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The Impact of the Northern Ethiopian Tigray War on Hypertensive Patients’ Follow up: A Brief Quantitative Study

Abraha Hailu1, Kibreab Gidey1*, Dawit Zenebe2, Ephrem Berhe1, Meskelu Kidu1, Samuel Berhane1, Hailemariam Gebrearegawi4, Hagazi Tesfay1, Desilu Mehari3, Hagos Kahsay1, Senait Alemayehu2 , Kidanu Gebremariam2, Tesfay Gebregziabher5

Background: A tragic and brutal war has been ongoing in Tigray, Northern Ethiopia since November 2020. More than 70% of health facilities had been dysfunctional. The conditions of the hypertensive patients follow up/care and other non-communicable disease is not studied since the war started.

Methods: This study was conducted in six zones of Tigrai from July 03 to August 5, 2021. Health facilities were randomly selected and data on patient’s follow-up of pre-war period (September 2020-October 2020) as well as the subsequent 8 months war period (November 2020-June 2021). Data were collected using a check list. The number of patients who had visits during pre-war and the 8 months war period were compared to assess the impact of the war.

Results: Pre-war and post war data from 46 health facilities in Tigray region (31 health centers, 9 primary hospitals and 6 general hospitals) was collected and analysed. There were 2565 average monthly hypertension visits to health facilities before war period which dropped to 1211 during the war period, a 52.7% reduction. There was reduction of hypertension visits across all health facilities; with health centres 51.2% and hospitals a 53.5% reduction. Eastern and Northwest zone health facilities had worst impact of the war as both showed >85% reduction in clinic visits. The impact of the war was highest in rural areas especially remote areas than urban areas. There was no available data from western Tigray zone and some other zones’ health centres and hospitals due to war destructions. The impact of the war on hypertensive patients could even be higher in these areas.

Conclusion: Due to the war, the care of hypertension had significantly decreased in Tigray. Reduction in the number of hypertensive patients follow up visits and hence care would lead to an increase in short and long-term morbidity/mortality from stroke, acute coronary syndrome, heart failure and sudden cardiac death among other consequences. We recommend humanitarian/development agencies and other organizations to consider morbidity from hypertension and all other chronic noncommunicable diseases when planning.