

5-9 Mild

71

37.8

10-14 Moderate

20

10.6

15-19 moderately severe

3

1.6

20-27 severe

1

0.5

3.4 Factors associated with anxiety and depression among community pharmacists

The factors associated with anxiety and depression among community pharmacists during the COVID-19 pandemic in Zambia are shown in Table 4. Anxiety was associated with fear of contracting and dying from COVID-19, fear of infecting loved ones if infected, experiencing traumatic events and being aware of government incentives for HCWs in the COVID-19 frontline. Besides, depression was associated with a fear of dying from COVID-19 if one contracted it.

Table 4: Factors associated with anxiety and depression among community pharmacists

Attribute

Anxiety (p-value)

Depression (p-value)

Fear of contracting and dying from COVID-19

<0.001a

<0.001b

Fear of infecting loved ones if infected

0.003a

-

Experienced traumatic event

0.036a

-

I am aware of government incentives for HCWs

0.009b

-

a = Chi-square; b = Fisher’s exact test

4. Discussion

This study assessed the impact of COVID-19 on the mental health of community pharmacists in Lusaka district of Zambia. The results of this study demonstrated that the prevalence of anxiety was 36.7% while that of depression was 50.5%. Particularly, 25% of the community pharmacists experienced mild anxiety while 37.8% showed mild depression due to the COVID-19 pandemic. Depression was associated with fear of dying from COVID-19 if it was contracted, while anxiety was associated with fear of dying from COVID-19 if it was contracted, fear of infecting loved ones if infected, experiencing a traumatic event and being aware of government incentives for HCWs in the COVID-19 frontline. The prevalence of anxiety in our study was lower than the 70.9%, 53.2%, and 41.9% reported in Spain [56], Qatar [57] and China [58], respectively. The anxiety experienced by community pharmacists during the COVID-19 pandemic was due to the fear of contracting the disease [47]. Community pharmacists have been overwhelmed with the influx of patients with different conditions, among them those suffering from COVID-19. Hence, their fear of contracting COVID-19 from these patients and later worrying about transmitting it to their family members contributed to the anxiety experienced by community pharmacies. The high levels of anxiety in other countries were due to the higher numbers of COVID-19 cases and deaths that were reported there compared to Zambia. In the USA, lower anxiety was reported compared to what was found in our study [59]. This was because the frontline workers received more support from the healthcare institutional leadership [59].

Anxiety was also due to the fear of infecting loved ones if infected. Pharmacists exhibited greater anxiety if they lived with those who were elderly, as they were more susceptible to contracting COVID-19, experiencing severe complications, and being at a higher risk of dying. Pharmacists in other settings also experienced anxiety for the same reason [16]. As such, most of the pharmacists were troubled with the thought of being the carriers of the disease to their family, and the chances of infecting the family and most worryingly, the elderly. Similar findings were reported in Malaysia in which HCWs experienced mental health challenges due to fear of contracting COVID-19 and transmitting it to their family members [60]. Furthermore, those who had experienced a traumatic event suffered more from anxiety than those who had not. Studies conducted elsewhere in New York [59] and Ethiopia [34] showed similar findings; those who had previous experience with disasters displayed higher rates of post-event psychiatric disorders compared to those indirectly affected [58].Our study found a 50.5% prevalence of depression which is slightly higher than the 44.8% in Qatar [57], but lower than what was reported in Spain [56]. The current study revealed that depression experienced by the majority of community pharmacists had a fear of contracting COVID-19. This made them feel that they could succumb to COVID-19 if they contracted it. For the current study, these fears could have been attributed to the lack of PPE materials for protecting themselves against COVID-19. Other studies conducted in France [43], Ghana [16] and Ethiopia [61] also found that community pharmacists experienced anxiety due to a lack of PPE. Besides, an increased influx of patients in community pharmacies during the COVID-19 pandemic could have also contributed to the reported fears. This is because community pharmacists were very accessible to the general public during the pandemic, especially due to the increased avoidance by patients from hospitals for fear of contracting the virus [44, 62]. Depression has also been reported among other HCWs other than pharmacists, especially those in direct contact with COVID-19 patients [63-67]. In Thailand, a lack of PPE was cited as one of the causes of anxiety and depression among nurses and doctors during the COVID-19 pandemic [28].

Depression was associated with the fear of contracting and dying from COVID-19 if one contracted it. These findings are in line with a study that was conducted among community pharmacists in Qatar [57]. A similar observation was reported among HCWs in Bangladesh [68]. Due to their demand and pertinent roles as frontline workers, community pharmacists may be exposed to various infections, including COVID-19 [62]. Therefore, during their operations, they tend to fear contracting the disease and later succumb to it, leading to increased depression and other mental health challenges [62]. Our study found that the majority of pharmacists (70.2%) would accept the COVID-19 vaccine if made available. This finding is encouraging as it shows that pharmacists know the benefits of vaccinations against COVID-19. Our findings are in agreement with studies conducted in Turkey and Ethiopia among HCWs and in China among pharmacists [69-71]. Although a lot of promotional messages have accompanied the rollout of vaccines globally, low rates of acceptance of COVID-19 vaccines by HCWs have been reported. Lower acceptance rates than those reported in our current study have been found in the United States of America, India, Sudan, Saudi Arabia, and South Africa [72-76]. In contrast, some studies have reported higher acceptance rates in other countries including, the United Arab Emirates, Singapore, Nigeria, and a different locality in Ethiopia [77-80]. These differences could be driven by different population characteristics, cultural influences, population experiences with the COVID-19 pandemic, and local enabling factors such as positive promotional messages. Our study indicates the impact of COVID-19 on the mental health of community pharmacists who are critical in providing healthcare services to most community members. This study was conducted in Lusaka district and this means that the findings of the survey may not be generalised to other community pharmacists across the country.

5. Conclusion

This study found that community pharmacists experienced anxiety and depression during the third wave of the COVID-19 pandemic in Zambia. Furthermore, a majority of the participants would accept being vaccinated against COVID-19. Community pharmacists are frontline HCWs as they provide necessary services amidst the pandemic. As one of the most accessible HCWs, they face many stressors that need to be specifically targeted to address pharmacists’ mental health issues effectively. There is a need to constantly monitor the psychological difficulties that healthcare workers, including community pharmacists, face during the COVID-19 period.

Acknowledgements

We are grateful to the community pharmacists who participated in this study.

Conflict of interest

All authors declare no conflict of interest.

References

  1. Mekonen E, Shetie B, Muluneh N. The Psychological Impact of COVID-19 Outbreak on Nurses Working in the Northwest of Amhara Regional State Referral Hospitals, Northwest Ethiopia. Psychol Res Behav Manag 13 (2021): 1353-1364.
  2. Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. J Adv Res 24 (2020): 91-98.
  3. Morens DM, Breman JG, Calisher CH, Doherty PC, Hahn BH, Keusch GT, Kramer LD, LeDuc JW, Monath TP, Taubenberger JK. The Origin of COVID-19 and Why It Matters. Am J Trop Med Hyg 103 (2020): 955-959.
  4. Byttebier K. ‘Origin and Causes of Covid-19’. Springer, Cham (2022): 1-26.
  5. Deng D, Naslund JA. Psychological Impact of COVID-19 Pandemic on Frontline Health Workers in Low- and Middle-Income Countries. Harvard public Heal Rev (Cambridge, Mass) 28 (2020): 20.
  6. Zhong BL, Luo W, Li HM, Zhang QQ, Liu XG, Li WT, Li Y. Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: A quick online cross-sectional survey. IntJ BiolSci 16 (2020): 1745-1752.
  7. Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed 91 (2020): 157-160.
  8. Mudenda S, Mukosha M, Mwila C, Saleem Z, Kalungia AC, Munkombwe D, Daka V, Witika BA, Kampamba M, Hikaambo CN, et al. Impact of the coronavirus disease on the mental health and physical activity of pharmacy students at the University of Zambia: a cross-sectional study. Int J Basic ClinPharmacol 10 (2021): 324.
  9. Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. ClinImmunol 215 (2020): 108427.
  10. Adhikari SP, Meng S, Wu Y-J, Mao Y-P, Ye R-X, Wang Q-Z, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty 9 (2020): 29.
  11. Dzingirai B, Matyanga CMJ, Mudzviti T, Siyawamwaya M, Tagwireyi D. Risks to the community pharmacists and pharmacy personnel during COVID-19 pandemic: Perspectives from a low-income country. J Pharm Policy Pract 13 (2020): 42.
  12. Saladino V, Algeri D, Auriemma V. The Psychological and Social Impact of Covid-19: New Perspectives of Well-Being. Front Psychol 11 (2020): 2550.
  13. Robertson LJ, Maposa I, Somaroo H, Johnson O. Mental health of healthcare workers during the COVID-19 outbreak: A rapid scoping review to inform provincial guidelines in South Africa. South African Med J 110 (2020): 1010-1019.
  14. Mudenda S, Chomba M, Mukosha M, Daka V, Chileshe M, Okoro RN, et al. Psychological impact of coronavirus disease (COVID-19) on health professions students at the University of Zambia: a cross-sectional study. PAMJ 2022 42 (2022): 237.
  15. Belash I, Barzagar F, Mousavi G, Janbazian K, Aghasi Z, Ladari A, et al. COVID-19 pandemic and death anxiety among intensive care nurses working at the Hospitals Affiliated to Tehran University of Medical Science. J Fam Med Prim Care 10 (2021): 2499-2502.
  16. Ofori AA, Osarfo J, Agbeno EK, Manu DO, Amoah E. Psychological impact of COVID-19 on health workers in Ghana: A multicentre, cross-sectional study. SAGE Open Med 9 (2021): 205031212110009.
  17. Arshad MS, Hussain I, Nafees M, Majeed A, Imran I, Saeed H, et al. Assessing the impact of covid-19 on the mental health of healthcare workers in three metropolitan cities of Pakistan. Psychol Res BehavManag 13 (2020): 1047-1055.
  18. Ali S, Maguire S, Marks E, Doyle M, Sheehy C. Psychological impact of the COVID-19 pandemic on healthcare workers at acute hospital settings in the South-East of Ireland: An observational cohort multicentre study. BMJ Open 10 (2020): 42930.
  19. Mudenda S, Chabalenge B, Matafwali S, Daka V, Chileshe M, Mufwambi W, et al. Psychological Impact of COVID-19 on Healthcare Workers in Africa, Associated Factors and Coping Mechanisms: A Systematic Review. Adv Infect Dis 12 (2022): 518-532.
  20. Spoorthy MS. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review. Asian J Psychiatr 51 (2020): 102119.
  21. Elbeddini A, Prabaharan T, Almasalkhi S, Tran C. Pharmacists and COVID-19. J Pharm Policy Pract13 (2020).
  22. Luo M, Guo L, Yu M, Wang H. The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public - A systematic review and meta-analysis. Psychiatry Res 291 (2020): 113190.
  23. Mehta S, Machado F, Kwizera A, Papazian L, Moss M, Azoulay É, et al. COVID-19: a heavy toll on health-care workers. Lancet Respir Med (2021).
  24. Wang N, Li Y, Wang Q, Lei C, Liu Y, Zhu S. Psychological impact of COVID-19 pandemic on healthcare workers in China Xi’an central hospital. Brain Behav11 (2021): e02028.
  25. Khanal P, Devkota N, Dahal M, Paudel K, Joshi D. Mental health impacts among health workers during COVID-19 in a low resource setting: A cross-sectional survey from Nepal. Global Health 16 (2020): 89.
  26. Halms T, Strasser M, Kunz M, Hasan A. How to Reduce Mental Health Burden in Health Care Workers During COVID-19?-A Scoping Review of Guideline Recommendations. Front Psychiatry 12 (2022): 770193.
  27. De Kock JH, Latham HA, Leslie SJ, Grindle M, Munoz SA, Ellis L, et al. A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being. BMC Public Health 21 (2021): 104.
  28. Chinvararak C, Kerdcharoen N, Pruttithavorn W, Polruamngern N, Asawaroekwisoot T, Munsukpol W, et al. Mental health among healthcare workers during COVID-19 pandemic in Thailand. PLoS One 17 (2022): e0268704.
  29. Søvold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh MW, Grobler C, et al. Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority. Front Public Heal 9 (2021): 514.
  30. Bahamdan AS. Review of the psychological impact of COVID-19 pandemic on healthcare workers in Saudi Arabia. Risk ManagHealthc Policy 14 (2021): 4105-4111.
  31. Zaki NW, Sidiq M, Qasim M, Aranas B, Hakamy A, Ruwais N, et al. Stress and psychological consequences of COVID-19 on health-care workers. J Nat Sci Med 3 (2020): 299.
  32. Armitage R, Nellums LB. Protecting health workers’ mental health during COVID-19. Public Health 185 (2020): 18.
  33. Patel V, Saxena S, Lund C, Thornicroft G, Baingana F, Bolton P, et al. The Lancet Commission on global mental health and sustainable development. Lancet 392 (2018): 1553-1598.
  34. Mulatu HA, Tesfaye M, Woldeyes E, Bayisa T, Fesseha H, Asrat R. The prevalence of common mental disorders among health care professionals during the COVID-19 pandemic at a tertiary Hospital in East Africa. medRxiv (2020): 20222430.
  35. Ogunleye OO, Godman B, Fadare JO, Mudenda S, Adeoti AO, Yinka-Ogunleye AF, et al. Coronavirus Disease 2019 (COVID-19) Pandemic across Africa: Current Status of Vaccinations and Implications for the Future. Vaccines 10 (2022): 1553.
  36. Turcu-Stiolica A, Kamusheva M, Bogdan M, Tadic I, Harasani K, Subtirelu MS, et al. Pharmacist’s Perspectives on Administering a COVID-19 Vaccine in Community Pharmacies in Four Balkan Countries. Front Public Heal 9 (2021): 766146.
  37. Alshahrani SM, Orayj K, Ibrahim ARN, Alqahtani AM, Alfatease A, Alshahrani A. Attitude and Willingness to Get COVID-19 Vaccines by a Community Pharmacist in Saudi Arabia: A Cross-Sectional Study. Patient Prefer Adherence 16 (2022): 2821-2834.
  38. Noushad M, Rastam S, Nassani MZ, Al-Saqqaf IS, Hussain M, Yaroko AA, Arshad M, Kirfi AM, Koppolu P, Niazi FH, et al. A Global Survey of COVID-19 Vaccine Acceptance among Healthcare Workers. Front Public Heal 9 (2022): 2437.
  39. Angelo AT, Alemayehu DS, Dacho AM. Knowledge, attitudes, and practices toward covid-19 and associated factors among university students in MizanTepi University, 2020. Infect Drug Resist 14 (2021): 349-360.
  40. Wada YH, Musa MK, Ekpenyong A, Adebisi YA, Musa MB, Khalid GM. Increasing coverage of vaccination by pharmacists in Nigeria; an urgent need. Public Heal Pract 2 (2021): 100148.
  41. Jarab AS, Al-Qerem W, Mukattash TL. Community pharmacists’ willingness and barriers to provide vaccination during COVID-19 pandemic in Jordan. Hum Vaccines Immunother 18 (2022): 2016009.
  42. Terrie YC. The role of the pharmacist in overcoming vaccine hesitancy. US Pharm 46 (2021): 28-31.
  43. Lange M, Joo S, Couette PA, de Jaegher S, Joly F, Humbert X. Impact on mental health of the COVID-19 outbreak among community pharmacists during the sanitary lockdown period. Ann Pharm Fr 78 (2020): 459-463.
  44. Ou HT, Kao Yang YH. Community pharmacists in Taiwan at the frontline against the novel coronavirus pandemic: Gatekeepers for the rationing of personal protective equipment. Ann Intern Med 173 (2020): 149-150.
  45. Cabas P, Di Bella S, Giuffrè M, Rizzo M, Trombetta C, Luzzati R, Antonello RM, Parenzan K, Liguori G. Community pharmacists’ exposure to COVID-19. Res SocAdm Pharm 17 (2021): 1882-1887.
  46. Khojah HMJ, Itani R, Mukattash TL, Karout S, Jaffal F, Abu-Farha R. Exposure of community pharmacists to COVID-19: A multinational cross-sectional study. J TaibahUniv Med Sci16 (2021): 920-928.
  47. Baldonedo-Mosteiro C, Franco-Correia S, Mosteiro-Diaz M-P. Psychological impact of COVID-19 on community pharmacists and pharmacy technicians. Explor Res ClinSoc Pharm 5 (2022): 100118.
  48. Santos PM dos, Silva CR da, Costa D, Torre C. Burnout in the Pharmaceutical Activity: The Impact of COVID-19. Front Psychiatry 12 (2022): 771462.
  49. Mulenga LB, Hines JZ, Fwoloshi S, Chirwa L, Siwingwa M, Yingst S, et al. Prevalence of SARS-CoV-2 in six districts in Zambia in July, 2020: a cross-sectional cluster sample survey. Lancet Glob Heal 9 (2021): e773-e781.
  50. The Medicines and Allied Substances (Certificate of Registration) Regulation 2017: Register of Certificates of Registration. Zambia Med RegulAuth 12 (2018): 1-30.
  51. com. Sample Size Calculator by Raosoft, Inc . Page 1 of 1 Sample size calculator. Online (2012).
  52. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Intern Med 166 (2006): 1092-1097.
  53. Aly HM, Nemr NA, Kishk RM, Elsaid NMA bakr. Stress, anxiety and depression among healthcare workers facing COVID-19 pandemic in Egypt: A cross-sectional online-based study. BMJ Open 11 (2021): e045281.
  54. Motahedi S, Aghdam NF, Khajeh M, Baha R, Aliyari R, Bagheri H, et al. Anxiety and depression among healthcare workers during COVID-19 pandemic: A cross-sectional study. Heliyon 7 (2021): e08570.
  55. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med 16 (2001): 606-613.
  56. Baldonedo-Mosteiro C, Mosteiro-Díaz M-P, Franco-Correia S, Tardón A. Emotional Burden among Pharmacists and Pharmacy Technicians during the COVID-19 Lockdown: A Cross-Sectional Study. Int J Environ Res Public Health 19 (2022): 10558.
  57. Samir AlKudsi Z, HanyKamel N, El-Awaisi A, Shraim M, Saffouh El Hajj M. Mental health, burnout and resilience in community pharmacists during the COVID-19 pandemic: A cross-sectional study. Saudi Pharm J 30 (2022): 1009-1017.
  58. Zhang N, Hong D, Yang H, Mengxi G, Huang X, Wang A, et al. Risk perception, anxiety, and depression among hospital pharmacists during the COVID-19 pandemic: The mediating effect of positive and negative affect. J Pacific Rim Psychol16 (2022).
  59. Feingold JH, Peccoralo L, Chan CC, Kaplan CA, Kaye-Kauderer H, Charney D, et al. Psychological Impact of the COVID-19 Pandemic on Frontline Health Care Workers During the Pandemic Surge in New York City. Chronic Stress 5 (2021): 247054702097789.
  60. Khoo EM, Abdullah A, Liew SM, Hussein N, Hanafi NS, Lee PY, et al. Psychological health and wellbeing of primary healthcare workers during COVID-19 pandemic in Malaysia: a longitudinal qualitative study. BMC Prim Care 23 (2022): 261.
  61. Kibret S, Teshome D, Fenta E, Hunie M, Tamire T. Prevalence of anxiety towards COVID-19 and its associated factors among healthcare workers in a Hospital of Ethiopia. PLoS One 15 (2020): e0243022.
  62. Elbeddini A, Wen CX, Tayefehchamani Y, To A. Mental health issues impacting pharmacists during COVID-19. J Pharm Policy Pract 13 (2020): 46.
  63. Sung CW, Chen CH, Fan CY, Chang JH, Hung CC, Fu CM, et al. Mental health crisis in healthcare providers in the COVID-19 pandemic: A cross-sectional facility-based survey. BMJ Open 11 (2021): e052184.
  64. Fournier A, Laurent A, Lheureux F, Ribeiro-Marthoud MA, Ecarnot F, Binquet C, Quenot JP. Impact of the COVID-19 pandemic on the mental health of professionals in 77 hospitals in France. PLoS One 17 (2022): e0263666.
  65. Biber J, Ranes B, Lawrence S, Malpani V, Trinh TT, Cyders A, et al. Mental health impact on healthcare workers due to the COVID-19 pandemic: a U.S. cross-sectional survey study. J Patient-Reported Outcomes 6 (2022): 63.
  66. Mascayano F, van der Ven E, Moro MF, Schilling S, Alarcón S, Al Barathie J, et al. The impact of the COVID-19 pandemic on the mental health of healthcare workers: study protocol for the COVID-19 HEalthcaRewOrkErS (HEROES) study. Soc Psychiatry PsychiatrEpidemiol 57 (2022): 633-645.
  67. Almalki AH, Alzahrani MS, Alshehri FS, Alharbi A, Alkhudaydi SF, Alshahrani RS, et al. The Psychological Impact of COVID-19 on Healthcare Workers in Saudi Arabia: A Year Later Into the Pandemic. Front Psychiatry 12 (2021): 797545.
  68. Sakib N, Akter T, Zohra F, Bhuiyan AKMI, Mamun MA, Griffiths MD. Fear of COVID-19 and Depression: A Comparative Study among the General Population and Healthcare Professionals during COVID-19 Pandemic Crisis in Bangladesh. Int J Ment Health Addict (2021).
  69. Okuyan B, Bektay MY, Demirci MY, Ay P, Sancar M. Factors associated with Turkish pharmacists’ intention to receive COVID-19 vaccine: an observational study. Int J Clin Pharm 44 (2022): 247-255.
  70. Wang MW, Wen W, Wang N, Zhou MY, Wang CY, Ni J, et al. COVID-19 Vaccination Acceptance among Healthcare Workers and Non-healthcare Workers in China: A Survey. Front Public Heal 9 (2021): 709056.
  71. Yilma D, Mohammed R, Abdela SG, Enbiale W, Seifu F, Pareyn M, et al. COVID-19 vaccine acceptability among healthcare workers in Ethiopia: Do we practice what we preach? Trop Med Int Heal 27 (2022): 418-425.
  72. Wiysonge CS, Alobwede SM, de Marie C Katoto P, Kidzeru EB, Lumngwena EN, Cooper S, Goliath R, Jackson A, Shey MS. COVID-19 vaccine acceptance and hesitancy among healthcare workers in South Africa 21 (2022): 549-559.
  73. Elharake JA, Galal B, Alqahtani SA, Kattan RF, Barry MA, Temsah M-H, et al. COVID-19 Vaccine Acceptance among Health Care Workers in the Kingdom of Saudi Arabia-NC-ND license. Int J Infect Dis 109 (2021): 286-293.
  74. Shekhar R, Sheikh AB, Upadhyay S, Singh M, Kottewar S, Mir H, et al. COVID-19 Vaccine Acceptance among Health Care Workers in the United States. Vaccines 9 (2021): 119.
  75. Mehta K, Dhaliwal ID BK, Zodpey S, Loisate S, Banerjee P, Sengupta P, et al. COVID-19 vaccine acceptance among healthcare workers in India: Results from a cross-sectional survey. PLOS Glob Public Heal 2 (2022): e0000661.
  76. Yassin EOM, Faroug HAA, Ishaq ZBY, Mustafa MMA, Idris MMA, Widatallah SEK, Abd El-Raheem GOH, Suliman MY. COVID-19 Vaccination Acceptance among Healthcare Staff in Sudan, 2021. J Immunol Res (2022): 3392667.
  77. Koh SWC, Liow Y, Loh VWK, Liew SJ, Chan YH, Young D. COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore. BMC Prim Care 23 (2022):1-9.
  78. Nomhwange T, Wariri O, Nkereuwem E, Olanrewaju S, Nwosu N, Adamu U, et al. COVID-19 vaccine hesitancy amongst healthcare workers: An assessment of its magnitude and determinants during the initial phase of national vaccine deployment in Nigeria. eClinicalMedicine 50 (2022):101499.
  79. Boche B, Kebede O, Damessa M, Gudeta T, Wakjira D. Health Professionals’ COVID-19 Vaccine Acceptance and Associated Factors in Tertiary Hospitals of South-West Ethiopia: A Multi-Center Cross-Sectional Study. Inquiry 59 (2022): 469580221083181.
  80. AlKetbi LMB, Elharake JA, Memari S Al, Mazrouei S Al, Shehhi B Al, Malik AA, et al. COVID-19 vaccine acceptance among healthcare workers in the United Arab Emirates. IJID Reg 1 (2021): 20-26.

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