Impact of the COVID-19 pandemic on the cost of chronic diseases treatment and care at public hospitals in Wallaga zones, Oromia Regional State, Ethiopia: a hospital-based, cross-sectional study.

OBJECTIVE: Globally, around one-third of the population has at least one long-term health condition that could be affected by the COVID-19 pandemic. Despite the fact that studies have revealed the direct impact of COVID-19 on healthcare provision and utilisation, the impact of the pandemic on the cost of chronic disease treatment and care from a patient perspective was scanty. So, the study aimed to determine the impact of the COVID-19 pandemic on cost of chronic diseases treatment and care at public hospitals in Wallaga zones, Oromia Regional State, Ethiopia, from 1 August to 31 August 2020. METHODS: An institutional-based cross-sectional study design was used, and the sample size for the study (n=642) was determined using a single population mean formula. Data were collected using interviews and analysed using SPSS V.25. Descriptive statistics were performed, and the cost of follow-up care before and after the pandemic was compared using a related-samples Wilcoxon signed-rank test, declaring the level of significance of the median cost difference at p<0.05. RESULTS: A total of 642 patients were included in the study, of whom 605 (94.2%) responded to the interviews. There was a significant median cost difference (n=593, Z=5.05, p=0.001) between the cost of chronic diseases among follow-up patients during the pandemic and the costs incurred by these patients before the pandemic. CONCLUSION: The cost of follow-up care among chronic disease patients during the COVID-19 pandemic was significantly higher compared with before the pandemic era. Therefore, healthcare providers should arrange special fee waiver mechanisms for chronic disease healthcare costs during such types of pandemics and provide the services at proximal health facilities.

Determinants of trust in healthcare facilities among community-based health insurance members in the Manna district of Ethiopia.

BACKGROUND: Low-income countries, including Ethiopia, face substantial challenges in financing healthcare services to achieve universal health coverage. Consequently, millions of people suffer and die from health-related conditions. These can be efficiently managed in areas where community-based health insurance (CBHI) is properly implemented and communities have strong trust in healthcare facilities. However, the determinants of community trust in healthcare facilities have been under-researched in Ethiopia. OBJECTIVE: To assess the determinants of trust in healthcare facilities among community-based health insurance members in the Manna District of Ethiopia. METHODS: A community-based cross-sectional study was conducted from March 01 to 30, 2020 among 634 household heads. A multistage sampling technique was used to recruit the study participants. A structured interviewer-administered questionnaire was used to collect the data. Descriptive statistics were computed as necessary. Multivariable linear regression analyses were performed, and variables with a p-value < 0.05 were considered to have a significant association with households' trust in healthcare facilities. RESULTS: In total, 617 households were included in the study, with a response rate of 97.0%. Household age (ß=0.01, 95% CI:0.001, 0.0013), satisfaction with past health services (ß=0.13, 95% CI:0.05, 0.22), perceived quality of services (ß= -0.47, 95% CI: -0.64, -0.29), perceived provider's attitude towards CBHI members (ß = -0.68, 95% CI: -0.88, -0.49), and waiting time (ß= -0.002, 95% CI:- 0.003, -0.001) were determinants of trust in healthcare facilities. CONCLUSION: This study showed that respondents' satisfaction with past experiences, older household age, long waiting time, perceived poor quality of services, and perceived unfavorable attitudes of providers towards CBHI members were found to be determinants of trust in healthcare facilities. Thus, there is a need to improve the quality of health services, care providers' attitudes, and clients' satisfaction by reducing waiting time in order to increase clients' trust in healthcare facilities.

Evaluation of Entomopathogenic Nematode Isolates against Subterranean Termites under Laboratory and Field Conditions.

Background: Termites are a major insect pest affecting agricultural production and woody materials. They cause severe devastation in the ecosystem, and lead to bare soil. This phenomenon causes the soil to become difficult to plow, which in turn leads to a reduction in the productivity of crops. It can cause 100 % yield losses based on crop types, level of the damage, and size of its populations. To manage this pest, different management options have been evaluated in Ethiopia. While insecticide usage is the dominant option, less attention has been given to Entomopathogenic Nematode (EPN) based management options. Therefore, this research was initiated to screen locally collected EPN isolates and evaluate promising isolates under field conditions on maize crop. Methods: 37 EPN isolates were screened under laboratory condition, while two isolates were evaluated at field condition. The screening of EPN isolates was laid out in a completely randomized design, and the field evaluation used a completely randomized block design, and treatments were replicated thrice. Mortality of insect, damaged root, stem, cob, damage severity, foraging termites, and yield of the crop data were collected. Results: The study indicated that all screened EPN isolates caused mortality on termites under laboratory conditions. The isolates achieved complete mortality of the insect pest within 12 days of exposure. The finding indicated that AEH and S#50 were the more pathogenic and virulent isolates on termites under laboratory conditions and taken to field study. The S#50 isolate was most pathogenic and reduced the infestation and severity of the insect pest on the maize crop under field conditions. Conclusions: This result showed that the entomopathogenic nematode isolates have the potential to manage subterranean termites in the maize field. Future studies should be based on collection of local isolates and develop a full package for the virulent isolates.

Compliance with Standard Precautions and Associated Factors Among Health Professionals in Public Hospitals of East Wallaga Zone, Oromia Regional State, Ethiopia.

Purpose: Health care workers are potentially exposed to infections through contact with blood and bodily fluids while performing their duties. Compliance with the standard precautions reduces the risks of health care workers' exposure to blood and bodily fluids. However, the compliance level among health care workers is not well studied in the study area. Therefore, this study aimed to assess the level of compliance with standard precautions and its associated factors among health care workers in all public hospitals of East Wallaga Zone, Western Ethiopia. Materials and Methods: Multi-facility-based cross-sectional study was conducted among 392 health care workers, from January to February, 2022. Simple random sampling technique was used to select study participants. Logistic regression model was fitted to determine presence of statistically significant associations. A p-value of less than or equal to 0.05 along with the adjusted odds ratio of 95% confidence interval was used to declare statistical significance. Results: The proportion of health care workers who comply with standard precautions was found to be 51.6% [95% CI; 46.9-56.7%]. Having positive attitude towards standard precautions (AOR=2.71; 95% C.I: 1.68-4.39), having training on standard precautions (AOR=3.27; 95% C.I: 2.019-5.29), and working in referral hospitals (AOR=1.83; 95% C.I: 1.13-2.96) were the associated factors of good compliance with standard precautions. Conclusion: In this study, half of the health care workers comply with standard precautions. Positive attitude, training, and level of hospitals were factors for compliance with the standard precautions. As a result, to sustain and improve compliance of health care workers on standard precautions, periodic in-service training is needed to bring about behavioral changes among health care workers, particularly for those working in other settings than referral hospitals.