1
|
Wondmeneh TG, Mohammed JA. COVID-19 mortality rate and its determinants in Ethiopia: a systematic review and meta-analysis. Front Med (Lausanne) 2024; 11:1327746. [PMID: 38476444 PMCID: PMC10928001 DOI: 10.3389/fmed.2024.1327746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/12/2024] [Indexed: 03/14/2024] Open
Abstract
Background The COVID-19 mortality rate continues to be high in low-income countries like Ethiopia as the new variant's transmission expands and the countries' limited capacity to combat the disease causes severe outcomes, including deaths. The aim of this study is to determine the magnitude of the COVID-19 mortality rate and its determinants in Ethiopia. Methods The main electronic databases searched were PubMed, CINAHL, Google Scholar, and African journals online. The included studies' qualities were assessed independently using the Newcastle-Ottawa scale. The data was extracted in Microsoft Excel spreadsheet format. The pooled effect size and odds ratios with 95% confidence intervals across studies were determined using the random-effects model. I2 is used to estimate the percentage of overall variation across studies due to heterogeneity. Egger's test and funnel plot were used to find the published bias. A subgroup analysis was conducted. The effect of a single study on the overall estimation was determined by sensitivity analysis. Results A total of 21 studies with 42,307 study participants were included in the final analysis. The pooled prevalence of COVID-19 mortality was 14.44% (95% CI: 10.35-19.08%), with high significant heterogeneity (I2 = 98.92%, p < 0.001). The risk of mortality from COVID-19 disease was higher for patients with comorbidity (AHR = 1.84, 95% CI: 1.13-2.54) and cardiovascular disease (AHR = 2, 95% CI: 1.09-2.99) than their counterparts without these conditions. Conclusion A significant number of COVID-19 patients died in Ethiopia. COVID-19 patients with comorbidities, particularly those with cardiovascular disease, should receive special attention to reduce COVID-19 mortality. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, registration identifier (ID) CRD42020165740.
Collapse
|
2
|
Gobena D, Gudina EK, Gebre G, Degfie TT, Mekonnen Z. Rapid antigen test as a screening tool for SARS-CoV-2 infection: Head-to-head comparison with qRT-PCR in Ethiopia. Heliyon 2024; 10:e23518. [PMID: 38169801 PMCID: PMC10758869 DOI: 10.1016/j.heliyon.2023.e23518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
Objective This study aimed to determine the diagnostic accuracy of the antigen rapid diagnostic test (Ag-RDT) as a screening tool for SARS-CoV-2 infection compared to Quantitative reverse transcription polymerase chain reaction (qRT-PCR). Methods This study was conducted at six referral hospitals in Oromia Region, Ethiopia. One thousand seven hundred twenty-one patients who visited the hospitals for various medical conditions were tested with qRT-PCR and/or Ag-RDTs. Qualitative detection of SARS-CoV-2 antigen was performed using the Panbio™ COVID-19 Ag rapid test device. Results Compared with qRT-PCR, Ag-RDTs had a sensitivity of 33.3 % (95%CI: 30.9%-35.9 %) and a specificity of 99.3 % (95%CI: 98.8%-99.7 %) to detect active SARS-CoV-2 infection. The area under the receiver operator curve was 0.67 (95%CI: 0.63-0.69). The sensitivity of Ag-RDTs appeared high in patients with shortness of breath (73.3 %) and those presenting with all three symptoms - fever, cough, and dyspnea (71.4 %). In all instances, specificity was more than 98 %. The Ag-RDT positivity rate also correlated well with viral load: 51.7 % in cases with cycle threshold (Ct) < 25 (high viral load) and only 3.4 % when Ct > 25 (low viral load). Conclusion Although Ag-RDT for diagnosing SARS-CoV-2 is a good option as a point-of-care screening tool, it has a low sensitivity to detect active infections. Using Panbio™ COVID-19 Ag Rapid test for diagnostic and treatment decisions may lead to a false negative, resulting in patient misdiagnosis, ultimately contributing to disease spread and poor patient outcome.
Collapse
Affiliation(s)
- Dabesa Gobena
- Public Health Emergency Management and Health Research Directorate, Oromia Health Bureau, Addis Ababa, Ethiopia
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | | | - Getu Gebre
- Public Health Emergency Management and Health Research Directorate, Oromia Health Bureau, Addis Ababa, Ethiopia
| | - Tizta Tilahun Degfie
- Department of Reproductive Health and Population Studies, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Fenot Project, Department of Global Health and Population, Harvard T.H. Chan School, Ethiopia
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| |
Collapse
|
3
|
Umer A, Mohammed H, Yazie B, Angaw DA, Gonete TZ, Endehabtu BF, Tilahun B, Jisso M, Tamiso A, Assesfa NA, Alemayehu A, Fikre R, Mizana BA, Dessie K, Sime H, Abera M, Mecha M, Yesuf EA, Gurmu KK, Kebede M. Assessment of Availability of Tracer Drugs and Basic Diagnostics at Public Primary Health Care Facilities in Ethiopia During COVID-19 Pandemic. Ethiop J Health Sci 2023; 33:135-142. [PMID: 38352669 PMCID: PMC10859737 DOI: 10.4314/ejhs.v33i2.7s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/09/2023] [Indexed: 02/16/2024] Open
Abstract
Background The emergence of COVID-19 pandemic has disrupted the supply chain and stock of medicines and drugs across the globe. Tracer drugs are essential medicines that address the population's priority health problems. Thus, this study aimed to assess availability of tracer drugs and basic diagnostics at public primary health care facilities in Ethiopia. Methods Facility based cross-sectional study was employed in four regions and one city administration. The primary health care units (PHCUs) were purposively selected in consultation with respective regional health bureaus. Finally, 16 hospitals, 92 health centers and 344 health posts were included. This study adopted WHO's tool that was being used to rapidly assess the capacity of health facilities to maintain the provision of essential health services during the COVID-19. Descriptive analysis was done using frequency and percentage, and results were presented. Results The overall mean availability of tracer drugs in PHCUs was 77.6%. Only 2.8% of PHCUs have all tracer drugs. The mean availability of basic diagnostic at national level was 86.6% in PHUs except health posts where it was less. Health facilities with all basic diagnostic services was 53.7%. Of the total 344 health posts assessed, 71% were providing diagnostic testing for malaria using either laboratory equipment or rapid diagnostic test (RDT) while 43% provide urine test for the pregnancy. Conclusion This study shows availability of all tracer drugs in PHCUs in Ethiopia was extremely low. There was regional variation in availability of tracer drugs and basic diagnostics. It is very crucial to increase availability of tracer drugs and diagnostics. Drugs and diagnostic materials should be supplied according to the capacity and location of health facilities.
Collapse
Affiliation(s)
- Abdurezak Umer
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | - Hussen Mohammed
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | - Bekele Yazie
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | - Dessie Abebaw Angaw
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Gonder, Ethiopia
| | - Tajebew Zayede Gonete
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Gonder, Ethiopia
| | - Berhanu Fikadie Endehabtu
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Gonder, Ethiopia
| | - Binyam Tilahun
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Gonder, Ethiopia
| | - Meskerem Jisso
- Hawassa University, College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Alemu Tamiso
- Hawassa University, College of Medicine and Health Sciences, Hawassa, Ethiopia
| | | | - Akalewold Alemayehu
- Hawassa University, College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Rekiku Fikre
- Hawassa University, College of Medicine and Health Sciences, Hawassa, Ethiopia
| | | | - Kassahun Dessie
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Gonder, Ethiopia
| | - Habtamu Sime
- Jimma University, Institute of Health, Jimma, Ethiopia
| | | | | | | | - Kassu Ketema Gurmu
- World Health Organization-Ethiopia, Health System Strengthening Unit, Addis Ababa, Ethiopia
| | - Mesfin Kebede
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| |
Collapse
|
4
|
Negsso A, Arega B, Abdissa F, Zewdu B, Teshome A, Minda A, Agunie A. Effect of COVID-19 pandemic on the incidence of acute diarrheal disease and pneumonia among under 5 children in Ethiopia- A database study. PLOS Glob Public Health 2023; 3:e0000304. [PMID: 37315030 DOI: 10.1371/journal.pgph.0000304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/05/2023] [Indexed: 06/16/2023]
Abstract
COVID-19 has had a devastating impact on preventable and treatable pediatric diseases in Ethiopia. This study looks at the impact of COVID-19 on pneumonia and acute diarrheal diseases in the country, as well as the differences between administrative regions. In Ethiopia, we conducted a retrospective pre-post study to assess the impact of COVID-19 on children under the age of five who had acute diarrhea and pneumonia and were treated in health facilities during the pre-COVID-19 era (March 2019 to February 2020) and the COVID-19 era (March 2020 to February 2021). From the National Health Management District Health Information System (DHIS2, HMIS), we retrieved data on total acute diarrheal disease and pneumonia, along with their regional and monthly distribution. We calculated incidence rate ratios comparing the rates of acute diarrhea and pneumonia during the pre-and post-COVID-19 eras and adjusted for the year, using Poisson regression. The number of under-five children treated for acute pneumonia decreased from 2,448,882 before COVID-19 to 2,089,542 ((14.7% reduction (95%CI;8.72-21.28), p<0.001)) during COVID-19. Similarly, the number of under-five children treated for acute diarrheal disease decreased from 3,287,850 in pre-COVID-19 to, 2,961,771((9.91% reduction (95%CI;6.3-17.6%),p<0.001)) during COVID-19. In the majority of the administrative regions studied, pneumonia and acute diarrhea diseases decreased during COVID-19, but they increased in Gambella, Somalia, and Afar. During the COVID-19 period, the greatest reduction of children with pneumonia (54%) and diarrhea disease (37.3%) was found in Addis Ababa (p<0.001). The majority of administrative regions included in this study have seen a decrease in pneumonia and acute diarrheal diseases among children under the age of five, while three regions namely, Somalia, Gambela, and Afar saw an increase in cases during the pandemic. This emphasizes the importance of using tailored approaches in mitigating the impact of infectious diseases such as diarrhea and pneumonia during situations of a pandemic such as COVID-19.
Collapse
Affiliation(s)
| | - Balew Arega
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - Fekadu Abdissa
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - Brook Zewdu
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | | | - Abrham Minda
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - Asnake Agunie
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| |
Collapse
|
5
|
Alemu D, Diribsa T, Debelew GT. COVID-19 Vaccine Hesitancy and Its Associated Factors Among Adolescents. Patient Prefer Adherence 2023; 17:1271-1280. [PMID: 37214557 PMCID: PMC10199707 DOI: 10.2147/ppa.s400972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 05/09/2023] [Indexed: 05/24/2023] Open
Abstract
Background Currently, COVID-19 disease is a major public health issue that affects a large number of people worldwide. The COVID-19 vaccine is one of the best preventative measures. Adolescents between the ages of 12 and 17 are eligible to get the COVID-19 vaccine. The COVID-19 pandemic cannot be stopped if people are reluctant to use this vaccine. However, the extent of COVID-19 vaccine hesitancy and related variables among adolescents are not well understood. Objectives To assess the magnitude of COVID-19 vaccine hesitancy and its associated factors among adolescents in Seka Chekorsa town, Jimma, Ethiopia. Methods Institutional-based cross-sectional study employing both qualitative and quantitative methods were used. The study participants were selected using a simple random sampling technique. Data were collected using interviewer-administered questions. Data collected was checked for completeness and entered into EPI data version 3.1. Finally, data were exported to SPSS version 25 for further analysis. The bivariate analysis was used to identify variables eligible for multivariate logistic regressions. In a multivariable analysis to identify factors that have statistically significant association, a p value less than 0.05 and a 95% confidence interval were used. The qualitative data were triangulated with quantitative data. Results In this study, 379 adolescents were participated, yielding a response rate of 95.2%. The magnitude of COVID-19 vaccine hesitancy among adolescents was 29% (95% CI: 24.3-33.5%). Being female (AOR = 1.89, 95%, 1.81-3.56), primary education (AOR = 2.99, 95% CI: 1.26-3.56), source information from social media (AOR = 2.42, 95% CI: 1.06-5.57), poor knowledge about COVID-19 disease (AOR = 3.18, 95% CI: 1.66-6.12), unfavorable attitude (AOR = 5.2, 95% CI: 2.76-9.79) and poor knowledge towards COVID-19 vaccine (AOR = 5.66, 95% CI, 2.91-11.0) were associated with COVID-19 vaccine hesitancy among adolescents. Conclusion This study shows that COVID-19 vaccine hesitancy among adolescents is very high. Being female, poor knowledge towards COVID-19 disease and the vaccine, an unfavorable attitude and social media were factors significantly associated with COVID-19 vaccine hesitancy.
Collapse
Affiliation(s)
- Dawit Alemu
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tujuba Diribsa
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Gurmesa Tura Debelew
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| |
Collapse
|
6
|
Galli M, Zardini A, Gamshie WN, Santini S, Tsegaye A, Trentini F, Marziano V, Guzzetta G, Manica M, d'Andrea V, Putoto G, Manenti F, Ajelli M, Poletti P, Merler S. Priority age targets for COVID-19 vaccination in Ethiopia under limited vaccine supply. Sci Rep 2023; 13:5586. [PMID: 37019980 PMCID: PMC10075159 DOI: 10.1038/s41598-023-32501-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/28/2023] [Indexed: 04/07/2023] Open
Abstract
The worldwide inequitable access to vaccination claims for a re-assessment of policies that could minimize the COVID-19 burden in low-income countries. Nine months after the launch of the national vaccination program in March 2021, only 3.4% of the Ethiopian population received two doses of COVID-19 vaccine. We used a SARS-CoV-2 transmission model to estimate the level of immunity accrued before the launch of vaccination in the Southwest Shewa Zone (SWSZ) and to evaluate the impact of alternative age priority vaccination targets in a context of limited vaccine supply. The model was informed with available epidemiological evidence and detailed contact data collected across different geographical settings (urban, rural, or remote). We found that, during the first year of the pandemic, the mean proportion of critical cases occurred in SWSZ attributable to infectors under 30 years of age would range between 24.9 and 48.0%, depending on the geographical setting. During the Delta wave, the contribution of this age group in causing critical cases was estimated to increase on average to 66.7-70.6%. Our findings suggest that, when considering the vaccine product available at the time (ChAdOx1 nCoV-19; 65% efficacy against infection after 2 doses), prioritizing the elderly for vaccination remained the best strategy to minimize the disease burden caused by Delta, irrespectively of the number of available doses. Vaccination of all individuals aged ≥ 50 years would have averted 40 (95%PI: 18-60), 90 (95%PI: 61-111), and 62 (95%PI: 21-108) critical cases per 100,000 residents in urban, rural, and remote areas, respectively. Vaccination of all individuals aged ≥ 30 years would have averted an average of 86-152 critical cases per 100,000 individuals, depending on the setting considered. Despite infections among children and young adults likely caused 70% of critical cases during the Delta wave in SWSZ, most vulnerable ages should remain a key priority target for vaccination against COVID-19.
Collapse
Affiliation(s)
- Margherita Galli
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
- Department of Mathematics, Computer Science and Physics, University of Udine, Udine, Italy
| | - Agnese Zardini
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | | | | | | | - Filippo Trentini
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
| | | | - Giorgio Guzzetta
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
- Epilab-JRU, FEM-FBK Joint Research Unit, Trento, Italy
| | - Mattia Manica
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
- Epilab-JRU, FEM-FBK Joint Research Unit, Trento, Italy
| | - Valeria d'Andrea
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | | | | | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Piero Poletti
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy.
- Epilab-JRU, FEM-FBK Joint Research Unit, Trento, Italy.
| | - Stefano Merler
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
- Epilab-JRU, FEM-FBK Joint Research Unit, Trento, Italy
| |
Collapse
|
7
|
Gobena D, Kebede Gudina E, Yilma D, Girma T, Gebre G, Gelanew T, Abdissa A, Mulleta D, Sarbessa T, Asefa H, Woldie M, Shumi G, Kenate B, Kroidl A, Wieser A, Eshetu B, Degfie TT, Mekonnen Z. Escalating spread of SARS-CoV-2 infection after school reopening among students in hotspot districts of Oromia Region in Ethiopia: Longitudinal study. PLoS One 2023; 18:e0280801. [PMID: 36735689 PMCID: PMC9897530 DOI: 10.1371/journal.pone.0280801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 01/09/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND COVID-19 pandemic caused by extended variants of SARS-CoV-2 has infected more than 350 million people, resulting in over 5.5 million deaths globally. However, the actual burden of the pandemic in Africa, particularly among children, remains largely unknown. We aimed to assess the seroepidemiological changes of SARS-CoV-2 infection after school reopening among school children in Oromia, Ethiopia. METHODS A prospective cohort study involving students aged 10 years and older were used. A serological survey was performed twice, at school reopening in December 2020 and four months later in April 2021. Participants were selected from 60 schools located in 15 COVID-19 hotspot districts in Oromia Region. Serology tests were performed by Elecsys anti-SARS-CoV-2 nucleocapsid assay. Data were collected using CSentry CSProData Entry 7.2.1 and exported to STATA version 14.2 for data cleaning and analysis. RESULTS A total of 1884 students were recruited at baseline, and 1271 completed the follow-up. SARS-CoV-2 seroprevalence almost doubled in four months from 25.7% at baseline to 46.3% in the second round, with a corresponding seroincidence of 1910 per 100,000 person-week. Seroincidence was found to be higher among secondary school students (grade 9-12) compared to primary school students (grade 4-8) (RR = 1.6, 95% CI 1.21-2.22) and among those with large family size (> = 5) than those with a family size of <3 (RR = 2.1, 95% CI 1.09-4.17). The increase in SARS-CoV-2 seroprevalence among the students corresponded with Ethiopia's second wave of the COVID-19 outbreak. CONCLUSION SARS-CoV-2 seroprevalence among students in hotspot districts of the Oromia Region was high even at baseline and almost doubled within four months of school recommencement. The high seroincidence coincided with the second wave of the COVID-19 outbreak in Ethiopia, indicating a possible contribution to school opening for the new outbreak wave.
Collapse
Affiliation(s)
- Dabesa Gobena
- Public Health Emergency Management and Health Research Directorate, Oromia Health Bureau, Addis Ababa, Ethiopia
- School of Medical Laboratory Science, Institute of Health, Jimma University, Jimma, Ethiopia
- * E-mail:
| | | | - Daniel Yilma
- Department of Internal Medicine, Jimma University, Jimma, Ethiopia
| | - Tsinuel Girma
- Fenot Project, School of Population and Public Health, University of British Columbia, Addis Ababa, Ethiopia
| | - Getu Gebre
- Public Health Emergency Management and Health Research Directorate, Oromia Health Bureau, Addis Ababa, Ethiopia
| | | | | | - Daba Mulleta
- Public Health Emergency Management and Health Research Directorate, Oromia Health Bureau, Addis Ababa, Ethiopia
| | - Tarekegn Sarbessa
- Public Health Emergency Management and Health Research Directorate, Oromia Health Bureau, Addis Ababa, Ethiopia
| | - Henok Asefa
- Department of Epidemiology, Jimma University, Jimma, Ethiopia
| | - Mirkuzie Woldie
- Fenot Project, School of Population and Public Health, University of British Columbia, Addis Ababa, Ethiopia
| | - Gemechu Shumi
- Fenot Project, School of Population and Public Health, University of British Columbia, Addis Ababa, Ethiopia
| | - Birhanu Kenate
- Fenot Project, School of Population and Public Health, University of British Columbia, Addis Ababa, Ethiopia
| | - Arne Kroidl
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
- German Center for Infection Research, Partner Site Munich, Munich, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
- German Center for Infection Research, Partner Site Munich, Munich, Germany
| | - Beza Eshetu
- Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia
| | - Tizta Tilahun Degfie
- Fenot Project, School of Population and Public Health, University of British Columbia, Addis Ababa, Ethiopia
| | - Zeleke Mekonnen
- School of Medical Laboratory Science, Institute of Health, Jimma University, Jimma, Ethiopia
| |
Collapse
|
8
|
Tilahun BD, Adane T, Fentanew M, Alene TD, Abebe GK, Ngusie HS. COVID-19 vaccine acceptance in the second wave of the pandemic among university students in Ethiopia: application of the health belief model. Ther Adv Infect Dis 2023; 10:20499361231213226. [PMID: 38107553 PMCID: PMC10722942 DOI: 10.1177/20499361231213226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/24/2023] [Indexed: 12/19/2023] Open
Abstract
Background The first case of COVID-19 virus was reported in Africa on 14 February 2020. The pandemic became more aggressive in the continent during the second wave than the first wave. Promoting vaccination behavior is an unparalleled measure to curb the spread of the pandemic. Regarding this, the health belief model (HBM) is the major model for understanding health behaviors. This study aimed to examine predictors of intended COVID-19 vaccine acceptance in the second wave of the pandemic among university students in Ethiopia using HBM. Methods A cross-sectional study was conducted among 423 randomly selected medical and health science students at the University of Gondar from 21 August to 15 September 2020. Analysis of data was performed using STATA 14.0. Linear regression analysis was applied and a p value of less than 0.05 was used to declare statistical significance. Results Among the total participants, 293 [72.2% (95.0%: CI: 67.2-76.8)] of them scored above the mean of COVID-19 vaccine acceptance. HBM explained nearly 46.3% (adjusted R2 = 0.463) variance in intention to receive the COVID-19 vaccine. Year of study (β = 0.288; 95% CI: 0.144-0.056), using social media (β = 0.58; 95% CI: 1.546-2.804), existing chronic disease (β = 0.12; 95% CI: 0.042-0.433), perceived overall health condition (β = 0.117; 95% CI: 0.307-0.091), perceived susceptibility (β = 0.58; 95% CI: 1.546-2.804), perceived benefit (β = 0.338; 95% CI: 1.578-2.863), and cues to action (β = 0.49; 95% CI: 0.388-0.99) were significantly associated with intended COVID-19 vaccine acceptance at p value < 0.5. Conclusion Approximately, three-quarters of the participants were above the mean score of COVID-19 vaccine acceptance, which is higher compared to previous reports in resource-limited settings. Interventions in this study setting chould include placing emphasis on the risks of acquiring COVID-19, enhancing perceived benefits of COVID-19 vaccination and improving cues to action by advocating COVID-19 vaccination. Our findings also implied that social media health campaigns are significant factor in COVID-19 vaccination behavioral change in this study setting.
Collapse
Affiliation(s)
- Befkad Derese Tilahun
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box: 400, Woldia, Amhara 400, Ethiopia
| | - Tiruneh Adane
- Department of Hematology and Immunohematology, School of Biomedical Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Molla Fentanew
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Tilahun Dessie Alene
- Department of Pediatrics and Child Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Gebremeskel Kibret Abebe
- Department of Emergency and Critical Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Habtamu Setegn Ngusie
- Department of Health Informatics, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| |
Collapse
|
9
|
Dadi LS, Kefeni BD, Kadi H, Kifle E, Yesuf EA, Hailemariam G, Edosa ZK, Befekadu T. Household Readiness to Care for Mild and Asymptomatic COVID-19 Cases at Home, Southwest Ethiopia: A Community-based Cross-Sectional Study. Ethiop J Health Sci 2022; 32:1071-1082. [PMID: 36475246 PMCID: PMC9692155 DOI: 10.4314/ejhs.v32i6.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/19/2022] [Indexed: 12/13/2022] Open
Abstract
Background Corona virus disease (COVID-19) continued with its notorious effects overwhelming health institutions. Thus, home-based identification and care for asymptomatic and mild cases of COVID-19 has been recommended. Therefore, the objective of this study was to assess the level of household readiness for caring asymptomatic and mild cases of COVID-19 at home. Methods A community-based cross-sectional study was conducted from March-June 2021 on randomly selected 778 households. Data entry and analysis were carried out using EpiData and SPSS version 25, respectively. Multivariable logistic regression was modeled to identify independent predictors of community readiness. Results Overall readiness of the community was very low (43.8%). Factors positively affecting household readiness were male household heads (AOR = 1.6; 95%CI: 1.05, 2.45), primary (AOR=2.0; CI:.62, 1.59) and higher (AOR = 1.90; 95%CI: 1.04, 3.45) educational level of the respondents, number of rooms within household (AOR = 1.22; CI: 1.03, 1.46), having additionally house (AOR = 2.61; CI: 1.35, 5.03), availability of single use eating utensils (AOR = 2.76; 95%CI: 1.66, 4.56), availability of community water supply (AOR = 8.21; 95% CI: 5.02, 13.43), and community participation and engagement (AOR = 2.81; 95% CI: 1.93, 4.08) in accessing transport, water and sanitation. Conclusions The community was less prepared in terms of housing, infection prevention, water and sanitation. Considering alternative options including universal coverage of vaccine is important; designed behavioral change communications can enhance community participation and engagement in improving access to transport, water and sanitation to reduce risk of infections.
Collapse
Affiliation(s)
- Lelisa Sena Dadi
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | | | - Hanan Kadi
- Jimma University Medical Center, Jimma, Ethiopia
| | - Enku Kifle
- Jimma University Medical Center, Jimma, Ethiopia
| | - Elias Ali Yesuf
- Department of Health Policy and management, Faculty of Public Health, Jimma University, Ethiopia
| | - Gelaw Hailemariam
- Department of Emergency medicine, Jimma University Medical Center, Jimma, Ethiopia
| | - Zerihun Kura Edosa
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | | |
Collapse
|
10
|
Abagero A, Ragazzoni L, Hubloue I, Barone-Adesi F, Lamine H, Addissie A, Della Corte F, Valente M. A Review of COVID-19 Response Challenges in Ethiopia. Int J Environ Res Public Health 2022; 19:11070. [PMID: 36078785 PMCID: PMC9518440 DOI: 10.3390/ijerph191711070] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
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.
Collapse
Affiliation(s)
- Abdulnasir Abagero
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy
- ReGEDiM—Research Group on Emergency Disaster Medicine, Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa 70710, Ethiopia
| | - Luca Ragazzoni
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy
- Department of Sustainable Development and Ecological Transition, University of Eastern Piedmont, 28100 Novara, Italy
| | - Ives Hubloue
- ReGEDiM—Research Group on Emergency Disaster Medicine, Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
| | - Francesco Barone-Adesi
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
| | - Hamdi Lamine
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy
- Department of Sustainable Development and Ecological Transition, University of Eastern Piedmont, 28100 Novara, Italy
- Faculty of medicine Ibn Aljazzar of Sousse, University of Sousse, Sousse 4002, Tunisia
| | - Adamu Addissie
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa 70710, Ethiopia
| | - Francesco Della Corte
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
| | - Martina Valente
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy
- Department of Sustainable Development and Ecological Transition, University of Eastern Piedmont, 28100 Novara, Italy
| |
Collapse
|
11
|
Girma D, Dejene H, Adugna L, Tesema M, Awol M. COVID-19 Case Fatality Rate and Factors Contributing to Mortality in Ethiopia: A Systematic Review of Current Evidence. Infect Drug Resist 2022; 15:3491-3501. [PMID: 35813083 PMCID: PMC9270043 DOI: 10.2147/idr.s369266] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 06/29/2022] [Indexed: 11/28/2022] Open
Abstract
Background The ongoing novel coronavirus disease 2019 (COVID-19) is triggering significant morbidity and mortality due to its contagious nature and absence of definitive management. In Ethiopia, despite a number of primary studies have been conducted to estimate the case fatality rate (CFR) of COVID-19, no review study has attempted to summarize the findings to better understand the nature of pandemics and the virulence of the disease. Objective To summarize the CFR of COVID-19 and factors contributing to mortality in Ethiopia. Methods PRISMA guideline was followed. PubMed, Science Direct, CINAHL, SCOPUS, Hinari, and Google Scholar were systematically searched using pre-specified keywords. Observational studies ie, cohort, cross-sectional, and case-control studies were included. The Newcastle-Ottawa scale adapted for observational studies was used to assess the quality of included studies. CFR was defined as the proportion of COVID-19 cases with the outcome of death within a given period. Factors contributing to COVID-19 mortality at p-value <0.05 were described narratively from the eligible articles. Results A total of 13 observational studies were included in this study. Consequently, this review confirmed the CFR of COVID-19 in Ethiopia ranges between 1–20%. Additionally, comorbid conditions, older age group, male sex, substance use, clinical manifestations (abnormal oxygen saturation level, atypical lymphocyte count, fever, and shortness of breath), disease severity, and history of surgery/trauma increased the likelihood of death from COVID-19 death. Conclusion This study shows that the range of CFR of COVID-19 in Ethiopia is almost equivalent to other countries, despite the country’s low testing capacity and case detection rate in reference to its total population. Comorbid diseases, older age group, male sex, cigarette smoking, alcohol drinking, clinical manifestations and disease severity, and history of surgery/trauma were factors contributing to COVID-19 mortality in Ethiopia. Therefore, given the alarming global situation and rapidly evolving large-scale pandemics, urgent interdisciplinary interventions should be implemented in those vulnerable groups to lessen the risk of mortality. Furthermore, the CFR of COVID-19 should be estimated from all treatment and rehabilitation centers in the country, as underestimation could be linked to a lack of preparedness and mitigation. A large set of prospective studies are also compulsory to better understand the CFR of COVID-19 in Ethiopia.
Collapse
Affiliation(s)
- Derara Girma
- Public Health Department, College of Health Sciences, Salale University, Fitche, Ethiopia
- Correspondence: Derara Girma, Email
| | - Hiwot Dejene
- Public Health Department, College of Health Sciences, Salale University, Fitche, Ethiopia
| | - Leta Adugna
- Public Health Department, College of Health Sciences, Salale University, Fitche, Ethiopia
| | - Mengistu Tesema
- Public Health Department, College of Health Sciences, Salale University, Fitche, Ethiopia
| | - Mukemil Awol
- Department of Midwifery, College of Health Sciences, Salale University, Fiche, Ethiopia
| |
Collapse
|
12
|
Bizuneh H, Mohammed S, Yesuf A. COVID-19 precautionary practices and associated factors among clients visiting a tertiary hospital, Addis Ababa, Ethiopia. PLoS One 2022; 17:e0267000. [PMID: 35436310 PMCID: PMC9015144 DOI: 10.1371/journal.pone.0267000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 03/31/2022] [Indexed: 12/02/2022] Open
Abstract
Background Despite efforts to contain the spread of COVID-19, Addis Ababa, the country’s COVID-19 epicenter, is experiencing a sharp increase in the number of cases and death rate. While poor public adherence to COVID-19 precautionary practices is evident, factors associated with it are not well studied. We aimed to assess the level of practice of COVID-19 precaution and associated factors. Methods This was a hospital-based cross-sectional study conducted from February 1st to 15th, 2021 at Saint Paul’s Hospital Millennium Medical College, a tertiary teaching hospital in Addis Ababa, Ethiopia. We used a structured questionnaire to conduct a face-to-face exit interview with clients visiting the hospital. Systematic random sampling was employed to recruit study participants. Binary and multivariable logistic regressions were implemented to examine factors associated with precautionary practices. Statistical significance was declared at p-value <0.05. The Crude odds ratio (COR) and Adjusted odds ratio (AOR) were reported with a 95% confidence interval. Results We analyzed data obtained from 262 participants. The mean age of participants was 36 (SD+12) years. The majority (207, 79%) of the study participants had a favorable attitude towards prevention and control measures of COVID-19. A little over half (116, 55.7%) of the respondents had a satisfactory level of practice of COVID-19 precautions. Living in an area with strict enforcement of COVID-19 precautionary measures [AOR: 2.25, 95% CI (1.22–4.15)], and having a favorable attitude of COVID-19 prevention [AOR: 4.88, 95% CI (2.08–11.68)] were significantly associated with satisfactory COVID-19 precautionary practices. Conclusions The level of practice of COVID-19 precaution was unsatisfactory. Favorable attitude and stricter enforcement of COVID-19 preventive measures might have contributed more to adherence to precautionary practices. The findings highlight the need for a public health education strategy targeted at improving attitudes of the community on COVID-19 focusing on the effectiveness of preventive measures.
Collapse
Affiliation(s)
- Hailemichael Bizuneh
- Epidemiology and Biostatistics Department, School of Public Health, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- * E-mail:
| | - Shikur Mohammed
- Epidemiology and Biostatistics Department, School of Public Health, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Aman Yesuf
- Epidemiology and Biostatistics Department, School of Public Health, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| |
Collapse
|
13
|
Adane T, Adugna Y, Aynalem M. 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 DOI: 10.1017/dmp.2022.72] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [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.
Collapse
|
14
|
Gizaw T, Jemal A, Gudeta T. Tracer Pharmaceuticals Availability and Distribution Trends Prior to and During the Covid-19 Pandemic: A Comparative Study. J Multidiscip Healthc 2022; 15:93-102. [PMID: 35058695 PMCID: PMC8765269 DOI: 10.2147/jmdh.s341855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/20/2021] [Indexed: 12/03/2022] Open
Abstract
Background Coronavirus disease 2019 (Covid-19) has had an unprecedented impact on the health products delivery system. To maintain routine health services, tracer pharmaceuticals (TPs) should always be available and accessible in healthcare institutions. Thus, this study aimed to explore the influence of the Covid-19 on TPs availability and distribution trends in the context of the Covid-19 pandemic in Ethiopia. Methods An institution-based comparative study was undertaken on 25 TPs in the pharmaceutical supply agency. From the agency’s logistical data, we collated the amount of TPs ordered, received, and distributed, as well as the stock status, by using an observation checklist. The collated data were recorded in Microsoft Excel and transferred to SPSS for analysis. A frequency and percentage analysis were performed to evaluate the fill rate, product availability, and stock-out duration. A dependent t-test was used to compare if there was a significant mean difference in TPs distribution before and after the Covid-19 at a p-value less than 5%. Results Before Covid-19, 18 (72%) of the TPs were refilled above 80% of amount ordered. After the pandemic, however, the fill rate dropped to 48%. The availability of TPs during the Covid-19 was 60%. During the six months of Covid-19, the average stock-out duration for all TPs was 34.68 days, with Cimetidine 200mg/mL injectable (line-item fill rate = 0, days out of stock = 180 days) being the most stocked-out item. Tracer pharmaceuticals distribution before Covid-19 (M = 81,317, SD = 139,274) were significantly different after the pandemic (M = 60,212, SD = 94,966) at the 5% significance level (t (24) = 2.289, p = 0.031). Conclusion This survey reveals how Covid-19 has influenced service providers’ logistics systems. Following the pandemic, the line fill rate fell below half with a three-fifths availability of products. To effectively manage supply chain disruptions experienced in Covid-19 and beyond, the agency in collaboration with stakeholders should make an effort to enhance end-to-end inventory visibility, establish a resilient logistics system, strengthen domestic manufacturers’ capabilities, and develop contingency plans with supplying partners.
Collapse
Affiliation(s)
- Tafesse Gizaw
- Quantification and Market Shaping Office, Ethiopian Pharmaceuticals Supply Agency, Jimma, Ethiopia
- Correspondence: Tafesse Gizaw Quantification and Market Shaping Office, Ethiopian Pharmaceuticals Supply Agency, PO Box 359, Jimma, Ethiopia Email
| | - Awol Jemal
- Department of Social and Administrative Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tadesse Gudeta
- Department of Social and Administrative Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| |
Collapse
|
15
|
Gudina EK, Ali S, Girma E, Gize A, Tegene B, Hundie GB, Sime WT, Ambachew R, Gebreyohanns A, Bekele M, Bakuli A, Elsbernd K, Merkt S, Contento L, Hoelscher M, Hasenauer J, Wieser A, Kroidl A. Seroepidemiology and model-based prediction of SARS-CoV-2 in Ethiopia: longitudinal cohort study among front-line hospital workers and communities. Lancet Glob Health 2021; 9:e1517-e1527. [PMID: 34678196 PMCID: PMC8525918 DOI: 10.1016/s2214-109x(21)00386-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 01/01/2023]
Abstract
Background Over 1 year since the first reported case, the true COVID-19 burden in Ethiopia remains unknown due to insufficient surveillance. We aimed to investigate the seroepidemiology of SARS-CoV-2 among front-line hospital workers and communities in Ethiopia. Methods We did a population-based, longitudinal cohort study at two tertiary teaching hospitals involving hospital workers, rural residents, and urban communities in Jimma and Addis Ababa. Hospital workers were recruited at both hospitals, and community participants were recruited by convenience sampling including urban metropolitan settings, urban and semi-urban settings, and rural communities. Participants were eligible if they were aged 18 years or older, had provided written informed consent, and were willing to provide blood samples by venepuncture. Only one participant per household was recruited. Serology was done with Elecsys anti-SARS-CoV-2 anti-nucleocapsid assay in three consecutive rounds, with a mean interval of 6 weeks between tests, to obtain seroprevalence and incidence estimates within the cohorts. Findings Between Aug 5, 2020, and April 10, 2021, we did three survey rounds with a total of 1104 hospital workers and 1229 community residents participating. SARS-CoV-2 seroprevalence among hospital workers increased strongly during the study period: in Addis Ababa, it increased from 10·9% (95% credible interval [CrI] 8·3–13·8) in August, 2020, to 53·7% (44·8–62·5) in February, 2021, with an incidence rate of 2223 per 100 000 person-weeks (95% CI 1785–2696); in Jimma Town, it increased from 30·8% (95% CrI 26·9–34·8) in November, 2020, to 56·1% (51·1–61·1) in February, 2021, with an incidence rate of 3810 per 100 000 person-weeks (95% CI 3149–4540). Among urban communities, an almost 40% increase in seroprevalence was observed in early 2021, with incidence rates of 1622 per 100 000 person-weeks (1004–2429) in Jimma Town and 4646 per 100 000 person-weeks (2797–7255) in Addis Ababa. Seroprevalence in rural communities increased from 18·0% (95% CrI 13·5–23·2) in November, 2020, to 31·0% (22·3–40·3) in March, 2021. Interpretation SARS-CoV-2 spread in Ethiopia has been highly dynamic among hospital worker and urban communities. We can speculate that the greatest wave of SARS-CoV-2 infections is currently evolving in rural Ethiopia, and thus requires focused attention regarding health-care burden and disease prevention. Funding Bavarian State Ministry of Sciences, Research, and the Arts; Germany Ministry of Education and Research; EU Horizon 2020 programme; Deutsche Forschungsgemeinschaft; and Volkswagenstiftung.
Collapse
Affiliation(s)
| | - Solomon Ali
- Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Eyob Girma
- Jimma University Institute of Health, Jimma, Ethiopia
| | - Addisu Gize
- Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | | | | | - Rozina Ambachew
- Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | - Mahteme Bekele
- Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Abhishek Bakuli
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany; German Center for Infection Research, partner site Munich, Munich, Germany
| | - Kira Elsbernd
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, Ludwig Maximilian University of Munich, Munich, Germany
| | - Simon Merkt
- Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn, Germany
| | - Lorenzo Contento
- Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany; German Center for Infection Research, partner site Munich, Munich, Germany
| | - Jan Hasenauer
- Institute of Computational Biology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany; Center for Mathematics, Technische Universität München, Garching, Germany; Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany; German Center for Infection Research, partner site Munich, Munich, Germany
| | - Arne Kroidl
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany; German Center for Infection Research, partner site Munich, Munich, Germany
| |
Collapse
|
16
|
Deressa W, Worku A, Abebe W, Getachew S, Amogne W. Social distancing and preventive practices of government employees in response to COVID-19 in Ethiopia. PLoS One 2021; 16:e0257112. [PMID: 34492089 PMCID: PMC8423289 DOI: 10.1371/journal.pone.0257112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/23/2021] [Indexed: 11/23/2022] Open
Abstract
Public health and social interventions are critical to mitigate the spread of the coronavirus disease 2019 (COVID-19) pandemic. Ethiopia has implemented a variety of public health and social measures to control the pandemic. This study aimed to assess social distancing and public health preventive practices of government employees in response to COVID-19. A cross-sectional study was conducted among 1,573 government employees selected from 46 public institutions located in Addis Ababa. Data were collected from 8th to 19th June 2020 using a paper-based self-administered questionnaire and analyzed using SPSS version 23.0. Descriptive statistics were used to summarize the data. Binary logistic regression analyses were used to identify factors associated with outcome variables (perceived effectiveness of facemask wearing to prevent coronavirus infection, and COVID-19 testing). Majority of the participants reported facemask wearing (96%), avoiding close contact with people including handshaking (94.8%), consistently followed government recommendations (95.6%), frequent handwashing (94.5%), practiced physical distancing (89.5%), avoided mass gatherings and crowded places (88.1%), restricting movement and travelling (71.8%), and stayed home (35.6%). More than 80% of the participants perceived that consistently wearing a facemask is highly effective in preventing coronavirus infection. Respondents from Oromia perceived less about the effectiveness of wearing facemask in preventing coronavirus infection (adjusted OR = 0.27, 95% CI:0.17-0.45). About 19% of the respondents reported that they had ever tested for COVID-19. Respondents between 40-49 years old (adjusted OR = 0.41, 95% CI:0.22-0.76) and 50-66 years (adjusted OR = 0.43, 95% CI:0.19-0.95) were less likely tested for coronavirus than the younger age groups. Similarly, respondents from Oromia were less likely to test for coronavirus (adjusted OR = 0.26, 95% CI:0.12-0.56) than those from national level. Participants who were sure about the availability of COVID-19 testing were more likely to test for coronavirus. About 57% of the respondents perceived that the policy measures in response to the pandemic were inadequate. The findings showed higher social distancing and preventive practices among the government employees in response to COVID-19. Rules and regulations imposed by the government should be enforced and people should properly apply wearing facemasks, frequent handwashing, social and physical distancing measures as a comprehensive package of COVID-19 prevention and control strategies.
Collapse
Affiliation(s)
- Wakgari Deressa
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Workeabeba Abebe
- Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sefonias Getachew
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wondwossen Amogne
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|