Quality of life among patients with the common chronic disease during COVID-19 pandemic in Northwest Ethiopia: A structural equation modelling.

BACKGROUND: Improving Quality of Life (QoL) for patients with chronic diseases is a critical step in controlling disease progression and preventing complications. The COVID-19 pandemic has hampered chronic disease management, lowering patients' quality of life. Thus, we aimed to assess the quality of life and its determinants in patients with common chronic diseases, in Northwest Ethiopia during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted among 1815 randomly selected chronic patients with common chronic diseases. A standardized WHOQOL BREF tool was used, and electronic data collection was employed with the kobo toolbox data collection server. Overall QoL and the domains of Health-Related Quality of life (HRQoL) were determined. Structural equation modelling was done to estimate independent variables' direct and indirect effects. Path coefficients with a 95% confidence interval were reported. RESULTS: About one in third, (33.35%) and 11.43% of the study participants had co-morbid conditions and identified complications, respectively. The mean score of QoL was 56.3 ranging from 14.59 and 98.95. The environmental domain was the most affected domain of HRQoL with a mean score of 52.18. Age, psychological, and environmental domains of HRQoL had a direct positive effect on the overall QoL while the physical and social relationships domains had an indirect positive effect. On the other hand, the number of medications taken, the presence of comorbidity, and complications had a direct negative impact on overall QoL. Furthermore, both rural residency and the presence of complications had an indirect negative effect on overall QoL via the mediator variables of environmental and physical health, respectively. CONCLUSION: The quality of life was compromised in chronic disease patients. During the COVID-19 pandemic, the environmental domain of HRQoL was the most affected. Several socio-demographic and clinical factors had an impact on QoL, either directly or indirectly. These findings highlighted the importance of paying special attention to rural residents, patients with complications, patients taking a higher number of medications, and patients with comorbidity.

The effect of COVID-19 on poor treatment control among ambulatory Hypertensive and/or Diabetic patients in Northwest Ethiopia.

BACKGROUND: Diabetes and hypertension have emerged as important clinical and public health problems in Ethiopia. The need to have long-term sustainable healthcare services for patients with diabetes and hypertension is essential to enhance good treatment control among those patients and subsequently delay or prevent complications. A collective shift towards acute care for COVID-19 patients combined with different measures to contain the pandemic had disrupted ambulatory care. Hence, it is expected to have a significant impact on treatment control of hypertensive and diabetic patients. However, there is limited evidence on the effect of the pandemic on treatment control and its determinants. Therefore, this study aimed to assess the effect of COVID-19 pandemic on treatment control of ambulatory Hypertensive and Diabetic patients and identify the factors for poor treatment control in North West Ethiopia. METHODS: A retrospective chart review and cross-sectional survey design were conducted between December 2020 and February 2021. Using a stratified systematic random sampling technique, 836 diabetic and/or hypertensive patients were included in the study. Web-based data collection was done using Kobo collect. The changes in the proportion of poor treatment control among ambulatory Hypertensive and/or Diabetic patients during the COVID-19 pandemic period were assessed. A multivariable binary logistic regression mixed model was fitted to identify the determinants of poor treatment control. The odds ratios were reported in both crude and adjusted form, together with their 95% confidence intervals and p-values. RESULT: Poor treatment control increased significantly from 24.81% (21.95, 27.92) prior to the COVID-19 pandemic to 30.33% (27.01, 33.88), 35.66% (32.26, 39.20), 36.69% (33.40, 40.12), and 34.18% (3102, 37.49) in the first, second, third, and fourth months following the date of the first COVID-19 case detection in Ethiopia, respectively. Marital status (AOR = 0.56, 95%CI; 0.41, 0.74), regimen of medication administration (AOR = 1.30, 95%CI; 1.02, 166), daily (AOR = 0.12, 95%CI; 0.08, 0.20), twice (AOR = 0.42, 95%CI; 0.30. 0.59), and three times (AOR = 0.31, 95%CI; 0.21, 0.47) frequency of medication, number medications taken per day (AOR = 0.79, 95%CI;0.73, 0.87), patients habits like hazardous alcohol use (AOR = 1.29, 95%CI; 1.02, 1.65) and sedentary lifestyle (AOR = 1.72,95%CI;1.46, 2.02), missed appointment during the COVID-19 pandemic (AOR = 2.09, 95%CI; 1.79, 2.45), and presence of disease related complication (AOR = 1.11, 95%CI; 0.93, 1.34) were significantly associated with poor treatment control among Diabetic and/or hypertensive patients during the COVID-19 pandemic. CONCLUSION: The COVID-19 pandemic had a substantial impact on ambulatory Diabetic and/or Hypertensive patients' treatment control. Being married, as well as the frequency and types of medicines taken per day were all found to be negatively associated with poor treatment control. During the COVID -19 pandemic, patients' habits such as hazardous alcohol use and sedentary lifestyle, longer follow-up time, having disease-related complication (s), patients taking injectable medication, number of medications per day, and missed appointments were positively associated with poor treatment control in ambulatory diabetic and hypertensive patients. Therefore, it is better to consider the risk factors of poor treatment control while designing and implementing policies and strategies for chronic disease control.

Utilization of health services and associated factors among fee waiver beneficiaries in Dawunt district, North Wollo zone, Ethiopia.

OBJECTIVE: This study aimed to assess the utilization of health services and associated factors among fee waiver beneficiaries in Dawunt district, Ethiopia, in 2020. STUDY DESIGN: A community-based cross-sectional study was used. METHODS: Using an interviewer-administered questionnaire, data were collected from 550 randomly selected households. EpiData version 4.6 was used to enter data, and SPSS version 23 was used to analyze it. Multivariable logistic regression analysis was applied to identify the associated factors with health service utilization. RESULTS: The overall health service utilization among fee waiver beneficiaries was 60.98% (95% confidence interval [CI]: 56.4-64.4%). Being an urban resident (adjusted odds ratio [AOR]: 3.2, 95% CI: 1.41-7.28), family size (AOR: 3.17, 95% CI: 1.49-6.75), perceived health status (AOR: 6.26, 95% CI: 3.76-10.41), travel time (AOR: 2.75, 95% CI: 1.25-6.06), perceived distance (AOR: 13.69, 95% CI: 5.22-35.91), and perceived medium (AOR: 3.07, 95% CI: 1.71-5.52) and cheap (AOR: 3.02, 95%CI: 1.43-6.36) transport costs were significantly associated with utilization of health services. CONCLUSIONS: This study revealed that the level of health service utilization among beneficiaries in the Dawunt district was 60.98%. Residence, family size, perceived health status, travel time to the nearest Health Facility (HF), perceived distance, and travel cost to reach the HFs were significantly associated with Health Services Utilization (HSU). Therefore, improving physical accessibility of health services and availability of necessary health services at an affordable cost will possibly result in better utilization of healthcare services.

Poor child complementary Feeding Practices in northwest Ethiopia: Finding from the Baseline Survey of Nutrition Project, 2016.

BACKGROUND: Improving infant and young child feeding practices is critical to improved nutrition, health, and development of children. Ethiopia adopted the WHO recommendations of child feeding practices and developed the national guideline. In spite of this fact, only few children start and received appropriate complementary feeding based on the recommendation. Therefore, the study aimed to determine dietary diversity score and its associated factors among under five children at Dabat Health and Demographic Surveillance System site (HDSS), northwest Ethiopia. METHODS: A cross-sectional community based study was carried out from February to June 2016. All children aged 6-59 months old who lived in HDSS site were included in the survey. Odds ratio (OR) with the corresponding 95% confidence interval (CI) was calculated to show the strength of association. Finally, variables with a P-value of < 0.05 were considered statistically significant.. RESULTS: In this study, a total of 3433 children were included. About 34.87% (95%CI: 33.27, 36.49%) of the children received adequately diversified diet. The odds of receiving adequately diversified diet was higher among children whose mother had secondary and above education (AOR = 6.51; 95%CI: 4.95, 8.56), had antenatal care (AOR = 1.90; 95%CI: 1.60, 2.26) and postnatal care visits (AOR = 1.31; 95%CI: 1.00, 1, 72), and children who feed with their family (AOR = 1.39; 95%CI: 1.17, 1.65). However, a lower dietary diversity score was observed among younger children; 6-11 months old (AOR = 0.59; 95%CI: 0.41, 0.85), and children from food insecure household (AOR = 0.76; 95%CI: 0.63, 0.92). CONCLUSIONS: Diversified diet feeding practice is low in Dabat HDSS site. Age of the child, maternal education, antenatal and postnatal care visits, and household food insecurity were significantly associated with dietary diversity of children. Hence, ensuring household food security and enhancing the coverage of maternal health care utilization are recommended to increase dietary diversity of children.

Dietary diversity practice and associated factors among pregnant women in North East Ethiopia.

OBJECTIVE: Diversified food during pregnancy is the very important since it is known to affect pregnancy and birth outcomes. The aim of this study was to assess dietary diversity practice and associated factors among rural pregnant women in North East Ethiopia. RESULT: A total of 647 pregnant women were participated with a response rate of 97.4%. The adequate dietary diversity practice of pregnant women was found to be 31.4% [95% confidence interval (CI) 27.8-35.2]. Cereals were the most commonly consumed food groups. Dietary diversity practice of pregnant women was associated with maternal education [Adjusted Odds Ratio (AOR) = 2.36, 95% CI 1.29, 4.32], wealth index (AOR = 1.85, 95% CI 1.21, 2.82), nutrition information (AOR = 2.51, 95% CI 1.05, 6.02) and Productive safety net program beneficiary (PSNP) (AOR = 1.7, 95% CI 1.16, 2.50). The dietary diversity practice of pregnant women was found to be low in the study area. Maternal education, wealth status, having nutrition information and PSNP beneficiary were the determinant factors.

Maternal characteristics and nutritional status among 6-59 months of children in Ethiopia: further analysis of demographic and health survey.

BACKGROUND: Nutritional status of children influences their health status, which is a key determinant of human development. In Ethiopia, 28% of child mortality is caused by under nutrition. There is also some controversial evidence about the association between maternal characteristics and nutritional status of under five children. This study was aimed to assess the association between maternal characteristics and nutritional status among 6-59 months of children in Ethiopia. METHODS: This was furtheranalysis ofthe 2016 Ethiopian Demographic and Health Surveyusing7452 children.. Generalized estimating equations was used to quantify the association of maternal factors with stunting and wasting. Both crude Odds ratio and adjusted odds ratio with the corresponding 95% confidence intervals were reported to show the strength of association. In multivariable analysis, variables with a p-value of < 0.05 were considered statistically significant. RESULTS: The higher odds of stunting were found among children whose mothers had no education (AOR = 1.58; 95%CI: 1.25, 2.0) and primary education (AOR = 1.42; 95%CI: 1.13, 1.78), underweight nutritional status (AOR = 1.59; 95%CI: 1.27, 2.0), and anemia (AOR = 1.16; 95%CI: 1.04, 1.30). Similarly, higher odds of wasting were observed among children whose mother had underweight nutritional status (AOR = 2.34; 95%CI: 1.65, 3.38), delivered at home (AOR = 1.31; 95%CI: 1.07, 1.60), and lower than 24 months birth interval (AOR = 1.31; 95%CI: 1.04, 1.64). CONCLUSION: Maternal education, nutritional status, and anemia were associated with child stunting. Also maternal nutritional status, place of delivery, and preceding birth interval were associated with wasting. Therefore, there is needed to enhance the nutritional status of children by improving maternal underweight nutritional status, maternal educational and maternal anemia status, prolonging birth interval, and promoting health facility delivery.