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1.
BMC Public Health ; 22(1): 128, 2022 01 18.
Article in English | MEDLINE | ID: covidwho-1629400

ABSTRACT

BACKGROUND: Major efforts are being made to control the spread and impacts of the coronavirus pandemic using vaccines. Ethiopia began on March 13, 2021, to vaccinate healthcare workers (HCWs) for COVID-19 with the AstraZeneca vaccine. However, willingness to be vaccinated depends to a large extent on factors beyond the availability of vaccines. This study aimed to determine the rate of intention to refuse COVID-19 vaccination   and associated factors among HCWs in northeastern Ethiopia. northeastern, Ethiopia. METHOD: An institution-based cross-sectional study  was employed among 404 HCWs in Dessie City, northeastern Ethiopia in May, 2021. Data were collected, checked, coded, entered into EpiData Version 4.6 and exported to Statistical Package of Social Sciences (SPSS) Version 25.0 for cleaning and analysis. The dependent variable was refuse to receive COVID-19 vaccination and the independent variables included socio-demographic factors, knowledge, attitudes and perceptions. A Binary logistic regression model was used to determine the association between vaccine refusal and the independent variables. From bivariate analysis, variables with p-values < 0.25 were retained for multivariable analysis. From multivariable analysis, variables with adjusted odds ratio (AOR), p-values <0.05 at 95% confidence interval (CI) were declared as factors significantly associated with refusal to be vaccinated among HCWs in Dessie City, northeastern Ethiopia. RESULTS: The proportion of HCWs with overall good knowledge, good perception, and positive attitudes about COVID-19 vaccination were 62.5%, 60.5%, and 52.3%, respectively; 64.0% of the HCWs wanted to be vaccinated while 36.0% said that they would refuse to do so. Multivariable analysis identified negative attitudes (AOR: 3.057; 95%CI [1.860 - 5.026]) and poor perceptions (AOR: 4.73; 95%CI [2.911 - 7.684]) about COVID-19 vaccines were significantly associated with refusal to be vaccinated for COVID-19. Nearly half (46.9%) of the HCWs stated that vaccines could worsen any pre-existing medical conditions and 39.5% of them thought that vaccines could cause COVID-19 infections. CONCLUSION: The willingness of HCWs to get vaccinated against COVID-19 was relatively high among HCWs. Negative attitudes and poor perceptions towards the anticipated COVID-19 vaccination were significant factors to refuse to be vaccinated. Our findings may provide information for the management authorities and stakeholders to promote and improve attitudes, knowledge and perceptions towards COVID-19 vaccination uptake among HCWs.


Subject(s)
COVID-19 Vaccines , COVID-19 , Cross-Sectional Studies , Ethiopia , Health Knowledge, Attitudes, Practice , Health Personnel , Humans , SARS-CoV-2
2.
PLoS One ; 16(12): e0261125, 2021.
Article in English | MEDLINE | ID: covidwho-1635556

ABSTRACT

INTRODUCTION: COVID-19 poses significant health and economic threat prompting international firms to rapidly develop vaccines and secure quick regulatory approval. Although COVID-19 vaccination priority is given for high-risk individuals including healthcare workers (HCWs), the success of the immunization efforts hinges on peoples' willingness to embrace these vaccines. OBJECTIVE: This study aimed to assess HCWs intention to be vaccinated against COVID-19 and the reasons underlying vaccine hesitancy. METHODS: A cross-sectional survey was conducted among HCWs in Addis Ababa, Ethiopia from March to July 2021. Data were collected from eligible participants from 18 health facilities using a pre-tested semi-structured questionnaire. Data were summarized using descriptive statistics and multivariable logistic regression was performed to explore factors associated with COVID-19 vaccine hesitancy. A p<0.05 was considered statistically significant. RESULTS: A total of 614 HCWs participated in the study, with a mean age of 30.57±6.87 years. Nearly two-thirds (60.3%) of HCWs were hesitant to use the COVID-19 vaccine. Participants under the age of 30 years were approximately five times more likely to be hesitant to be vaccinated compared to those over the age of 40 years. HCWs other than medical doctors and/or nurses (AOR = 2.1; 95%CI; 1.1, 3.8) were more likely to be hesitant for COVID-19 vaccine. Lack of believe in COVID-19 vaccine benefits (AOR = 2.5; 95%CI; 1.3, 4.6), lack of trust in the government (AOR = 1.9; 95%CI; 1.3, 3.1), lack of trust science to produce safe and effective vaccines (AOR = 2.6; 95%CI; 1.6, 4.2); and concern about vaccine safety (AOR = 3.2; 95%CI; 1.9, 5.4) were also found to be predictors of COVID-19 vaccine hesitancy. CONCLUSION: COVID-19 vaccine hesitancy showed to be high among HCWs. All concerned bodies including the ministry, regional health authorities, health institutions, and HCWs themselves should work together to increase COVID-19 vaccine uptake and overcome the pandemic.


Subject(s)
COVID-19 , Health Personnel/statistics & numerical data , /statistics & numerical data , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Ethiopia , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , Vaccination/statistics & numerical data
3.
Health Qual Life Outcomes ; 19(1): 268, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1633878

ABSTRACT

BACKGROUND: Covid-19 causes a wide range of symptoms in patients, ranging from mild manifestations to severe disease and death. This study assessed the health-related quality of life (HRQOL) and associated factors of Covid-19 patients using primary data from confirmed cases in South Central Ethiopia. METHODS: We employed a facility-based, cross-sectional study design and conducted the study at the Bokoji Hospital Covid-19 treatment centre. A structured questionnaire and the EQ-5D-3L scale were used to collect the data for analysis. The HRQOL results measured by the EQ-5D-3L tool were converted to a health state utility (HSU) using the Zimbabwe tariff. The average health utility index and HSU-visual analogue scale across diverse sociodemographic and clinical characteristics were compared using the Mann-Whitney U test or Kruskal-Wallis test. We employed a multiple linear regression to examine factors associated with HSU values simultaneously. The data were analysed using STATA version 15. RESULTS: The overall mean HSU score from the EQ-5D was 0.688 (SD: 0.285), and the median was 0.787 (IQR 0.596, 0.833). The mean HSU from the visual analogue scale score was 0.69 (SD: 0.129), with a median of 0.70 (IQR 0.60, 0.80). Those who received dexamethasone and intranasal oxygen supplement, those with comorbidity, those older than 55 years and those with a hospital stay of more than 15 days had significantly lower HSU scores than their counterparts (p < .001). CONCLUSION: Covid-19 substantially impaired the HRQOL of patients in Ethiopia, especially among elderly patients and those with comorbidity. Therefore, clinical follow-up and psychological treatment should be encouraged for these groups. Moreover, the health utility values from this study can be used to evaluate quality adjusted life years for future cost-effectiveness analyses of prevention and treatment interventions against Covid-19.


Subject(s)
COVID-19 , Quality of Life , Aged , COVID-19/drug therapy , Cross-Sectional Studies , Ethiopia , Hospitals , Humans , SARS-CoV-2
4.
PLoS One ; 16(12): e0261065, 2021.
Article in English | MEDLINE | ID: covidwho-1632252

ABSTRACT

BACKGROUND: Curtailing physical contact between individuals reduces transmission and spread of the disease. Social distancing is an accepted and effective strategy to delay the disease spread and reduce the magnitude of outbreaks of pandemic COVID-19. However, no study quantified social distancing practice and associated factors in the current study area. Therefore, the study aimed to assess social distancing practice and associated factors in response to COVID-19 pandemic in West Guji Zone, Southern Ethiopia, 2020. METHODS AND MATERIALS: A Community based cross-sectional study design was conducted among randomly selected 410 household members of Bule Hora Town, West Guji Zone. Data were collected by pre-tested interviewer administered structured questionnaire adapted from previous peer reviewed articles. The data were coded and entered in to Epi data version 3.5 and analyzed by SPSS version 23. The bivariate and multivariate logistic regressions analysis was done to identify factors associated with social distancing practice. Adjusted odds ratio with 95% confidence interval and p value <0.05 were used to declare statistical significance. RESULT: Out of 447 planned samples, 410 participants were successfully interviewed and included into final analysis; making the response rate of 91.7%. The median (±IQR) age of study participants was 28(±9) years. In this study, 38.3% [95% CI: 33.5%, 43.1%)] of the study participants have good social distancing practices for the prevention of COVID-19. Age group 26-30 years [AOR = 2.56(95% CI: 1.18-5.54)] and 31-35 years [AOR = 3.57(95%CI: 1.56-8.18)], employed [AOR = 6.10(95%CI: 3.46-10.74)],poor knowledge [AOR = 0.59 (95% CI:0.36-0.95)], negative attitude [AOR = 0.55 (95% CI:0.31-0.95)] and low perceived susceptibility [AOR = 0.33(95%CI: 0.20-0.54)] were significantly associated with good social distancing practice. CONCLUSION: Social distancing practice is relatively poor in the study area. The knowledge and attitude level of participants were identified to be the major factors for the observed poor social distancing practice. Sustained efforts to improve awareness and attitudes towards COVID-19 prevention might improve adherence to social distancing practices.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Health Knowledge, Attitudes, Practice , Physical Distancing , Adult , COVID-19/psychology , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Humans , Male , Pandemics , Risk Factors , Self Efficacy , Socioeconomic Factors , Young Adult
5.
J Environ Public Health ; 2021: 7112548, 2021.
Article in English | MEDLINE | ID: covidwho-1622110

ABSTRACT

Background: Most of the households in developing countries burn biomass fuel in traditional stoves with incomplete combustion that leads to high indoor air pollution and acute respiratory infections. Acute respiratory infection is the most common cause of under-five morbidity and mortality accounting for 2 million deaths worldwide and responsible for 18% of deaths among under-five children in Ethiopia. Although studies were done on acute respiratory infections, the majority of studies neither clinically diagnose respiratory infections nor use instant measurement of particulate matter. Methods: The community-based cross-sectional study design was employed among under-five children in Jimma town from May 21 to June 7, 2020. A total of 265 children through systematic random sampling were included in the study. The data were collected using a pretested semistructured questionnaire and laser pm 2.5 meter for indoor particulate matter concentration. Associations among factors were assessed through correlation analysis, and binary logistic regression was done to predict childhood acute respiratory infections. Variables with p-value less than 0.25 in bivariate regression were the candidate for the final multivariate logistic regression. Two independent sample t-tests were done to compare significant mean difference between concentrations of particulate matter. Results: Among 265 under-five children who were involved in the study, 179 (67.5%) were living in households that predominantly use biomass fuel. Prevalence of acute respiratory infections in the study area was 16%. Children living in households that use biomass fuel were four times more likely to develop acute respiratory infections than their counterparts (AOR: 4.348; 95% CI: 1.632, 11.580). The size of household was significantly associated with the prevalence of acute respiratory infections. Under-five children living in households that have a family size of six and greater had odds of 1.7 increased risk of developing acute respiratory infections than their counterparts (AOR: 1.7; 95% CI: 1.299, 2.212). The other factor associated with acute respiratory infection was separate kitchen; children living in households in which there were no separate kitchen were four times at increased risk of developing acute respiratory infection than children living in households which have separate kitchen (AOR: 4.591; 95% CI: 1.849, 11.402). The concentration of indoor particulate matter was higher in households using biomass fuel than clean fuel. There was statistically higher particulate matter concentration in the kitchen than living rooms (t = 4.509, p ≤ 0.001). Particulate matter 2.5 concentrations (µg/m3) of the households that had parental smoking were significantly higher than their counterparts (AOR: 20.224; 95% CI: 1.72, 12.58). Conclusion: There is an association between acute respiratory infections and biomass fuel usage among under-five children. Focusing on improved energy sources is essential to reduce the burden and assure the safety of children.


Subject(s)
Air Pollution, Indoor , Respiratory Tract Infections , Air Pollution, Indoor/statistics & numerical data , Biomass , Child , Cross-Sectional Studies , Ethiopia/epidemiology , Humans , Particulate Matter/analysis , Particulate Matter/toxicity , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology
6.
PLoS One ; 16(3): e0249214, 2021.
Article in English | MEDLINE | ID: covidwho-1605662

ABSTRACT

The novel coronavirus (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Despite strong efforts that have been taking place to control the pandemic globally, the virus is on the rise in many countries. Hence, this study assessed the maternal health care services utilization amidst the COVID-19 pandemic in West Shoa zone, Central Ethiopia. A community-based cross-sectional study was conducted among 844 pregnant women or those who gave birth in the last 6 months before the study. A multi-stage sampling technique was used to select the study participants. The data were collected through face-to-face interviews using a semi-structured questionnaire. Logistic regressions were performed to identify the presence of significant associations, and an adjusted odds ratio with 95%CI was employed for the strength and directions of association between the independent and outcome variables. A P-value of <0.05 was used to declare statistical significance. The prevalence of maternal health service utilization during the COVID-19 pandemic was 64.8%. The odds of maternal health service utilization was higher among mothers who had primary (AOR = 2.16, 95%CI: 1.29-3.60), secondary (AOR = 1.97, 95%CI: 1.13-3.44), and college and above education (AOR = 2.89, 95%CI: 1.34-6.22) than those who could not read and write. Besides, mothers who did travel 30-60 minutes (AOR = 0.37, 95%CI: 0.23-0.59) and 60-90minutes (AOR = 0.10, 95%CI: 0.05-0.19) to reach the health facility had a lower odds of maternal health service utilization than those who did travel <30 minutes. Moreover, mothers who earn 1000-2000 (AOR = 3.10, 95%CI: 1.73-5.55) and > 2000 birrs (AOR = 2.66 95%CI: 1.52-4.64) had higher odds of maternal health service utilization than those who earn <500 birrs. Similarly, the odds of utilizing maternal health service were higher among mothers who did not fear COVID-19 infection (AOR = 2.79, 95%CI: 1.85-4.20), who had not had to request permission from husband to visit the health facility (AOR = 7.24, 95%CI: 2.65-19.75), who had practicedCOVID-19 prevention measure (AOR = 5.82, 95%CI: 3.87-8.75), and used face mask (AOR = 2.06, 95% CI: 1.28-3.31) than their counterpart. Empowering mothers and creating awareness on COVID-19 preventionis recommended to improve maternal health service utilization during the COVID-19 pandemic.


Subject(s)
COVID-19/pathology , Health Facilities/statistics & numerical data , Maternal Health Services/statistics & numerical data , Adolescent , Adult , COVID-19/epidemiology , COVID-19/virology , Cross-Sectional Studies , Educational Status , Ethiopia/epidemiology , Female , Humans , Logistic Models , Masks , Odds Ratio , Pandemics , Pregnancy , SARS-CoV-2/isolation & purification , Social Class , Young Adult
7.
BMJ Open ; 12(1): e056009, 2022 01 03.
Article in English | MEDLINE | ID: covidwho-1608870

ABSTRACT

OBJECTIVES: This study aims to identify levels of adherence to antiretroviral therapy (ART) drugs and factors associated with them in Northwest Ethiopia. We hypothesise that in the era of COVID-19, there would be suboptimal adherence to ART drugs. DESIGN: An observational cross-sectional study was conducted. Factors associated with the level of adherence were selected for multiple logistic regressions at a p value of less than 0.2 in the analysis. Statistically significant associated factors were identified at a p value less than 0.05 and adjusted OR with a 95% CI. SETTING: The study was conducted in one specialised hospital and three district hospitals found in the South Gondar zone, Northwest Ethiopia. PARTICIPANTS: About 432 people living with HIV/AIDS receiving highly active ART in South Gondar zone public hospitals and who have been on treatment for more than a 3-month period participated in the study. PRIMARY AND SECONDARY OUTCOME MEASURES: Levels of adherence to ART drugs and their associated factors. RESULTS: Among 432 study participants, 81.5% (95% CI: 78% to 85.2%) of participants were optimally adherent to ART drugs. Determinants of a low level of adherence: stigma or discrimination (OR=0.4, p=0.016), missed scheduled clinical visit (OR=0.45, p=0.034), being on tuberculosis treatment (OR=0.45, p=0.01), recent CD4 cell count less than 500 cells/mm3 (OR=0.3, p=0.023) and patients who had been on WHO clinical stage III at the time of ART initiation (OR=0.24, p=0.027) were factors significantly associated with adherence to ART drugs. CONCLUSIONS: Level of adherence was relatively low compared with some local studies. The intervention targeted to reduce discrimination, counselling before initiation of treatment and awareness regarding compliance is advised to improve adherence to antiretroviral regimens.


Subject(s)
COVID-19 , HIV Infections , Cross-Sectional Studies , Ethiopia , HIV Infections/drug therapy , Humans , Medication Adherence , SARS-CoV-2
8.
Front Public Health ; 9: 753867, 2021.
Article in English | MEDLINE | ID: covidwho-1581121

ABSTRACT

Background: There is a global concern that coronavirus disease 2019 (COVID-19) cannot be addressed without the integration and active engagement of communities. We aimed to investigate the knowledge, attitude, and practices (KAP) of the residents in Eastern Ethiopia toward COVID-19. Method: A community-based cross-sectional study was conducted on May 1-30, 2020 among the residents of Dire Dawa, Eastern Ethiopia. Data were collected using a structured questionnaire on the awareness, knowledge, attitudes, and preventive practices toward COVID-19. We used random sampling to select the participants. Data was entered into the statistics and data (STATA) version for data cleaning and analysis. Binary logistic regression models with 95% CI were used to conduct bivariable [crude odds ratio (COR)] and multivariable [adjusted odds ratio (AOR)] analyses. Result: A total of 415 community residents responded to the questionnaire. Of those participants, 52.5% (95% CI 47.7-57) had adequate knowledge, 31.6% (95% CI 27-36) had favorable attitudes, and 49% (95% CI 45-50) had good practice toward the precautionary measures of COVID-19. Adequate knowledge had a significant association with urban residence (AOR = 5, 95% CI 3.1-8.4) and literacy (AOR = 3.1, 95% CI 1.5-6.7). Good preventions practices had a significant association with place of residence (AOR = 4.1, 95% CI 2.3-7.2), literacy (AOR = 2.9, 95% CI: 1,2-7.4), adequate knowledge (AOR = 3.5, 95% CI 2.3-5.8), and favorable attitude (AOR = 2.3, 95% CI 1.4-3.8) about the disease. Conclusion: The overall COVID-19-related KAP was inadequate in the majority of the residents of Dire Dawa that occupy irregular migration flows. These call for robust community-centered behavioral communication strategies that could bridge the gaps and help prevent and control COVID-19 and other future pandemics in their community.


Subject(s)
COVID-19 , Cross-Sectional Studies , Ethiopia/epidemiology , Health Knowledge, Attitudes, Practice , Humans , SARS-CoV-2
9.
Front Public Health ; 9: 782705, 2021.
Article in English | MEDLINE | ID: covidwho-1581106

ABSTRACT

Objective: The use of personal protective equipment and hand hygiene are often the most recommended line of defense against coronavirus disease-19 (COVID-19). The purpose of this study is to determine the magnitude of compliance and associated factors of personal protective equipment (PPE) utilization and hand hygiene practice among healthcare workers in public hospitals of South Wollo Zone, Northeastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted among 489 healthcare workers in public hospitals of South Wollo Zone, Northeastern Ethiopia from June 15 to July 30, 2021. Proportional sample size allocation to each selected hospital followed by simple random sampling techniques were used to select the study participants using human resource records from each hospital. A pre-tested and structured self-administered questionnaire with WHO's standardized hand hygiene and PPE utilization observational checklist were used to collect data. Bivariate and multivariable analyses with 95% CI and p-value < 0.05 were employed to identify the associated factors of personal protective equipment utilization. Results: About 32 and 22.3% of healthcare workers were compliant with personal protective equipment utilization and hand hygiene practice, respectively. Feedback for safety (AOR = 2.05; 95% CI: 1.26-3.35), training on COVID-19 prevention (AOR = 3.43; 95% CI: 2.01-5.86), and perception to infection risk (AOR = 1.98; 95% CI: 1.18-3.33) were significant factors of good compliance with personal protective equipment utilization. Conclusion: The magnitude of good compliance with personal protective equipment utilization and hand hygiene was low. Interventions to promote personal protective equipment utilization and hand hygiene should focus on feedback for safety, training on COVID-19 prevention, and perception of infection risk.


Subject(s)
COVID-19 , Hand Hygiene , Cross-Sectional Studies , Ethiopia , Health Personnel , Hospitals, Public , Humans , Personal Protective Equipment , SARS-CoV-2
10.
BMC Public Health ; 21(1): 2297, 2021 12 18.
Article in English | MEDLINE | ID: covidwho-1582084

ABSTRACT

BACKGROUND: COVID-19 has been swiftly spreading throughout the world ever since it emerged in Wuhan, China, in late December 2019. Case detection and contact identification remain the key surveillance objectives for effective containment of the pandemic. This study was aimed at assessing performance of surveillance in early containment of COVID 19 in Western Oromia, Ethiopia. METHODS: A cross-sectional study was conducted from August 1 to September 30, 2020, in the 7 kebeles of Nekemte and 2 kebeles of Shambu Town. Residents who lived there for at least the past six months were considered eligible for this study. Data were collected from community and health system at different levels using semi structured questionnaire and checklist, respectively. Participants' health facility usage (dependent variable) and perceived risk, awareness, Socioeconomic Status, and practices (independent variable) were assessed. Bivariable analysis was computed to test the presence of an association between dependent and independent variables. Independent predictors were identified on multivariable logistic regression using a p-value of (<0.05) significance level. We have checked the model goodness of fit test by Hosmer-lemeshow test. RESULTS: One hundred seventy-nine (41%) of the participants believe that they have a high risk of contracting COVID-19 and 127 (29%) of them reported they have been visited by health extension worker. One hundred ninety-seven (45.2%) reported that they were not using health facilities for routine services during this pandemic. Except one hospital, all health facilities (92%) were using updated case definition. Three (33%) of the assessed health posts didn't have community volunteers. On multivariable logistic regression analysis, the source of income AOR=0.30, 95% CI (0.11, 0.86), perceived level of risk AOR=3.42, 95% CI (2.04, 5.7) and not visited by health extension workers AOR=0.46, 95% CI (0.29, 0.74) were found to be independent predictors of not using health facilities during this pandemic. CONCLUSION: Event based surveillance, both at community and health facility level, was not performing optimally in identifying potential suspects. Therefore, for effective early containment of epidemic, it is critical to strengthen event based surveillance and make use of surveillance data for tailored intervention in settings where mass testing is not feasible.


Subject(s)
COVID-19 , Cross-Sectional Studies , Ethiopia/epidemiology , Health Knowledge, Attitudes, Practice , Humans , SARS-CoV-2
11.
BMC Med ; 19(1): 198, 2021 08 12.
Article in English | MEDLINE | ID: covidwho-1571757

ABSTRACT

BACKGROUND: The COVID-19 pandemic has disrupted the delivery of immunisation services globally. Many countries have postponed vaccination campaigns out of concern about infection risks to the staff delivering vaccination, the children being vaccinated, and their families. The World Health Organization recommends considering both the benefit of preventive campaigns and the risk of SARS-CoV-2 transmission when making decisions about campaigns during COVID-19 outbreaks, but there has been little quantification of the risks. METHODS: We modelled excess SARS-CoV-2 infection risk to vaccinators, vaccinees, and their caregivers resulting from vaccination campaigns delivered during a COVID-19 epidemic. Our model used population age structure and contact patterns from three exemplar countries (Burkina Faso, Ethiopia, and Brazil). It combined an existing compartmental transmission model of an underlying COVID-19 epidemic with a Reed-Frost model of SARS-CoV-2 infection risk to vaccinators and vaccinees. We explored how excess risk depends on key parameters governing SARS-CoV-2 transmissibility, and aspects of campaign delivery such as campaign duration, number of vaccinations, and effectiveness of personal protective equipment (PPE) and symptomatic screening. RESULTS: Infection risks differ considerably depending on the circumstances in which vaccination campaigns are conducted. A campaign conducted at the peak of a SARS-CoV-2 epidemic with high prevalence and without special infection mitigation measures could increase absolute infection risk by 32 to 45% for vaccinators and 0.3 to 0.5% for vaccinees and caregivers. However, these risks could be reduced to 3.6 to 5.3% and 0.1 to 0.2% respectively by use of PPE that reduces transmission by 90% (as might be achieved with N95 respirators or high-quality surgical masks) and symptomatic screening. CONCLUSIONS: SARS-CoV-2 infection risks to vaccinators, vaccinees, and caregivers during vaccination campaigns can be greatly reduced by adequate PPE, symptomatic screening, and appropriate campaign timing. Our results support the use of adequate risk mitigation measures for vaccination campaigns held during SARS-CoV-2 epidemics, rather than cancelling them entirely.


Subject(s)
COVID-19/prevention & control , Disease Outbreaks/prevention & control , Health Personnel , Immunization Programs/organization & administration , SARS-CoV-2 , Vaccination , Brazil , Burkina Faso , COVID-19/epidemiology , Child , Ethiopia , Female , Humans , Male , Pandemics , Personal Protective Equipment
12.
Reprod Health ; 18(1): 246, 2021 Dec 13.
Article in English | MEDLINE | ID: covidwho-1571836

ABSTRACT

BACKGROUND: World health organization (WHO) defines intimate partner violence (IPV) is physical, sexual, or emotional abuse by an intimate partner or ex-partner or spouse to a woman. From all forms of violence, ~ 1.3 million people worldwide die each year, accounting for 2.5% of global mortality. During the COVID-19 crisis, control and prevention measures have brought women and potential perpetrators together which increase the risk of IPV. Therefore, this study was aimed to assess the magnitude and associated factors of IPV against women during COVID-19 in Ethiopia. METHODS: Community based cross-section study was employed among 462 reproductive-age women to assess IPV and associated factors during COVID-19 pandemic. To select study participants one-stage cluster sampling technique was used. The data were entered into Epi data version 4.2 and exported to SPSS for analysis. Bivariate and multivariate analysis was used to check the association of dependent and independent variables and statistical significance was declared at P < 0.05. RESULT: A total of 448 study subjects were responded making a response rate of 96.97%. Two- third (67.6%) of the respondent's age range was between 20 and 29 years. All of the participants heard about the pandemic of COVID-19 at the time of onset. The lifetime and the last twelve months prevalence of women with IPV was 42.19% and 24.11%, respectively. About 58 (12.9%) had experienced all three types of violence. Participants age ≥ 35 (AOR = 2.02; 95% CI: 1.99-4.29), rural residence (AOR = 3.04; 95% CI: 2.59-6.25), husband's educational status of diploma and above (AOR = 0.35; 95% CI: 0.14-0.83), COVID-19 pandemic (AOR = 4.79; 95% CI: 1.13-6.86), and low social support (AOR = 3.23; 95% CI: 1.99-6.23) were independent predictors. CONCLUSIONS: In this study two in five women undergo one type of violence in their lifetime. The occurrence of the COVID-19 pandemic has its impact on violence. Age ≥ 35, rural residence, husband's educational status of diploma and above, history of child death, COVID-19 pandemic, and low social support were independent predictors of violence. This implies insight to concerned bodies like policymakers and stakeholders to design appropriate policies to avert this magnitude and making zero tolerance for violence in society.


Intimate partner violence is physical, sexual, or emotional abuse by an intimate partner or ex-partner or spouse to a woman. Community based cross-section study was employed among 462 reproductive-age women to assess the magnitude and associated factors of IPV against women during COVID-19 in Ethiopia. Bivariate and multivariate analysis was used to check the association of dependent and independent variables and statistical significance was declared at P < 0.05. A total of 448 study subjects were responded making a response rate of 96.97%. In this study two in five women undergo one type of violence in their lifetime. The occurrence of the COVID-19 pandemic has its impact on violence. Age ≥ 35, rural residence, husband's educational status of diploma and above, history of child death, COVID-19 pandemic and low social support were independent predictors of violence. This sparks light to concerned bodies like policymakers and stack holders to design appropriate policies to avert this magnitude and making zero tolerance for violence in society.


Subject(s)
COVID-19 , Intimate Partner Violence , Adult , Ethiopia/epidemiology , Female , Humans , Pandemics , Prevalence , Risk Factors , SARS-CoV-2 , Sexual Partners , Young Adult
13.
PLoS One ; 16(11): e0260270, 2021.
Article in English | MEDLINE | ID: covidwho-1523455

ABSTRACT

BACKGROUND: Coronavirus disease 19 (COVID-19) is a newly emerging pandemic affecting more than 120 million people globally. Compliance with preventive practices is the single most effective method to overcome the disease. Although several studies have been conducted regarding COVID-19, data on healthcare provider's adherence to COVID-19 preventive practices during childbirth through direct observation is limited. Therefore, this study aimed to assess healthcare provider's adherence to COVID-19 preventive practices during childbirth in northwest Ethiopia. METHODS: A multicenter study was conducted at hospitals in northwest Ethiopia among 406 healthcare providers from November 15 /2020 to March 10 /2021. A simple random sampling technique was employed to select the study subjects. Data were collected via face-to-face interviews and direct observation using a structured questionnaire and standardized checklist respectively. EPI INFO version 7.1.2 and SPSS 25 were used for data entry and analysis respectively. Binary logistic regression analyses were undertaken to identify associated factors. The level of significance was decided based on the adjusted odds ratio (AOR) with a 95% confidence interval at a p-value of ≤ 0.05. RESULTS: The proportion of healthcare providers having good adherence to COVID-19 preventive practices during intrapartum care was 46.1% (95% CI: 41.2, 50.9). Healthcare providers who had job satisfaction (AOR = 3.18; 95% CI: 1.64, 6.13), had smartphone and/or computer (AOR = 2.75; 95% CI: 1.62, 4.65), ever received training on infection prevention (AOR = 3.58; 95% CI: 2.20, 5.84), earned higher monthly income (AOR = 2.15; 95% CI: 1.30, 3.57), and worked at health facility in the urban area (AOR = 1.72; 95% CI: 1.07, 2.77) had a significant association with adherence to COVID-19 preventive practices. Moreover, the most commonly mentioned barriers for not adhering to the preventive practice of COVID-19 were crowdedness of the delivery room, non-availability of personal protective equipment, and shortage of alcohol or sanitizer. CONCLUSION: The healthcare provider's adherence to COVID-19 preventive practices was low. Hence, stakeholders need to pay special attention to increase healthcare provides' job satisfaction. In addition, the provision of continuous training on infection prevention would be helpful. Furthermore, personal protective equipment, alcohol, and sanitizer supply must be provided for healthcare providers.


Subject(s)
COVID-19/prevention & control , Health Facilities/statistics & numerical data , Health Knowledge, Attitudes, Practice , Health Personnel/statistics & numerical data , Pandemics/prevention & control , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Humans , Male , Middle Aged , Pregnancy , Surveys and Questionnaires , Young Adult
14.
Lancet Glob Health ; 9(11): e1477-e1478, 2021 11.
Article in English | MEDLINE | ID: covidwho-1526007
15.
PLoS One ; 16(11): e0259874, 2021.
Article in English | MEDLINE | ID: covidwho-1518361

ABSTRACT

The World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020 and by November 14, 2020 there were 53.3M confirmed cases and 1.3M reported deaths in the world. In the same period, Ethiopia reported 102K cases and 1.5K deaths. Effective public health preparedness and response to COVID-19 requires timely projections of the time and size of the peak of the outbreak. Currently, Ethiopia under the COVAX facility has begun vaccinating high risk populations but due to vaccine supply shortages and the absence of an effective treatment, the implementation of NPIs (non-pharmaceutical interventions), like hand washing, wearing face coverings or social distancing, still remain the most effective methods of controlling the pandemic as recommended by WHO. This study proposes a modified Susceptible Exposed Infected and Recovered (SEIR) model to predict the number of COVID-19 cases at different stages of the disease under the implementation of NPIs at different adherence levels in both urban and rural settings of Ethiopia. To estimate the number of cases and their peak time, 30 different scenarios were simulated. The results indicated that the peak time of the pandemic is different in urban and rural populations of Ethiopia. In the urban population, under moderate implementation of three NPIs the pandemic will be expected to reach its peak in December, 2020 with 147,972 cases, of which 18,100 are symptomatic and 957 will require admission to an Intensive Care Unit (ICU). Among the implemented NPIs, increasing the coverage of wearing masks by 10% could reduce the number of new cases on average by one-fifth in urban-populations. Varying the coverage of wearing masks in rural populations minimally reduces the number of cases. In conclusion, the models indicate that the projected number of hospital cases during the peak time is higher than the Ethiopian health system capacity. To contain symptomatic and ICU cases within the health system capacity, the government should pay attention to the strict implementation of the existing NPIs or impose additional public health measures.


Subject(s)
COVID-19 , Pandemics , Ethiopia , Masks , Quarantine
16.
PLoS One ; 16(11): e0259454, 2021.
Article in English | MEDLINE | ID: covidwho-1506294

ABSTRACT

BACKGROUND: The COVID-19 pandemic seems to have a different picture in Africa; the first case was identified in the continent after it had already caused a significant loss to the rest of the world and the reported number of cases and mortality rate has been low. Understanding the characteristics and outcome of the pandemic in the African setup is therefore crucial. AIM: To assess the characteristics and outcome of Patients with COVID-19 and to identify determinants of the disease outcome among patients admitted to Millennium COVID-19 Care Center in Ethiopia. METHODS: A prospective cohort study was conducted among 1345 consecutively admitted RT-PCR confirmed Patients with COVID-19 from July to September, 2020. Frequency tables, KM plots, median survival times and Log-rank test were used to describe the data and compare survival distribution between groups. Cox proportional hazard survival model was used to identify determinants of time to clinical recovery and the independent variables, where adjusted hazard ratio, P-value and 95% CI for adjusted hazard ratio were used for testing significance and interpretation of results. Binary logistic regression model was used to assess the presence of a statistically significant association between disease outcome and the independent variables, where adjusted odds ratio, P-value and 95% CI for adjusted odds ratio were used for testing significance and interpretation of results. RESULTS: Among the study population, 71 (5.3%) died, 72 (5.4%) were transferred and the rest 1202 (89.4%) were clinically improved. The median time to clinical recovery was 14 days. On the multivariable Cox proportional hazard model; temperature (AHR = 1.135, 95% CI = 1.011, 1.274, p-value = 0.032), COVID-19 severity (AHR = 0.660, 95% CI = 0.501, 0.869, p-value = 0.003), and cough (AHR = 0.705, 95% CI = 0.519, 0.959, p-value = 0.026) were found to be significant determinants of time to clinical recovery. On the binary logistic regression, the following factors were found to be significantly associated with disease outcome; SPO2 (AOR = 0.302, 95% CI = 0.193, 0.474, p-value = 0.0001), shortness of breath (AOR = 0.354, 95% CI = 0.213, 0.590, p-value = 0.0001) and diabetes mellitus (AOR = 0.549, 95% CI = 0.337, 0.894, p-value = 0.016). CONCLUSIONS: The average duration of time to clinical recovery was 14 days and 89.4% of the patients achieved clinical recovery. The mortality rate of the studied population is lower than reports from other countries including those in Africa. Having severe COVID-19 disease severity and presenting with cough were found to be associated with delayed clinical recovery of the disease. On the other hand, being hyperthermic is associated with shorter disease duration (faster time to clinical recovery). In addition, lower oxygen saturation, subjective complaint of shortness of breath and being diabetic were associated with unfavorable disease outcome. Therefore, patients with these factors should be followed cautiously for a better outcome.


Subject(s)
COVID-19/epidemiology , Hospitalization/statistics & numerical data , Adult , Ethiopia/epidemiology , Female , Humans , Logistic Models , Male , Middle Aged , Odds Ratio , Pandemics/statistics & numerical data , Pregnancy , Proportional Hazards Models , Prospective Studies , SARS-CoV-2/pathogenicity , Severity of Illness Index , Time Factors , Treatment Outcome
17.
BMJ Open ; 11(10): e050812, 2021 10 29.
Article in English | MEDLINE | ID: covidwho-1504736

ABSTRACT

OBJECTIVES: This survey aimed to assess the awareness and readiness of healthcare providers to use telemonitoring (TM) technologies for managing diabetes patients as well as to identify associated factors in Ethiopia. DESIGN: An institution-based cross-sectional quantitative survey was conducted by using a pretested self-administered questionnaire from February to March 2020. Data analysis used a binary logistic regression and partial proportional odds model for factor identification. PARTICIPANTS: Randomly selected 423 study physicians and nurses. SETTING: This study was conducted at the University of Gondar and Tibebe Ghion specialised teaching referral hospitals. OUTCOME MEASURES: Awareness and readiness towards TM in diabetes care. RESULT: Out of 406 healthcare providers (69.7%, n=283 nurses and 30.3%, n=123 physicians) who completed the survey, 345 (38.7%) heard about TM, when it came to readiness, 321 (25.1%) and 121 (65.5%) of respondents had average and low readiness towards TM, respectively. The result of regression analysis shows that awareness towards TM was higher among respondents who had access to a computer (adjusted OR (AOR): 2.8 (95% CI 1.1 to 7.1)), computer-related training (AOR: 4.6 (95% CI 1.63 to 12.95)) and those who had the experience of supporting patients through digital tools (AOR: 1.7 (95% CI 1.0 to 2.8)). Self-perceived innovators and those who had access to a computer, computer-related training and favourable attitude towards TM had significantly higher readiness to use TM. CONCLUSION: The findings of this survey revealed low awareness and readiness of participant's towards TM. However, this study suggests the need of improving participant's attitudes, access to smartphones and computers and technical skills to fill this gap.


Subject(s)
Diabetes Mellitus , Health Facilities , Cross-Sectional Studies , Diabetes Mellitus/therapy , Ethiopia , Health Knowledge, Attitudes, Practice , Hospitals, Teaching , Humans , Surveys and Questionnaires
18.
Ethiop J Health Sci ; 31(4): 699-708, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1497599

ABSTRACT

Background: With the rising number of new cases of COVID-19, understanding the oxygen requirement of severe patients assists in identifying at risk groups and in making an informed decision on building hospitals capacity in terms of oxygen facility arrangement. Therefore, the study aimed to estimate time to getting off supplemental oxygen therapy and identify predictors among COVID-19 patients admitted to Millennium COVID-19 Care Center in Ethiopia. Methods: A prospective observational study was conducted among 244 consecutively admitted COVID-19 patients from July to September, 2020. Kaplan Meier plots, median survival times and Log-rank test were used to describe the data and compare survival distribution between groups. Cox proportional hazard survival model was used to identify determinants of time to getting off supplemental oxygen therapy, where hazard ratio (HR), P-value and 95%CI for HR were used for testing significance and interpretation of results. Results: Median time to getting off supplemental oxygen therapy among the studied population was 6 days (IQR,4.3-20.0). Factors that affect time to getting off supplemental oxygen therapy were age group (AHR=0.52,95%CI=0.32,0.84, p-value=0.008 for ≥70 years) and shortness of breath (AHR=0.71,95%CI=0.52,0.96, p-value=0.026). Conclusion: Average duration of supplemental oxygen therapy requirement among COVID-19 patients was 6 days and being 70 years and older and having shortness of breath were found to be associated with prolonged duration of supplemental oxygen therapy requirement. This result can be used as a guide in planning institutional resource allocation and patient management to provide a well-equipped care to prevent complications and death from the disease.


Subject(s)
COVID-19 , Aged , Ethiopia , Humans , Oxygen , Retrospective Studies , SARS-CoV-2 , Survival Analysis
19.
Ethiop J Health Sci ; 31(4): 689-698, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1497598

ABSTRACT

Background: The novel coronavirus has caused a profound impact on service utilization or delivery practices of health facilities globally. This study aims to evaluate the trend of health service utilization before and during the COVID-19 pandemic at selected hospitals in Addis Ababa, Ethiopia. Method: A facility-based cross-sectional study was conducted from 1st through 30th of August 2020 using a mixed-methods design. For the quantitative evaluation, ten months' time-series data, starting from September 2019 to July 2020 was retrieved from the HMIS unit of each hospital. Microsoft excel v.2010 was used to analyze quantitative data. Qualitative data was collected using a semi-structured key-informant interview guide and analyzed using QDA-minor software. Results: Twelve service delivery departments were included in the evaluation of each hospital. Of all, OPD, ART, VCT, PICT, and EPI services showed major disruption in both hospitals following the COVID-19 outbreak. Noticeable change was recorded in March and April for most units. Qualitative exploration showed multiple challenges namely; inadequate supply, poor infrastructure, low service utilization, staff workload, increased risk, poor job satisfaction of health professionals, and perception or attitude-related problems to be persistent at the hospitals. Conclusion: Main service delivery units of the hospitals, such as OPD, ART, VCT, PICT, and EPI have faced massive depression during the COVID-19 pandemic. The facilities had also encountered multifaceted challenges most from the internal environment. Immediate action should be in place to halt the negative impacts of the pandemic on the identified spots and challenges.


Subject(s)
COVID-19 , Pandemics , Cross-Sectional Studies , Delivery of Health Care , Ethiopia/epidemiology , Health Services , Hospitals , Humans , SARS-CoV-2
20.
PLoS One ; 16(10): e0258662, 2021.
Article in English | MEDLINE | ID: covidwho-1496511

ABSTRACT

We aimed to apply the Systems Engineering Initiative for Patient Safety (SEIPS) model to increase effectiveness and sustainability of the World Health Organization's (WHOs) hand hygiene (HH) guidelines within healthcare systems. Our cross-sectional, mixed-methods study took place at Jimma University Medical Center (JUMC), a tertiary care hospital in Jimma, Ethiopia, between November 2018 and August 2020 and consisted of three phases: baseline assessment, intervention, and follow-up assessment. We conducted questionnaires addressing HH knowledge and attitudes, interviews to identify HH barriers and facilitators within the SEIPS framework, and observations at the WHO's 5 moments of HH amongst healthcare workers (HCWs) at JUMC. We then implemented HH interventions based on WHO guidelines and results from our baseline assessment. Follow-up HH observations were conducted months later during the Covid-19 pandemic. 250 HCWs completed questionnaires with an average knowledge score of 61.4% and attitude scores indicating agreement that HH promotes patient safety. Interview participants cited multiple barriers to HH including shortages and location of HH materials, inadequate training, minimal Infection Prevention Control team presence, and high workload. We found an overall baseline HH compliance rate of 9.4% and a follow-up compliance rate of 72.1%. Drastically higher follow-up compared to baseline compliance rates were likely impacted by our HH interventions and Covid-19. HCWs showed motivation for patient safety despite low HH knowledge. Utilizing the SEIPS model helped identify institution-specific barriers that informed targeted interventions beyond WHO guidelines aimed at increasing effectiveness and sustainability of HH efforts.


Subject(s)
Hand Disinfection/methods , Hand Disinfection/trends , Hand Hygiene/methods , Adult , COVID-19/prevention & control , Cross Infection/prevention & control , Cross-Sectional Studies , Ethiopia , Female , Guideline Adherence/statistics & numerical data , Hand Hygiene/trends , Health Knowledge, Attitudes, Practice , Health Personnel/psychology , Humans , Infection Control/methods , Male , Pandemics/prevention & control , SARS-CoV-2/pathogenicity , Surveys and Questionnaires , Tertiary Care Centers
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