Community-Based Assessment of People with Chronic Diseases and Conditions Worsening the Severity of COVID-19 in Addis Ababa City Administration

AbstractBackground: the COVID-19 pandemic stayed in a sporadic form for a long time after introducing the coronavirus in the country, later appearing in clusters within communities. During such sporadic and clustered spread of the disease, the government of Ethiopia started identifying suspects through active surveillance for COVID-19. This study aimed to describe people who have chronic illnesses that could be underlying conditions for increased severity of COVID-19.Methods: A survey was conducted in May 2020 using active community-based case surveillance in 30 randomlyselected woredas in Addis Ababa City. Data were collected from each household member by assessing for general conditions and diseases expected to increase their risk of suffering higher severity from COVID-19. Data were stored in M.S. Excel and analyzed using SPSS-version 26 for windows. Descriptive analysis was conducted to know the proportion of persons with chronic diseases, and thus the population with a higher risk of suffering more severity from COVID-19 by place, person, and time. The results are presented using tables and graphs as appropriate.Results: The point prevalence of flu-like syndrome was 51.9 per 100,000 persons, and the prevalence was higher among older people. The study showed that 11,600 per 100,000 households have at least a member with chronic diseases that worsen the severity of COVID-19 morbidity. The survey also found 6,939 and 5,140 households per 100,000 households have diabetes mellitus and hypertension, respectively, and about 1950 per 100,000 households were with bronchial asthma. Nearly a quarter of the households have people with two or more chronic diseases that worsen their risk of facing a more severe course of COVID-19 than it would be for people without those underlying conditions.Discussion: High proportion of households have people with chronic diseases that worsen their risk of suffering a more severe course of COVID-19 than it would be for people without those underlying conditions. The Ministry of Health should devise and implement mechanisms to safeguard people with chronic diseases from contracting the diseases. [Ethiop. J. Health Dev. 2021; 35(2):133-140]Keywords: COVID-19, chronic diseases, severe course of COVID-19, Addis Abab

Effect of an Educational Intervention on Lifestyle Modification of Patients With Hypertension at Bishoftu General Hospital, Ethiopia, 2021

A pilot interventional quasi-experimental study without a comparison group was conducted to evaluate the effect of a 3-month educational intervention on clinical measurement changes among 50 patients with hypertension at the Bishoftu General Hospital in Oromia Region, Ethiopia. We measured blood pressure, weight, and total cholesterol at baseline and within a week of postintervention. We found significant decreases in systolic (-12.4 mm Hg; P < .001) and diastolic (-4.6 mm Hg; P < .001) blood pressure, total cholesterol (-34.8 mg/dl; P < .001), and weight (-2.6 kg; P < .001). The educational intervention was found to be effective in reducing risk factors for cardiovascular disease

COVID 19 Epidemic Trajectory Modeling Results for Ethiopia

AbstractBackground: An outbreak of “pneumonia of unknown etiology" later renamed as Novel Corona Virus (COVID 19) was first reported from Hubei Province, China on 31 December 2019. The cases have increased exponentially; the pandemic has reached all countries in the world with 81.2 million confirmed cases and over 1.8 million by December 28, 2020. Ethiopia reported its first case on March 13, 2020, and as of December 28, 2020, the country had 122864 confirmed COVID-19 cases and 1909 deaths. Being a new pandemic its epidemiologic trajectories across regions and populations remains unknown. Mathematical models are widely used to understand and predict the possible courses of an outbreak, given a set of underlying assumptions. Objective: This study intends to model COVID 19 epidemic trajectory under different assumptions and to predict the likely timing of peak of the epidemic in Ethiopia. Methods: Standard Susceptible Exposed, Infected and Recovery (SEIR) compartmental epidemiological deterministic model was employed to estimate and predict COVID 19 in progression in Ethiopia and Addis Ababa at different points of time. Exhaustive literature reviews were carried out to contextualize COVID 19 pandemic epidemiological. Efficacy and coverage of face mask and social distancing were considered in the best and worst situation to run the model and estimate the number of infections after sustained local transmissions. Result. Without any intervention, the COVID 19 viruses spread will peak at 150 days from the first report, infecting 8.01million people given local/community transmission. As the compliance with face mask coverage increases by 25%, 50%, and 75%, the infection will be reduced by about 20%, 40%, and 60% respectively social distancing compliance by le 25% of the population alone will reduce above 60% of infections. Compliance of 40% face mask use and social distance combined effect will reduce 97% of the estimated number of cases. Conclusion: This predication indicated that compliance with combination of non-pharmaceutical intervention such as use of face mask use with physical distance averted significant number of COVID infection. For a county like Ethiopia with poor health systems resilience, mitigating the pandemic at an early stage through strong preventive measures is necessary. [Ethiop. J. Health Dev. 2021; 35(SI-1):25-32] Key word: COVID 19, Modelling, Non-Pharmaceutica intervention, Ethiopi

Cholera outbreak in Addis Ababa, Ethiopia: A case-control study.

BACKGROUND:Cholera remains a significant public health problem in more than one-third of the countries of the world. Cholera outbreak has become more common in Addis Ababa particularly in the rainy seasons; however, there is a paucity of data on risk factors associated with cholera outbreaks rendering interventions difficult. We investigated the outbreak to identify its etiology, source, risk factors and in order to control the outbreak. METHODS:We compared cases with health center-based unmatched controls (1:2). Cases were patients aged ≥5 years with acute watery diarrhea, with or without vomiting while controls were persons aged ≥5 years without history of acute watery diarrhea. We interviewed our study participants using structured questionnaire to collect demographic and cholera risk factors data. We described the outbreak over time, and then tested our hypotheses using unconditional logistic regression. RESULTS:The outbreak began on 7 September, 2017 reaching its peak on 23 September, 2017 and ended on 01 October, 2017. We identified a total of 25 cases (Median age: 38 years; IQR: 20 years) and recruited 50 controls (Median age: 35 years; IQR: 29 years). All case-patients had acute watery diarrhea and dehydration requiring intravenous fluids. All cases were admitted to cholera treatment center but there were no deaths. Stool and water samples yielded isolates of Vibrio cholerae O1 of serological subtype Ogawa. Consumption of contaminated holy water (AOR: 20.5, 95%CI: 3.50, 119.61) and raw vegetables (AOR: 15.3, 95%CI: 3, 81.51) were independent risk factors whereas washing hands with soap after visiting latrine (AOR: 0.04, 95%CI: 0.01, 0.25) was independent protective factor. CONCLUSION:Our findings demonstrated cholera foodborne transmission via consumption of raw vegetables, and its waterborne transmission via consumption of contaminated holy water. Washing hands with soap after visiting latrine was protective. We recommended cooking of vegetables and promoting hand washing

Road traffic accident risk indicators among traumatized patients visiting emergency outpatient clinics in public hospitals in Addis Ababa, Ethiopia

This study sought to assess the magnitude and factors associated with road traffic accidents among traumatized patients attending at emergency outpatient departments of public hospitals in Addis Ababa. Facility-based cross-sectional study design was employed on 381 samples. All traumatized patients who attend at emergency department of public hospitals in Addis Ababa city was population of the study. Systematic random sampling technique were employed to select study unites. The data was entered and cleaned by Epi-info version 7 and analyzed using SPSS for windows version 23.0 and presented using tables and figures. A total of 373 samples were collected in the study and the most of samples were in the 30–40 years of age range. The magnitude of the road traffic accident was 57.1%. Most of the study participant (64.83%) were male and the maximum age was 79 with a mean of age is (+/- 34 years) responders. Road traffic accident is more prevalence among the most productive and economically active age group. Being Females are 0.48 times higher protective for RTA than Males. Occupation (driver) 5.3 times higher risk to road traffic accident than students, weather condition(cloudy) 0.4 times protective than sunny for RTA and driving at a day time 2.1 times higher risk for RTA than at night. Improve the traffic system and community-based awareness creation could decrease the incident of car accident

A Review of COVID-19 Response Challenges in Ethiopia

Background: The COVID-19 pandemic has positioned fragile healthcare systems in low-income countries under pressure, leading to critical gaps in service delivery. The pandemic response demands the healthcare system to be resilient and continue provision of healthcare services. This review is aimed at describing the healthcare response challenges during the pandemic in Ethiopia. Methodology: Eligible studies dealing with challenges of the healthcare system in response to the COVID-19 pandemic in Ethiopia were included. The six World Health Organization (WHO) healthcare system building blocks were used to categorize healthcare challenges. PubMed ProQuest, databases were searched, and results were summarized using systematic review synthesis. Results: Financial constraints led to a shortage of mechanical ventilators. Furthermore, the pandemic hindered the capacity to avail full packages of personal protective equipment in health facilities and intensive care capacity. The pandemic also affected the delivery of maternal, child and new-born services, prevention, and treatment of childhood illness, including immunization services. Conclusions: The COVID-19 pandemic posed various challenges to the performance of the healthcare system in Ethiopia. It is recommended that policy makers and stakeholders enhance pandemic preparedness and strengthen response capacity by considering the six WHO healthcare system building blocks

COVID-19 and the public response: Knowledge, attitude and practice of the public in mitigating the pandemic in Addis Ababa, Ethiopia.

BackgroundThe COVID-19 pandemic is impacting the global community in many ways. Combating the COVID-19 pandemic requires a coordinated effort through engaging public and service providers in preventive measures. The government of Ethiopia had already announced prevention guidelines for the public. However, there is a scarcity of evidence-based data on the public knowledge, attitude, and practice (KAP) and response of the service providers regarding COVID-19.ObjectiveThis study aimed to assess the public KAP and service providers' preparedness towards the pandemic in Addis Ababa, Ethiopia.MethodsA community-based cross-sectional study was conducted in Addis Ababa, Ethiopia, from late March to the first week of April 2020. Participants were conveniently sampled from 10 different city sites. Data collection was performed using a self-administered questionnaire and observational assessment using a checklist. All statistical analysis was performed using SPSS version Descriptive statistics, correlation coefficient and chi-square tests were performed.ResultA total of 839 public participants and 420 service providers enrolled in the study. The mean age was 30.30 (range = 18-72) years. The majority of the respondents (58.6%) had moderate knowledge about COVID-19, whereas 37.2% had good knowledge. Moreover, 60.7% and 59.8% of the participants had a positive attitude towards preventive measures and good practice to mitigate the pandemic, respectively. There was a moderate positive correlation between knowledge and attitude, whereas the correlations between knowledge and practice and attitude and practice were weak. With regard to service providers' preparedness, 70% have made hand-washing facilities available. A large majority of the respondents (84.4%) were using government-owned media followed by social media (46.0%) as a main source of information.ConclusionThe public in Addis Ababa had moderate knowledge, an optimistic attitude and descent practice. The information flow from government and social media seemed successful seeing the majority of the respondents identifying preventive measures, signs and symptoms and transmission route of SARS-CoV-2. Knowledge and attitude was not associated with practice, thus, additional innovative strategies for practice changes are needed. Two thirds of the service provider made available hand washing facilities which seems a first positive step. However, periodic evaluation of the public KAP and assessment of service providers' preparedness is mandatory to combat the pandemic effectively

Evaluation of COVID-19 related knowledge and preparedness in health professionals at selected health facilities in a resource-limited setting in Addis Ababa, Ethiopia.

BackgroundThe World Health Organization has declared that infection with SARS-CoV-2 is a pandemic. Experiences with SARS in 2003 and SARS-CoV-2 have shown that health professionals are at higher risk of contracting COVID-19. Hence, it has been recommended that aperiodic wide-scale assessment of the knowledge and preparedness of health professionals regarding the current COVID-19 pandemic is critical.ObjectivesThis study aimed to assess the knowledge and preparedness of health professionals regarding COVID-19 among selected hospitals in Addis Ababa, Ethiopia.MethodsA facility-based cross-sectional study was conducted from the last week of March to early April, 2020. Government (n = 6) and private hospitals (n = 4) were included. The front-line participants with high exposure were proportionally recruited from their departments. The collected data from a self-administered questionnaire were entered using EpiData and analyzed in SPSS software. Both descriptive statistics and inferential statistics (chi-square tests) are presented.ResultsA total of 1334 health professionals participated in the study. The majority (675, 50.7%) of the participants were female. Of the total, 532 (39.9%) subjects were nurses/midwives, followed by doctors (397, 29.8%) and pharmacists (193, 14.5%). Of these, one-third had received formal training on COVID-19. The mean knowledge score of participants was 16.45 (±4.4). Regarding knowledge about COVID-19, 783 (58.7%), 354 (26.5%), and 196 (14.7%) participants had moderate, good, and poor knowledge, respectively. Lower scores were seen in younger age groups, females, and non-physicians. Two-thirds (63.2%) of the subjects responded that they had been updated by their hospital on COVID-19. Of the total, 1020 (76.5%) participants responded that television, radio, and newspapers were their primary sources of information. Established hospital preparedness measures were confirmed by 43-57% of participants.ConclusionThe current study revealed that health professionals in Addis Ababa, Ethiopia, already know important facts but had moderate overall knowledge about the COVID-19 pandemic. There were unmet needs in younger age groups, non-physicians, and females. Half of the respondents mentioning inadequate preparedness of their hospitals point to the need for more global solidarity, especially concerning the shortage of consumables and lack of equipment