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.

Healthcare professionals are at higher risk of contracting the novel coronavirus due to their work exposure in the healthcare settings. Practicing appropriate preventive measures to control COVID-19 infection is one of the most important interventions that healthcare workers are expected to use. The aim of this study was to assess the level of risk perception and practices of preventive measures of COVID-19 among health workers in Addis Ababa, Ethiopia. A hospital-based cross-sectional study was conducted from 9th to 26th June 2020 among healthcare professionals working at six public hospitals in Addis Ababa. Data were collected using a self-administered structured questionnaire. Frequency, percentage, and mean were used to summarize the data. A binary logistic regression analyses were performed to identify factors associated with risk perception about COVID-19. A total of 1,134 participants were surveyed. Wearing facemask (93%), hand washing for at least 20 seconds (93%), covering mouth and nose while coughing or sneezing (91%), and avoiding touching eyes, nose, and mouth (91%) were the commonly self-reported preventive practices. About 88% perceived that they were worried about the risk of becoming infected with coronavirus, and majority (91%) worried about the risk of infection to their family. The mean score of overall fear and worry of COVID-19 was 2.37 on a scale of 1 to 3. Respondents who ever provided clinical care to COVID-19 patients were more likely to report fear and worry (adjusted OR=1.34, 95% CI:1.02-1.91), however those who ever participated in Ebola or SARS outbreaks were less likely to report fear and worry due to COVID-19 crisis (adjusted OR=0.66, 95% CI:0.48-0.90). This study has revealed widespread practices of preventive measures and the highest perceived risk of COVID-19 among healthcare workers. Therefore, an effective risk communication intervention should be implemented to ensure the maintenance of appropriate practices during the current COVID-19 pandemic.

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Healthcare professionals (HCPs) are at the frontline in the fight against COVID-19 and are at an increased risk of becoming infected with coronavirus. Risk of infection can be minimized by use of proper personal protective equipment (PPE). This study assessed the availability of PPE and satisfaction of HCPs in six public hospitals in Addis Ababa, Ethiopia. A cross-sectional study was conducted from 9th to 26th June 2020. The study hospitals included: Tikur Anbessa Specialized Hospital, Zewditu Memorial Hospital, Ghandi Memorial Hospital, Menelik II Hospital, Yekatit 12 Hospital Medical College and St. Paul Hospital Millennium Medical College. Data were collected using a self-administered questionnaire. Descriptive statistics were used to describe the data and Chi-square test was used to assess the association between the groups. Bivariate and multivariable logistic regression models were used to assess factors associated with the satisfaction level of healthcare workers with regard to the availability and use of proper PPE during the current COVID-19 pandemic. A total of 1,134 (92.3%) valid questionnaires from a possible 1,228 were included in the analysis. The mean (SD) age of the participants was 30.26 (6.43) year and 52.6% were females. Nurses constituted about 40% of the overall sample, followed by physicians (22.2%), interns (10.8%), midwives (10.3%) and others (16.7%). An overall shortage of PPE was reported in all study hospitals. The majority (77%) of the healthcare professionals reported that their hospital did not have adequate PPE. A critical shortage of N95 respirator was particularly reported, the self-reported availability of N95 increased from 13% to 24% before and during COVID-19, respectively. The self-reported use of N95 increased from 9% to 21% before and during COVID-19, respectively. Almost 72% of the respondents were dissatisfied with the availability of PPE in their hospital. The independent predictors of the respondents satisfaction level about PPE were male gender (adjusted OR=1.39, 95% CI:1.05-1.85), healthcare workers who reported that PPE was adequately available in the hospital (adjusted OR=7.53, 95% CI:5.08-11.16), and preparedness to provide care to COVID-19 cases (adjusted OR=1.65, 95% CI:1.22-2.12). A critical shortage of appropriate PPE both before and during COVID-19 was identified. The high level of dissatisfaction with the availability of PPE might potentially lead to a lower level of preparedness and readiness to fight against COVID-19. Therefore, urgent efforts are needed to adequately supply the healthcare facilities with appropriate PPE to alleviate the challenges.

Background: Public health measures are critical to mitigate the spread of the novel coronavirus disease 2019 (COVID-19) pandemic. Ethiopia has implemented a variety of essential public health measures in response to the spread of the virus. This study aimed to assess social distancing and preventive practices of government employees in response to COVID-19. Methods: A cross-sectional study was conducted among 1573 government employees selected from 46 public institutions (16 National, 18 from Addis Ababa City Administration, and 12 from Oromia Regional State) 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. ANOVA and t-tests were applied to assess the difference between groups. Bivariate and multivariable logistic regression analyses were used to identify factors associated with outcome variables. Results: The majority of the participants reported wearing of facemask (96%), avoiding close contact with people including handshaking (94.5%), frequent had washing (94.1%), maintaining physical distancing (89.5%), avoiding mass gatherings (88.1%), and restricting movement and travelling (84.1%). More than 80% of the participants perceived that consistently wearing a facemask is highly effective in preventing the transmission of coronavirus. Participants from Oromia reported statistically significantly lower odds of perceived effectiveness of 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. Participants within the age groups of 18-29 were more likely to test for coronavirus than the older age groups. Whilst, respondents from Oromia were less likely to test for coronavirus than those from national level (adjusted OR=0.31, 95% CI:0.16-0.60). About one-third (31.3%) of the respondents strongly agreed that the policy responses that the Government had taken to contain the spread of coronavirus were reasonable, and 38.5% agreed with the policy responses. Conclusions: The findings showed higher social distancing and preventive practices among the government employees in response to COVID-19. People should properly apply social distancing measures, wearing facemasks, and washing hands frequently with water and soap as a comprehensive package of SARS-CoV-2 prevention and control strategies. Rules and regulations imposed by the Government should be properly enforced in order to control the pandemic.