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.

Hypothermia on admission to a neonatal intensive care unit in Oromia, western Ethiopia: a case-control study.

Objective: Hypothermia is believed to affect more than half of Ethiopian neonates. The goal of this study is to determine risk factors for newborn hypothermia in neonates admitted to public hospitals in the east Wollega zone of western Ethiopia's neonatal intensive care unit. Design: Unmatched case-control study using neonates admitted to the intensive care unit. Setting: Neonatal intensive care units at public hospitals in western Ethiopia. Patients: Neonates admitted to intensive care units. Main outcomes: The cases were all neonates with hypothermia (less than 36.5°C) and the controls were all neonates with a body temperature of greater or equal to 36.5°C when admitted to the neonatal intensive care unit for other reasons. Results: The study involved the participation of 73 cases and 146 controls. The study found that delayed breastfeeding initiation after 1 hour (adjusted OR (AOR)=3.72; 95% CI: 1.39 to 10.00), admission weight less than 2500 g (AOR=3.43; 95% CI: 1.18 to 9.97), cardiopulmonary resuscitation at birth (AOR=3.42; 95% CI: 1.16 to 10.10.08), lack of immediate skin-to-skin contact with their mother (AOR=4.54; 95% CI: 1.75 to 11.81), night-time delivery (AOR=6.63; 95% CI: 2.23 to 19.77) and not wearing a cap (AOR=2.98; 95% CI: 1.09 to 8.15) were all associated with newborn hypothermia. Conclusions: Neonatal hypothermia was associated with obstetric, neonatal and healthcare provider factors. As a result, special consideration should be given to the thermal care of low birthweight neonates and the implementation of warm-chain principles with low-cost thermal protection in Ethiopian public health facilities.

Predictors of health-related quality of life among patients with diabetes on follow-up at Nekemte specialised Hospital, Western Ethiopia: a cross-sectional study.

OBJECTIVE: To assess health-related quality of life (HRQoL) and its predictors among patients with diabetes on follow-up at Nekemte Specialised Hospital in Western Ethiopia. DESIGN, SETTING AND PARTICIPANTS: This facility-based cross sectional study was conducted among 224 patients with diabetes mellitus (types I and II) on follow-up at one of the public hospitals in western Ethiopia. Respondents were selected by systematic random sampling and interviewed with the aid of a questionnaire. MAIN OUTCOME MEASURED: HRQoL was measured by using the Medical outcomes study 36-item Short Form (SF-36) Health Survey from 15 April to 5 June 2019. A structured questionnaire was used for data collection from participants selected by systematic random sampling. Multiple linear regression was used for the final model. RESULT: A total of 215 patients with diabetes consented and completed the study, giving a response rate of 96%. The mean score of the overall HRQoL of the study participants was 50.3±18.1. The highest mean score was obtained in the physical functioning domain and the lowest mean score in the general health domain. Age, education status, history of smoking, feeling of stigmatisation and body mass index were inversely associated with the overall HRQoL. Gender (male), marital status (currently married), absence of comorbidity and absence of chronic complications related to diabetes mellitus were positively associated with overall HRQoL. CONCLUSION: The overall HRQoL of patients with diabetes on follow-up at the study area was found to be moderate. General health, mental health, bodily pain and vitality were the most affected domains. Both the mental and physical components need to be considered when caring for the patients with diabetes on follow-up beyond provision of treatment.