Quality of life among patients with the common chronic disease during COVID-19 pandemic in Northwest Ethiopia: A structural equation modelling.

BACKGROUND: Improving Quality of Life (QoL) for patients with chronic diseases is a critical step in controlling disease progression and preventing complications. The COVID-19 pandemic has hampered chronic disease management, lowering patients' quality of life. Thus, we aimed to assess the quality of life and its determinants in patients with common chronic diseases, in Northwest Ethiopia during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted among 1815 randomly selected chronic patients with common chronic diseases. A standardized WHOQOL BREF tool was used, and electronic data collection was employed with the kobo toolbox data collection server. Overall QoL and the domains of Health-Related Quality of life (HRQoL) were determined. Structural equation modelling was done to estimate independent variables' direct and indirect effects. Path coefficients with a 95% confidence interval were reported. RESULTS: About one in third, (33.35%) and 11.43% of the study participants had co-morbid conditions and identified complications, respectively. The mean score of QoL was 56.3 ranging from 14.59 and 98.95. The environmental domain was the most affected domain of HRQoL with a mean score of 52.18. Age, psychological, and environmental domains of HRQoL had a direct positive effect on the overall QoL while the physical and social relationships domains had an indirect positive effect. On the other hand, the number of medications taken, the presence of comorbidity, and complications had a direct negative impact on overall QoL. Furthermore, both rural residency and the presence of complications had an indirect negative effect on overall QoL via the mediator variables of environmental and physical health, respectively. CONCLUSION: The quality of life was compromised in chronic disease patients. During the COVID-19 pandemic, the environmental domain of HRQoL was the most affected. Several socio-demographic and clinical factors had an impact on QoL, either directly or indirectly. These findings highlighted the importance of paying special attention to rural residents, patients with complications, patients taking a higher number of medications, and patients with comorbidity.

The effect of COVID-19 on poor treatment control among ambulatory Hypertensive and/or Diabetic patients in Northwest Ethiopia.

BACKGROUND: Diabetes and hypertension have emerged as important clinical and public health problems in Ethiopia. The need to have long-term sustainable healthcare services for patients with diabetes and hypertension is essential to enhance good treatment control among those patients and subsequently delay or prevent complications. A collective shift towards acute care for COVID-19 patients combined with different measures to contain the pandemic had disrupted ambulatory care. Hence, it is expected to have a significant impact on treatment control of hypertensive and diabetic patients. However, there is limited evidence on the effect of the pandemic on treatment control and its determinants. Therefore, this study aimed to assess the effect of COVID-19 pandemic on treatment control of ambulatory Hypertensive and Diabetic patients and identify the factors for poor treatment control in North West Ethiopia. METHODS: A retrospective chart review and cross-sectional survey design were conducted between December 2020 and February 2021. Using a stratified systematic random sampling technique, 836 diabetic and/or hypertensive patients were included in the study. Web-based data collection was done using Kobo collect. The changes in the proportion of poor treatment control among ambulatory Hypertensive and/or Diabetic patients during the COVID-19 pandemic period were assessed. A multivariable binary logistic regression mixed model was fitted to identify the determinants of poor treatment control. The odds ratios were reported in both crude and adjusted form, together with their 95% confidence intervals and p-values. RESULT: Poor treatment control increased significantly from 24.81% (21.95, 27.92) prior to the COVID-19 pandemic to 30.33% (27.01, 33.88), 35.66% (32.26, 39.20), 36.69% (33.40, 40.12), and 34.18% (3102, 37.49) in the first, second, third, and fourth months following the date of the first COVID-19 case detection in Ethiopia, respectively. Marital status (AOR = 0.56, 95%CI; 0.41, 0.74), regimen of medication administration (AOR = 1.30, 95%CI; 1.02, 166), daily (AOR = 0.12, 95%CI; 0.08, 0.20), twice (AOR = 0.42, 95%CI; 0.30. 0.59), and three times (AOR = 0.31, 95%CI; 0.21, 0.47) frequency of medication, number medications taken per day (AOR = 0.79, 95%CI;0.73, 0.87), patients habits like hazardous alcohol use (AOR = 1.29, 95%CI; 1.02, 1.65) and sedentary lifestyle (AOR = 1.72,95%CI;1.46, 2.02), missed appointment during the COVID-19 pandemic (AOR = 2.09, 95%CI; 1.79, 2.45), and presence of disease related complication (AOR = 1.11, 95%CI; 0.93, 1.34) were significantly associated with poor treatment control among Diabetic and/or hypertensive patients during the COVID-19 pandemic. CONCLUSION: The COVID-19 pandemic had a substantial impact on ambulatory Diabetic and/or Hypertensive patients' treatment control. Being married, as well as the frequency and types of medicines taken per day were all found to be negatively associated with poor treatment control. During the COVID -19 pandemic, patients' habits such as hazardous alcohol use and sedentary lifestyle, longer follow-up time, having disease-related complication (s), patients taking injectable medication, number of medications per day, and missed appointments were positively associated with poor treatment control in ambulatory diabetic and hypertensive patients. Therefore, it is better to consider the risk factors of poor treatment control while designing and implementing policies and strategies for chronic disease control.

Correction: Adherence towards COVID-19 mitigation measures and its associated factors among Gondar City residents: A community-based cross-sectional study in Northwest Ethiopia.

[This corrects the article DOI: 10.1371/journal.pone.0244265.].

Anxiety and associated factors among Ethiopian health professionals at early stage of COVID-19 pandemic in Ethiopia.

INTRODUCTION: In late 2019, a new coronavirus disease known as COVID-19 (novel coronavirus disease 2019) was identified. As there is no any drug to treat this pandemic, the healthcare professionals are disproportionately at higher risk. The mental health outcome is expected to be high. Anxiety is expected to have a significant impact on health professionals, especially among those who work without adequate resources for self-protection. OBJECTIVES: The objectives of this research was to assess self-reported anxiety symptoms and associated factors among Ethiopian healthcare professionals in the early stages of the pandemic. METHODS: We have conducted an online cross-sectional study to collect information from healthcare professionals in Ethiopia during the early stage of the outbreak from April 7, 2020 to May 19, 2020. GAD-7 was used for measurement of anxiety. We have used a cut of point of 10 and above to report anxiety symptoms. We have used Google Forms for online data collection and SPSS-22 for analysis. To determine associated factors for anxiety, a binary logistic regression model was used. Variables with p-value < 0.2 during the bivariable binary logistic regression were exported for further analysis in the multivariable binary logistic regression. Finally, variables with p-value <0.05 were considered as significantly associated with the outcomes. RESULTS: Three hundred and eighty-eight healthcare professionals filled the online questionnaire; Majority (71.1%) were males. Significant number of respondents (78.9%) reported lack of adequate personal protective equipment (PPE) at the work place. The prevalence of anxiety was 26.8%. Being female (AOR: 1.88; 95% C.I:1.11, 3.19), visiting/treating 30-150 patients per day (AOR: 3.44; 95% C.I:1.51, 7.84), those employed at private healthcare institutions (AOR: 2.40; 95% C.I:1.17, 4.90), who do not believe that COVID-19 is preventable (AOR: 2.04; 95% C.I:1.04, 4.03) and those who reported lack of PPE (AOR: 1.98; 95% C.I:1.04, 3.79) were more likely to be anxious. CONCLUSIONS: The anxiety prevalence among healthcare professionals in Ethiopia during early stage of COVID-19 pandemic was high. This study shows that lack of preventive equipment, being female, contact with many patients, low self-efficacy and working in private health facilities were risk factors for anxiety. Anxiety prevention among health professionals during COVID-19 pandemic requires a holistic approach including provision of sufficient PPE, improving self-efficacy and addressing problems both at public and private institutions and focusing more on female health professionals.

Knowledge and attitude of the communities towards COVID-19 and associated factors among Gondar City residents, northwest Ethiopia: A community based cross-sectional study.

BACKGROUND: COVID-19 is the novel coronavirus responsible for the ongoing global outbreak of acute respiratory disease and viral pneumonia. In order to tackle the devastating condition of the virus, countries need to attack the virus with aggressive and targeted tactics. Thus, to strengthen the COVID-19 mitigation measures and to give rapid response, there is an urgent need to understand the public's knowledge and attitude about of the pandemic at this critical moment. OBJECTIVE: This study was aimed to assess the knowledge and attitude of communities about COVID-19 and associated factors among Gondar City residents. METHODS: A community based cross-sectional study was done among 623 respondents in Gondar city from April 20-27/2020. Data were collected using a structured questionnaire adapted from different literatures. The data were entered using Epi data version 3.1 and then exported into STATA version 14 for analysis. Bi-variable and multivariable binary logistic regression were performed. Adjusted odds ratio with 95% CI was used to declare statistically significant variables on the basis of p value less than 0.05 in the multivariable binary logistic regression model. RESULTS: The overall knowledge and attitude of the community towards COVID19 was 51.85% [95% CI (47.91%-55.78%)] and 53.13% [95% CI (49.20, 57.06%)], respectively. In this study, being married [AOR = 0.60 at 95% CI: (0.42, 0.86)], educational level; primary [AOR = 3.14 at 95% CI: (1.78,5.54)], secondary [AOR = 2.81 at 95% CI: (1.70,4.63)], college and above [AOR = 4.49 at 95% CI: 7.92, 13.98)], and family size [AOR = 1.80, at 95% CI: (1.05, 3.08)] were emerged as statistically significant factors impacting the knowledge of the community about COVID-19. Besides, educational level; primary [AOR = 1.76 at 95% CI: (1.03, 3.01)], secondary [AOR = 1.69 at 95% CI: (1.07, 2.68)], and college & above [AOR = 2.38 at 95% CI: (1.50, 3.79)], and family size; four to six members [AOR = 1.84 at 95% CI (1.27, 2.67)], above seven members [AOR = 1.79 at 95% CI (1.08, 2.96)] were factors identified as significantly attribute for positive attitude of the communities towards COVID-19. CONCLUSION: More than half of the respondents had better knowledge and attitude regarding COVID-19. Higher educational level and larger family size were significant factors predominantly affecting the knowledge and attitude of the communities towards COVID-19.

Depression, Anxiety, and Stress Symptoms and Its Associated Factors Among Residents of Gondar Town During the Early Stage of COVID-19 Pandemic.

PURPOSE: An acute respiratory disease caused by the novel coronavirus disease (COVID) was identified in late 2019. COVID-19 triggered a wide range of psychological problems, such as anxiety, depression, and stress. However, studies on mental health status in developing countries including Ethiopia related to COVID-19 are very limited. Therefore, this study was aimed at determining the magnitude of depression, anxiety, and stress, and their associated factors among Gondar town population during the early stage of the COVID-19 pandemic. PATIENTS AND METHODS: A community-based cross-sectional study was conducted among 660 residents of Gondar town in April 2020. A multi-stage sampling technique was employed to select study participants. A 21 item depression, anxiety, and stress scale (DASS-21) was used. Variables with a p-value <0.05 in the final model were declared as statistically significant. Hosmer and Lemeshow goodness of fit test was used to check the model fitness. RESULTS: In this study, the prevalence of depression was 32.0% (95% CI: 28.4-35.5), anxiety 25.8% (95% CI: 22.4-29.1), and stress 14.7% (95% CI: 12.0-17.4), respectively. The odds of developing depression was higher among female respondents (AOR=2.30, 95% CI: 1.01, 3.83) and ever smokers (AOR=2.8, 95 CI: 1.23, 6.28) as compared to their counterparts. Besides, history of medical illness and ever smoking increase the odds of anxiety by 2.3 (AOR=2.3; 95% CI: 1.42-3.76), and 2.8 (AOR=2.8; 95% CI: 1.23-3.83), respectively. Furthermore, being unemployed and family size of <5 increase the odds of stress by 2.1 (AOR=2.1; 95% CI: 1.17-3.83) and 1.8 (AOR=1.8; 95% CI: 1.09-2.81), respectively. CONCLUSION: In this study, the overall depression, anxiety, and stress were significantly high. There are number of factors associated with depression, anxiety, and stress. Designing and implementing tailored strategies for COVID-19 prevention and control could be supremely important to reduce mental health problems in the community.

Adherence towards COVID-19 mitigation measures and its associated factors among Gondar City residents: A community-based cross-sectional study in Northwest Ethiopia.

BACKGROUND: Considering its pandemicity and absence of effective treatment, authorities across the globe have designed various mitigation strategies to combat the spread of COVID-19. Although adherence towards preventive measures is the only means to tackle the virus, reluctance to do so has been reported to be a major problem everywhere. Thus, this study aimed to assess the community's adherence towards COVID-19 mitigation strategies and its associated factors among Gondar City residents, Northwest Ethiopia. METHODS: A community-based cross-sectional study was employed among 635 respondents from April 20-27, 2020. Cluster sampling technique was used to select the study participants. Data were collected using an interviewer-administered structured questionnaire. Epi-Data version 4.6 and STATA version 14 were used for data entry and analysis, respectively. Binary logistic regressions (Bivariable and multivariable) were performed to identify statistically significant variables. Adjusted odds ratio with 95% CI was used to declare statistically significant variables on the basis of p < 0.05 in the multivariable logistic regression model. RESULTS: The overall prevalence of good adherence towards COVID-19 mitigation measures was 51.04% (95%CI: 47.11, 54.96). Female respondents [AOR: 2.39; 95%CI (1.66, 3.45)], receiving adequate information about COVID-19 [AOR: 1.58; 95%CI (1.03, 2.43)], and favorable attitude towards COVID-19 preventive measures were significantly associated with good adherence towards COVID-19 mitigation measures. Whereas, those respondents who had high risk perception of COVID-19 were less likely to adhere towards COVID-19 mitigation measures [AOR: 0.61; 95% CI (0.41, 0.92)]. CONCLUSIONS: The findings have indicated that nearly half of the study participants had poor adherence towards COVID-19 mitigation measures. Sex, level of information exposure, attitude towards COVID-19 preventive measures, and risk perception of COVID-19 were factors which significantly influenced the adherence of the community towards COVID-19 mitigation measures. Therefore, it is crucial to track adherence responses towards the COVID-19 preventive measures, scale up the community's awareness of COVID-19 prevention and mitigation strategies through appropriate information outlets, mainstream media, and rely on updating information from TV, radio, and health care workers about COVID-19.

Community's misconception about COVID-19 and its associated factors among Gondar town residents, Northwest Ethiopia

Background: Despite the implementation of various strategies such as the declaration of COVID-19 emergency state, staying at home, lockdown, and massive protective equipment distribution, still COVID-19 is increasing alarmingly. Therefore, the study aimed to assess the community's perception of COVID-19 and its associated factors in Gondar town, Northwest Ethiopia. Methods: A community-based cross-sectional study was employed among 635 Gondar administrative town residents, from April 20 to April 27, 2020. Study participants were selected using a cluster sampling technique. Data were collected using an interviewer-administered structured questionnaire. Epi-Data version 4.6 and STATA 14 were used for data entry and analysis, respectively. Logistic regressions (bivariable and multivariable) were performed to identify statistically significant variables at p < 0.05. Results: Of the 635 study participants, 623 have completed the study with a 98.1% response rate. The mean age of participants was 36.32 years (SD ± 13.24). The overall magnitude of the community's misconception about COVID-19 stood at 56.9% (349). Age and religion showed a negative association with misconceptions. To be specific, being in the age group of 27–33 (AOR = 0.52, 95% CI 0.32, 0.86) and being a Muslim (AOR 0.51, 95% CI 0.34, 0.78) were negatively associated with the misconception of COVID-19, whereas occupation and awareness showed positive associations with the misconception. To be specific, having an unemployed occupational status (AOR = 1.79, 95% CI 1.14, 2.82) and being unaware of the number of cases of COVID-19 (AOR 1.66, 95% CI 1.05, 2.62) were positively associated with the community's misconception on COVID-19. Conclusion: The magnitude of the community's misconception about COVID-19 among Gondar town residents was high. Age, religion, unemployment, and unawareness about the number of COVID-19 cases were significant factors of misconception about COVID-19. Thus, stakeholders ought to build community perceptions about COVID 19. To resolve misinformation about COVID-19, accurate and relevant information should be provided to the community using appropriate communication media. [ABSTRACT FROM AUTHOR] Copyright of Tropical Medicine & Health is the property of Japanese Society of Tropical Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Community Level of COVID-19 Information Exposure and Influencing Factors in Northwest Ethiopia.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging respiratory infection, and the crisis has become a worldwide issue, and society has become concerned in various aspects. Good information exposure related to transmission, prevention, and risk factors of COVID-19 can be the best means to reduce the risk of disease exposure and mitigate further spread. The countries that have well practiced this strategy (society information exposure) were controlling disease progression, but there is a low practice in sub-Saharan countries, including Ethiopia. Therefore, this study aimed to evaluate the information exposure level about COVID-19 and influencing factors among northwest community of Ethiopia. METHODS AND MATERIALS: Community-based cross-sectional study design was employed among the community of Gondar city from April 20 to 27, 2020. A total of 623 study participants were involved in this interview, and a systematic sampling technique was applied to select the households. Data were entered into EpiData version 4.6 and then exported to STATA version 14 for analysis. A multivariable binary logistic regression was employed to identify factors associated with good information exposure about COVID-19. The adjusted odds ratio (AOR) with 95% confidence interval (CI) was estimated to show the strength of association. A p-value <0.05 was a cut-off point to declare statistical significance. RESULTS: The overall rate of information exposure about COVID-19 was 44.9%. Age 18-26 years [AOR=0.53; 95% CI (0.28-0.99)] and 34-45 years [AOR=0.44; 95% CI (0.24-0.80)], elementary school [AOR=2.48; 95% CI (1.20-5.15)], secondary school [AOR=3.98; 95% CI (1.99-7.99)], college and above [AOR=8.38; 95% CI (4.10-17.26)], browsed or follow social media [AOR=2.21; 95% CI (1.44-3.38)] and those having a discussion with their family members [AOR=2.37; 95% CI (1.44-3.90)] and friends [AOR=2.15; 95% CI (1.38-3.34)] were the factors significantly associated with good information exposure towards COVID-19. CONCLUSION: Communities total level of good information exposure from different information platforms about COVID-19 in this study area remains low. Age, high level of education, browsing social media, and those having interpersonal (family and friends) discussion were the factors that significantly influence communities who have good information exposure related to COVID-19. Therefore, efforts on community mobilization through regional/national mass media and other information conveying platforms are recommended.

Community's perceived high risk of coronavirus infections during early phase of epidemics are significantly influenced by socio-demographic background, in Gondar City, Northwest Ethiopia: A cross-sectional -study.

BACKGROUND: Epidemiological studies during the early phase of the coronavirus (COVID-19) pandemics reported different level of people's risk perception in different countries. There is a paucity of data on perceived high risk of COVID-19 and associated factors in Ethiopia. We sought to assess the prevalence of community's perceived high risk about COVID-19 infections and associated factors among Gondar town community. METHODS: A cross-sectional study was carried out from April 20 to 27, 2020 in Gondar town community, Northwest Ethiopia. Multistage cluster sampling technique was used to recruit 635 participants. Structured and pre-tested questionnaire was used to collect the data. Descriptive statistics, bivariate and multivariable binary logistic regression were used to summarize the results. RESULTS: A total of 623 participants were considered in the analysis with a response rate of 98.1%. The prevalence of coronavirus high risk perceptions of the respondents was found to be 23.11% (95% CI; 19.80%-26.43%). Age above 45 years (AOR = 1.41, 95%CI; 1.19-2.66), college and above educational level (AOR = 0.28, 95%CI; 0.21-0.98), and poor knowledge towards COVID-19 virus (AOR = 1.57, 95%CI; 1.09-2.23) were significantly associated with perceived high risk about COVID-19. CONCLUSIONS: The prevalence of perceived high risk of COVID-19 was found to be low. Factors such as age, educational status, and knowledge about COVID-19 virus were found to be independent predictors of perceived high risk towards COVID-19. Government and non-government organizations should use formal and informal means of educating the community.