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BackgroundCOVID-19, the disease caused by the new coronavirus SARS-CoV-2 is among the most obscure global pandemics resulting in diverse health and economic disruptions. It adversely affects the routine health care delivery and health service uptake by patients. However, its impact on care-seeking behaviour is largely unknown in Ethiopia.ObjectiveThis study was to determine the impact of the pandemic on care-seeking behaviour of patients with chronic health condition at Tikur Anbessa Specialized hospital in Addis Ababa.MethodsA cross-sectional hospital-based survey conducted between May and July 2020 on patients whose appointment was between March to June 2020. Sample of 750 patients were approached using phone call and data collection was done using a pretested questionnaire. After cleaning, the data entered in to IBM SPSS software package for analysis.ResultsA total of 644 patients with a median age of 25 years, and M: F ratio of 1:1.01 was described with a response rate of 86%. A loss to follow up, missed medication and death occurred in 70%, 12%, and 1.3% of the patients respectively. In the multivariable logistic regression analysis, patients above 60 years old were more likely to miss follow-up (OR-23.28 (9.32-58.15), P<001). Patients who reported fear of COVID-19 at the hospital were 19 times more likely to miss follow-up (adjusted OR=19.32, 95% CI:10.73-34.79, P<0.001), while patients who reported transportation problems were 6.5 times more likely to miss follow-up (adjusted OR=6.11, 95% CI:3.06-12.17, P<0.001).ConclusionsCOVID-19 pandemic affected the care-seeking behaviour of patients with chronic medical condition adversely and the impact was more pronounced among patients with severe disease, fear of COVID19 and with transportation problems. Education on preventive measures of COVID-19, use of phone clinic and improving chronic illness services at the local health institutions may reduce loss to follow-up among these patients.What is already known?As a result of COVID-19, an essential maternal, newborn and child health (MNCH) services in Addis Ababa city showed that first antenatal attendance and under-five pneumonia treatment decreased by 12 and 35%.A drop in client flow was ascribed to fear of acquiring COVID-19 at health facilities, limited access due to movement restrictions, and dedication of health facilities as COVID-19 treatment centers.What are the new findings?A cross-sectional hospital-based telephone survey indicated that a loss to follow up, missed medication and death occurred in 70%, 12%, and 1.3% of patients with chronic medical conditions respectively.What do the new findings imply?Fear of COVID-19 and transportation problems are the most commonly stated reasons thus, the finding implies that since health care services to patients with chronic medical conditions is concentrated in specialized referral hospitals mostly aggregated in big cities, patients who travel long distance to get the service are at high risk of Loss to follow up.Strengthening the chronic care service at a local health institutions, and promoting COVD-19 preventive measures, may help decrease the LTFU and associated complications.

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Background Scimitar syndrome is a rare form of partial anomalous pulmonary venous drainage associated with pulmonary hypertension and congestive heart failure that may lead to death in the newborn infant. Although it is described with anomalies of the lung, heart and their vascular structure, extremely rare association with imperforate anus had been reported. The third case of Scimitar syndrome and imperforate anus will be reported in this case report. Case presentation A 3 days old male neonate with imperforate anus presented with abdominal distention. Loop colostomy was done to relieve abdominal distension. The chest x-ray revealed a curved shadow on the right mid lung zone extending to the diaphragm abutting and indenting the inferior vena cava (scimitar sign). Abdominal ultrasound, transthoracic echocardiography and computerized tomographic angiography confirmed the presence of Scimitar vein and associated dextro-position of the heart, hypoplastic right lung, hypoplastic right pulmonary artery, secundum atrial septal defect with bidirectional shunt, patent ductus arteriosus, pulmonary hypertension, left superior vena cava, and systemic collateral arteries feeding the lower lobe of the right lung. The rare association of scimitar syndrome with imperforate anus is discussed. Conclusion Scimitar syndrome associated with imperforate anus with and without VACTERL association has been reported previously only in four cases. The knowledge of association between imperforate anus and Scimitar syndrome helps for early detection and management of cases. It is recommended to have high index of suspicion in every newborn with imperforate anus to check for symptoms of dextro-position of the heart, right lung hypoplasia which may be indicate scimitar syndrome. Electronic supplementary material The online version of this article (10.1186/s12887-019-1643-z) contains supplementary material, which is available to authorized users.

Background: The rate of benzathine penicillin G (BPG) injection to prevent rheumatic heart disease (RHD) is insufficient owing to poor knowledge and the negative attitude of health workers. We aim to investigate the gap of knowledge, attitude, and experience of clinical nurses at the primary health-care level who had not received training on rheumatic fever (RF)/RHD prevention to get information on their training need. Methods: A cross-sectional survey was conducted on clinical nurses at randomly selected health centers in Addis Ababa. After interviewing with semi-structured questionnaires, the data were analyzed on SPSS software version 25. Results: A total of 278 nurses (92% response) with a mean age of 28 years were analyzed. The knowledge scores on “organisms causing tonsillopharyngitis (TP),” “the route of administration of penicillin,” and “when to give BPG after preparation” were good (≥75%). Participants' score was poor (<50% score) in the knowledge of “duration of treatment of tonsillopharyngitis, frequency of chemoprophylaxis of RF/RHD, and the relationship between throat infection and RF.” Knowledge on “prevention of pain using lidocaine,” “warming the syringe and allowing alcohol to dry from the swab before injecting” were also good. In contrast, knowledge of “delivering injection very slowly,” “using vibration before/during injection, and “distracting patient using conversation” was poor. Attitude was positive to statements such as “single dose BPG injection given every 3–4 weeks,” “BPG injection is effective in the treatment of streptococcal pharyngitis and the prevention of RF/RHD,” “good patient – health provider relationship enables the success of prophylaxis.” and “educating patients, health-care providers and their caregivers help adherence to BPG prophylaxis. Fear of anaphylactic reaction, pain at the injection site, and blockage of the syringe during injection were the negative experiences reported. Conclusions: The knowledge of clinical nurses on the prevention of RF/RHD was generally good. However, their knowledge of safe injection techniques was partial. On the other hand, most attitude statements were positive. Fear of anaphylactic shock while injecting BPG, pain, and blockade of the syringe was the common barriers experienced.