ABSTRACT
Background: Anti-SARS-CoV-2 antibody tests are increasingly used for sero-epidemiological purposes to provide a better understanding of the extent of the infection in the community, and to monitor the progression of the COVID-19 epidemic. A sero-prevalence study was conducted to estimate prior infections with SARS-CoV-2 in Addis Ababa. Methods: A cross-sectional study was conducted from April 23 to 28, 2020 among 301 randomly selected residents of Addis Ababa;sub-city health offices, health facilities and health extension workers were contacted, to obtain a population profile and to conduct the random selection of study participants. Participants were selected, who had not been in direct contact with people who had contracted COVID-19, to maintain consistency among the study population. Interviews on socio demographic and behavioural risk factors, followed by serological tests were performed for SARS-CoV-2 IgM, and IgG antibodies, using the COVID-19 IgG/IgM Rapid Test Cassette. Based on the manufacturer information, the test has a sensitivity of 87.9% and specificity of 100% for IgM;and a sensitivity of 97.2% and specificity of 100% for IgG. A Polymerase chain reaction (RT-PCR) test was also done on combined nasopharyngeal and oropharengeal swabs. Findings: The unadjusted antibody-based crude SARS-CoV-2 prevalence was 7.6% and the adjusted (weighted average) SARS-CoV-2 prevalence was estimated at 8.8% (95% CI 5.5%-11.6%) for the study population. Higher sero-prevalence were observed for males (9.0%), age below 50 years (8.2%), students and unemployed (15.6%), as well as those with primary education (12.1%), educated above high school (37.9%), non- smokers (78.7%), with no history of regular alcohol (53.8%), no chat (70.8%), and no shisha use (94.7%). According to the findings, a significantly higher number of individuals had been infected in Addis Ababa as compared to what was being detected and reported by the RT-PCR test, which is suggestive of community transmission.
ABSTRACT
Background: Knowledge and perceptions of the public about the 2019 coronavirus disease (COVID-19) play a critical role in the prevention of the disease through adopting effective preventive measures. The aim of this study was to assess the knowledge and perceptions of COVID-19 as well as the source of information about the disease among government employees. Methods: A cross-sectional survey of 1,573 government employees from 46 public institutions located in Addis Ababa was undertaken from 8th to 19th June 2020. Systematic random sampling or consecutive sampling techniques were used to select the study participants. Paper-based self-administered questionnaires were used for data collection. ANOVA test and t-test were used to assess the difference between the groups. Results: The respondents demonstrated very high knowledge of the cause of COVID-19 (93%), its main clinical symptoms (>90%), modes of transmission (89%), and the main preventive measures (>90%). Almost all respondents reported that people with travel history (86.8%) or people with close contact with COVID-19 patients (93.5%) were at higher risk to coronavirus infection. About 51% of the participants reported that people without travel history or people who had no contact with confirmed cases were also at risk of infection. About 84% of the respondents perceived those older adults above 60 years were most at risk to die from COVID-19. The majority of the respondents reported that adults with other underlying health problems (95.4%), cigarette smokers (88.1%) and substance users (87.5%) were more likely to die from the disease. Television (32.2%) and health workers (30.5%) constituted the most trusted sources of information related to COVID-19. Conclusions: This study has found higher levels of knowledge and perceptions among respondents about COVID-19. Efforts should be focused on improving the knowledge, perceived susceptibility, severity, and benefits of preventive measures by providing timely and adequate information through trusted sources of information.
ABSTRACT
Background: Health service delivery and the uptake of health services were greatly affected by COVID-19. The current study assessed the change in patients' care-seeking behavior after the first COVID-19 case was reported in Ethiopia. Methods: A cross-sectional survey was conducted among patients who were appointed at Tikur Anbessa Specialized Hospital (TASH), between mid-March to mid-June 2020. Data was collected through telephone, using a pre-tested, structured questionnaire. Data were analyzed using SPSS software version 25. Descriptive statistics and binary logistic regression models were used to describe the data and assess factors associated with loss to follow-up (LTFU). Results: Among 644 interviewed patients, 70% were lost to follow-up. Fear of COVID-19 infection (87.1%) and transportation problem due to lockdown (82.7%) were among the main reasons for loss to follow-up. Patients aged >= 60 years had highest odds of missing a follow-up in the multivariable logistic regression analysis. The odds of loss to follow up (LTFU) for the fear of COVID-19 was 13 times higher than among patients who did not have fear (AOR=13.39, 95% CI: 7.96-22.50). The odds of loss to follow up among patients who reported transportation problems were 3.6 times higher than among those who did not have transport problems (AOR=3.64, 95% CI: 1.93-6.88,). The odds of loss to follow up among patients with severe and very severe illness were about three times higher (AOR=2.7, 95% CI: 1.48-5.01). Conclusion: Patient's care-seeking behavior with chronic medical conditions at the chronic care clinics of TASH were seriously compromised during COVID-19. Patient's age (>60 years), chronic disease severity, fear of COVID 19 and transportation problems significantly predicted LTFU. Strategies such as task shifting and establishment of telemedicine services should be explored to meet the ongoing health needs of chronically ill patients on established follow up care.