1.0 INTRODUCTION

1.1 BACKGROUND

The coronavirus disease 2019(COVID-19) is a global public health emergency that has affected both physical and mental health. In China where the pandemic originated ,35% of the population reported having experienced psychological distress(1).This is due to the rapid spread of the virus leading to a high mortality rate , institutional quarantine and strict isolation of cases along with daily analysis and misinformation which have triggered several mental illnesses most especially stress, anxiety and depression among health care workers and the general population including university students (2).Tanzania announced the first case of COVID-19 through the ministry of Health Community Development, Gender, Elderly and Children under its minister Ummy Mwalimu on 16th March 2020, which was imported by a woman through Kilimanjaro International Airport in Arusha from Belgium. Following the first case announcement, immediately on 17th March, the Prime Minister Kassim Majaliwa announced first control measures for COVID-19 local transmission: closure of all school levels and ban of all public or social gatherings while on subsequent date the order was extended to collages and higher education institutions for indefinite close. On 23rd March, the government declared that all incoming travelers from COVID-19 affected countries to be quarantined for 2 weeks at their own costs. Self-isolation at home or hospitals and wearing of face masks in crowded areas were compulsory to any who suspects any COVID-19 symptoms in order to avoid more spread of the virus(3). Until 10thApril, the reported cumulative cases both in Tanzania mainland and Zanzibar reached 32, and it was at this point of daily increase of infection, the president Magufuli asked spiritualsto go and pray in their respective churches and mosques to seek help and protection from God against the disease. Tanzania stopped reporting any new cases on 4th May 2020 following false test results issued by National Health Laboratory after biological samples submitted from a papaya, car oil and a goat been tested positive during its laboratory check -up. Tanzania except all other precautions measures like keeping distance , washing hands with soap or use hand sanitizer and wearing facemasks in crowded areas, there is no biological evidence of disappearing of the disease, the president on 21st may 2020 declared that all collages and high schools students to reopen with effect from 1st June , the same on sports and international flights without quarantine(3).Among university students, studies indicate that psychological distress is estimated to range from 26.6% to 70% with a prevalence of stress , anxiety and depression at 44.4%,25% and 19.06% respectively(4). More studies show that living in urban areas, family income stability and living with parents are protective against anxiety whereas having relatives or acquaintances with COVID-19 increase the risk for anxiety. Also, the students who anticipated events such as exchange programs and graduation ceremonies for final year students were more stressed following the closure of schools. The use of official channels as main sources of information about COVID-19 are protective factors for both anxiety and depression while the unease of risk of the exposure and extreme fear are significantly associated with a high risk for psychological distress(5). In Tanzania, despite the increasing number of cases for the months March to May 2020 coupled with the closure of schools for more than 2months, little is known about the psychological distress brought. This study will provide insight into the psychological state of CUHAS students during the COVID-19 pandemic and enable proper planning psychological support for students to ensure positive coping following the pandemic.

1.2 PROBLEM STATEMENT

Tanzania is among the African countries that have been hit by the COVID-19 epidemic.Dar-es-salaam city and Island of Zanzibar are leading the number of infected cases other regions affected are Mwanza, Dodoma, Pwani ,Kagera, Manyara, and Morogoro. Several measures have been adopted to control the COVID-19 transmission in Tanzania,including closing all schools and universities, observing physical distancing, the prohibition of mass gatherings, isolation and care for infected people and suspected cases.Reports from different outbreaks recommended that knowledge and attitudes towards infectious diseases can some time result in a level of panic among population and complicate endeavors to prevent the spread of the disease(6).This study therefore is going to explore the psychological distress and their associated factors among CUHAS students as an impact from the covid19 pandemic in Tanzania.

1.3 RATIONALE OF THE STUDY

Mental health is one of the most affected aspects of life during pandemics like COVID-19and psychological issues need to be diagnosed as they emerge to promote positive coping with post-traumatic stress, depression, and anxiety. This study will ultimately encourage positive coping and improve the mental health of CUHAS university students during and after the pandemic.

1.4 RESEARCH QUESTION

What are the psychological distress and their associated factors experienced by Catholic University of Health and Allied Sciences students during the COVID-19 pandemic?

1.5 RESEARCH OBJECTIVES

1.5.1 BROAD OBJECTIVE

To determine the psychological distress among the CUHAS students during the COVID-19 pandemic in Tanzania.

1.5.2 SPECIFIC OBJECTIVES

1. To determine the levels of depression, anxiety, and stress among CUHAS students during the COVID-19 pandemic in Tanzania.
2. To determine the factors associated with depression, anxiety and stress among CUHAS students during the COVID-19 pandemic in Tanzania