The performance of COVID-19 Surveillance System as timely containment strategy in Western Oromia, Ethiopia.

BACKGROUND: COVID-19 has been swiftly spreading throughout the world ever since it emerged in Wuhan, China, in late December 2019. Case detection and contact identification remain the key surveillance objectives for effective containment of the pandemic. This study was aimed at assessing performance of surveillance in early containment of COVID 19 in Western Oromia, Ethiopia. METHODS: A cross-sectional study was conducted from August 1 to September 30, 2020, in the 7 kebeles of Nekemte and 2 kebeles of Shambu Town. Residents who lived there for at least the past six months were considered eligible for this study. Data were collected from community and health system at different levels using semi structured questionnaire and checklist, respectively. Participants' health facility usage (dependent variable) and perceived risk, awareness, Socioeconomic Status, and practices (independent variable) were assessed. Bivariable analysis was computed to test the presence of an association between dependent and independent variables. Independent predictors were identified on multivariable logistic regression using a p-value of (<0.05) significance level. We have checked the model goodness of fit test by Hosmer-lemeshow test. RESULTS: One hundred seventy-nine (41%) of the participants believe that they have a high risk of contracting COVID-19 and 127 (29%) of them reported they have been visited by health extension worker. One hundred ninety-seven (45.2%) reported that they were not using health facilities for routine services during this pandemic. Except one hospital, all health facilities (92%) were using updated case definition. Three (33%) of the assessed health posts didn't have community volunteers. On multivariable logistic regression analysis, the source of income AOR=0.30, 95% CI (0.11, 0.86), perceived level of risk AOR=3.42, 95% CI (2.04, 5.7) and not visited by health extension workers AOR=0.46, 95% CI (0.29, 0.74) were found to be independent predictors of not using health facilities during this pandemic. CONCLUSION: Event based surveillance, both at community and health facility level, was not performing optimally in identifying potential suspects. Therefore, for effective early containment of epidemic, it is critical to strengthen event based surveillance and make use of surveillance data for tailored intervention in settings where mass testing is not feasible.

Predictors of Health-Care Workers' Unwillingness to Continue Working During the Peak of COVID-19 in Western Ethiopia: An Extended Parallel-Process Model Study.

PURPOSE: Willingness to work in disasters is context-specific and corresponds to the nature, magnitude, and threats posed by a particular public health emergency. None us is certain that our health professionals will continue to provide service should the COVID-19 pandemic crisis climb to its worst level. It was with this uncertainty in mind that this study was done to assess predictors of the unwillingness of health-care workers (HCWs) to continue providing their professional services during the climax of the COVID-19 crisis. METHODS: This was a facility-based descriptive cross-sectional study undertaken among 633 HCWsin western Ethiopia. RESULTS: Overall, 205 (32.4%) providers said that they would be unwilling to continue work if COVID-19 peaked. Of these, 176 (27.9%) respondents reported that they would stop going in to work before they were at greatest risk. Statistical analysis performed to predict HCWs unwillingness' to continue work at peak COVID-19 showed male sex (AOR 11.4, 95% CI 8.32-12.6), younger age (AOR 25.3, 95% CI 4.61-40.67), lack of experience in handling similar pandemics (AOR 5.15, 95% CI 1.1-255), and low perceived level of hospital preparedness (AOR 2.05, 95% CI 0.80-5.21) were predictors of unwillingness. In accordance with the extended parallel-process model, higher threat perception (P≤0.001) and low efficacy perception (P≤0.040) were associated with unwillingness of the HCWs to continue working. CONCLUSION: The proportion of HCWs unwilling to continue their job during COVID-19 is sufficient to affect efforts tof fight the pandemic. As the question of whether our HCWs must risk themselves to treat COVID-19 patients does not have a uniform answer, working on predictors of potential unwillingness is of paramount importance.

Integrated pharmaceutical logistics system implementation in selected health facilities of Ethiopia: The case of four WOLLEGA ZONES.

BACKGROUND: The pharmaceutical supply chain management system of Ethiopia has several problems including non-availability, poor storage, weak stock management and irrational use. However, few studies were conducted on progress and challenges towards implementation of Integrated Pharmaceuticals Logistics System (IPLS) in the study area. Therefore, this study aimed to assess the progress and challenges towards the implementation of IPLS in selected health facilities of Wollega zones, Western Ethiopia. METHODS: A cross sectional quantitative and qualitative study was conducted in selected health facilities from February 15 to March 15, 2015. The calculated sample size was 31 health facilities with 20% margin of error and 90% confidence interval (CI). The Logistics Indicator Assessment Tool (LIAT) was used to collect information from selected health facilities; while an in-depth interview was held with chief pharmacist to collect qualitative data. Correlation and multiple linear regression analysis were used at significance level of 90%CI. RESULTS: The average availability of bin cards for the selected products was 83.9% for hospitals, 75.4% for health centers, and 70.6% for health posts. On average, hospitals had an updated bin card for 43.8% of the product while health centers and health posts had an updated bin card for 32.9% and 32% of their products, respectively. On average the exact accuracy of request and resupply form (RRF) data for hospital and health center was 45.6% and 37.1%, respectively. IPLS implementation was related with health facility stores infrastructures (40.1%), Logistics Management Information System/LMIS/ (32.2%), stock availability and status (31.9%), storage condition (17.7%) and order fill rate (14.1%). Multivariable regression revealed LMIS (std. ß = 2.539, p = 0.022), stock status (std. ß = 0.848, p = 0.049) and availability of tracer medicines (std. ß = 0.212, p = 0.013) were positively associated with IPLS implementation. CONCLUSION: There have been significant improvements in supply chain indicators in the availability of essential health commodities since IPLS has been implemented, with some variation by level of facility and product type. Involvement of all stakeholders is necessary to sustain the system. Additionally, there needs to be more focus on monitoring and evaluation of IPLS including more focused studies.

Adherence to Anti-Tuberculosis Treatment Among Pediatric Patients at Nekemte Specialized Hospital, Western Ethiopia.

BACKGROUND: Non-adherence to tuberculosis treatment is the most challenging and hindering factor for successful tuberculosis therapy. The long duration of tuberculosis treatment and the undesirable effects of anti-tuberculosis drugs result in non-adherence to treatment among pediatric patients. Hence, this study was aimed to evaluate pediatrics adherence status among tuberculosis pediatric patients on anti-tuberculosis treatment at Nekemte Specialized Hospital. METHODS: A health facility-based cross-sectional study design was used to recruit pediatric TB patients who were receiving their treatment between February 15 and March 15, 2019. Adherence to tuberculosis therapy was evaluated using data obtained from face-to-face interviews of their respective caregivers. The collected data were entered into EPI-manager 4.0.2 software and analyzed using SPSS version 24. Logistic regression was used to analyze the variables and variables with p-value <0.05 had a statistically significant association with the adherence to anti TB treatment. RESULTS: Among 202 participants involved in the study, 120 (59.4%) of them were males and 119 (58.9%) were in the age category of 11-15 years. A total of 166 (82.2%) of the patients had extra-pulmonary tuberculosis and 174 (86.1%) of them were in the intensive phase. Of the pediatric tuberculosis patients, 48 (73.3%) of them have adhered to the treatment regimen. Female gender [AOR: 3.3, 95% CI: 1.52-7.2], younger age (0-5 years) [AOR: 5.96 95% CI: 1.81-19.6], living in urban area [AOR: 3.73, 95% CI: 1.67-8.36], and patients who did not experience side effect [AOR: 2.87, 95% CI: 1.41-5.81] were predictors of good adherence to tuberculosis treatment up on multivariable logistic regression analysis. CONCLUSION: The level of adherence observed in our study area was low. Age, sex, residence, and side effect experience showed an association with tuberculosis treatment adherence. Therefore, health care providers should educate all patients with tuberculosis before the initiation of anti-tuberculosis treatment.