Epidemiological, clinical and laboratory profile of patients presenting with severe acute respiratory syndrome (SARS-CoV-2) in Ethiopia

INTRODUCTION

Data regarding patients presenting with severe acute respiratory syndrome (SARS-CoV-2) illness have not adequately been documented which provides distinct insights into low-resource settings like Ethiopia. Thus, the study aimed to compare epidemiological, clinical and laboratory profiles of patients presenting with acute respiratory syndrome illness in Addis Ababa Ethiopia.

METHODS

We used a comparative cross-sectional study design among patients with SARS-CoV-2 illness at St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia from October 2020 to September 2021. Using a structured questionnaire a consecutive sampling technique was applied to collect socio-demographic data. Additionally, nasal swabs were collected to confirm SARS-CoV-2 infection using a Real-Time Polymerase Chain Reaction. Blood samples were also collected from the participants for laboratory profiles (hematological tests like; white blood cell count, hematocrit, and platelet count; and biochemical and enzymatic tests like; aspartate transaminase (AST), creatinine, etc) analysis. Data were entered and analyzed using SPSS version 23.0 and p-values ≤0.05 were considered as statistically significant.

RESULTS

Of the total 413 participants presenting with SARS-CoV-2 illness, 250 (60.5%) participants tested positive for COVID-19 disease. COVID-19 patients were less likely to use an alcohol-based method of hand washing (12.5% vs 87.5%; p = 0.048). The COVID-19 patients had a higher proportion of headache (67.3% vs 32.7%, p = 0.001), sore throat (72.5% vs 27.5%, p = 0.001), and loss of sense of taste (74.4% vs 25.6%, p = 0.002). Patients with COVID-19 have significantly higher neutrophil than their counterparts (68.2% vs 31.8%; p = 0.001). Similarly, creatinine (64.9% vs 35.1%, p = 0.001) from renal function and alkaline phosphatase (66.8% vs 33.2%, p = 0.046) in the liver function tests were significantly higher in the COVID-19 patients.

CONCLUSION

Our findings suggest the need to substantially consider headache, sore throat, and loss of taste as potential clinical diagnostic symptoms for early screening and testing. Elevation of neutrophil, creatinine, alkaline phosphatase profiles are also used for potential diagnostic biomarkers in screening and testing suspected patients.

Assessment of magnitude and spectrum of cardiovascular disease admissions and outcomes in Saint Paul Hospital Millennium Medical College, Addis Ababa: A retrospective study

BACKGROUND

Cardiovascular diseases(CVD) remain the leading cause of death in the world and over 80% of all cardiovascular-related deaths occur in low and middle income countries. Ethiopia is in epidemiologic transition from predominantly infectious diseases to non-communicable diseases and the CVD is a major public health challenge.

METHODS

The aim of this study was to assess the magnitude and spectrum of cardiovascular admission and its outcomes among medical patients admitted to both Medical Ward and ICU of St. Paul Teaching Hospital from 1st of Jan 2020 to 1st of Jan 2021.

RESULTS

Out of 1,165 annual medical admissions, the prevalence of cardiovascular diseases(CVD) was 30.3%. About 60%(212) of patients had advanced congestive heart failure of diverse causes. Hypertensive heart disease (HHD) was the next predominant diagnosis (41%(146)), and also the leading cause of cardiac diseases followed by rheumatic valvular heart disease(RVHD) (18%(64)) and Ischemic heart disease (IHD) (12.2%(43)), respectively. Yong age, rural residence and female sex were associated with RVHD(p = 0.001). Stroke also accounted for 20%(70) of CVD admission (hemorrhagic stroke-17% Vs Ischemic stroke-83%). Hypertension was the predominate risk factor for CVD and present in 46.7%(168) of patients. The mean hospital stay was 12days and in-hospital mortality rate was 24.3% with septic shock being the commonest immediate cause of death followed by fatal arrhythmia, brain herniation, and massive PTE.

CONCLUSION

Cardiovascular diseases were common in the study area causing significant morbidity and mortality. Therefore, comprehensive approach is imperative to timely screen for cardiovascular risk reduction, disease control and complication prevention. Strategies should also be designed to increase public awareness regarding the cardiovascular risk reduction, drug adherence, and possible complications.

COVID-19 precautionary practices and associated factors among clients visiting a tertiary hospital, Addis Ababa, Ethiopia

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 1^st to 15^th, 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.

Magnitude and associated factors of poor medication adherence among diabetic and hypertensive patients visiting public health facilities in Ethiopia during the COVID-19 pandemic

Objective

This study aims to assess the magnitude and associated factors of poor medication adherence among diabetic and hypertensive patients visiting public health facilities in Addis Ababa, Ethiopia during the COVID-19 pandemic.

Methods

A multi-site cross-sectional design was conducted from 1^st through 30^th of August 2020 at public health facilities of the study area. Adult outpatients with T2DM and hypertension visiting hospitals and health centers were included in the study. A proportion to size allocation method was used to determine the required sample size per facility. Data was collected using the 8-item Morisky medication adherence scale. Descriptive statistics and binary logistic regression were used to analyze data. A 95% confidence interval and p≤0.05 statistical significance was considered to determine factors associated with poor medication adherence.

Results

A total of 409 patients were included in the present study. About 57% of the patients reported that the COVID-19 pandemic has posed negative impacts on either of their follow-up visits, availability of medications, or affordability of prices. And, 21% have reported that they have been affected in all aspects. The overall magnitude of poor medication adherence was 72%. Patients with extreme poverty were more likely to have good medication adherence (AOR: 0.59; 95%C.I: 0.36–0.97), whereas attendance to a health center (AOR: 1.71; 95%C.I: 1.02–2.85), presence of comorbidity (AOR: 2.05; 95%C.I: 1.13–3.71), and current substance use history (AOR: 11.57; 95%C.I: 1.52–88.05) predicted high odds of poor adherence.

Conclusion

Over a three-fourth of the patients, in the study setting, have poor adherence to their anti-diabetic and antihypertensive medications. Health facility type, income level, comorbidity, and current substance use history showed a statistically significant association with poor adherence to medication. Stakeholders should set alternative strategies as perceived impacts of the COVID-19 pandemic on medication adherence are high in the study area.