Navigating long-COVID in East Africa: Symptomatology, health-care experiences, and health system suggestions in Ethiopia and Uganda
1
Research project Management, Malaria Consortium, Addis Ababa, Ethiopia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
While acute COVID-19 has been extensively characterized, understanding of long-COVID remains limited, particularly in resource-constrained settings. This study explored the lived experiences of long-COVID patients in Ethiopia and Uganda, focusing on clinical presentation, healthcare-seeking behaviors, and the readiness of national health systems to address their needs.
METHODS:
Qualitative phenomenological design was employed across ten major hospitals in both countries. Data was collected through thirty in-depth interviews and ten focus group discussions with long-COVID patients and their close attendants, complemented by sixty key informant interviews with healthcare providers. Thematic analysis was conducted to identify major symptom categories, service access patterns, and system-level challenges and suggestions in long-COVID recognition and management.
RESULTS:
Participants reported persistent symptoms predominantly within the cardiopulmonary, musculoskeletal, and neurocognitive domains, including chronic fatigue, enduring cough, musculoskeletal pain and memory and cognitive impairments. Several participants described recurrent infections with unusually prolonged recovery time, while many male respondents reported a sustained decline in sexual desire and performance. Healthcare providers consistently noted increasing encounters of patients with persistent post-COVID symptoms but lacked diagnostic guidance and formal criteria for long-COVID classification. Systemic gaps in awareness, diagnostic capacity, and care pathways contributed to underdiagnosis, misdiagnosis, and suboptimal management. Participants highlighted profound physical, psychological, and socioeconomic impacts linked to long-COVID and emphasized barriers to effective care-seeking.
CONCLUSIONS:
Long-COVID poses a growing public health challenge in Ethiopia and Uganda, exposing critical gaps in long-COVID care and health system preparedness. Strengthened national response through guideline development, integrated screening and care pathways, provider training, and improved risk communication—is urgently needed to enhance care-seeking, recognition, and management of long-COVID in low-resource contexts.
While acute COVID-19 has been extensively characterized, understanding of long-COVID remains limited, particularly in resource-constrained settings. This study explored the lived experiences of long-COVID patients in Ethiopia and Uganda, focusing on clinical presentation, healthcare-seeking behaviors, and the readiness of national health systems to address their needs.
METHODS:
Qualitative phenomenological design was employed across ten major hospitals in both countries. Data was collected through thirty in-depth interviews and ten focus group discussions with long-COVID patients and their close attendants, complemented by sixty key informant interviews with healthcare providers. Thematic analysis was conducted to identify major symptom categories, service access patterns, and system-level challenges and suggestions in long-COVID recognition and management.
RESULTS:
Participants reported persistent symptoms predominantly within the cardiopulmonary, musculoskeletal, and neurocognitive domains, including chronic fatigue, enduring cough, musculoskeletal pain and memory and cognitive impairments. Several participants described recurrent infections with unusually prolonged recovery time, while many male respondents reported a sustained decline in sexual desire and performance. Healthcare providers consistently noted increasing encounters of patients with persistent post-COVID symptoms but lacked diagnostic guidance and formal criteria for long-COVID classification. Systemic gaps in awareness, diagnostic capacity, and care pathways contributed to underdiagnosis, misdiagnosis, and suboptimal management. Participants highlighted profound physical, psychological, and socioeconomic impacts linked to long-COVID and emphasized barriers to effective care-seeking.
CONCLUSIONS:
Long-COVID poses a growing public health challenge in Ethiopia and Uganda, exposing critical gaps in long-COVID care and health system preparedness. Strengthened national response through guideline development, integrated screening and care pathways, provider training, and improved risk communication—is urgently needed to enhance care-seeking, recognition, and management of long-COVID in low-resource contexts.
| eISSN: | 2654-1459 |
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