Browsing by Author "Alemayehu, Senait"

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    The association between medication adherence and cognitive function impairment among hypertensive patients a case-control study in Mekelle, northern Ethiopia
    (Addis Abeba University, 2020-10) Alemayehu, Senait; Dr. Deyessa, Negussie (MD, Ph.D.)
    Background: Hypertension is a global public health problem. In developing countries, the high prevalence of hypertension followed by poor hypertension control remains a significant public health challenge. The brain is one of the main target organs affected by hypertension, excluding age hypertension is the most important risk factor for cerebrovascular pathology leading to cognitive function impairment. However, the level of antihypertensive medication adherence among hypertension patients and the difference in the development of cognitive function impairment is not well studied. Objective: This study aimed to assess the association between medication adherence and cognitive function impairment among hypertensive patients in Mekelle, northern Ethiopia from April to September 2020 G.C. Method: An unmatched case-control study design was conducted in the selected health facilities in Mekelle, Ethiopia from April to September 2020. The study population was hypertensive patients, aged 60 years and above and who have been on antihypertensive medications for at least 6 months. A sample size of 106 cases and 106 controls were included in the study, participants with cognitive function impairment were considered as cases, and participants without cognitive function impairment were controls. The data collection was done twice and the data were collected by reviewing the medical chart of patients and interviewer-administered questionnaire, by trained data collectors. Mini-Mental State Examination was used to assess the cognition status of the study participants and to assess the antihypertensive medication adherence, Morisky Medication Adherence Scale was used. The collected questionnaires were entered into Epi data version 3.1 and exported to SPSS version 23 for cleaning and further analysis. Bivariable and multivariable logistic regression was used for analysis. An adjusted odds ratio along with a 95% confidence interval and a p-value of < 0.05 was used for declaring statistical significance. Result: The prevalence of medication adherence was found to be 34(32.1%) among cases and 84(79.2%) among controls. Medication adherence was independently significantly associated to cognitive function impairment with [AOR =7.77, 95% CI: (3.44 -17.24)]. The odds of cognitive function impairment was 7.7 times more among antihypertensive medication non-adherent participants compared to those who were adherent. Marital status and educational status were also found to be significantly associated with cognitive function impairment Conclusion and recommendation: There is an association between antihypertensive medication adherence and cognitive function impairment after controlling for possible confounders. Further work needs to be done by the health professionals on informing patients about the consequences of elevated and/ or uncontrolled BP and on the benefits of medication adherence and the consequences of non-adherence.
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    Cost-effectiveness Analysis of Multi Drug Resistant Tuberculosis at Treatment Initiative and Follow up Centers in Addis Ababa, Ethiopia
    (Addis Ababa Universty, 2018-10) Alemayehu, Senait; HaileMariam, Damen (Professor)
    Background: Ethiopia is among 30 high burden TB, TB/HIV and MDR-TB country which account 80% all new TB case worldwide [55].According to2014 national drug resistant TB report the prevalence of MDR-TB was 2.3% and 17.8% among new and perversely TB treated case respectively. The data indicate that MDR-TB has been becoming a significant public health threat in the country. Significance of the study is to avoid the financial risk results from illness-related expenditures and identify the most cost effective intervention. Objective: To analyze the cost-effectiveness of MDR-TB treatment in hospitals (treatment initiative center) and health centers (treatment follow up center). Methods: Full economic evaluation using markov model to provide relevant cost and effectiveness information. The study was in St. Peter specialized and ALERT Hospitals as treatment Initiated centers (TIC) and health centers or treatment follow up centers (TFC). A total sample of two hundred fifty five MDR-TB patients with age greater than 15, selected by using simple random sampling. The data are collected from the hospitals record and patients’ interview after having an informed consent. Markov model, is created using TreeAge Pro Suite 2018 to analyze and estimate cost-effectiveness of the MDRTB treatment at treatment Initiation and follow up centers (TIC and TFC). The Model also structured in five health states. The costs and effectiveness discounted for the base case at an annual rate of 3% at the time of study. The Probability and costs have one year cycle length and life time horizon. Data are checked for its completeness cleaned and analyzed with Markov model developed using TreeAge Software to estimate the Cost-effectiveness of the MDR-TB treatment. Effects are measured as Treatment Success Rate (TSR), treatment failure, death and disability-adjusted life-years (DALYs) averted. Costs are assessed societal perspective in the two major areas, patients and service providers. The escorts/care givers are excluded from the study due to non-reliability of data that could be found for the analysis. Results: The cost of MDR-TB treatment for HIV negative patients per TSR USD 8416.17 for TIC and USD 6,657.15 for TFC the Cost-effectiveness analysis depicted that both treatment centers (TIC and TFC) are cost effective in treating MDR-TB at the incremental cost-effectiveness ratio (ICER) of $1641 per DALYs averted. However, the study revealed that TFC (health center) is decidedly cost effective for the treatment of Tuberculosis’s at the TSR of 88% to 94% if WTP threshold is define one GDP per capital per DALY averted in Ethiopia. Conclusion: The study also provides evidence that the costs of MDR-TB treatment is high specially at TIC than at TFC, however based on the results of the study analysis for MDR-TB treatment both are Cost-effectiveness option at less than 3 times GPD per capital per DALYs averted in Ethiopia and compares the treatment at initiation and follows up centers (TIC and TFC) centers TFC was less cost. .