Understanding the lived experiences of individuals with post-acute sequelae of SARS-CoV-2 infection (PASC) in Rwanda: a phenomenological qualitative study.

objectivesTo qualitatively explore the lived experiences of individuals with post-acute sequelae of SARS-CoV-2 infection (PASC) in Rwanda, with the aim of informing context-appropriate interventions to improve patients' quality of life.

designQualitative, phenomenological study using in-depth interviews and thematic analysis.

settingAll provinces of Rwanda, including the City of Kigali.

participantsAdults who tested positive for PASC during a nationwide prevalence study were purposively sampled across all study sites. A total of 30 people were interviewed before saturation was reached.

resultsParticipants' lived experiences with PASC were characterised by numerous themes. Despite describing significant life changes since their COVID-19 infection, they remained uncertain about the relationship between their ongoing symptoms and their previous COVID-19 infection. This uncertainty was worsened by healthcare providers who did not ask about COVID-19 history during consultations. Participants also described feelings of frustration and sadness caused by their inability to perform physically demanding jobs such as farming and manual labour, which had previously been their sources of income. Symptoms such as body weakness, persistent fatigue, breathlessness and memory loss contributed to financial hardship and difficulty meeting basic family needs, such as school fees and food, because participants were unable to work. For many participants, this financial pressure translated into constant fear, isolation and depression. Participants called for greater public awareness about PASC, more research into its symptoms and treatment and for healthcare providers to routinely ask patients about their previous COVID-19 infection. The results of this study also highlight the need for comprehensive approaches to address the physical, emotional and socioeconomic burden of PASC in Rwanda.

conclusionsIndividuals living with PASC in Rwanda face a compounded burden shaped by both the symptoms themselves and a broader environment of diagnostic uncertainty, limited specialist care and social stigma. These findings point to an urgent need for PASC-specific education for healthcare providers, public awareness initiatives and integrated psychosocial support within Rwanda's existing community health infrastructure. Future research should explore feasible approaches to address the burden of PASC in low-resource settings.