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Characteristics, treatment outcomes and experiences of COVID-19 patients under home-based care in Kapelebyong district in Uganda: a mixed-methods study.

Authors :
James E
Wanume B
Musaba MW
Nantale R
Mutaki V
Nambozo B
Okia D
Soita D
Napyo A
Matovu JKB
Namulondo R
Lubaale J
Okello F
Mulebeke R
Kakuru A
Amejje N
Emojong D
Okolimong C
Ouma S
Okware S
Olupot-Olupot P
Mukunya D
Source :
Tropical medicine and health [Trop Med Health] 2022 Dec 14; Vol. 50 (1), pp. 93. Date of Electronic Publication: 2022 Dec 14.
Publication Year :
2022

Abstract

Background: A rapid increase in community transmission of COVID-19 across the country overwhelmed Uganda's health care system. In response, the Ministry of Health adopted the home-based care strategy for COVID-19 patients with mild-to-moderate disease. We determined the characteristics, treatment outcomes and experiences of COVID-19 patients under home-based care during the second wave in Kapelebyong district, in eastern Uganda.<br />Methods: We conducted a sequential explanatory mixed-methods study. We first collected quantitative data using an interviewer-administered questionnaire to determine characteristics and treatment outcomes of COVID-19 patients under home-based care. Cured at home was coded as 1 (considered a good outcome) while being admitted to a health facility and/or dying were coded as 0 (considered poor outcomes). Thereafter, we conducted 11 in-depth interviews to explore the experiences of COVID-19 patients under home-based care. Multivariable logistic regression was used to assess factors associated with poor treatment outcomes using Stata v.15.0. Thematic content analysis was used to explore lived experiences of COVID-19 patients under home-based care using NVivo 12.0.0 RESULTS: A total of 303 study participants were included. The mean age ± standard deviation of participants was 32.2 years ± 19.9. Majority of the participants [96.0% (289/303)] cured at home, 3.3% (10/303) were admitted to a health facility and 0.7% (2/303) died. Patients above 60 years of age had 17.4 times the odds of having poor treatment outcomes compared to those below 60 years of age (adjusted odds ratio (AOR): 17.4; 95% CI: 2.2-137.6). Patients who spent more than one month under home-based care had 15.3 times the odds of having poor treatment outcomes compared to those that spent less than one month (AOR: 15.3; 95% CI: 1.6-145.7). From the qualitative interviews, participants identified stigma, fear, anxiety, rejection, not being followed up by health workers and economic loss as negative experiences encountered during home-based care. Positive lived experiences included closeness to friends and family, more freedom, and easy access to food.<br />Conclusion: Home-based care of COVID-19 was operational in eastern Uganda. Older age (> 60 years) and prolonged illness (> 1 months) were associated with poor treatment outcomes. Social support was an impetus for home-based care.<br /> (© 2022. The Author(s).)

Details

Language :
English
ISSN :
1348-8945
Volume :
50
Issue :
1
Database :
MEDLINE
Journal :
Tropical medicine and health
Publication Type :
Academic Journal
Accession number :
36517922
Full Text :
https://doi.org/10.1186/s41182-022-00486-5