Spatial analysis of depression and anxiety among frontline health workers during Nigeria’s COVID-19 pandemic – Cross sectional study

Abstract

Abstract Background The COVID-19 pandemic caused considerable panic and anxiety among health workers in all countries of the world, including Nigeria. This study aimed to identify the spatial clustering for prevalence and factors associated with anxiety and depression among frontline health workers (FHWs) during COVID-19 in the 36 states of Nigeria. Methods This was a cross sectional study conducted in COVID-19 hospital treatment centres (one in each state) across 36 Nigerian states and Federal Capital Territory. A total of 3,353 FHWs were recruited using convenient sampling technique. The main outcomes were depression and anxiety symptoms examined using the Hospital Anxiety and Depression Scale (HADS) and categorised into binary. Multivariate logistic regression analysis was conducted to identify factors associated with anxiety and depression. Additionally, spatial distribution for anxiety and depression was analysed, and a series of maps were generated using ArcGIS Desktop Results FHWs in the Southeastern States of Anambra, Enugu, Abia, and Imo, experienced higher odds of depression and anxiety compared with other states. For anxiety alone, higher odds were observed among FHWs in Benue, Cross River, Ebonyi, and Edo states. Logistic regression analyses revealed higher odds for anxiety and depression among Nurses, while FHWs who have practiced for 1–6 years had significantly higher odds for depression (adjusted odds ratios (AOR) = 3.21, 95%CI: 1.90, 5.43 for 5–6 years; and AOR = 2.33, 95%CI: 1.27, 4.26 for 1–4 years). The odds for anxiety and depression were significantly lower among FHWs who had a previous history of psychological distress compared with those with no previous history. Conclusions Findings can be applied to public health policy that focuses on reducing levels of anxiety and depression during the pandemic and other future pandemics and should target FHWs with limited years of experience. Regional disparities emphasise the critical need for targeted interventions to safeguard healthcare workers' mental well-being, especially in high-risk regions.