PriMera Scientific Medicine and Public Health (ISSN: 2833-5627)

Case Study

Volume 4 Issue 1

Psychological Indexes Among Secondary School Pupils During COVID-19 Pandemic in Selected Schools of Lusaka, Zambia; A Cross Sectional Study

Allan Mbewe*, Nkhama E, Ngandu R and Siziya S

December 29, 2023

DOI : 10.56831/PSMPH-04-111


Background: Learners continued learning and preparing for their final examinations during COVID-19 pandemic. However, the extent to which the pandemic had affected the mental health status of these learners was largely unknown. We investigated psychological indexes among secondary school pupils in Lusaka, Zambia in the era of the on -going COVID -19 pandemic.

Methodology: A cross-sectional study was conducted among pupils attending secondary schools in Lusaka district between June and September 2020. Five out of sixteen high secondary schools were randomly selected from the list. Insomnia severity Index, a rating instrument for anxiety and a patient health questionnaire for depression were used to collect data. Data analyses were conducted using IBM SPSS®. Statistics 20. Adjusted odds ratios (AOR) and their 95% confidence intervals (CI) are reported.

Results: A total of 1333/1800 (74.1%) pupils participated in the survey. Males were 792 (59.4%). The majority (60.4%) of the pupils were aged between 12-19 years. Age, gender, marital status and religion were associated with anxiety (p < 0.05). Pupils of age 12 - 19 years were 25% (AOR=1.25, 95% CI [1.11, 1.42]) more likely to have anxiety compared to those aged 20 - 25 years. Gender was the only factor that was independently associated with insomnia. Male pupils were 13% (AOR=0.87, 95% CI [0.77, 0.97]) less likely to have insomnia than female pupils.

Conclusion: Insomnia, depression and anxiety were common among learners especially among female students in their final year of their secondary education. The government should develop policy that compel schools to provide psychological services for the learners and more targeted at female students and younger learners.

Keywords: COVID-19 pandemic; High school, Pupils, Adolescents; Insomnia; Anxiety; Depression


  1. Cucinotta D and Vanelli M. “WHO declares COVID-19 a pandemic”. Acta Biomed 91.1 (2020): 157-60.
  2. World Health Organization. Weekly epidemiological update - 5 January 2021. WHO COVID-19 Epidemiol Updat 1 (2021): 4.
  3. Ministry of Health.
  4. Tarsitani L., et al. “Post-traumatic stress Disorder among COVID-19 survivors at 3-month follow-up after hospital discharge”. J Gen Intern Med 36.6 (2021): 1702-7.
  5. Marelli S., et al. “Impact of COVID-19 lockdown on sleep quality in university students and administration staff”. J Neurol 268.1 (2021): 8-15.
  6. Xiong J., et al. “Impact of COVID-19 pandemic on mental health in the general population: A systematic review”. J Affect Disord 277 (2020): 55-64.
  7. Mak IWC., et al. “Long-term psychiatric morbidities among SARS survivors”. Gen Hosp Psychiatry 31.4 (2009): 318-26.
  8. Auerbach AJ and Gale W. “The effects of the COVID pandemic on the federal budget outlook”. Bus Econ 55.4 (2020): 202-12.
  9. Pedrosa AL., et al. “Emotional, behavioral, and psychological impact of the COVID-19 pandemic”. Front Psychol 11 (2020): 1-18.
  10. Cuiyan W., et al. “Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China”. Int. J. Environ. Res. Public Health 17.5 (2020): 1729.
  11. Wilczewski M, Gorbaniuk O and Giuri P. “The psychological and academic effects of studying from the home and host country during the COVID-19 pandemic”. Frontiers in psychology 12 (2021): 1-8.
  12. Huang Y., et al. “The impacts of coping style and perceived social support on the mental health of undergraduate students during the early phases of the COVID-19 pandemic in China: a multicenter survey”. BMC Psychiatry (2021): 1-12.
  13. Cao W., et al. “The psychological impact of the COVID-19 epidemic on college students in China”. Psychiatry Res 287 (2020): 112934.
  14. Ministry of General Education.
  15. Ministry of Education.
  16. Mulenga LB., et al. “Prevalence of SARS-CoV-2 in six districts in Zambia in July, 2020: a cross-sectional cluster sample survey”. Lancet Glob Health 9.6 (2021): e773-81.
  17. Zung WWK. “A rating instrument for anxiety disorders”. Psychosomatics 12.6 (1971): 371-9.
  18. Morin CM., et al. “The Insomnia Severity Index: Psychometric indicators to detect insomnia cases and evaluate treatment response”. SLEEP 34.5 (2021): 601-8.
  19. Kroenke K, Spitzer RL and Williams JBW. Patient questionnaire 74001006647 Pfizer Inc. Patient Health Questionnaire (PHQ-9). A2663B, 10-04-2005 Trademark: PIME-MD.
  20. Bravo A. School Functioning of a Particularly Vulnerable Group: Children and Young People in Residential Child Care 8 (2017): 1-12.
  21. Takubo Y., et al. “Psychological impacts of the COVID-19 pandemic on one-month postpartum mothers in a metropolitan area of Japan”. BMC Pregnancy Childbirth (2021): 1-13.
  22. Ayouni I., et al. “Effective public health measures to mitigate the spread of COVID-19: a systematic review”. BMC Pubic Health (2021): 1-14.
  23. Girum T., et al. “Optimal strategies for COVID-19 prevention from global evidence achieved through social distancing, stay at home, travel restriction and lockdown: a systematic review”. BMC Public Health (2021): 1-18.
  24. Alberta C., et al. “Cross-Sectional study protocol for the COVID-19 impact survey of mothers and their 7 - 11 year old”. Frontiers in Psychology 12 (2021): 1-8.
  25. Kontoangelos K, Economou M and Papageorgiou C. “Mental Health Effects of COVID-19 Pandemia: A Review of Clinical and Psychological Traits”. Psychiatry Investigation (2020): 491-505.
  26. Milgrom J., et al. “Social Support — A Protective Factor for Depressed Perinatal Women?”. Int. J. Environ. Res. Public Health 16 (2019): 1426.
  27. Wang C., et al. “Depressive, anxiety, and insomnia symptoms between population in quarantine and general population during the COVID-19 pandemic: a case-controlled study”. BMC Psychiatry (2021): 99.
  28. Marelli S., et al. “Impact of COVID‑19 lockdown on sleep quality in university students and administration staff”. J Neurol 11 (2020): 1-8.
  29. Umlauf MG., et al. “Obstructive Sleep Apnea, Nocturia and Polyuria in Older Adults”. Sleep 27.1 (2004).
  30. Gruber R., et al. “The impact of COVID-19 related school shutdown on sleep in adolescent: a natural experience”. Sleep Medicine 76 (2020): 33-35.
  31. Yousif W, Wahed A and Hassan SK. “Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students”. Alexandria J Med 53.1 (2017): 77-84.
  32. Benjamin S, Lachal J and Radjack R. “Adolescent psychiatry disorders during the COVID-19 pademic and lockdown”. Psychiatry Research 291 (2020): 113264.
  33. Wang J., et al. “Gender differences in psychosocial status of adolescents during COVID-19: a six-country cross-sectional survey in Asia Pacific”. BMC Public Health (2021): 1-18.
  34. Yu X., et al. “Distinctive trajectories of the COVID-19 epidemic by age and gender: A retrospective modeling of the epidemic in South Korea”. Int J Infect Dis 98 (2020): 200-5.
  35. Gilsbach S, Herpertz-dahlmann B and Konrad K. “Psychological Impact of the COVID-19 pandemic on children and adolescents with and without mental disorders”. Frontiers in Public Health 9 (2021): 1-8.
  36. Rania N and Coppola I. “Psychological Impact of the Lockdown in Italy Due to the COVID-19 Outbreak: Are There Gender Differences?”. Frontiers in Psychology 12 (2021): 567470.
  37. Zhang X., et al. “Prevalence of and risk factors for depressive and anxiety symptoms in a large sample of Chinese adolescents in the post-COVID-19 era”. Child Adolesc Psychiatry Ment Health 15.1 (2021): 80.
  38. Sauer K., et al. “How often do German children and adolescents show signs of common mental health problems? Results from different methodological approaches - A cross-sectional study”. BMC Public Health 14.1 (2014).
  39. Patel BD and Lomas DA. “Obstructive pulmonary disease”. Genes Common Dis I (2007): 391-405.
  40. Anwer S., et al. “Evaluation of sleep habits, generalized anxiety, perceived stress, and research outputs among postgraduate research students in hong kong during the coronavirus (COVID-19) pandemic”. J Multidiscip Health 14 (2021): 3135-49.
  41. Sasangohar F., et al. “Provider burnout and fatigue during the COVID-19 Pandemic: Lessons learned from a high-volume intensive care unit”. Anesth Analg 131.1 (2020): 106-11.
  42. Götz M., et al. “Children, COVID-19 and the media”. Televizion (2020): 4-9.
  43. Phiri D., et al. “Spread of COVID-19 in Zambia: An assessment of environmental and socioeconomic factors using a classification tree approach”. Sci African 12 (2021): e00827.