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1.
PLoS One ; 17(7): e0271231, 2022.
Article in English | MEDLINE | ID: covidwho-2196936

ABSTRACT

The rapid spread of COVID-19 in Ethiopia was attributed to joint effects of multiple factors such as low adherence to face mask-wearing, failure to comply with social distancing measures, many people attending religious worship activities and holiday events, extensive protests, country election rallies during the pandemic, and the war between the federal government and Tigray Region. This study built a system dynamics model to capture COVID-19 characteristics, major social events, stringencies of containment measures, and vaccination dynamics. This system dynamics model served as a framework for understanding the issues and gaps in the containment measures against COVID-19 in the past period (16 scenarios) and the spread dynamics of the infectious disease over the next year under a combination of different interventions (264 scenarios). In the counterfactual analysis, we found that keeping high mask-wearing adherence since the outbreak of COVID-19 in Ethiopia could have significantly reduced the infection under the condition of low vaccination level or unavailability of the vaccine supply. Reducing or canceling major social events could achieve a better outcome than imposing constraints on people's routine life activities. The trend analysis found that increasing mask-wearing adherence and enforcing more stringent social distancing were two major measures that can significantly reduce possible infections. Higher mask-wearing adherence had more significant impacts than enforcing social distancing measures in our settings. As the vaccination rate increases, reduced efficacy could cause more infections than shortened immunological periods. Offsetting effects of multiple interventions (strengthening one or more interventions while loosening others) could be applied when the levels or stringencies of one or more interventions need to be adjusted for catering to particular needs (e.g., less stringent social distancing measures to reboot the economy or cushion insufficient resources in some areas).


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Ethiopia/epidemiology , Humans , Masks , Pandemics/prevention & control , SARS-CoV-2
2.
BMC Cardiovasc Disord ; 22(1): 26, 2022 02 02.
Article in English | MEDLINE | ID: covidwho-2153508

ABSTRACT

BACKGROUND: Ethiopia has a high acute rheumatic fever (ARF) and rheumatic heart disease (RHD) prevalence, and to our knowledge, there are no data on the status of secondary prevention in children with RHD. This study describes the status of secondary RHD prevention. METHODS: A multicenter, prospective study was performed on children aged 5-17 years with RHD in Ethiopia. Good adherence was defined as at least 80% completion of benzathine penicillin (BPG) or oral Amoxicillin within the previous year. The primary outcome measure was adherence to prophylaxis, expressed as a proportion. Socio-demographics, severity of RHD, and ARF recurrence were evaluated. RESULTS: A total of 337 children with a mean age of 12.9 ± 2.6 years were included. The majority (73%) had severe aortic/mitral disease. Participants were on BPG (80%) or Amoxicillin (20%) prophylaxis. Female sex (P = 0.04) use of BPG (0.03) and shorter mean duration of prophylaxis in months (48.5 ± 31.5 vs. 60.7 ± 33, respectively, P < 0.008) predicted good adherence. Running out of medications (35%), interrupted follow-up (27%), and the COVID-19 pandemic (26%) were the most common reasons for missing prophylaxis. Recurrence of ARF was higher in participants on Amoxicillin compared with BPG (40% vs. 16%, P < 0.001) and in those with poor adherence compared with good adherence (36.8% vs. 17.9%, respectively, P = 0.005). Type and duration of prophylaxis (OR 0.5, CI = 0.24, 0.9, P = 0.02; OR = 1.1, CI = 1.1, 1.2, P = 0.04, respectively), and sex (OR = 1.9, CI = 1.1, 3.4, P = 0.03) were independent predictors of poor adherence. CONCLUSION: Poor adherence is prevalent in Ethiopian children living with RHD. Amoxicillin is a suboptimal option for prophylaxis as its use is associated with lower adherence and a higher rate of ARF recurrence.


Subject(s)
Amoxicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Penicillin G Benzathine/therapeutic use , Rheumatic Heart Disease/prevention & control , Secondary Prevention , Adolescent , Child , Child, Preschool , Ethiopia/epidemiology , Female , Humans , Male , Medication Adherence , Prevalence , Prospective Studies , Recurrence , Rheumatic Heart Disease/diagnosis , Rheumatic Heart Disease/epidemiology , Rheumatic Heart Disease/microbiology , Risk Assessment , Risk Factors , Time Factors , Treatment Outcome
3.
Glob Health Sci Pract ; 10(5)2022 10 31.
Article in English | MEDLINE | ID: covidwho-2145169

ABSTRACT

INTRODUCTION: Meeting the sexual and reproductive health and rights (SRHR) needs of internally displaced persons (IDPs) is critical. Despite increased prioritization and coverage of sexual and reproductive health (SRH) services in humanitarian settings in recent decades, significant unmet needs remain. In Ethiopia, there are more than 2 million IDPs, an estimated 40% of whom have unmet need for modern contraceptives. To address this, EngenderHealth implemented a model of SRHR programming in Ethiopia's Somali region. We share the lessons learned from this project to improve access to SRH services among IDPs. METHODS: In 2021, an independent research team implemented a qualitative process evaluation among 13 key informant interviews (KIIs) with health system actors, local government partners, and organizations, and 4 focus group discussions (FGDs) with community members and community health volunteers. The team selected participants purposively following the maximum variation sampling technique and analyzed the data in NVivo 12. The team used KII and FGD guides to explore and understand what was implemented, which stakeholders were engaged in the processes and how, what was achieved, and the barriers and facilitators in implementation. RESULTS: Contributions to project achievements included strong partnerships and stakeholder engagement, an enabling environment for SRHR, improving health worker capacity, and flexibility and adaptability. Challenges included a fragile security situation, retention of providers, and difficulty in accessing gender-based violence services, exacerbated by the coronavirus disease (COVID-19) pandemic. CONCLUSION: Our article offers guidance for organizations and government entities seeking to design and implement SRHR programs in humanitarian settings. Findings highlight the importance of prioritizing SRHR programming in IDP settings and illustrate adaptable activities to assist with project implementation and minimize operational challenges.


Subject(s)
COVID-19 , Refugees , Humans , Reproductive Health , Ethiopia , Somalia
4.
Front Public Health ; 10: 1033351, 2022.
Article in English | MEDLINE | ID: covidwho-2142360

ABSTRACT

Background: HIV services were inevitably disrupted and affected due to COVID-19. There are many challenges in implementing appropriate HIV services, particularly in the provision of health care and the link between people living with HIV/AIDS and retention in care. The study investigated the impact of COVID-19 on HIV services and the anticipated benefit of the COVID-19 vaccination on HIV service restoration in North Shewa, Oromia, Ethiopia. Methods: A qualitative descriptive study approach was used to explore how healthcare delivery evolved during the outbreak of COVID-19 in Ethiopia. Sixteen antiretroviral therapy (ART) clinics were selected from 13 districts and one administrative town in Ethiopia. From them, 32 ART providers were purposively selected based on their experience in ART provision. Data were collected from June to July 2021 using in-depth interviews. A thematic analysis approach was used to analyze the data, based on themes and subthemes emerging from the data. ATLAS.ti software was used for coding. Results: Healthcare for people living with HIV was interrupted due to the COVID-19 pandemic. Medical appointments, HIV testing and counseling services, opportunistic infection treatment, medicine supply, and routine viral load and CD4 T-cell count tests were interrupted. Due to a shortage of healthcare staff, outreach testing services and home index testing were discontinued and HIV testing was limited only to hospitals and health centers. This has substantially affected accessibility to HIV testing and reduced the quality of HIV service delivery. Telehealth and less frequent visits to health facilities were used as alternative ways of delivering HIV services. The COVID-19 vaccination campaign is expected to restore healthcare services. Vaccination may also increase the confidence of healthcare providers by changing their attitudes toward COVID-19. Conclusions: The COVID-19 pandemic has substantially impacted HIV services and reduced the quality of HIV care in Ethiopia. Health facilities could not provide routine HIV services as they prioritize the fight against COVID-19, leading to an increase in service discontinuation and poor adherence.


Subject(s)
COVID-19 , HIV Infections , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Ethiopia/epidemiology , COVID-19 Vaccines , Pandemics , HIV Infections/epidemiology , HIV Infections/therapy , Vaccination
5.
Sci Rep ; 12(1): 20282, 2022 Nov 24.
Article in English | MEDLINE | ID: covidwho-2133623

ABSTRACT

Since Coronavirus Disease-2019 (COVID-19) outbreak was reported, many commercial Nucleic Acid Amplification Tests (NAAT) have been developed all over the world, and it has been the standard method. Even though several assays were rapidly developed and applied to laboratory diagnostic testing, the performance of these assays was not evaluated in different contexts. Thus, this study aimed to assess the performance of Abbott SARS-CoV-2, Daan Gene, BGI and Sansure Biotech assays by using Composite Reference Standard (CRS). The study was conducted at the Ethiopian Public Health Institute (EPHI) from December 1 to 30/2020. Of the 164 nasopharyngeal samples were extracted by using a QIAamp RNA mini kit and Abbott DNA sample preparation system. Out of 164 samples, 59.1% were positive and 40.9% were negative by CRS. Sansure Biotech positivity was significantly low compared to CRS (p < 0.05). The overall agreement of the four assays compared to CRS was 96.3-100%. The performance of the four assays had almost comparable diagnostic performance, except for a low positive rate of Sansure Biotech assay. Hence, Sansure Biotech assay [Research Use Only (RUO)] needs further verification on its use in Ethiopia. Finally an additional study should be considered for evaluating assays with respective manufacturer claims.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , SARS-CoV-2/genetics , Ethiopia/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , Nucleic Acid Amplification Techniques , Reference Standards
6.
PLoS One ; 17(10): e0268160, 2022.
Article in English | MEDLINE | ID: covidwho-2140397

ABSTRACT

BACKGROUND: Rapid diagnostics are vital for curving the transmission and control of the COVID-19 pandemic. Although many commercially available antigen-based rapid diagnostic tests (Ag-RDTs) for the detection of SARS-CoV-2 are recommended by the WHO, their diagnostic performance has not yet been assessed in Ethiopia. So far, the vast majority of studies assessing diagnostic accuracies of rapid antigen tests considered RT-PCR as a reference standard, which inevitably leads to bias when RT-PCR is not 100% sensitive and specific. Thus, this study aimed to evaluate the diagnostic performance of Panbio™ jointly with the RT-PCR for the detection of SARS-CoV-2. METHODS: A prospective cross-sectional study was done from July to September 2021 in Addis Ababa, Ethiopia, during the third wave of the pandemic involving two health centers and two hospitals. Diagnostic sensitivity and specificity of Panbio™ and RT-PCR were obtained using Bayesian Latent-Class Models (BLCM). RESULTS: 438 COVID-19 presumptive clients were enrolled, 239 (54.6%) were females, of whom 196 (44.7%) had a positive RT-PCR and 158 (36.1%) were Panbio™ positive. The Panbio™ and RT-PCR had a sensitivity (95% CrI) of 99.6 (98.4-100) %, 89.3 (83.2-97.6) % and specificity (95% CrI) of 93.4 (82.3-100) %, and 99.1 (97.5-100) %, respectively. Most of the study participants, 318 (72.6%) exhibited COVID-19 symptoms; the most reported was cough 191 (43.6%). CONCLUSION: As expected the RT-PCR performed very well with a near-perfect specificity and a high, but not perfect sensitivity. The diagnostic performance of Panbio™ is coherent with the WHO established criteria of having a sensitivity ≥80% for Ag-RDTs. Both tests displayed high diagnostic accuracies in patients with and without symptoms. Hence, we recommend the use of the Panbio™ for both symptomatic and asymptomatic individuals in clinical settings for screening purposes.


Subject(s)
COVID-19 , SARS-CoV-2 , Female , Humans , Male , SARS-CoV-2/genetics , COVID-19/diagnosis , COVID-19/epidemiology , Reverse Transcriptase Polymerase Chain Reaction , Pandemics , Cross-Sectional Studies , Ethiopia/epidemiology , Bayes Theorem , Prospective Studies , Sensitivity and Specificity , Antigens, Viral/analysis
7.
Sci Rep ; 12(1): 19722, 2022 Nov 16.
Article in English | MEDLINE | ID: covidwho-2116742

ABSTRACT

Climatic conditions play a key role in the transmission and pathophysiology of respiratory tract infections, either directly or indirectly. However, their impact on the COVID-19 pandemic propagation is yet to be studied. This study aimed to evaluate the effects of climatic factors such as temperature, rainfall, relative humidity, sunshine duration, and wind speed on the number of daily COVID-19 cases in Addis Ababa, Ethiopia. Data on confirmed COVID-19 cases were obtained from the National Data Management Center at the Ethiopian Public Health Institute for the period 10th March 2020 to 31st October 2021. Data for climatic factors were obtained from the Ethiopia National Meteorology Agency. The correlation between daily confirmed COVID-19 cases and climatic factors was measured using the Spearman rank correlation test. The log-link negative binomial regression model was used to fit the effect of climatic factors on COVID-19 transmission, from lag 0 to lag 14 days. During the study period, a total of 245,101 COVID-19 cases were recorded in Addis Ababa, with a median of 337 new cases per day and a maximum of 1903 instances per day. A significant correlation between COVID-19 cases and humidity was observed with a 1% increase in relative humidity associated with a 1.1% [IRRs (95%CI) 0.989, 95% (0.97-0.99)] and 1.2% [IRRs (95%CI) 0.988, (0.97-0.99)] decrease in COVID-19 cases for 4 and 5 lag days prior to detection, respectively. The highest increase in the effect of wind speed and rainfall on COVID-19 was observed at 14 lag days prior to detection with IRRs of 1.85 (95%CI 1.26-2.74) and 1.078 (95%CI 1.04-1.12), respectively. The lowest IRR was 1.109 (95%CI 0.93-1.31) and 1.007 (95%CI 0.99-1.02) both in lag 0, respectively. The findings revealed that none of the climatic variables influenced the number of COVID-19 cases on the day of case detection (lag 0), and that daily average temperature and sunshine duration were not significantly linked with COVID-19 risk across the full lag period (p > 0.05). Climatic factors such as humidity, rainfall, and wind speed influence the transmission of COVID-19 in Addis Ababa, Ethiopia. COVID-19 cases have shown seasonal variations with the highest number of cases reported during the rainy season and the lowest number of cases reported during the dry season. These findings suggest the need to design strategies for the prevention and control of COVID-19 before the rainy seasons.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Ethiopia/epidemiology , Pandemics , Incidence , Humidity
8.
J Glob Health ; 12: 05046, 2022 Nov 12.
Article in English | MEDLINE | ID: covidwho-2115607

ABSTRACT

Background: Continuous monitoring of the pandemic's impact on health service provision and mental health, COVID-19 perceptions, and compliance with prevention measures among health care providers (HCPs) can help with mitigating the pandemic's negative effects. Methods: A computer-assisted telephone interviewing (CATI) survey was conducted among 1499 HCPs in Burkina Faso (Ouagadougou), Ethiopia (Addis Ababa), Nigeria (Lagos and Ibadan), Tanzania (Dar es Salaam), and Ghana (Kintampo). Self-reported mental health, perceptions of the COVID-19 pandemic, and prevention measures available in the workplace were assessed. HCPs' responses to questions regarding the impact of COVID-19 on nine essential health services were summed into a score; high service disruption was defined as a score higher than the total average score across all sites. Modified Poisson regression was used to identify potential factors related to high service disruption. Results: Overall, 26.9% of HCPs reported high service disruption, with considerable differences across sites (from 1.6% in Dar es Salaam to 45.0% in Addis Ababa). A considerable proportion of HCPs reported experiencing mild psychological distress (9.4%), anxiety (8.0%), and social avoidance or rejection (13.9%) due to their profession. Participants in Addis Ababa (absolute risk ratio (ARR) = 2.10; 95% confidence interval (CI) = 1.59-2.74), Lagos (ARR = 1.65; 95% CI = 1.24-2.17), and Kintampo (ARR = 2.61; 95% CI = 1.94-3.52) had a higher likelihood of reporting high service disruption compared to those in Ouagadougou. Reporting ever-testing for COVID-19 (ARR = 0.82; 95% CI = 0.69-0.97) and the presence of COVID-19 guidelines in the workplace (ARR = 0.63; 95% CI = 0.53-0.77) were both associated with lower reported health service disruption among HCPs. Conclusion: The COVID-19 pandemic continues to disrupt essential health services and present a challenge to HCPs' mental health, with important differences across countries and settings; interventions are needed to mitigate these negative effects of the pandemic.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Pandemics , Mental Health , Nigeria , COVID-19 Testing , Ethiopia , Tanzania , Health Personnel/psychology , Health Services , Delivery of Health Care
9.
J Diabetes Res ; 2022: 9652940, 2022.
Article in English | MEDLINE | ID: covidwho-2113176

ABSTRACT

Introduction: New onset of diabetes mellitus was noted as the commonest comorbidity in the COVID-19 pandemic, which contributed to a worse prognosis. Existing evidence showed that new-onset diabetes is associated with increased mortality compared to nondiabetic and known diabetic patients in the COVID-19 era. SARS-CoV-2 virus can worsen existing diabetes; at the same time, it can trigger new-onset diabetes that eventually worsens patient outcomes. Thus, this study is aimed at determining the prevalence and factors associated with new onset of diabetes mellitus among COVID-19 patients. Methods: Institution-based retrospective cross-sectional study design was conducted by reviewing 244 patient's records in the Addis Ababa COVID-19 care center. Descriptive statistics and binary logistic regression were used. During bivariate analysis, variables with p ≤ 0.25 were transferred into multivariate analysis. Adjusted odds ratios to determine the strength and presence of the association with a 95% confidence interval and p value ≤ 0.05 were considered, respectively. Results: The mean age of the study participants was 53.2 years with (SD = 13.35). The study findings showed that 31.1% (CI: 25.4-37.4) of COVID-19 patients had new onset of diabetes mellitus; of those, 11.8% had type 1 and 88.2% had type 2 diabetes. Being male (aOR = 2.9; 95% CI: 1.2, 7.1), family history of hypertension (aOR = 3.7; 95% CI: 1.3, 10.5), obesity (aOR = 3.1; 95% CI: 1.01, 8.9), having pulmonary embolism (aOR = 0.2; 95% CI: 0.06, 0.04), and hyperkalemia (aOR = 9.3; 95% CI: 1.8, 47.3) showed statistically significant association with new onset of diabetes mellitus. Conclusion: A significant proportion of COVID-19 patients had been diagnosed with new onset of diabetes mellitus, and new-onset type 2 diabetes mellitus is the most common diabetes mellitus type. Being male, obesity, having a pulmonary embolism, family history of hypertension, and hyperkalemia were independently associated with new onset of diabetes mellitus among COVID-19 patients. Therefore, focused interventions need to be strengthened towards the identified factors.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Hyperkalemia , Hypertension , Pulmonary Embolism , Humans , Male , Middle Aged , Female , COVID-19/complications , COVID-19/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Cross-Sectional Studies , Hyperkalemia/complications , Hyperkalemia/epidemiology , Ethiopia/epidemiology , Retrospective Studies , Pandemics , Risk Factors , SARS-CoV-2 , Hypertension/epidemiology , Hypertension/complications , Obesity/complications , Obesity/epidemiology , Pulmonary Embolism/complications , Pulmonary Embolism/epidemiology
10.
Int J Infect Dis ; 111: 179-185, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-2113609

ABSTRACT

BACKGROUND: Ethiopia reported the first case of COVID-19 on 13th March, 2020 with community transmission ensuing by mid-May. A national, population-based serosurvey against anti-SARS-CoV-2 IgG was conducted to measure the prevalence of prior COVID-19 infections and better approximate the burden across major towns in Ethiopia. METHODS: We conducted a cross-sectional, population-based serosurvey from June 24 to July 8, 2020 in 14 major urban areas. Two-stage cluster sampling was used to randomly select enumeration areas and households. All persons aged ≥15 years were enrolled. Serum samples were tested by Abbott™ ARCHITECT™ assay for SARS-CoV-2 IgG antibodies. National COVID-19 surveillance data on the median date of the serosurvey is analyzed for comparison. FINDINGS: Adjusted seroprevalence was 3.5% (95% CI: 3.2%-3.8%) after controlling for age, sex and test kit performance. Males (3.7%) and females (3.3%) were nearly equally infected, while middle-aged adults '40-65 years' had the highest (4.0%) prevalence. Gambella (7.5%), Dire Dawa (6.2%) and Jigjiga (6.1%) were the most affected towns. About 6.7% and 8.0% of seropositives had symptoms and chronic underlying illness, respectively. A surveillance system had identified 4,416 RT-PCR confirmed cases in Addis Ababa. INTERPRETATION: This serosurvey shows that a majority of urban Ethiopians remain uninfected with SARS-CoV-2. Most anti-SARS-CoV-2 IgG positive cases were asymptomatic with no underlying illness, keeping case detection to a minimum.


Subject(s)
COVID-19 , SARS-CoV-2 , Adolescent , Adult , Aged , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Humans , Male , Middle Aged , Risk Factors , Seroepidemiologic Studies
11.
PLoS One ; 17(11): e0276857, 2022.
Article in English | MEDLINE | ID: covidwho-2098764

ABSTRACT

INTRODUCTION: Medical students are among the potential risky population for the transmission of COVID 19 infections; their willingness to receive COVID 19 vaccine is not well studied. Thus, this study assessed Predictors of Unwillingness to receive COVID -19 vaccines among Ethiopian Medical students. METHODS: From the 25th of May, 2020 to the 26th of June, 2021, an institution-based cross-sectional study was done at Mizan-Tepi University Teaching Hospital,On 313 medical students from each department and batch were chosen using a multistage sampling approach. A bivariate and multivariable logistic regression were done to identify the predictors of Unwillingness to receive COVID -19 vaccines. Figures, tables, and graphs were used to present the findings. The adjusted odds ratio and its 95% confidence interval were provided. RESULTS: In this study 124 (40.7%) 95% CI (35.1,46.4) medical students were not willing to receive the COVID-19 vaccine. And also increased in the age of the student[AOR 0.43, 95% CI; (.29,.63)], Knowledge status about COVID 19 infection transmission, risk factors and control behavior[AOR 1.45, 95% CI; (1.14, 1.85)], perceived susceptibility to COVID 19 infection [AOR 1.70 (1.15, 2.51)], perceived severity of COVID 19 infection[AOR 1.26 (1.01, 1.57)], perceived benefit of COVID 19 vaccine [AOR .58(.38, .88)], positive attitude towards COVID 19 vaccines [AOR .46(.35, .62)], and confidence in safety and efficacy of the vaccine and public authorities decissin in the best interest of the community [AOR 1.93(1.24, 2.99)] were predictors of non-willingness to receive COVID 19 vaccine. CONCLUSION: Non-willingness to accept the COVID 19 vaccine was predicted by student age, elements in the Health belief model such as anticipated susceptibility, severity, and benefit, and a positive attitude and trust in the vaccine.


Subject(s)
COVID-19 , Students, Medical , Vaccines , Humans , COVID-19 Vaccines/therapeutic use , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , COVID-19/epidemiology , COVID-19/prevention & control , Ethiopia/epidemiology
12.
PLoS One ; 17(11): e0276763, 2022.
Article in English | MEDLINE | ID: covidwho-2098756

ABSTRACT

BACKGROUND: Coronavirus disease has spread worldwide since late 2019. Vaccination is critical in controlling this pandemic. However, vaccine acceptance among pregnant women is not well-studied. Therefore, this study aimed to assess the COVID-19 vaccine acceptance and associated factors among pregnant women attending antenatal care clinics in Gondar town, Northwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted among pregnant women attending antenatal care clinics at Gondar town, Northwest Ethiopia, 2021. About 510 study subjects were selected using a systematic random sampling technique from August 25 to September 10/2021. Data collection was done by using an interviewer-administered, structured questionnaire. Epi-info 7.2 was used to enter data and then exported to SPSS version 25 software for analysis. Bivariable and multivariable binary logistic regression models were used to identify factors associated with the outcome variable. Variables with a p-value < 0.2 in the bivariable analysis were entered into the multivariable analysis to control for possible confounders. Statistical significance is determined using an adjusted odds ratio and 95% confidence interval (CI) at a p-value of < 0.05. RESULTS: Of 510 participants, 211 (41.4%) were willing to take COVID-19 vaccines. Maternal age ≥ 35 years (AOR: 5.678, 95% CI: 1.775-18.166), having contact history with COVID-19 diagnosed people (AOR: 7.724, 95% CI: 2.183, 27.329), having a pre-existing chronic disease (AOR: 3.131, 95% CI: 1.700-5.766), good knowledge about COVID-19 vaccine (AOR: 2.391, 95% CI: 1.144, 4.998) and good attitude towards COVID-19 vaccine (AOR: 2.128, 95% CI: 1.348) were significantly associated with the outcome variable. CONCLUSIONS: The willingness to take COVID-19 vaccine among pregnant mothers was low. Age, contact history with COVID-19 diagnosed people, chronic disease, knowledge, and attitude towards COVID-19 vaccine were factors associated with COVID-19 vaccine willingness. To enhance the COVID-19 vaccine acceptance, the government with different stakeholders should strengthen public education about the importance of getting COVID-19 vaccine.


Subject(s)
COVID-19 , Pregnant Women , Female , Humans , Pregnancy , Adult , Cross-Sectional Studies , COVID-19 Vaccines/therapeutic use , COVID-19/epidemiology , COVID-19/prevention & control , Ethiopia/epidemiology , Ambulatory Care Facilities
13.
J Glob Health ; 12: 04087, 2022 Oct 23.
Article in English | MEDLINE | ID: covidwho-2090805

ABSTRACT

Background: The burden of diabetes-related deaths reached two million in 2019 globally. Accessibility to health care services and adherence to follow-up and therapy are key to improving outcomes for diabetic patients. We aimed to assess outpatient department (OPD) service utilization and diabetes-related hospitalizations over a period of 44 months. Methods: A retrospective cohort study was conducted on OPD visits and hospitalizations recorded between January 1, 2018, and August 31, 2021, at the St Luke Catholic Hospital (Ethiopia). All diabetic patients were included in the analysis. A linear regression model was used for univariate analysis of OPD visits and hospitalizations and their association with potential predictors. The autoregressive integrated moving average (ARIMA) method was applied to both the time series of OPD visits and hospitalizations. Potential predictors were sociodemographic factors, COVID-19 cases, mean monthly temperature and precipitations. Results: In the time series analysis, OPD visits increased over time (P < 0.01) while hospitalizations were stable. The time series model was ARIMA (0,1,1) for OPD visits and ARIMA (0,0,0) for hospitalizations. There were 1685 diabetes OPD patients (F = 732, 43%). Females had an average of 16% fewer OPD accesses per month (P < 0.01) and a lower number of hospitalizations per month (P = 0.03). There were 801 patients missing follow-up (48%). The time between follow-up increased with age (P < 0.01). OPD visits decreased differently by geographic area as COVID-19 cases increased (P < 0.01). There were 57 fewer forecast OPD visits per month on average using COVID-19 cases as ARIMA regressor. The odds ratio (OR) of new diagnosis at hospitalization was lower in patients with type 2 diabetes (OR = 0.26, 95% CI = 0.14-0.49, P = 0.02). Conclusions: Despite an increase in OPD visits for diabetic patients over the study period, the number of losses at follow-up and diagnoses at hospitalization remains high. Female sex, older age, and COVID-19 were associated with impaired OPD service accessibility. Primary health care should be implemented to achieve better health coverage and improve diabetes management.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Humans , Female , Ethiopia/epidemiology , Retrospective Studies , COVID-19/epidemiology , COVID-19/therapy , Outpatients , Emergency Service, Hospital , Hospitalization , Ambulatory Care , Hospitals
14.
PLoS One ; 17(10): e0276692, 2022.
Article in English | MEDLINE | ID: covidwho-2089440

ABSTRACT

BACKGROUND: Coronavirus disease (COVID-19) infection during pregnancy causes adverse maternal and perinatal outcomes such as preterm birth, low birth weight, severe illness, intensive care unit admission, mechanical ventilation, and death. Pregnant women's knowledge, attitude, and practice (KAP) towards COVID-19 infection prevention are crucial to ensure the health of the mother and foetus. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of pregnant women's KAP towards COVID-19 infection prevention in Ethiopia. METHODS: We searched PubMed, Scopus, Google Scholar, African Online Journal, and Web of Sciences database to retrieve related articles. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline was used. Funnel plot and Eggers test were done to assess publication bias. Cochrane Q-test and I2 statistic were done to chick evidence of heterogeneity. Subgroup analysis was computed based on the study region and year of publication. Data were extracted using a Microsoft Excel spreadsheet and analyzed using STATA version 14 statistical software. Weighted inverse variance random effect model was run to estimate the pooled prevalence of pregnant women's KAP towards COVID-19 infection prevention. RESULTS: A total of 9 studies with 4,103 pregnant women were included. The pooled prevalence of knowledge, attitude, and practice towards COVID-19 infection prevention among pregnant women's in Ethiopia were 60.24% (95% CI; 53.69 to 66.79, I2 = 95%), 62.46% (95% CI; 45.68, 79.23, I2 = 98.8%), and 52.29% (95% CI; 43.91%-60.66% I2 = 96.5%) respectively. Maternal age (AOR = 1.87, 1.40-2.49), residence (AOR = 2.23, 1.50-3.31), secondary and above educational status (AOR = 3.36, 2.46-4.58), good knowledge (AOR = 2.73, 2.18-3.41), and fear of COVID-19 infection (AOR = 2.60, 1.78, 3.80) were factors associated with COVID-19 infection prevention practice among pregnant women's in Ethiopia. CONCLUSION: The knowledge, attitude, and practice of COVID-19 infection prevention among pregnant women were low. Therefore, policymakers, maternal and child health program planners, and stakeholders should target to improve pregnant women's awareness regarding COVID-19 infection preventive measures.


Subject(s)
COVID-19 , Premature Birth , Child , Pregnancy , Female , Infant, Newborn , Humans , Pregnant Women , Ethiopia/epidemiology , Health Knowledge, Attitudes, Practice , COVID-19/epidemiology , COVID-19/prevention & control
15.
PLoS One ; 17(10): e0276553, 2022.
Article in English | MEDLINE | ID: covidwho-2089435

ABSTRACT

INTRODUCTION: So far, shreds of evidence have shown that COVID-19 related hospitalization, serious outcomes, and mortality were high among individuals with chronic medical conditions. However, strict compliance with basic public health measures such as hand washing with soap, social distancing, and wearing masks has been recommended and proven effective in preventing transmission of the infection. Therefore, this study aimed to determine the level of compliance with COVID-19 preventive measures and identify its predictors among patients with common chronic diseases in public hospitals of Southern Ethiopia by applying the proportional odds model. METHODS: A facility-based cross-sectional study was employed in public hospitals of Southern Ethiopia between February and March 2021. Using a systematic random sampling technique, 419 patients with common chronic diseases were recruited. Data were collected using an Open Data Kit and then submitted to the online server. The proportional odds model was employed, and the level of significance was declared at a p-value of less than 0.05. RESULTS: This study revealed that 55.2% (95%CI: 50.4%-59.9%) of the study participants had low compliance levels with COVID-19 preventive measures. The final proportional odds model identified that perceived susceptibility (AOR: 0.91, 95%CI: 0.84, 0.97), cues to action (AOR: 0.89, 95%CI: 0.85, 0.94), having access to drinking water piped into the dwelling (AOR: 0.52, 95%CI: 0.32, 0.84), having no access to any internet (AOR: 0.62, 95%CI: 0.42, 0.92), having no functional refrigerator (AOR: 2.17, 95%CI: 1.26, 3.74), and having poor knowledge (AOR: 1.42, 95%CI: 1.02, 1.98) were the independent predictors of low compliance level with COVID-19 preventive measures. CONCLUSION: In the study area, more than half of the participants had low compliance levels with COVID-19 preventive measures. Thus, the identified factors should be considered when designing, planning, and implementing new interventional strategies, so as to improve the participants' compliance level.


Subject(s)
COVID-19 , Drinking Water , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Ethiopia/epidemiology , Soaps , Chronic Disease
16.
PLoS One ; 17(10): e0275596, 2022.
Article in English | MEDLINE | ID: covidwho-2079747

ABSTRACT

BACKGROUND: Corona Virus Disease 2019 is a novel respiratory disease commonly transmitted through respiratory droplets. The disease has currently expanded all over the world with differing epidemiologic trajectories. This investigation was conducted to determine the basic clinical and epidemiological characteristics of the disease in Ethiopia. METHODS: A prospective case-ascertained study of laboratory-confirmed COVID-19 cases and their close contacts were conducted. The study included 100 COVID-19 laboratory-confirmed cases reported from May 15, 2020 to June 15, 2020 and 300 close contacts. Epidemiological and clinical information were collected using the WHO standard data collection tool developed first-few cases and contacts investigation. Nasopharyngeal and Oropharyngeal samples were collected by using polystyrene tipped swab and transported to the laboratory by viral transport media maintaining an optimal temperature. Clinical and epidemiological parameters were calculated in terms of ratios, proportions, and rates with 95% CI. RESULT: A total of 400 participants were investigated, 100 confirmed COVID-19 cases and 300 close contacts of the cases. The symptomatic proportion of cases was 23% (23) (95% CI: 15.2%-32.5%), the proportion of cases required hospitalization were 8% (8) (95%CI: 3.5%-15.2%) and 2% (95%CI: 0.24% - 7.04%) required mechanical ventilation. The secondary infection rate, secondary clinical attack rate, median incubation period and median serial interval were 42% (126) (95% CI: 36.4%-47.8%), 11.7% (35) (95% CI: 8.3%-15.9%), 7 days (IQR: 4-13.8) and 11 days (IQR: 8-11.8) respectively. The basic reproduction number (RO) was 1.26 (95% CI: 1.0-1.5). CONCLUSION: The proportion of asymptomatic infection, as well as secondary infection rate among close contacts, are higher compared to other studies. The long serial interval and low basic reproduction number might contribute to the observed slow progression of the pandemic, which gives a wide window of opportunities and time to control the spread. Testing, prevention, and control measures should be intensified.


Subject(s)
COVID-19 , Coinfection , COVID-19/epidemiology , Ethiopia/epidemiology , Humans , Polystyrenes , SARS-CoV-2
17.
PLoS One ; 17(8): e0272570, 2022.
Article in English | MEDLINE | ID: covidwho-2079720

ABSTRACT

INTRODUCTION: With fragile health care systems, sub-Saharan Africa countries like Ethiopia are facing a complex epidemic, and become difficult to control the noble coronavirus. The use of COVID-19 preventive measures is strongly recommended. This study aimed to assess the adherence of COVID-19 mitigation measures and associated factors among health care workers. METHODS: A facility-based cross-sectional study was conducted among health care workers at referral hospitals in the Amhara regional state of Ethiopia from May 15 to June 10; 2021. It was a web-based study using an online questionnaire. STATA 14.2 was used for data analysis. Variables with a p-value<0.05 at 95% confidence level in multivariable analysis were declared as statistically significant using binary logistic regression. RESULT: Adherence to COVID-19 mitigation measures was 50.24% in the current study. The odd of adherence of participants with a monthly income of ≥12801birr was 15% whereas the odds of adherence of participants who hesitate to take the COVID 19 vaccine were 10% as compared to those who don't hesitate. Participants who had undergone COVID-19 tests adhered 6.64 times more than their counterparts. Those who believe adequate measurements are taken by the government adhered 4.6 times more than those who believe not adequate. Participants who believe as no risk of severe disease adhered 16% compared to those with fear of severe disease. Presence of households aged >60years adhered about 7.9 times more than with no households aged>60. Participants suspected of COVID-19 diagnosis adhered 5.7 times more than those not suspected. CONCLUSION: In this study, a significant proportion of healthcare workers did not adhere to COVID-19 mitigation measures. Hence, giving special attention to healthcare workers with a monthly income of ≥12801 birr, being hesitant towards COVID-19 vaccine, being aged 26-30, and perceiving no risk of developing a severe infection is crucial to reduce non-adherence.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing , COVID-19 Vaccines , Cross-Sectional Studies , Ethiopia/epidemiology , Health Personnel , Hospitals , Humans , Referral and Consultation
18.
PLoS One ; 17(10): e0275320, 2022.
Article in English | MEDLINE | ID: covidwho-2065131

ABSTRACT

BACKGROUND: Reluctance to the COVID-19 preventive measures have been repeatedly reported in Ethiopia although compliance with these actions is the key step to minimize the pandemic's burden. Hence, this systematic review and meta-analysis aims to address the gap in the literature by determining the pooled magnitude of adherence to COVID-19 preventive measures and identifying its associated factors in Ethiopia. MATERIALS AND METHODS: The electronic databases used to search articles were PubMed/MEDLINE, CINAHL, Web of Science, ScienceDirect, Research4Life and other sources of grey literature including Google Scholar and World Health Organization (WHO) database portals for low- and middle-income countries. Full English-language articles published between 2019 and 2022 were eligible for the review and meta-analysis. Relevant data extracted and descriptive summaries of the studies presented in tabular form. The methodological quality of articles assessed using the Joanna Briggs Institute (JBI) quality assessment tool. The pooled magnitude of adherence determined by applying a random-effects model at a 95% CI. RESULTS: Of 1029 records identified, 15 articles were included in the systematic review and 11 were selected for meta-analysis. The pooled estimate of adherence to COVID-19 preventive measures in Ethiopia was 41.15% (95% CI:32.16-50.14%). Furthermore, perceived COVID-19 disease severity (AOR:1.77, 95% CI: (1.40-2.25)), attitude (AOR:1.85, 95% CI: (1.36-2.53)) and knowledge (AOR:2.51, 95% CI: (1.67-3.78)) to COVID-19 preventive measures showed significant association with adherence to COVID-19 preventive measures. CONCLUSION: The magnitude of adherence to COVID-19 preventive measures in Ethiopia appeared to be low. Therefore, the government of Ethiopia and other stakeholders should mobilize resources to improve the adherence level of the community to the COVID-19 preventive measures and decrease public fatigue.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Ethiopia/epidemiology , Humans , Prevalence
19.
Antimicrob Resist Infect Control ; 11(1): 126, 2022 10 08.
Article in English | MEDLINE | ID: covidwho-2064850

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) has been rapidly spreading across the globe since the World Health Organization (WHO) has declared the disease outbreak as a global pandemic on March 11, 2020. Hand hygiene, via either regular handwashing with soap and water or using hand sanitizers, is among the various measures that need to be followed to control the outbreak of the disease. Alcohol-based hand sanitizers (ABHS) are the "gold standard" for hand disinfection because of their broad antimicrobial spectrum of activity, easy availability, better safety profile, and general acceptability to users. This study aimed at evaluating the physicochemical quality and antimicrobial efficacy of the locally manufactured ABHS marketed in Addis Ababa, Ethiopia. METHODS: A cross-sectional survey was used to collect ABHS from Addis Ababa marketplaces. A total of 25 sample products were randomly selected from different categories of hand sanitizer manufacturers. The physicochemical evaluation of the products was carried out as per the United States Pharmacopoeia and WHO standards. Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Staphylococcus aureus, Salmonella spp., and Shigella spp clinical isolates were used for the antimicrobial efficacy test. RESULTS: The Fourier Transform Infrared result confirmed that all the test products met the identification test for ethanol. The majority (68%) of ABHS complied with the test for ethanol content (75-85% v/v). However, only 3 products fulfilled the hydrogen peroxide content (0.112-0.137% v/v). LPC307 showed the maximum zone of inhibition of 12 mm against Escherichia coli whereas MPC204 exhibited only 3 mm. LPC101 was found to be more sensitive to Shigella and Klebsiella Spp with minimum inhibitory concentration values of 20% and 10%, respectively. The sample product LPC101 showed a minimum bactericidal concentration of 20% against Escherichia coli, Pseudomonas aeruginosa, and Klebsiella spp. CONCLUSION: One-third of the tested ABHS did not comply with the WHO ethanol content limit and the majority of the products failed to meet the label claim for hydrogen peroxide content. Besides, nearly all products proved that they have activity against all the tested pathogenic microorganisms at a minimum concentration from 10 to 80%; though, they did not show 99.9% bacteriostatic or bactericidal activities as claimed. The study findings suggested regular monitoring of the quality of marketed ABHS considering the current wide use of these products.


Subject(s)
COVID-19 , Hand Sanitizers , Anti-Bacterial Agents/pharmacology , COVID-19/prevention & control , Cross-Sectional Studies , Escherichia coli , Ethanol , Ethiopia/epidemiology , Hand Sanitizers/pharmacology , Humans , Hydrogen Peroxide/pharmacology , Soaps , Water
20.
Pan Afr Med J ; 43: 2, 2022.
Article in English | MEDLINE | ID: covidwho-2056372

ABSTRACT

Introduction: in the last two years, COVID-19 has largely changed the rhythm of human life and overwhelmed the healthcare systems globally. Patients with pre-existing chronic diseases have worse outcomes during the COVID-19 pandemic. Methods: an institution-based cross-sectional study was conducted from April 1-30, 2021. Data were collected using an interviewer-administered questionnaire and data extraction checklist. A systematic random sampling technique was used to select a total of 400 study participants. Data were entered into EPI data version 3.5.3 and exported to Statistical Package for the Social Science (SPSS) version 23.0 for analysis. Multivariable logistic regression was used and variables with a p-value < 0.05 were considered statistically significant. Results: three hundred and ten (77.5%) of the respondents had a poor overall health-related quality of life (HRQOL) during the COVID-19 pandemic. Younger age (AOR=0.10.95% CI: 0.04-0.27), no formal education (AOR=5.03, 95% CI: 1.92-13.22), shorter treatment duration(AOR=0.11, 95% CI: 0.04-0.29), presence of respiratory symptoms (AOR=9.69, 95% CI: 2.93-32.09) and missed health-care appointment during COVID-19 (AOR=3.68, 95%CI: 1.82-7.43) were significantly associated with health-related quality of life (HRQOL). Conclusion: most of the respondents had a poor overall health-related quality of life during the COVID-19 pandemic. Consideration of the influence of outbreaks on the continuity of care for a patient and focusing on contributing factors should be an essential concern of the healthcare system. The objective is to assess health-related quality and factors associated with health-related quality of life among patients with chronic diseases during the COVID-19 pandemic.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Cross-Sectional Studies , Quality of Life , Pandemics , Health Knowledge, Attitudes, Practice , Chronic Disease , Ethiopia/epidemiology
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