The Effect of Armed Conflict on Treatment Interruption, Its Outcome and Associated Factors Among Chronic Disease Patients in North East, Amhara, Ethiopia, 2022

Abstract

Background

The health services delivery system is debilitated in conflict setting areas due to damage of health facilities and attack on health care providers. Armed conflict is a complex phenomenon which causes a large amount of death and disability worldwide. However, there is lack of information towards treatment interruption among chronic disease patients in conflict areas. Hence, this study was conducted to assess the prevalence of armed conflict induced treatment interruption and its outcome among chronic disease patients.

Methods

A mixed cross sectional study design was conducted on a total of 399 sample size at North Wollo and Waghimra zone hospitals. To select study participants a consecutive sampling method was used. Multiple logistic regressions were computed to evaluate the association and thematic analysis was used to analyse qualitative data.

Results

From the total 399 study participants, 264 (64.6%) study participants interrupted their medication. Treatment interruption is significantly associated with poor service availability and perceived high stress.

Conclusion

War has detrimental health effects, both immediate and long term, on populations. Treatment interruptions due to armed conflict were caused by poor health care access, lack of medications and lack of transport and displacement of hospital staff, insecurity and fear. Treatment interruption results in morbidity, mortality, lifelong complications, disability, psychological and economic impact.

Keywords:

• armed conflict
• chronic disease
• treatment interruption

Abbreviations

ART, Anti-retroviral Treatment; DM, Diabetes Mellitus; CHF, Congestive Heart Failure; HIV/AIDS, Human Immuno Virus/Acquired Immuno Deficiency Syndrome; HTN, Hypertension; NCD, Non-Communicable Disease.

Data Sharing Statement

The dataset used and analysed for the current study is available from the corresponding author upon reasonable request.

Ethics Approval and Consent to Participate

Ethical clearance was obtained from Woldia University, College of Health Sciences, Research and Community Service Review Committee (RCSRC). A formal letter for permission and support was written to RHB from Woldia University and finally to selected health facilities. All the study participants were informed about the purpose of the study, and their right to refuse. Written and signed voluntary informed consent was obtained from study subjects prior to distributing the questionnaire. The respondents were informed that the information obtained from them was treated with complete confidentiality and does not cause any harm on them as well as the study participants were informed that the result of the study will be published for the scientific community and the informed consent include publication of anonymized responses. This study was also complying with the Declaration of Helsinki.

Acknowledgment

We would like to thank Woldia University for giving us the chance to prepare this research. We would also like to express our gratitude to study participants, data collectors, supervisors and North Wollo and Waghemra zone health bureau. We also thank Mr. Addisu Getie for his support during manuscript revision.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare no conflicts of interest in this work.

Additional information

Funding

There is no funding to report.