Characteristics, treatment outcomes and experiences of COVID-19 patients under home-based care in Kapelebyong district in Uganda: a mixed-methods study
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Published:2022-12-14
Issue:1
Volume:50
Page:
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ISSN:1349-4147
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Container-title:Tropical Medicine and Health
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language:en
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Short-container-title:Trop Med Health
Author:
James Eudu, Wanume Benon, Musaba Milton W., Nantale RitahORCID, Mutaki Vivian, Nambozo Brendah, Okia David, Soita David, Napyo Agnes, Matovu Joseph K. B., Namulondo Racheal, Lubaale Jovani, Okello Francis, Mulebeke Ronald, Kakuru Abel, Amejje Nancy, Emojong David, Okolimong Charles, Ouma Simple, Okware Sam, Olupot-Olupot Peter, Mukunya David
Abstract
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.
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.
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.
Publisher
Springer Science and Business Media LLC
Subject
Infectious Diseases,Public Health, Environmental and Occupational Health
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