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Teka G, Woldeab A, Dereje N, Eshetu F, Gizachew L, Tazu Z, Lisanwork L, Tigabu E, Gebeyehu A, Tayachew A, Biru M, Berkessa T, Keraleme A, Bikale F, Shure W, Agune A, Haile B, Addis B, Moges M, Gonta M, Hailemariam A, Binkley L, Nawaz S, Wang SH, Mekuria Z, Aklilu A, Aliy J, Lulseged S, Girmay A, Patrick A, Amare B, Delelegn H, Daves S, Yimer G, Abate E, Wossen M, Melaku Z, Gebreyes W, Williams DE, Abayneh A. Regional and temporal variations in COVID-19 cases and deaths in Ethiopia: Lessons learned from the COVID-19 enhanced surveillance and response. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003175. [PMID: 38781131 PMCID: PMC11115226 DOI: 10.1371/journal.pgph.0003175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 04/08/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND The COVID-19 pandemic is one of the most devastating public health emergencies of international concern to have occurred in the past century. To ensure a safe, scalable, and sustainable response, it is imperative to understand the burden of disease, epidemiological trends, and responses to activities that have already been implemented. We aimed to analyze how COVID-19 tests, cases, and deaths varied by time and region in the general population and healthcare workers (HCWs) in Ethiopia. METHODS COVID-19 data were captured between October 01, 2021, and September 30, 2022, in 64 systematically selected health facilities throughout Ethiopia. The number of health facilities included in the study was proportionally allocated to the regional states of Ethiopia. Data were captured by standardized tools and formats. Analysis of COVID-19 testing performed, cases detected, and deaths registered by region and time was carried out. RESULTS We analyzed 215,024 individuals' data that were captured through COVID-19 surveillance in Ethiopia. Of the 215,024 total tests, 18,964 COVID-19 cases (8.8%, 95% CI: 8.7%- 9.0%) were identified and 534 (2.8%, 95% CI: 2.6%- 3.1%) were deceased. The positivity rate ranged from 1% in the Afar region to 15% in the Sidama region. Eight (1.2%, 95% CI: 0.4%- 2.0%) HCWs died out of 664 infected HCWs, of which 81.5% were from Addis Ababa. Three waves of outbreaks were detected during the analysis period, with the highest positivity rate of 35% during the Omicron period and the highest rate of ICU beds and mechanical ventilators (38%) occupied by COVID-19 patients during the Delta period. CONCLUSIONS The temporal and regional variations in COVID-19 cases and deaths in Ethiopia underscore the need for concerted efforts to address the disparities in the COVID-19 surveillance and response system. These lessons should be critically considered during the integration of the COVID-19 surveillance system into the routine surveillance system.
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Affiliation(s)
- Gizaw Teka
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adane Woldeab
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | | | - Frehywot Eshetu
- Division of Global Health Protection (DGHP), US Centers for Disease Control and Prevention (CDC), Addis Ababa, Ethiopia
| | - Lehageru Gizachew
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Zelalem Tazu
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Leuel Lisanwork
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Eyasu Tigabu
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Ayele Gebeyehu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adamu Tayachew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mengistu Biru
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | - Wolde Shure
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Admikew Agune
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Bizuwork Haile
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Beza Addis
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Muluken Moges
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Melaku Gonta
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Laura Binkley
- The Ohio State University Global One Health initiative (GOHi), Columbus, Ohio, United States of America
| | - Saira Nawaz
- The Ohio State University Global One Health initiative (GOHi), Columbus, Ohio, United States of America
| | - Shu-Hua Wang
- The Ohio State University Global One Health initiative (GOHi), Columbus, Ohio, United States of America
- Department of Internal Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Zelalem Mekuria
- The Ohio State University Global One Health initiative (GOHi), Columbus, Ohio, United States of America
| | | | - Jemal Aliy
- ICAP at Columbia University, Addis Ababa, Ethiopia
| | | | - Abiy Girmay
- World Health Organization (WHO) Ethiopia Office, Addis Ababa, Ethiopia
| | - Abok Patrick
- World Health Organization (WHO) Ethiopia Office, Addis Ababa, Ethiopia
| | - Berhanu Amare
- Division of Global Health Protection (DGHP), US Centers for Disease Control and Prevention (CDC), Addis Ababa, Ethiopia
| | - Hulemenaw Delelegn
- Division of Global Health Protection (DGHP), US Centers for Disease Control and Prevention (CDC), Addis Ababa, Ethiopia
| | - Sharon Daves
- Division of Global Health Protection (DGHP), US Centers for Disease Control and Prevention (CDC), Addis Ababa, Ethiopia
| | - Getnet Yimer
- University of Pennsylvania, Perelman School of Medicine, Pennsylvania, Philadelphia, United States of America
| | - Ebba Abate
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Mesfin Wossen
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Wondwossen Gebreyes
- The Ohio State University Global One Health initiative (GOHi), Columbus, Ohio, United States of America
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Desmond E. Williams
- Division of Global Health Protection (DGHP), US Centers for Disease Control and Prevention (CDC), Addis Ababa, Ethiopia
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Wagnew F, Alene KA, Kelly M, Gray D. Geospatial Overlap of Undernutrition and Tuberculosis in Ethiopia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7000. [PMID: 37947558 PMCID: PMC10647613 DOI: 10.3390/ijerph20217000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/26/2023] [Accepted: 10/29/2023] [Indexed: 11/12/2023]
Abstract
Undernutrition is a key driver of the global tuberculosis (TB) epidemic, yet there is limited understanding regarding the spatial overlap of both diseases. This study aimed to determine the geographical co-distribution and socio-climatic factors of undernutrition and TB in Ethiopia. Data on undernutrition were found from the Ethiopian Demographic and Health Survey (EDHS). Data on TB were obtained from the Ethiopia national TB prevalence survey. We applied a geostatistical model using a Bayesian framework to predict the prevalence of undernutrition and TB. Spatial overlap of undernutrition and TB prevalence was detected in the Afar and Somali regions. Population density was associated with the spatial distribution of TB [β: 0.008; 95% CrI: 0.001, 0.014], wasting [β: -0.017; 95% CrI: -0.032, -0.004], underweight [β: -0.02; 95% CrI: -0.031, -0.011], stunting [β: -0.012; 95% CrI: -0.017, -0.006], and adult undernutrition [β: -0.007; 95% CrI: -0.01, -0.005]. Distance to a health facility was associated with the spatial distribution of stunting [β: 0.269; 95% CrI: 0.08, 0.46] and adult undernutrition [β: 0.176; 95% CrI: 0.044, 0.308]. Healthcare access and demographic factors were associated with the spatial distribution of TB and undernutrition. Therefore, geographically targeted service integration may be more effective than nationwide service integration.
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Affiliation(s)
- Fasil Wagnew
- National Centre for Epidemiology and Population Health (NCEPH), College of Health and Medicine, The Australian National University, Canberra 2601, Australia;
- College of Health Sciences, Debre Markos University, Debre Markos P.O. Box 269, Ethiopia
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Nedlands 6009, Australia;
| | - Kefyalew Addis Alene
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Nedlands 6009, Australia;
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley 6102, Australia
| | - Matthew Kelly
- National Centre for Epidemiology and Population Health (NCEPH), College of Health and Medicine, The Australian National University, Canberra 2601, Australia;
| | - Darren Gray
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia;
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Beshah SA, Zeru A, Tadele W, Defar A, Getachew T, Fekadu Assebe L. A cost-effectiveness analysis of COVID-19 critical care interventions in Addis Ababa, Ethiopia: a modeling study. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2023; 21:40. [PMID: 37365623 DOI: 10.1186/s12962-023-00446-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023] Open
Abstract
OBJECTIVE To estimate and compare the cost-effectiveness of COVID-19 critical care intervention approaches: noninvasive (oxygen without intubation) and invasive (intubation) management in Ethiopia. METHODS A Markov model is used to compare the costs and outcomes for non-invasive and invasive COVID-19 clinical interventions using both primary and secondary data sources. Healthcare provider costs (recurrent and capital cost) and patient-side costs (direct and indirect) were estimated and reported in United States Dollars (US$), 2021. The outcome measure used in this analysis was DALYs averted. Both the average cost-effectiveness ratio (ACER) and incremental cost-effectiveness ratio (ICER) were reported. One-way and probabilistic sensitivity analyses were applied to assess the robustness of the findings. The analysis is conducted using Tree Age pro health care software 2022. RESULT The average cost per patient per episode for mild/moderate, severe, noninvasive, and invasive critical management was $951, $3449, $5514, and $6500, respectively. According to the average cost-effective ratio (ACER), non-invasive management resulted in $1991 per DALY averted, while invasive management resulted in $3998 per DALY averted. Similarly, the incremental cost-effective ratio (ICER) of invasive compared to noninvasive management was $ 4948 per DALY averted. CONCLUSION Clinical management of critical COVID-19 cases in Ethiopia is associated with a significant financial burden. Invasive intervention is unlikely to be a cost-effective COVID-19 intervention in Ethiopia compared to noninvasive critical case management using a willingness to pay threshold of three times GDP per capita.
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Affiliation(s)
- Senait Alemayehu Beshah
- Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Arega Zeru
- Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wogayehu Tadele
- Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Atkure Defar
- Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Theodros Getachew
- Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Lelisa Fekadu Assebe
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
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Odhiambo JN, Dolan CB, Troup L, Rojas NP. Spatial and spatio-temporal epidemiological approaches to inform COVID-19 surveillance and control: a systematic review of statistical and modelling methods in Africa. BMJ Open 2023; 13:e067134. [PMID: 36697047 PMCID: PMC9884571 DOI: 10.1136/bmjopen-2022-067134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE Various studies have been published to better understand the underlying spatial and temporal dynamics of COVID-19. This review sought to identify different spatial and spatio-temporal modelling methods that have been applied to COVID-19 and examine influential covariates that have been reportedly associated with its risk in Africa. DESIGN Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES Thematically mined keywords were used to identify refereed studies conducted between January 2020 and February 2022 from the following databases: PubMed, Scopus, MEDLINE via Proquest, CINHAL via EBSCOhost and Coronavirus Research Database via ProQuest. A manual search through the reference list of studies was also conducted. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Peer-reviewed studies that demonstrated the application of spatial and temporal approaches to COVID-19 outcomes. DATA EXTRACTION AND SYNTHESIS A standardised extraction form based on critical appraisal and data extraction for systematic reviews of prediction modelling studies checklist was used to extract the meta-data of the included studies. A validated scoring criterion was used to assess studies based on their methodological relevance and quality. RESULTS Among 2065 hits in five databases, title and abstract screening yielded 827 studies of which 22 were synthesised and qualitatively analysed. The most common socioeconomic variable was population density. HIV prevalence was the most common epidemiological indicator, while temperature was the most common environmental indicator. Thirteen studies (59%) implemented diverse formulations of spatial and spatio-temporal models incorporating unmeasured factors of COVID-19 and the subtle influence of time and space. Cluster analyses were used across seven studies (32%) to explore COVID-19 variation and determine whether observed patterns were random. CONCLUSION COVID-19 modelling in Africa is still in its infancy, and a range of spatial and spatio-temporal methods have been employed across diverse settings. Strengthening routine data systems remains critical for generating estimates and understanding factors that drive spatial variation in vulnerable populations and temporal variation in pandemic progression. PROSPERO REGISTRATION NUMBER CRD42021279767.
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Affiliation(s)
- Julius Nyerere Odhiambo
- Ignite Global Health Research Lab, Global Research Institute, William & Mary, Williamsburg, Virginia, USA
- Kinesiology and Health Sciences, William & Mary, Williamsburg, Virginia, USA
| | - Carrie B Dolan
- Ignite Global Health Research Lab, Global Research Institute, William & Mary, Williamsburg, Virginia, USA
- Kinesiology and Health Sciences, William & Mary, Williamsburg, Virginia, USA
| | - Lydia Troup
- Ignite Global Health Research Lab, Global Research Institute, William & Mary, Williamsburg, Virginia, USA
| | - Nathaly Perez Rojas
- Ignite Global Health Research Lab, Global Research Institute, William & Mary, Williamsburg, Virginia, USA
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Koye DN, Melaku YA, Gelaw YA, Zeleke BM, Adane AA, Tegegn HG, Gebreyohannes EA, Erku DA, Tesfay FH, Gesesew HA, Mekonnen A, Dadi AF, Alene KA. Mapping national, regional and local prevalence of hypertension and diabetes in Ethiopia using geospatial analysis. BMJ Open 2022; 12:e065318. [PMID: 36600383 PMCID: PMC9743363 DOI: 10.1136/bmjopen-2022-065318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES This study aimed to map the national, regional and local prevalence of hypertension and diabetes in Ethiopia. DESIGN AND SETTING Nationwide cross-sectional survey in Ethiopia combined with georeferenced ecological level data from publicly available sources. PARTICIPANTS 9801 participants aged between 15 and 69 years. PRIMARY OUTCOME MEASURES Prevalence of hypertension and diabetes were collected using the WHO's STEPS survey approach. Bayesian model-based geostatistical techniques were used to estimate hypertension and diabetes prevalence at national, regional and pixel levels (1×1 km2) with corresponding 95% credible intervals (95% CrIs). RESULTS The national prevalence was 19.2% (95% CI: 18.4 to 20.0) for hypertension and 2.8% (95% CI: 2.4 to 3.1) for diabetes. Substantial variation was observed in the prevalence of these diseases at subnational levels, with the highest prevalence of hypertension observed in Addis Ababa (30.6%) and diabetes in Somali region (8.7%). Spatial overlap of high hypertension and diabetes prevalence was observed in some regions such as the Southern Nations, Nationalities and People's region and Addis Ababa. Population density (number of people/km2) was positively associated with the prevalence of hypertension (β: 0.015; 95% CrI: 0.003-0.027) and diabetes (β: 0.046; 95% CrI: 0.020-0.069); whereas altitude in kilometres was negatively associated with the prevalence of diabetes (β: -0.374; 95% CrI: -0.711 to -0.044). CONCLUSIONS Spatial clustering of hypertension and diabetes was observed at subnational and local levels in Ethiopia, which was significantly associated with population density and altitude. The variation at the subnational level illustrates the need to include environmental drivers in future NCDs burden estimation. Thus, targeted and integrated interventions in high-risk areas might reduce the burden of hypertension and diabetes in Ethiopia.
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Affiliation(s)
- Digsu Negese Koye
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Methods and Implementation Support for Clinical and Health research Hub (MISCH), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Yohannes Adama Melaku
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Yalemzewod Assefa Gelaw
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Berihun Megabiaw Zeleke
- Planetary Health Division, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Akilew Awoke Adane
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- Ngangk Yira Institute for Change, Murdoch University, Murdoch, Western Australia, Australia
| | - Henok Getachew Tegegn
- School of Rural Medicine, University of New England, Armidale, New South Wales, Australia
| | - Eyob Alemayehu Gebreyohannes
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- Division of Pharmacy, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Daniel Asfaw Erku
- Centre for Applied Health Economics, Griffith University, Nathan, Queensland, Australia
| | - Fisaha Haile Tesfay
- School of Public Health, Mekelle University, Mekelle, Ethiopia
- Institute of Health Transformation, Deakin University, Melbourne, Victoria, Australia
| | - Hailay Abrha Gesesew
- School of Public Health, Mekelle University, Mekelle, Ethiopia
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia
| | - Alemayehu Mekonnen
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
| | - Abel Fekadu Dadi
- College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Menzies Health Research Institute, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kefyalew Addis Alene
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- School of Population Health, Curtin University, Perth, Western Australia, Australia
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Effects of climatic factors on COVID-19 transmission in Ethiopia. Sci Rep 2022; 12:19722. [PMID: 36385128 PMCID: PMC9668213 DOI: 10.1038/s41598-022-24024-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022] Open
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.
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Churiso G, Diriba K, Girma H, Tafere S. Laboratory Findings in Different Disease Status of COVID-19 Admitted Patients at Dilla University Referral Hospital Treatment Center, South Ethiopia. Infect Drug Resist 2022; 15:4307-4320. [PMID: 35965852 PMCID: PMC9373995 DOI: 10.2147/idr.s370907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/01/2022] [Indexed: 01/09/2023] Open
Abstract
Background Millions were infected and many were dying because of the coronavirus disease 2019, since its emergence. The patients experience asymptomatic, mild, moderate, severe and critical disease with varying signs and symptoms. Decreased lymphocytes and abnormal liver and renal function tests are common among COVID-19 patients. Severe and critical cases show higher number of white blood cells, and neutrophils. However, studies showed different laboratory findings in different disease status. Therefore, this study investigated laboratory findings of COVID-19 admitted patients at Dilla University Referral Hospital treatment center, South Ethiopia. Methods A retrospective study design was conducted on 220 patients confirmed by real time polymerase chain reaction, and admitted to Dilla University Referral Hospital treatment center from September 2020 to July 2021. Data were collected from the patients’ record, and analyzed by GraphPad Prism version 8.0.1.244 software. Descriptive statistics were used to analyze the frequency while independent t-test was used to compare means of each parameter for each disease status. Results Of the 220 study cases, 120 (54.5%) were severe, 89 (40.5%) were moderate and 11 (5.0%) were mild. One hundred forty (71.1%) of the 197 laboratory tested cases, 87 (77.7%) of severe, and 49 (64.5%) of the moderate cases had neutrophils above normal range. However, 134 (68.0%) of them, 82 (73.2%) of severe and 49 (64.5%) of moderate cases showed decreased lymphocyte level. Most of the cases showed an increased level of aspartate transaminase, alanine transaminase, alkaline phosphatase, total bilirubin, and total calcium. There was statistically significant mean neutrophils (p=0.04), number of white blood cells (p= 0.02), and creatinine level (p=0.00) difference between severe and mild cases. Conclusion Most of the severe COVID-19 patients showed increased neutrophils, liver function tests; and decreased lymphocytes; suggesting higher inflammation and lymphopenia. Therefore, patients with severe and critical disease status require close follow-up.
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Affiliation(s)
- Gemechu Churiso
- Department of Medical Laboratory Sciences, Dilla University, Dilla, Ethiopia
| | - Kuma Diriba
- Department of Medical Laboratory Sciences, Dilla University, Dilla, Ethiopia
| | - Henok Girma
- Ohio State University, Global One Health Initiative, Dilla, Ethiopia
| | - Soressa Tafere
- COVID-19 Treatment Center, Dilla University, Dilla, Ethiopia
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Weldetsadik AY, Abayneh M, Abraha M, Sirgu S, Bekele D. Clinical Characteristics and Outcome of Pediatric COVID-19 Patients in Ethiopia During the Early COVID-19 Pandemic: A Prospective Cohort Study. Pediatric Health Med Ther 2022; 13:165-174. [PMID: 35573390 PMCID: PMC9106426 DOI: 10.2147/phmt.s359333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/28/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Setting Methods Results Conclusion
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Affiliation(s)
- Abate Yeshidinber Weldetsadik
- Department of Pediatrics and Child Health, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Correspondence: Abate Yeshidinber Weldetsadik, Department of Pediatrics and Child Health, St Paul’s Hospital Millennium Medical College, PO. Box 1271, Addis Ababa, Ethiopia, Tel +251 911993975, Email
| | - Mahlet Abayneh
- Department of Pediatrics and Child Health, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mebratu Abraha
- Research Directorate, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Sisay Sirgu
- Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Delayehu Bekele
- Department of Obstetrics and Gynecology St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Yemata GA, Tesfaw A, Mihret G, Tiruneh M, Walle Z, Molla E, Sisay E, Admassu FT, Habtie E, Desalagn T, Shimels H, Teshome F. Survival Time to COVID-19 Severity and Its Predictors in South Gondar Zone, North-West Ethiopia: A Prospective Cohort Study. J Multidiscip Healthc 2022; 15:1187-1201. [PMID: 35634568 PMCID: PMC9139343 DOI: 10.2147/jmdh.s361061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background Methods Results Conclusion and Recommendation
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Affiliation(s)
- Getaneh Atikilt Yemata
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia
- Correspondence: Getaneh Atikilt Yemata, Email
| | - Aragaw Tesfaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia
| | - Gashaw Mihret
- Department of Pediatrics, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia
| | - Mulu Tiruneh
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia
| | - Zebader Walle
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia
| | - Eshetie Molla
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia
| | - Ermias Sisay
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia
| | - Fitalew Tadele Admassu
- Department of Biomedical Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia
| | - Eyaya Habtie
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia
| | - Tsion Desalagn
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia
| | - Habtamu Shimels
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia
| | - Fentaw Teshome
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia
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10
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Prevalence of COVID-19 in West Gondar Zone, Northwest Ethiopia: A Population-Based Retrospective Study. Disaster Med Public Health Prep 2022; 17:e156. [PMID: 35317876 PMCID: PMC9095846 DOI: 10.1017/dmp.2022.72] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) has spread rapidly around the world, affecting every community directly or indirectly. Therefore, this study aims to investigate the prevalence of COVID-19 infection in the population of the West Gondar zone. METHOD A retrospective cross-sectional study was conducted from November 2020 to January 2021, in the West Gondar zone, Northwest Ethiopia. Records of study participants with required information like age, gender, travel history, type of specimen taken, and site of specimen taken were included. For analysis, the statistical package for social sciences (SPSS) version 20 software was used. Descriptive statistics were summarized as percentages and means ± standard deviation. The chi-squared test is used to compare categorical data. RESULTS A total of 1,166 participants were enrolled in this study. Of them, 16 individuals had positive results, giving a prevalence of 1.37% (95% CI: 0.66-2.08). Living in an urban area (P-value = 0.035) and being female (P-value = 0.045) was statistically associated with the positive rate for COVID-19. CONCLUSIONS This study revealed a low prevalence of COVID-19 infection in the study area despite the increasing and rapid dissemination of the disease. State-wide population prevalence study should be done to estimate the general prevalence of COVID-19 in Ethiopia.
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11
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Churiso G, Diriba K, Girma H, Tafere S. Clinical Features and Time to Recovery of Admitted COVID-19 Cases at Dilla University Referral Hospital Treatment Center, South Ethiopia. Infect Drug Resist 2022; 15:795-806. [PMID: 35281575 PMCID: PMC8904438 DOI: 10.2147/idr.s356606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/15/2022] [Indexed: 12/23/2022] Open
Abstract
Background Since coronavirus disease 2019 emergence, millions were infected and many were dying because of the virus. Clinical features and time to recovery of admitted clients vary across settings. Therefore showing clinical features and recovery time from COVID-19 in a different setting is necessary to design appropriate treatment and preventive measures. So, this study attempted to investigate the clinical features and time to recovery of admitted clients to Dilla University Referral Hospital treatment center, Ethiopia. Methods A retrospective study design was conducted in 220 patients confirmed by real time polymerase chain reaction and admitted to Dilla University Referral Hospital treatment center from September 2020 to July 2021. Data were collected from the patients’ record. Data entry was done by an Epi-Info version 7.2.1.0 and analyzed by Statistical Package for the Social Sciences version 25 software. Descriptive statistics were used for clinical features, and median time to recovery was computed by using Kaplan–Meier. Results Common clinical features were cough 209 (95%), shortness of breath 153 (69.5%), fever 133 (60.5%), headache 75 (34.1%), easy fatigue 68 (30.9%), joint pain 56 (25.5%), tachypnea 197 (89.5%), hypoxia 95 (43.2%), and tachycardia 83 (37.7%). The overall median recovery time for admitted cases was 5 days. There was significant difference between recovery probability of severe and moderate cases, severe and mild cases (p=0.00), who had normal body temperature and hypothermic (p=0.05), who had normal breathing rate and bradypnea patients (p= 0.014). Conclusion COVID-19 patients frequently show cough, shortness of breath, fever, headache, easy fatigue and joint pain. Median time to recovery was 5 days. Having a normal body temperature, normal breathing rate, and severe disease status had statistically significant association with median recovery time. So, close follow up is required for client admitted with severe disease.
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Affiliation(s)
- Gemechu Churiso
- Department of Medical Laboratory Sciences, Dilla University, Dilla, Ethiopia
- Correspondence: Gemechu Churiso, Email
| | - Kuma Diriba
- Department of Medical Laboratory Sciences, Dilla University, Dilla, Ethiopia
| | - Henok Girma
- Ohio State University, Global One Health Initiative, Dilla, Ethiopia
| | - Soressa Tafere
- COVID-19 Treatment Center, Dilla University, Dilla, Ethiopia
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12
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Alene KA, Elagali A, Barth DD, Rumisha SF, Amratia P, Weiss DJ, Atalell KA, Erena AK, Gething PW, Clements ACA. Spatial codistribution of HIV, tuberculosis and malaria in Ethiopia. BMJ Glob Health 2022; 7:bmjgh-2021-007599. [PMID: 35217531 PMCID: PMC8867247 DOI: 10.1136/bmjgh-2021-007599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 01/20/2022] [Indexed: 12/15/2022] Open
Abstract
Background HIV, tuberculosis (TB) and malaria are the three most important infectious diseases in Ethiopia, and sub-Saharan Africa. Understanding the spatial codistribution of these diseases is critical for designing geographically targeted and integrated disease control programmes. This study investigated the spatial overlap and drivers of HIV, TB and malaria prevalence in Ethiopia. Methods HIV, TB and malaria data were obtained from different nationwide prevalence surveys, and geospatial covariates were obtained from publicly available sources. A Bayesian model-based geostatistical framework was applied to each survey leveraging the strength of high-resolution spatial covariates to predict continuous disease-specific prevalence surfaces and their codistribution. Results The national prevalence was 1.54% (95% CI 1.40 to 1.70) for HIV, 0.39% (95% CI 0.34 to 0.45) for TB and 1.1% (95%CI 0.95 to 1.32) for malaria. Substantial subnational variation was predicted with the highest HIV prevalence estimated in Gambela (4.52%), Addis Ababa (3.52%) and Dire Dawa (2.67%) regions. TB prevalence was highest in Dire Dawa (0.96%) and Gambela (0.88%), while malaria was highest in Gambela (6.1%) and Benishangul-Gumuz (3.8%). Spatial overlap of their prevalence was observed in some parts of the country, mainly Gambela region. Spatial distribution of the diseases was significantly associated with healthcare access, demographic, and climatic factors. Conclusions The national distribution of HIV, TB and malaria was highly focal in Ethiopia, with substantial variation at subnational and local levels. Spatial distribution of the diseases was significantly associated with healthcare access, demographic and climatic factors. Spatial overlap of HIV, TB and malaria prevalence was observed in some parts of the country. Integrated control programmes for these diseases should be targeted to these areas with high levels of co-endemicity.
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Affiliation(s)
- Kefyalew Addis Alene
- Geospatial Health and Development, Telethon Kids Institute, Nedlands, Western Australia, Australia .,Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Ahmed Elagali
- Geospatial Health and Development, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Dylan D Barth
- University of Western Australia, Perth, Western Australia, Australia.,Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Susan F Rumisha
- Geospatial Health and Development, Telethon Kids Institute, Nedlands, Western Australia, Australia.,National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Punam Amratia
- Geospatial Health and Development, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Daniel J Weiss
- Geospatial Health and Development, Telethon Kids Institute, Nedlands, Western Australia, Australia.,Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Kendalem Asmare Atalell
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Peter W Gething
- Geospatial Health and Development, Telethon Kids Institute, Nedlands, Western Australia, Australia.,Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Archie C A Clements
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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13
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Arega B, Negesso A, Taye B, Weldeyohhans G, Bewket B, Negussie T, Teshome A, Endazenew G. Impact of COVID-19 pandemic on TB prevention and care in Addis Ababa, Ethiopia: a retrospective database study. BMJ Open 2022; 12:e053290. [PMID: 35135769 PMCID: PMC8829833 DOI: 10.1136/bmjopen-2021-053290] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE The current COVID-19 pandemic in Ethiopia could cause severe dysfunction in tuberculosis (TB) treatment, diagnostic services, and prevention and control efforts. In this study, we evaluated the effect of COVID-19 on TB service indicators in Addis Ababa, where more than two-thirds of the country's COVID-19 morbidity was recorded. DESIGN We performed a comparative retrospective study to evaluate the impact of COVID-19 on TB services during the pre-COVID-19 era (from April 2019 to March 2020) and the COVID-19 era (from April 2020 to March 2021) in Addis Ababa, Ethiopia. We extracted data on total TB detection rate, TB treatment success rate, isoniazid prophylaxis therapy, and drug susceptibility tests and others from the health information system. Using Poisson regression, we estimated the incidence rate ratios and the absolute number difference of the indicators (number per quarter and year) in the COVID-19 and pre-COVID-19 eras. RESULTS Compared with the pre-COVID-19 era, the total TB detection, bacteriologically confirmed TB, TB treatment success rate, latent TB infection treatment and community health workers' engagement in TB detection decreased, respectively, by 11%, 11.8%, 17%, 44.7% and 77.2% during the COVID-19 period. Rifampicin resistance increased by 27.7% during the same period. Comparative analysis showed a significant decline in these TB service indicators (p<0.001) CONCLUSION: The COVID-19 pandemic has had a negative impact on TB service indicators in Addis Ababa. This highlights the importance of reinforcing TB services, including adopting alternative digital health technology to screen for TB and integrating TB and COVID-19 services to mitigate COVID-19's challenges to TB prevention and care.
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Affiliation(s)
- Balew Arega
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - Abebe Negesso
- Addis Ababa City Administration Health Bureau, Addis Ababa, Ethiopia
| | - Betelhem Taye
- Addis Ababa City Administration Health Bureau, Addis Ababa, Ethiopia
| | | | - Bekure Bewket
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | | | - Ayele Teshome
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
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14
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Jung M, Jembere GB, Park YS, Muhwava W, Choi Y, Cho Y, Ko W. The triple burden of communicable and non-communicable diseases and injuries on sex differences in life expectancy in Ethiopia. Int J Equity Health 2021; 20:180. [PMID: 34344371 PMCID: PMC8330193 DOI: 10.1186/s12939-021-01516-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ethiopia has experienced great improvements in life expectancy (LE) at birth over the last three decades. Despite consistent increases in LE for both males and females in Ethiopia, the country has simultaneously witnessed an increasing discrepancy in LE between males and females. METHODS This study used Pollard's actuarial method of decomposing LE to compare age- and cause- specific contributions to changes in sex differences in LE between 1995 and 2015 in Ethiopia. RESULTS Life expectancy at birth in Ethiopia increased for both males and females from 48.28 years and 50.12 years in 1995 to 65.59 years and 69.11 years in 2015, respectively. However, the sex differences in LE at birth also increased from 1.85 years in 1995 to 3.51 years in 2015. Decomposition analysis shows that the higher male mortality was consistently due to injuries and respiratory infections, which contributed to 1.57 out of 1.85 years in 1995 and 1.62 out of 3.51 years in 2015 of the sex differences in LE. Increased male mortality from non-communicable diseases (NCDs) also contributed to the increased difference in LE between males and females over the period, accounting for 0.21 out of 1.85 years and 1.05 out of 3.51 years in 1995 and 2015, respectively. CONCLUSIONS While injuries and respiratory infections causing male mortality were the most consistent causes of the sex differences in LE in Ethiopia, morality from NCDs is the main cause of the recent increasing differences in LE between males and females. However, unlike the higher exposure of males to death from injuries due to road traffic injuries or interpersonal violence, to what extent sex differences are caused by the higher male mortality compared to female mortality from respiratory infection diseases is unclear. Similarly, despite Ethiopia's weak social security system, an explanation for the increased sex differences after the age of 40 years due to either longer female LE or reduced male LE should be further investigated.
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Affiliation(s)
- Myunggu Jung
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
| | | | - Young Su Park
- Center for Arts and Humanities, Haverford College, Haverford, PA, USA
| | - William Muhwava
- African Centre for Statistics, United Nations Economic Commission for Africa, Addis Ababa, Ethiopia
| | - Yeohee Choi
- Department of Social Welfare, Graduate School of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Youngtae Cho
- Institute of Environment and Health, Population Policy Research Center, Seoul National University, Seoul, South Korea
| | - Woorim Ko
- Institute of Environment and Health, Population Policy Research Center, Seoul National University, Seoul, South Korea.
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15
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Yadeta TA, Dessie Y, Balis B. Magnitude and Predictors of Health Care Workers Depression During the COVID-19 Pandemic: Health Facility-Based Study in Eastern Ethiopia. Front Psychiatry 2021; 12:654430. [PMID: 34335321 PMCID: PMC8319716 DOI: 10.3389/fpsyt.2021.654430] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/19/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Depression of health care workers was related to work absences, resignations, and poor work performance, affecting the quality of patient care and the health care system. The Coronavirus disease pandemic has had an effect on the mental health of health care workers. Health care workers are facing challenges that can be stressful, overwhelming, and cause strong emotions, may put them at higher risk to develop depression. There is limited evidence that assesses health care workers' depression and its associated factors in the study area during the Coronavirus disease pandemic. Therefore this study aimed to assess depression and associated factors among health care workers in eastern Ethiopia. Method: The cross-sectional study design was conducted from October 26th to November 15, 2020. A total of 265 health care workers from 10 health facilities participated. Patient Health Questionnaire was used for the collection of depressive symptoms. The data were analyzed by using STATA version 14 software. To assess the association between depression and the predictors Adjusted Odds Ratio along with a 95% confidence interval was estimated by using logistic regression analysis. A statistical significance was declared at p-value ≤ 0.05. Results: Of the total 265 study participant, 176 (66.4%) and 95% CI: 60.4%, 71.8% of them reported depressive symptoms. Of 176 reported symptoms of depression 27.9, 24.1, 9.4, 3.7, and 1.1% were had minimal, mild, moderate, moderate-severe, and severe depressive symptoms respectively. The multivariable logistic regression analysis revealed the odds of depression were 2.34 times higher among female participants compared to male participants (AOR: 2.34, 95%CI: 1.09-5.02). In addition, the odds of depression for participants who perceived susceptibility to COVID-19 was 4.05 times higher among their counterpart (AOR: 4.05, 95%CI: 1.12-14.53). Conclusions: Health care workers who experienced depression in the study was high. Health care workers' mental health needs to be protected during the COVID-19 pandemic. Female health care workers and health care workers perceived susceptibility of COVID-19 need attention.
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Affiliation(s)
- Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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