Vol 60, No Supplement -1 (2022)

Introduction: Coronavirus disease 2019 (COVID-19) is a global pandemic upending the health, political and economic landscape of the world. Knowledge about COVID-19 has evolved very fast and the epidemiologic pattern is far from comprehensive. Therefore, the primary aim of this study was to map the epidemiology of COVID-19 in Ethiopia in the past two years and to draw lessons for effective control measures.

Methods: A prospective synthesis on reports of new infections and mortality due to COVID-19 infection in Ethiopia from the first index case report in March 13, 2020 until June 20, 2022. Number of new cases, deaths and recoveries were extracted on daily bases from publicly available sources. Descriptive analysis was conducted, and trends were graphically depicted.

Results: Ethiopia is currently in the fifth wave of COVID-19 pandemic, sharing the global trend. So far, more than 5 million tests were carried out with 484,536 people (9.58%) with confirmed disease. The severity rate has declined with every wave with the most severe illness having occurred in the first wave and the least severe in the latest wave. Thus, the Case Fatality Rate (CFR) has declined from 4.7 in the first wave to 1.5 in the 4^th wave. So far, 21% of the population has been fully vaccinated.

Conclusion: While the decline in mortality is encouraging, knowledge about the pandemic and vaccination trends remain poor. Continued efforts to understand the pandemic in Ethiopia and addressing barriers to vaccination are urgent priorities.

Introduction: Public health control measures were crucial to curb the health crisis of Corona Virus Disease 2019 (COVID-19). However, these control responses, along with health system fragility and import dependence, are also likely to lead to significant socioeconomic crisis. This study aimed to present empirical evidence on the socioeconomic effects of COVID-19 in Ethiopia exploring how differences in effects varied by gender and wealth.

Methods: Eleven rounds of panel data from the COVID-19 high frequency phone survey (HFPS) conducted among households in Ethiopia were used. Data were collected between April 2020 and May 2021 among 3249 households in Round 1, which eventually waned and reached 1982 households in Round 11. Employment, income loss, and food insecurity experiences were used to measure economic impacts. Adjusted sample weights were applied to address potential selection bias associated with phone surveys. In addition, we employed reduced panel data economic regressions to estimate the change in outcomes over time and examine differences by gender and socioeconomic status.

Results: There was a significant adverse socioeconomic effect in terms of job loss, income loss and food insecurity. The effect was particularly pronounced during the early months of the pandemic with subsequent lingering effect observed in all the rounds. Disparities in outcomes, particularly employment and food insecurity, were observed by gender and wealth status.

Conclusion: The early public health measures may have contributed to the socioeconomic shockwaves, with clear indications of disparity. Policy measures should consider the needs of those groups in society predisposed to inequity, and factors that may worsen economic impact, such as import dependence for essential therapeutics.

Introduction: The COVD-19 pandemic has resulted in unprecedented global health and economic crisis, particularly in countries struggling with poverty. We conducted a national survey to understand the economic and health impacts of COVID-19 in Ethiopia.

Methods: A pilot, population-based, cross-sectional survey was conducted among adults randomly selected from the Ethio Telecom list of mobile phone numbers. Participants underwent a comprehensive phone interview about the impact of COVID-19 on their economic well-being and the health-related risks associated with COVID-19.

Results: Of 4,180 calls attempted, 1194 were answered, of which a successful interview was made with 614 participants. COVID-19 affected the family income of 343 [55.9%] participants, 56 [9.1%] lost their job, 105 [17.1%] perceived high stress in their household, and 7 [1.14%] reported death in their family in the past month. The odds of having a decreased income due to COVID-19 were 2.4 times higher among self-employed [adjusted odds ratio (AOR) 2.4, 95% CI (1.58-3.77)] and 2.8 times higher among unemployed [AOR 2.8, 95% CI (1.35-5.85)] participants. Two-hundred twenty-one [36%] participants had comorbidity in their household with hypertension, 72 [11.7%], diabetes,50 [8.1%], asthma, 48 [7.8%], and other chronic diseases, 51 [8.4%]. Forty-six [7.5%] participants had COVID-like symptoms in the previous month, where cough, headache, and fatigue were the most common.

Introduction: Despite major advances in Corona Virus Disease 2019 (COVID-19) vaccine development, vaccine hesitancy threatens the progress made to curb the disease. We aimed to assess the level of COVID-19 vaccine hesitancy and the underlying determinants in Ethiopia.

Methods: A pilot mobile phone survey of adults in Ethiopia with mobile phones selected randomly.

Results: The pilot survey included 614 participants who were predominantly male (71.7%), and married (68.2%) with a median age of 34 years (interquartile range [IQR] = 14.0). Overall, 150 (24.4%) participants reported to have been vaccinated; either the first [57 (38%)], second [19 (12.7%)], or both [74 (49.3%)] doses. About one in six participants (16.3%; n=100) reported vaccine hesitancy, with a significant difference by employment status, with self-employed more likely to show hesitancy [adjusted odds ratio (AOR) 1.85, 95% CI (1.05-3.27)], and region. Major drivers of hesitancy were lack of interest [n=30 (30%)], fear of side-effects [n=24 (24%)], and lack of trust in the vaccine [n=13 (13%)]. Having chronic disease conditions in the family had no association with hesitancy (p > 0.05).

Conclusion: While representativeness of the sample is an issue, the findings show a relatively low rate of COVID-19 vaccine hesitancy among the Ethiopian population. The major drivers of hesitancy, lack of interest, fear of side-effects, and lack of trust in the vaccine, may be reversed by disseminating accurate and timely information using credible sources across communities.    

Introduction: The Ethiopian Ministry of Health strongly recommends that anyone, regardless of vaccination status, wears a standard face mask consistently when in public. This study aimed to assess the self-reported use and predictors of wearing face masks in the general population in Ethiopia.

Methods: This was a population-based cross-sectional study using a telephone survey. Adults living in Ethiopia were randomly selected from the Ethio Telecom list of mobile phone numbers and interviewed about their mask-wearing practice and individual and household-level factors that could impact on the use of face masking. Multivariable logistic regression was used to measure associations.

Results: A total of 614 participants were interviewed from September to November 2021. The prevalence of self-reported face mask use when in public was 81.1%. Living outside Addis Ababa, including Oromia [adjusted odds ratio [(AOR) 0.30, 95% confidence interval (CI) (0.14, 0.63)], Amhara [AOR 0.11, 95% CI (0.05, 0.23)], and Southern Nations, Nationalities and People’s Region [AOR 0.31, 95% CI (0.12-0.79)] and being divorced or widowed [AOR 0.18, 95% CI (0.06, 0.62)] were found to be inversely associated with face mask use. Female gender [AOR 1.91, 95% CI (1.02, 3.58)] and older age [age ≥ 50, AOR 2.96, 95% CI (1.09-7.97)] were positively associated with the use of face masks. Attending social events [AOR 0.51, 95% CI (0.31-0.82)], was negatively associated with the use of face masks.

Conclusion: Self-reported use of face masks was relatively high nationally, but inconsistent among different regions and demographics. The findings imply that policies and messaging campaigns may need to focus on specific populations and behaviors in this ongoing pandemic.

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic substantially disrupts population health and wellbeing globally, while little is known about the effect on mental wellbeing in developing countries. This study aimed to assess the impact of COVID-19 on mental wellbeing of individuals and households in Ethiopia.

Methods: A cross-sectional, national pilot survey was conducted through phone interviews from September to November 2021. Mental wellbeing and disability were assessed using a questionnaire adapted from the 5-item World Health Organization Wellbeing Index (WHO-5), the Oslo Social Support Scale (OSSS-3), and the WHO Disability Assessment Scale (WHODAS 2.0).

Results: A total of 614 adults completed the pilot survey. The mean age was 36 years (standard deviation 11) and 71.7% were male. Mental wellbeing was poor in 218 (35.5%) participants. The most important predictors for poor mental wellbeing were rural residence (Adjusted Odds Ratio [AOR] 1.89; 95% CI 1.14, 3.14; p=0.012), perceived COVID-19 risk (AOR 1.75; 95% CI 1.18, 2.60; p=0.005), household stress (AOR 2.09; 95% CI 1.31, 3.34; p=0.002), experience of symptom of COVID-19 in the household (AOR 2.14; 95% CI 1.13, 4.04; p=0.019), and poor social support (AOR 2.43; 95% CI 1.51, 3.91; p<0.001).

Conclusion: The study provides evidence that COVID-19 had a significant adverse impact on the mental wellbeing of individuals and households in Ethiopia. Further studies are needed to understand in detail the implications of the pandemic and interventions needed to keep mental wellbing of citizens.

Introduction: The impact of COVID-19 on people with Severe Mental Health Conditions (SMHCs) has been neglected. We aimed to describe the effect and explore the consequences of COVID-19 on people with SMHCs and mental health services in rural districts of Ethiopia.

Methods: We conducted a mixed-method study nested within well-characterized population cohorts in Butajira and Sodo districts. We sampled 336 people (168 people with SMHCs, 168 comparisons) in a cross-sectional survey. We conducted qualitative key informant interviews with psychiatric nurses (n=3),  primary health care workers (n=3), service users (n=4), family members (n=6) and community members (n=2). We assessed wellbeing (WHO wellbeing index), social support (Oslo social support scale; OSS) and food security quantitatively and used thematic analysis to explore impacts. 

Results: People with SMHCs reported significantly lower wellbeing (WHO wellbeing score 52 vs. 72; p<0.001), less social support (OSS score 8.68 vs. 9.29; p<0.001), worse living standards (47.0% vs. 29.0%; p<0.001) and increased food insecurity (26.0% vs. 12.5%; p<0.001). Household economic status worsened for over one-third of participants.

Participants reported increased relapse, exacerbated stigma due to perceived susceptibility of people with SMHCs to COVID-19, and increased restraint. In mental healthcare settings, there was decreased patient flow but an increase in new cases. Innovations included flexible dispensing of medicines, longer appointment intervals and establishing new treatment centers.

Conclusions: COVID-19 had negative consequences on people with SMHCs and mental health services, which must be anticipated and prevented in any future humanitarian crisis. Adaptive responses used during COVID may increase health system resilience.