COVID-19 Pandemic: Psychosocial Distress and Social Burdens Experienced by Cancer Patients at Cancer Diseases Hospital, Lusaka, Zambia

Background: Cancer diagnosis has been reported in some studies to have a significant psychosocial impact on both the patients and their caregivers. The estimated prevalence of psychosocial distress is between 35% and 55%. Commonly encountered psychological issues include and are not limited to fear, anxiety, and emotional distress. Many sources of emotional distress in patients with cancer during the COVID-19 pandemic have been reported to include poorly controlled symptoms arising from a lack of access to symptom control services and treatment. Social distress is associated with social isolation, separation from family and loss of employment. Cancer patients and society have been reported to experience anxiety, despair, and stress due to the COVID-19 restrictions on community movement and hospital appointment rescheduling. The objective of this study was to explore psychosocial distress and social burdens experienced by cancer patients during the COVID-19 pandemic. Methods: A descriptive phenomenological design was employed to describe “lived experiences of patients with Cancer” during the COVID-19 Pandemic. A total of 20 participants with Cancer and COVID-19 positive were purposefully selected and interviewed. Thematic analysis was utilized for data analysis by the use of themes generated from participants’ responses. Findings: Five major themes emerged: fear, self-isolation compliance, anxiety, low income and emotional distress. The findings of the study indicated that participants experienced fear, emotional distress and anxiety when diagnosed with COVID-19. Conclusion: The experiences of psychosocial distress and social burdens were a result of a lack of psychosocial support by both caregivers and health care workers. This study recommends appropriate health education concerning psychosocial support for cancer patients and the need to have appropriate clinical protocols and materials in allaying anxiety and fear in cancer patients during the COVID-19 pandemic.

Estimating the economic and social consequences for patients diagnosed with human African trypanosomiasis in Muchinga,Lusaka and Eastern Provinces of Zambia(2004-2014)

Background:Acute human African trypanosomiasis(rHAT)caused by Trypanosoma brucei rhodesiense is associated with high mortality and is fatal if left untreated.Only a few studies have examined the psychological,social and economic impacts of rHAT.In this study,mixed qualitative and quantitative research methods were used to evaluate the socio-economic impacts of rHAT in Mambwe,Rufunsa,Mpika and Chama Districts of Zambia.Methods:Individuals diagnosed with rHAT from 2004 to 2014 were traced using hospital records and discussions with communities.Either they,or their families,were interviewed using a structured questionnaire and focus group discussions were conducted with affected communities.The burden of the disease was investigated using disability adjusted life years(DALYs),with and without discounting and age-weighting.The impact of long-term disabilities on the rHAT burden was also investigated.Results:Sixty four cases were identified in the study.The majority were identified in second stage,and the mortality rate was high(12.5%).The total number of DALYs was 285 without discounting or age-weighting.When long-term disabilities were included this estimate increased by 50%to 462.The proportion of years lived with disability(YLD)increased from 6.4%to 37%of the undiscounted and un-age-weighted DALY total.When a more active surveillance method was applied in 2013-2014 the cases identified increased dramatically,suggesting a high level of under-reporting.Similarly,the proportion of females increased substantially,indicating that passive surveillance may be especially failing this group.An average of 4.9 months of productive time was lost per patient as a consequence of infection.The health consequences included pain,amnesia and physical disability.The social consequences included stigma,dropping out of education,loss of friends and self-esteem.Results obtained from focus group discussions revealed misconceptions among community members which could be attributed to lack of knowledge about rHAT.Conclusions:The social and economic impact of rHAT on rural households and communities is substantial.Improved surveillance and strengthening of local medical services are needed for early and accurate diagnosis.Disease prevention should be prioritised in communities at risk of rHAT,and interventions put in place to prevent zoonotic disease spill over from domestic animals and wildlife.Supportive measures to mitigate the long-term effects of disability due to rHAT are needed.

Will the State-owned Capital Transfer Policy Enhance the Sustainability of the Urban Employee Basic Pension Insurance Fund in China?

To analyze the efect of the state-owned capital transfer policy on the sustainability of China's urban employee basic pension insurance fund(CUEBPIF),this study develops an actuarial model for pension insurance.The results reveal the following:(i)Without policy intervention,the CUEBPIF would face a deficit in 2027 and a cumulative shortfall of RMB207.44 trillion by 2050,and the proportion of fiscal subsidies for the CUEBPIF in the total fiscal expenditure would increase to 12.86 percent in 2050.(i)Based on a delayed retirement policy,the transfer of 10 percent of state-owned capital can delay the onset of the fund deficit by 6 years,and the accumulated shortfall in 2050 would fall to RMB39.42 trillion,and the proportion of fiscal subsidies would decrease by I1.77 percentage points.(ii)The state-owned capital transfer policy can improve the sustainability of the CUEBPIF and reduce the burden of enterprise social security contributions when the transfer ratio increases to 20 percent.