All Publications

  • Staying Physically Active Is Associated with Better Mental Health and Sleep Health Outcomes during the Initial Period of COVID-19 Induced Nation-Wide Lockdown in Jordan. International journal of environmental research and public health Al-Ajlouni, Y. A., Park, S. H., Alawa, J., Dodin, B., Shamaileh, G., Makarem, N., Keyes, K. M., Duncan, D. T. 1800; 19 (2)


    Jordan, a Middle Eastern country, initially responded to an outbreak of COVID-19 cases within its own borders by imposing a 7-week strict lockdown and closure of international and domestic travel. Such measures drastically influenced lifestyle behaviors of the population. This study aimed to investigate the prevalence of physical activity, and its association with mental and sleep health outcomes among Jordanians during a period of COVID-19 induced lockdown. Validated questionnaires were administered using a web-based platform to evaluate moderate-to-vigorous physical activity (MVPA), anxiety and depressive symptoms, sleep health, and sociodemographic characteristics. A modified Poisson regression model with robust error variance was used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs). Compared to participants who met the guidelines, those who did not had significantly higher prevalence of moderate or severe anxiety symptoms than that of minimal or mild anxiety symptoms and increased depressive symptoms. Insufficient MVPA was associated with higher prevalence of poor sleep quality, short sleep duration (<7 h) and sleep problems. Overall, sufficient MVPA was associated with better mental and sleep health during the COVID-19 induced nation-wide lockdown in Jordan. While further research is necessary, promoting physical activity during the lockdown could potentially improve mental and sleep health outcomes among the population.

    View details for DOI 10.3390/ijerph19020776

    View details for PubMedID 35055598

  • Knowledge and perceptions of COVID-19, prevalence of pre-existing conditions and access to essential resources in Somali IDP camps: a cross-sectional study. BMJ open Alawa, J., Al-Ali, S., Walz, L., Wiles, E., Harle, N., Awale, M. A., Mohamed, D., Khoshnood, K. 2021; 11 (6): e044411


    OBJECTIVES: This study examined knowledge and perceptions of COVID-19, prevalence of pre-existing conditions and access to essential resources among residents of internally displaced person (IDP) camps in Somalia, where overcrowded settlements with weakened infrastructure, inadequate water, sanitation, and hygiene facilities, and limited access to health services make this vulnerable population particularly susceptible to a COVID-19 outbreak.DESIGN: A descriptive, cross-sectional survey.SETTING: Twelve IDP camps across six areas of the Lower Shabelle region in Somalia.PARTICIPANTS: 401 adult Somali IDP camp residents.RESULTS: The majority of participants were female (86%) and had received no formal education (89%). While 58% reported being in 'good' health, half of the participants reported having one or more pre-existing conditions. Though 77% of respondents reported taking at least one COVID-19 preventative public health measure, respondents reported a lack of access to adequate sanitation, an inability to practice social distancing and nearly universal inability to receive a COVID-19 screening exam. Questions assessing knowledge surrounding COVID-19 prevention and treatment yielded answers of 'I don't know' for roughly 50% of responses. The majority of participants were not familiar with basic information about the virus or confident that they could receive medical services if infected. 185 (47%) respondents indicated that camp living conditions needed to change to prevent the spread of COVID-19.CONCLUSION: This study highlights low levels of COVID-19 knowledge and limited access to essential prevention and treatment resources among individuals living in Somali IDP camps. A massive influx of additional resources is required to adequately address COVID-19 in Somalia, starting with codesigning interventions to educate those individuals most vulnerable to infection.

    View details for DOI 10.1136/bmjopen-2020-044411

    View details for PubMedID 34187818

  • Knowledge of and preparedness for COVID-19 among Somali healthcare professionals: A cross-sectional study. PloS one Alawa, J., Walz, L., Al-Ali, S., Harle, N., Wiles, E., Awale, M. A., Mohamed, D., Khoshnood, K. 2021; 16 (11): e0259981


    Somalia is considered severely underprepared to contain an outbreak of COVID-19, with critical shortages in healthcare personnel and treatment resources. In limited-resource settings such as Somalia, providing healthcare workers with adequate information on COVID-19 is crucial to improve patient outcomes and mitigate the spread of the SARS-CoV-2 virus. This study assessed the knowledge of, preparedness for, and perceptions toward COVID-19 prevention and treatment among Somali healthcare workers.A descriptive, cross-sectional survey was completed by 364 Somali healthcare workers in summer of 2020 utilizing a convenience sampling method.Participants' most accessed sources of COVID-19 information were from social media (64.8%), official government and international health organization websites (51.1%,), and traditional media sources such as radio, TV, and newspapers (48.1%). A majority of participants demonstrated strong knowledge of treatment of COVID-19, the severity of COVID-19, and the possible outcomes of COVID-19, but only 5 out of 10 symptoms listed were correctly identified by more than 75% of participants. Although participants indicated seeing a median number of 10 patients per week with COVID-19 related symptoms, access to essential medical resources, such as N95 masks (30.2%), facial protective shields (24.5%), and disposable gowns (21.4%), were limited. Moreover, 31.3% agreed that Somalia was in a good position to contain an emerging outbreak of COVID-19. In addition, 40.4% of participants agreed that the Somali government's response to the pandemic was sufficient to protect Somali healthcare professionals.This study provides evidence for the need to equip Somali healthcare providers with more information, personal protective equipment, and treatment resources such that they can safely and adequately care for COVID-19 patients and contain the spread of the virus. Social media and traditional news outlets may be effective outlets to communicate information regarding COVID-19 and the Somali government's response to frontline healthcare workers.

    View details for DOI 10.1371/journal.pone.0259981

    View details for PubMedID 34813620

  • Addressing COVID-19 in humanitarian settings: a call to action. Conflict and health Alawa, J., Alawa, N., Coutts, A., Sullivan, R., Khoshnood, K., Fouad, F. M. 2020; 14: 64


    Refugees and internally displaced persons in humanitarian settings are particularly susceptible to the spread of infectious illnesses such as COVID-19 due to overcrowding and inadequate access to clean water, sanitation, and hygiene facilities. Countries facing conflict or humanitarian emergencies often have damaged or fragmented health systems and little to no capacity to test, isolate, and treat COVID-19 cases. Without a plan to address COVID-19 in humanitarian settings, host governments, aid agencies, and international organizations risk prolonging the spread of the virus across borders, threatening global health security, and devastating vulnerable populations. Stakeholders must coordinate a multifaceted response to address COVID-19 in humanitarian settings that incorporates appropriate communication of risks, sets forth resource-stratified guidelines for the use of limited testing, provides resources to treat affected patients, and engages displaced populations.

    View details for DOI 10.1186/s13031-020-00307-8

    View details for PubMedID 32934662