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 1st through 30th 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.

BackgroundThe Coronavirus pandemic is presenting several challenges in Ethiopia on an unprecedented scale. It is affecting the country in different ways ranging from a significant impact on the economy to a disrupted public health delivery of both curative and preventive services. The aim of this study was to assess health related quality of life of patients with chronic non-communicable diseases during the Coronavirus pandemic in Addis Ababa, Ethiopia.MethodsA multi-facility based cross sectional study design was conducted in August 2020 among public health institutions in Addis Ababa. Health facilities were chosen purposively based on high number of patient flow. Participants from each health facility were drawn after proportional to size allocation. A translated EQ-5D-3L VAS instrument was used to collect data. Analysis was done using SPSS v.26.0. Descriptive statistics, Mann Whitney U test, Kruskal Wallis test, Spearman’s rank correlation test and Binary logistic regression were applied. ResultsOf the 409 participants included in the study, majority were in the age group of 46-60 (36%), females (56%), from hospitals (54.8%), jobless (25.4%), married (63.3%) and orthodox Christian (71.4%). Above two third of the patients reported no problems for self-care, usual activity and depression/anxiety. All dimensions showed an increasing proportion of moderate to severe problems in the age group beyond 45. Facility type (U=16651, P=0.001), comorbid condition (U=13248.00, P=0.000) and age (rs=-0.27, p=0.000) were found to show statistically significant score difference for GQoL. An overall prevalence of any problem was 59%. Education level, visit to a health center and marriage were associated with less odds of an affected HRQoL unlike lower monthly income and presence of comorbidities which were opposite.ConclusionsHRQoL of patients in the study settings was found to be suboptimal and below the general population. Education and arrangement of safe and quality health services to such group of patients is warranted especially during the COVID-19 pandemic.

Background: As a chronic illness with potential complications in physical, emotional, social, and economic aspects, HIV poses deterioration in patients’ quality of life.The aim of this study was to assess status of the functional and current quality of life, and associated factors among clients visiting ART clinics in Addis Ababa, Ethiopia. Methods: A multi-site cross-sectional study was conducted in August 2020. All adults with HIV and on active ART at least for 6 months earlier to the study period, and visiting the selected public health facilities were considered. Facilities were selected purposively, and clients were enrolled using a systematic random sampling technique after a proportion to size allocation. Data were collected using a modified and translated questionnaire of the EQ 5D and EQ-VAS. The analysis was done using SPSS v.26 for windows. Descriptive statistics and non-parametric inferential tests namely; Mann Whitney U test, Kruskal Wallis test, and Spearman’s correlation tests were carried out to test the presence of correlates with dependent variables. Ethical approval was sought from Saint Paul’s Hospital Millennium Medical College and Addis Ababa regional health bureau. Results: Out of 371 clients, the majority were from health centers (58%), aged 43 years or below (54%), males (63%), either with primary or secondary education (61%) and married (46.6%) while half were either government or private employees. Pain/discomfort and depression/anxiety were the dimensions most affected with predominance in the age group above 43. The mean score of EQ 5D index values was 0.87 (SD: ±0.05; 95% C.I; 0.86-0.87) and that of EQ-VAS was 81 (SD: ±15, 95% C.I: 80-83). About 38% and 43% of the clients showed an altered health state of any degree in functional and current overall status respectively. Comorbidity, history of current substance use, facility type, social support, and sleep disturbance showed a statistically significant correlation with the functional and current overall health status. Conclusion: A considerable proportion of clients have altered functional and overall health status with pain/discomfort and depression/anxiety most affected. Inclusion of multidisciplinary treatment for HIV and the highlighting of psychosocial issues that are likely amongst this group are warranted.

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Aim: This study assessed the level of adherence to antiretroviral drugs and the associated factors among clients who have a follow-up at public health facilities in central Ethiopia. Method: A multi-site cross-sectional study was conducted from August 1–30, 2020 at seven public health institutions. A systematic random sampling method was used to recruit 385 participants. Data was collected using a structured interviewer-administered questionnaire. Analysis was done using descriptive statistics, and binary logistic regression model. The OR with its 95% C.I was employed to present analytic outputs. Statistical significance for the multivariable model was considered at p ≤ 0.05. Results: Of the 371 participants, the majority were females (233, 62.8%), attended health centers (215, 58.0%), and were married (173, 46.6%). Eighty-nine (89, 24.0%) of the participants have at least one comorbidity. About 72 (19.0%) and 50 (13.5%) of the respondents stated that the COVID-19 has posed challenges on their follow-ups and availability of medications respectively. Nearly a half of the people living with HIV and comorbid T2DM or hypertension (29, 48.0%) reported that they had encountered an increase in the price of medications compared to the pre-COVID-19 times. About half of the respondents in the study setting have perfect adherence to antiretroviral therapy (ART) (200, 54.0%). Basic education (aOR = 3.02: 95% CI: 1.57–5.80), marriage (aOR = 2.27: 95% CI: 1.24–4.15), attendance to a health center (aOR = 0.59: 95% CI: 0.36–0.98) and sleep disturbance (aOR = 0.47: 95% CI: 0.26–0.84) showed a statistically significant association with adherence to ART. Conclusion: About half of the respondents in the study settings have perfect adherence to their ART medications. As multiple factors interplay in the success rate of adherence to ART, stakeholders should place and strengthen practices, such as active follow-up and tracing of cases, ensuring medication affordability (access and low pricing), and psycho-social support to patients.