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Gaur U, Sealy W, Bharatha A, Sobers NP, Krishnamurthy K, Campbell MH, Cumberbatch C, Drakes M, Gibbs M, Alexander C, Harewood H, Adams OP, Gupta S, Parsa AD, Kabir R, Majumder MAA. Knowledge, Attitudes, and Practices of Hand Hygiene, Mask Use, and Social Distancing among Public Hospital and Polyclinic Nurses in Barbados during the Coronavirus 2019 Pandemic. EPIDEMIOLOGIA 2024; 5:122-136. [PMID: 38534805 DOI: 10.3390/epidemiologia5010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Nurses are essential members of the healthcare workforce and were among the first-line carers for patients in community and hospital settings during the COVID-19 pandemic. As a result, they were at a heightened risk of infection, resulting in several reported deaths among nursing staff. Several preventive measures were adopted to contain the spread of the COVID-19 virus. This study aims to explore the knowledge, attitudes, and practices (KAP) of nurses regarding hand hygiene, mask wearing, and social distancing measures in healthcare settings in Barbados during the COVID-19 pandemic. METHOD An online survey of nurses working in public hospitals and polyclinics (public primary care clinics) in Barbados from March 2021 to December 2021 was conducted. A nonsystematic convenience sampling method was employed to recruit nurses who were readily available and willing to participate. A questionnaire captured the sociodemographic information and knowledge and practices related to hand hygiene, the use of face masks, and social distancing. Each correct response received one mark. Overall knowledge scores were categorized as poor (<60%), average (60-80%), or good (>80-100%). RESULTS Of the 192 participants, the majority were female (82.8%) and had >5 years of experience (82%). The findings revealed that 45.8% had poor knowledge of hand hygiene, and that the knowledge of 43.8% of respondents was average. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 2.1 times increased odds (95% confidence interval 1.0, 4.2) of having good knowledge compared to other nursing categories. Regarding mask wearing, 53.6% of nurses had average knowledge, and 27.1% had good knowledge. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 3.3 times increased odds (95% confidence interval 1.5, 7.4) of having good knowledge compared to nursing assistants. A total of 68.6% of respondents followed the correct steps of handwashing every time, and 98.3% wore a mask in public places. More than half of the nurses (51.2%) kept a safe distance from others to avoid spreading SARS-CoV-2; one-third were in a crowded place(s) in the past three months, and 55.8% usually followed guidelines for social isolation as recommended by the WHO. CONCLUSIONS The study identified knowledge deficiencies related to hand hygiene and wearing masks among nurses. It is imperative to provide additional training on infection control measures.
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Affiliation(s)
- Uma Gaur
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
| | - Wendy Sealy
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
| | - Ambadasu Bharatha
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
| | - Natasha P Sobers
- George Alleyne Chronic Disease Research Centre, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
| | - Kandamaran Krishnamurthy
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
| | - Michael H Campbell
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
| | - Cara Cumberbatch
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
| | - Maia Drakes
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
| | - Marielle Gibbs
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
| | - Charisse Alexander
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
| | - Heather Harewood
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
| | - O Peter Adams
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
| | - Subir Gupta
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
| | - Ali Davod Parsa
- School of Allied Health and Social Care, Faculty of Health, Medicine and Social Care, Anglia Ruskin University, Chelmsford CM1 1SQ, UK
| | - Russell Kabir
- School of Allied Health and Social Care, Faculty of Health, Medicine and Social Care, Anglia Ruskin University, Chelmsford CM1 1SQ, UK
| | - Md Anwarul Azim Majumder
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown BB11000, Barbados
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Hakim S, Chowdhury MAB, Uddin MJ, Leslie HH. Availability of basic infection control items and personal protection equipment in 7948 health facilities in eight low- and middle-income countries: Evidence from national health system surveys. J Glob Health 2024; 14:04042. [PMID: 38426844 PMCID: PMC10906347 DOI: 10.7189/jogh.14.04042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Background Hundreds of millions of people become infected globally every year while seeking care in health facilities that lack basic needs like infection control measures and personal protective equipment (PPE). We aimed to evaluate the availability of infection control items and PPE in eight low- and middle-income countries and identify disparities in the availability of those items. Methods In this study, we combined publicly available nationally representative cross-sectional health system surveys (Service Provision Assessments by the Demographic and Health Survey Programme) conducted in eight countries between 2013 and 2018: Afghanistan, Bangladesh, the Democratic Republic of the Congo, Haiti, Malawi, Nepal, Senegal, and Tanzania. The availability of infection control items was evaluated using a list of six items (a waste receptacle, a sharps container, disinfectant, single-use disposable or auto-disposable syringes, soap and running water, or an alcohol-based hand rub, and guidelines for standard precautions). PPE includes four items: gloves, medical masks, gowns, and eye protection. We considered these items available in a facility if they were observed in general outpatient areas or any service-specific area (i.e. delivery room). Results We analysed data from 7948 health facilities (694 hospitals and 7254 health centres/clinics). Overall, among the infection control items and PPE, most surveyed facilities had high availability of single-use disposable or auto-disposable syringes (91.40%) and latex gloves (92.56%). Of infection control measures, guidelines for infection control were the least available during the survey, with the lowest (6.15%) in Nepal and the highest (68.18%) in Malawi. Of the PPE items, eye protection was the least available during the survey, with the lowest (5.4% in Senegal) and the highest (28.17%) in Haiti. Only 1567 (19.71%) facilities looked to have all the basic infection control materials, and 1023 (12.87%) of the analysed facilities possessed all of the PPE. Within the same country, the availability of items varied more between hospitals and health centres/clinics than between them. Conclusions All eight of our study countries experience shortages of the most fundamental standard precaution items to avert infection. Steps must be taken in each of these countries to reduce inadequacies and disparities and enhance efficiency in the conversion of health-system inputs into the facility's availability of standard precaution items for infection control - to curb the risk of infectious disease transmission.
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Affiliation(s)
- Shariful Hakim
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- Chander Hat Degree College, Nilphamari, Bangladesh
| | | | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- Department of General Educational and Development, Daffodil International University, Dhaka, Bangladesh
| | - Hannah H Leslie
- Division of Prevention Science, Department of Medicine, University of California San Francisco (UCSF), San Francisco, California, USA
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Gómez-Pérez GP, de Graaff AE, Dekker JT, Agyei BB, Dada I, Milimo E, Ommeh MS, Risha P, Rinke de Wit TF, Spieker N. Preparing healthcare facilities in sub-Saharan Africa for future outbreaks: insights from a multi-country digital self-assessment of COVID-19 preparedness. BMC Health Serv Res 2024; 24:254. [PMID: 38413977 PMCID: PMC10900561 DOI: 10.1186/s12913-024-10761-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/20/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Despite previous experience with epidemics, African healthcare systems were inadequately prepared and substantially impacted by the coronavirus disease 2019 (COVID-19) pandemic. Limited information about the level of COVID-19 preparedness of healthcare facilities in Africa hampers policy decision-making to fight future outbreaks in the region, while maintaining essential healthcare services running. METHODS Between May-November 2020, we performed a survey study with SafeCare4Covid - a free digital self-assessment application - to evaluate the COVID-19 preparedness of healthcare facilities in Africa following World Health Organization guidelines. The tool assessed (i) COVID-19-related capabilities with 31 questions; and (ii) availability of essential medical supplies with a 23-supplies checklist. Tailored quality improvement plans were provided after assessments. Information about facilities' location, type, and ownership was also collected. RESULTS Four hundred seventy-one facilities in 11 African countries completed the capability assessment; 412 also completed the supplies checklist. The average capability score on a scale of 0-100 (n=471) was 58.0 (interquartile range 40.0-76.0), and the average supplies score (n=412) was 61.6 (39.0-83.0). Both scores were significantly lower in rural (capability score, mean 53.6 [95%CI:50.3-57.0]/supplies score, 59.1 [55.5-62.8]) versus urban facilities (capability score, 65.2 [61.7-68.7]/supplies score, 70.7 [67.2-74.1]) (P<0.0001 for both comparisons). Likewise, lower scores were found for public versus private clinics, and for primary healthcare centres versus hospitals. Guidelines for triage and isolation, clinical management of COVID-19, staff mental support, and contact tracing forms were largely missing. Handwashing stations were partially equipped in 33% of facilities. The most missing medical supply was COVID-19 specimen collection material (71%), while 43% of facilities did not have N95/FFP2 respirators and 19% lacked medical masks. CONCLUSIONS A large proportion of public and private African facilities providing basic healthcare in rural areas, lacked fundamental COVID-19-related capabilities and life-saving personal protective equipment. Decentralization of epidemic preparedness efforts in these settings is warranted to protect healthcare workers and patients alike in future epidemics. Digital tools are of great value to timely measure and improve epidemic preparedness of healthcare facilities, inform decision-making, create a more stakeholder-broad approach and increase health-system resilience for future disease outbreaks.
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Affiliation(s)
- Gloria P Gómez-Pérez
- PharmAccess Foundation, Amsterdam, The Netherlands.
- Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, The Netherlands.
| | | | | | | | | | | | | | - Peter Risha
- PharmAccess Tanzania, Dar es Salaam, Tanzania
| | - Tobias F Rinke de Wit
- PharmAccess Foundation, Amsterdam, The Netherlands
- Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, The Netherlands
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Daba C, Atamo A, Gebretsadik Weldehanna D, Oli A, Debela SA, Luke AO, Gebrehiwot M. Infection prevention and control compliance of healthcare workers towards COVID-19 in conflict-affected public hospitals of Ethiopia. BMJ Open 2023; 13:e074492. [PMID: 38159945 PMCID: PMC10759124 DOI: 10.1136/bmjopen-2023-074492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE Non-compliance with COVID-19 infection prevention and control (IPC) is one of the global public health problems particularly among those frontline healthcare workers. However, there are no detailed investigations on COVID-19 IPC compliance among healthcare workers in conflict-affected settings. The objective of this research was to assess compliance with COVID-19 IPC measures and determine the factors associated with it among healthcare providers in Ethiopian governmental hospitals affected by conflict. DESIGN A cross-sectional study was carried out within institutional settings. STUDY SETTING AND PERIOD The study was conducted in three public hospitals located in northeastern Ethiopia during the period of March to April 2022. PARTICIPANTS Simple random sampling technique was used to select 325 healthcare workers after proportional allocation was made to each public hospital. PRIMARY OUTCOME MEASURES The primary outcome was non-compliance with COVID-19 IPC. A multivariable logistic regression analysis was employed to identify factors associated with the lack of adherence to the COVID-19 IPC protocol. RESULTS Nearly half (150, 46.2%) of the healthcare workers had non-compliance with COVID-19 IPC protocol. Absence of hand washing soap (adjusted OR (AOR)=2.99; 95% CI 2.46 to 5.76), workload (AOR=2.25; 95% CI 1.33 to 3.84), disruption in the supply of piped water (AOR=1.82; 95% CI 1.11 to 2.99), did not undergo training in COVID-19 IPC (AOR=2.85; 95% CI 1.85 to 4.84), absence of COVID-19 IPC guidelines (AOR=2.14; 95% CI 1.11 to 4.13) and chewing khat (AOR=2.3; 95% CI 1.32 to 3.72) were determinant factors for non-compliance. CONCLUSIONS The magnitude of non-compliance with COVID-19 IPC was high. Hospital managers and federal ministry of health should provide regular training on COVID-19 IPC, continuous piped water and personal protective facilities for healthcare workers. Ultimately, improving the security situation in the area would help improve COVID-19 IPC compliance among healthcare workers in these and other similar conflict-affected settings.
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Affiliation(s)
- Chala Daba
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Amanuel Atamo
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Daniel Gebretsadik Weldehanna
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abdi Oli
- Department of Mathemathics, College of Natural and Computational Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Abebe Debela
- Department of Public Health, College of Medicine and Health Sciences, Salale University, Fitche, Ethiopia
| | - Amana Ogeto Luke
- Department of Public Health, Lancha Campus, Rift Valley University, Addis Ababa, Ethiopia
| | - Mesfin Gebrehiwot
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Massele A, Rogers AM, Gabriel D, Mayanda A, Magoma S, Cook A, Chigome A, Lorenzetti G, Meyer JC, Moore CE, Godman B, Minzi O. A Narrative Review of Recent Antibiotic Prescribing Practices in Ambulatory Care in Tanzania: Findings and Implications. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2195. [PMID: 38138298 PMCID: PMC10745081 DOI: 10.3390/medicina59122195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023]
Abstract
Background and objectives: There are concerns with the current prescribing practices of antibiotics in ambulatory care in Tanzania, including both the public and private sectors. These concerns need to be addressed as part of the national action plan (NAP) of Tanzania to reduce rising antimicrobial resistance (AMR) rates. Issues and concerns include high rates of prescribing of antibiotics for essentially self-limiting conditions. Consequently, there is a need to address this. As a result, the aims of this narrative review were to comprehensively summarize antibiotic utilization patterns particularly in ambulatory care and their rationale in Tanzania and to suggest ways forward to improve future prescribing practices. Materials and Methods: We undertook a narrative review of recently published studies and subsequently documented potential activities to improve future prescribing practices. Potential activities included instigating quality indicators and antimicrobial stewardship programs (ASPs). Results: Published studies have shown that antibiotics are being excessively prescribed in ambulatory care in Tanzania, in up to 95% to 96.3% of presenting cases depending on the sector. This is despite concerns with their appropriateness. High rates of antibiotic prescribing are not helped by variable adherence to current treatment guidelines. There have also been concerns with extensive prescribing of 'Watch' antibiotics in the private sector. Overall, the majority of antibiotics prescribed across the sectors, albeit inappropriately, were typically from the 'Access' group of antibiotics in the AWaRe (Access/Watch/Reserve) classification rather than 'Watch' antibiotics to limit AMR. The inappropriate prescribing of antibiotics in ambulatory care is linked to current knowledge regarding antibiotics, AMR, and ASPs among both prescribers and patients. Recommended activities for the future include improved education for all groups, the instigation of updated quality indicators, and the regular monitoring of prescribing practices against agreed-upon guidelines and indicators. Education for healthcare professionals on ASPs should start at undergraduate level and continue post qualification. Community advocacy on the rational use of antibiotics should also include social media activities to dispel misinformation. Conclusion: The quality of current prescribing practices of antibiotics in ambulatory care is sub-optimal in Tanzania. This needs to be urgently addressed.
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Affiliation(s)
- Amos Massele
- Department of Clinical Pharmacology and Therapeutics, Hubert Kairuki Memorial University, 70 Chwaku Road Mikocheni, Dar Es Salaam P.O. Box 65300, Tanzania
| | - Anastasia Martin Rogers
- Department of Microbiology and Parasitology, Faculty of Medicine, Hubert Kairuki Memorial University, 70 Chwaku Road Mikocheni, Dar Es Salaam P.O. Box 65300, Tanzania; (A.M.R.); (D.G.); (A.M.)
| | - Deogratias Gabriel
- Department of Microbiology and Parasitology, Faculty of Medicine, Hubert Kairuki Memorial University, 70 Chwaku Road Mikocheni, Dar Es Salaam P.O. Box 65300, Tanzania; (A.M.R.); (D.G.); (A.M.)
| | - Ashura Mayanda
- Department of Microbiology and Parasitology, Faculty of Medicine, Hubert Kairuki Memorial University, 70 Chwaku Road Mikocheni, Dar Es Salaam P.O. Box 65300, Tanzania; (A.M.R.); (D.G.); (A.M.)
| | - Sarah Magoma
- Department of Infectious Diseases, Faculty of Medicine, University of Dodoma, Dodoma P.O. Box 582, Tanzania;
| | - Aislinn Cook
- Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St. George’s University of London, London SW17 0RE, UK; (A.C.); (G.L.); (C.E.M.)
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX1 2JD, UK
| | - Audrey Chigome
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa (J.C.M.)
| | - Giulia Lorenzetti
- Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St. George’s University of London, London SW17 0RE, UK; (A.C.); (G.L.); (C.E.M.)
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa (J.C.M.)
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa
| | - Catrin E. Moore
- Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St. George’s University of London, London SW17 0RE, UK; (A.C.); (G.L.); (C.E.M.)
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa (J.C.M.)
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
| | - Omary Minzi
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar Es Salaam P.O. Box 65013, Tanzania;
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Tani K, Osetinsky B, Mhalu G, Mtenga S, Fink G, Tediosi F. Healthcare workers' experiences with COVID-19-related prevention and control measures in Tanzania. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002678. [PMID: 38051721 PMCID: PMC10697532 DOI: 10.1371/journal.pgph.0002678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023]
Abstract
The ability of a health system to withstand shocks such as a pandemic depends largely on the availability and preparedness of health-care workers (HCWs), who are at the frontline of disease management and prevention. Despite the heavy burden placed on HCWs during the COVID-19 pandemic, little is known regarding their experiences in low-income countries. We conducted a web-based survey with HCWs in randomly selected districts of Tanzania to explore their experiences with COVID-19-related prevention and control measures. The survey assessed implementation of COVID-19 control guidelines in health facilities, HCW perceptions of safety, well-being and ability to provide COVID-19 care, and challenges faced by frontline workers during the pandemic. We used multivariate regression analysis to examine the association between HCW and health facility characteristics, a score of guideline implementation, and challenges faced by HCWs. 6,884 Tanzanian HCWs participated in the survey between December 2021 to March 2022. The majority of respondents were aware of the COVID-19 guidelines and reported implementing preventive measures, including masking of both HCWs and patients. However, HCWs faced several challenges during the pandemic, including increased stress, concerns about infection, and inadequate personal protective equipment. In particular, female HCWs were more likely to report exhaustion from wearing protective equipment and emotional distress, while physicians were more likely to experience all challenges. While most HCWs reported feeling supported by facility management, they also reported that their concerns about COVID-19 treatment were not fully addressed. Notably, perceptions of protection and well-being varied widely among different HCW cadres, highlighting the need for targeted interventions based on level of exposure. In addition, various factors such as HCW cadre, facility ownership and COVID-19 designation status influenced HCWs' opinions about the health system's response to COVID-19. These findings highlight the importance of consistent implementation of guidelines and social and emotional support for HCWs.
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Affiliation(s)
- Kassimu Tani
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Brianna Osetinsky
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Grace Mhalu
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Sally Mtenga
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Gaube S, Walton K, Kleine AK, Däumling S, Rohrmeier C, Müller S, Bonrath E, Schneider-Brachert W. Examining outpatients' hand hygiene behaviour and its relation to COVID-19 infection prevention measures. J Hosp Infect 2023; 141:55-62. [PMID: 37634601 DOI: 10.1016/j.jhin.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/03/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND The increasing demand for outpatient care is associated with a higher risk of infection transmission in these settings. However, there is limited research on infection prevention and control practices in ambulatory clinics, and none focuses on patients. AIM To examine outpatients' hand hygiene behaviours, their determinants, and their associations with other infection prevention measures during the COVID-19 pandemic. METHODS We observed the hand hygiene behaviour of one cohort of patients in one outpatient clinic and surveyed a separate sample in five clinics about their hand hygiene practice in outpatient facilities. A questionnaire based on the Theoretical Domains Framework (TDF) was used to examine predictors of the behaviour. Moreover, patients indicated their compliance with COVID-19 infection prevention measures, vaccination status, disease risk perception, and vaccine hesitancy. FINDINGS Observed hand hygiene rates among 618 patients were low (12.8%), while 67.3% of the 300 surveyed patients indicated sanitizing their hands upon entering the clinic. The TDF domains 'memory, attention, and decision processes' and 'emotions' significantly predicted both current (today's) and general hand hygiene behaviour in outpatient clinics. Hand hygiene behaviour and compliance with COVID-19 infection prevention showed a positive association; however, no significant connection was found with patients' vaccination status, suggesting different behavioural motivators. CONCLUSION Hand hygiene among outpatients should be improved through interventions focusing on helping patients remember to clean their hands. More research on infection prevention in outpatient facilities is needed to ensure patient safety.
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Affiliation(s)
- S Gaube
- Global Business School for Health, University College London, London, UK.
| | - K Walton
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - A-K Kleine
- LMU Center for Leadership and People Management, LMU Munich, Munich, Germany
| | - S Däumling
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - C Rohrmeier
- Faculty of Medicine, University of Regensburg, Regensburg, Germany; HNO-Gemeinschaftspraxis, Straubing, Germany
| | - S Müller
- Clinic and Polyclinic for Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany; MKG-Praxis im Turm, Straubing, Germany
| | - E Bonrath
- Praxis für Chirurgie & Handchirurgie, Regensburg, Germany
| | - W Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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Houben F, Heijer CDD, Dukers-Muijrers NH, Smeets-Peels C, Hoebe CJ. Psychosocial determinants associated with healthcare workers' self-reported compliance with infection prevention and control during the COVID-19 pandemic: a cross-sectional study in Dutch residential care facilities for people with intellectual and developmental disabilities. BMC Public Health 2023; 23:2052. [PMID: 37858182 PMCID: PMC10588203 DOI: 10.1186/s12889-023-16912-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Healthcare workers' (HCWs) compliance with infection prevention and control (IPC) is crucial to reduce the infection transmission risk. However, HCWs' compliance with IPC in residential care facilities (RCFs) for people with intellectual and developmental disabilities (IDDs) is known to be suboptimal. Therefore, this study examined sociodemographic and psychosocial determinants associated with IPC non-compliance in this setting, to inform IPC policy and promotion programmes for adequate IPC behaviour. METHODS An online questionnaire was administered to 285 HCWs from 16 RCFs between March 2021 and March 2022. Determinants associated with IPC non-compliance were assessed using logistic regression analyses. RESULTS Being a woman (OR: 3.57; 1.73-7.37), and being a non-medical professional were associated with increased odds of non-compliance (social workers, OR: 2.83; 1.65-4.85; behavioural specialists, OR: 6.09; 1.98-18.72). Perceived inadequate education/training (aOR: 1.62; 1.15-2.27) and perceived time constraints/competing priorities (aOR: 1.43; 1.03-1.98) were also associated with increased odds of non-compliance, independent of sociodemographic variables. In contrast, the belief that the supervisor complies with IPC (descriptive norm supervisor) was associated with decreased odds of non-compliance (aOR: 0.60; 0.41-0.88). CONCLUSIONS To improve IPC in disability care settings, the implementation of tailored and structural IPC education and training programmes (e.g., on-the-job training) is recommended to increase HCWs' capabilities and bridge the IPC compliance gap between medical and non-medical professionals. In addition, role models, particularly supervisors, are crucial for promoting IPC behaviour. Facilities should create a culture of IPC compliance by norm setting, acting on, and modelling IPC behaviours at all levels of the organisation (management, medical, and non-medical staff).
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Affiliation(s)
- Famke Houben
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands.
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands.
| | - Casper Dj den Heijer
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, Maastricht, 6202 AZ, The Netherlands
| | - Nicole Htm Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | | | - Christian Jpa Hoebe
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, Maastricht, 6202 AZ, The Netherlands
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Oy S, Saing CH, Ung M, Zahari M, Nouhak I, Kim S, Nagashima-Hayashi M, Khuon D, Koy V, Mam S, Sayasone S, Saphonn V, Yi S. Developing an infection prevention and control intervention to reduce hospital-acquired infections in Cambodia and Lao People's Democratic Republic: the HAI-PC study protocol. Front Public Health 2023; 11:1239228. [PMID: 37799162 PMCID: PMC10548876 DOI: 10.3389/fpubh.2023.1239228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/30/2023] [Indexed: 10/07/2023] Open
Abstract
Background Hospital-acquired infections (HAIs) are significant public health issues, especially in low-and middle-income countries (LMICs). Hand hygiene and low-level disinfection of equipment practices among healthcare workers are some of the essential measures to reduce HAIs. Various infection prevention and control (IPC) interventions to reduce HAI incidence have been developed. However, effective interventions have not been well developed in the LMICs context. Therefore, this protocol aims to develop, pilot, and assess the feasibility and acceptability of an IPC intervention in Cambodia and the Lao People's Democratic Republic. Methods This study will consist of four phases guided by the Medical Research Council (MRC) Framework. Three hospitals will be purposely selected - each from the district, provincial, and national levels - in each country. The gap analysis will be conducted in Phase 1 to explore IPC practices among healthcare workers at each hospital through desk reviews, direct observation of hand hygiene and low-level disinfection of equipment practices, in-depth interviews with healthcare workers, and key informant interviews with stakeholders. In Phase 2, an IPC intervention will be developed based on the results of Phase 1 and interventions selected from a systematic literature review of IPC interventions in LMICs. In Phase 3, the developed intervention will be piloted in the hospitals chosen in Phase 1. In Phase 4, the feasibility and acceptability of the developed intervention will be assessed among healthcare workers and representatives at the selected hospitals. National consultative workshops in both countries will be conducted to validate the developed intervention with the national technical working groups. Discussion The MRC Framework will be employed to develop and evaluate an intervention to reduce HAIs in two LMICs. This theoretical framework will be used to explore the factors influencing hand hygiene compliance among healthcare workers. The gap analysis results will allow us to develop a comprehensive IPC intervention to reduce HAI incidence in Cambodia and Lao People's Democratic Republic. Findings from this protocol will feed into promising IPC interventions to reduce HAI incidence in other resource-limited settings. Clinical trial registration ClinicalTrial.Gov, identifier NCT05547373.
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Affiliation(s)
- Sreymom Oy
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Chan Hang Saing
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Mengieng Ung
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Marina Zahari
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Inthavong Nouhak
- Department of International Program for Health in the Tropics, Lao Tropical and Public Health Institute, Vientiane, Lao People’s Democratic Republic
| | - Sothea Kim
- University of Health Sciences, Phnom Penh, Cambodia
| | - Michiko Nagashima-Hayashi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Dyna Khuon
- University of Health Sciences, Phnom Penh, Cambodia
| | - Virya Koy
- Department of Hospital Services, Ministry of Health, Phnom Penh, Cambodia
| | - Sovatha Mam
- University of Health Sciences, Phnom Penh, Cambodia
| | - Somphou Sayasone
- Department of International Program for Health in the Tropics, Lao Tropical and Public Health Institute, Vientiane, Lao People’s Democratic Republic
| | | | - Siyan Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Public Health Program, College of Education and Health Sciences, Touro University California, Vallejo, CA, United States
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Aljaberi MA, Al-Sharafi MA, Uzir MUH, Sabah A, Ali AM, Lee KH, Alsalahi A, Noman S, Lin CY. Psychological Toll of the COVID-19 Pandemic: An In-Depth Exploration of Anxiety, Depression, and Insomnia and the Influence of Quarantine Measures on Daily Life. Healthcare (Basel) 2023; 11:2418. [PMID: 37685451 PMCID: PMC10487588 DOI: 10.3390/healthcare11172418] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023] Open
Abstract
The COVID-19 pandemic, on a global scale, has prompted multifaceted challenges, including a notable psychological toll on the general population. This study uses mixed-method approach for a nuanced exploration of these experiences. Using a phenomenological strategy, qualitative responses from 999 participants were analyzed regarding their pandemic-induced anxiety and the influence of quarantine measures on their lives. Quantitative measures, including the revised Impact of Event Scale (IES-R), patient health questionnaire-9 (PHQ-9), the seven-item generalized anxiety disorder assessment (GAD-7), and Insomnia Severity Index (ISI), were used to quantify trauma, depression, anxiety, and insomnia attributed to COVID-19. Partial least squares structural equation modeling (PLS-SEM) was utilized for quantitative data analysis. The anxiety-related responses were mainly clustered into four themes: life threats, support shortage, economic consequences, and disruptions to family and social life. Subthemes that addressed the perceived effects encapsulated disruptions to academic and professional lives, familial and social relationships, psychopathological stress, and movement limitations. The findings from quantitative analysis revealed the significant associations between COVID-19-related trauma and symptoms of anxiety, depression, and insomnia, as indicated by coefficients exceeding 0.10 (all z-values > 1.96; p-values < 0.05). In conclusion, the findings underscore COVID-19's role in escalating anxiety, influenced by various factors, and its disruptive effects on daily life due to quarantine measures. The strong associations between the pandemic and the symptoms of depression, anxiety, and insomnia underscore the urgency of comprehensive psychological and public health interventions to alleviate these impacts.
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Affiliation(s)
- Musheer A. Aljaberi
- Faculty of Medicine and Health Sciences, Taiz University, Taiz 6803, Yemen
- Faculty of Nursing and Applied Sciences, Lincoln University College, Petaling Jaya 47301, Malaysia
- Department of Community Health, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang 43300, Malaysia;
| | - Mohammed A. Al-Sharafi
- Institute of Informatics and Computing in Energy, Universiti Tenaga Nasional, Putrajaya Campus, Kajang 43000, Malaysia;
| | - Md. Uzir Hossain Uzir
- Faculty of Business and Accountancy, Lincoln University College, Petaling Jaya 47301, Malaysia;
| | - Aiche Sabah
- Faculty of Human and Social Sciences, Hassiba Benbouali University of Chlef, Chlef 02076, Algeria;
| | - Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Smouha, Alexandria 21527, Egypt;
| | - Kuo-Hsin Lee
- Department of Emergency Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung City 824, Taiwan
- School of Medicine, College of Medicine, I-Shou University, No. 8, Yi-Da Road, Jiao-Su Village, Yan-Chao District, Kaohsiung City 824, Taiwan
| | - Abdulsamad Alsalahi
- Department of Pharmacology, Faculty of Pharmacy, Sana’a University, Sana’a 1247, Yemen;
| | - Sarah Noman
- Department of Community Health, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang 43300, Malaysia;
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan;
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Margao S, Fofanah BD, Thekkur P, Kallon C, Ngauja RE, Kamara IF, Kamara RZ, Tengbe SM, Moiwo M, Musoke R, Fullah M, Kanu JS, Lakoh S, Kpagoi SSTK, Kamara KN, Thomas F, Mannah MT, Katawera V, Zachariah R. Improvement in Infection Prevention and Control Performance Following Operational Research in Sierra Leone: A Before (2021) and After (2023) Study. Trop Med Infect Dis 2023; 8:376. [PMID: 37505672 PMCID: PMC10383112 DOI: 10.3390/tropicalmed8070376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 07/29/2023] Open
Abstract
INTRODUCTION Infection prevention and control (IPC) is crucial to limit health care-associated infections and antimicrobial resistance. An operational research study conducted in Sierra Leone in 2021 reported sub-optimal IPC performance and provided actionable recommendations for improvement. METHODS This was a before-and-after study involving the national IPC unit and all twelve district-level secondary public hospitals. IPC performance in 2021 (before) and in 2023 (after) was assessed using standardized World Health Organization checklists. IPC performance was graded as: inadequate (0-25%), basic (25.1-50%), intermediate (50.1-75%), and advanced (75.1-100%). RESULTS The overall IPC performance in the national IPC unit moved from intermediate (58%) to advanced (78%), with improvements in all six core components. Four out of six components achieved advanced levels when compared to the 2021 levels. The median score for hospitals moved from basic (50%) to intermediate (59%), with improvements in six of eight components. Three of four gaps identified in 2021 at the national IPC unit and four of seven at hospitals had been addressed by 2023. CONCLUSIONS The study highlights the role of operational research in informing actions that improved IPC performance. There is a need to embed operational research as part of the routine monitoring of IPC programs.
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Affiliation(s)
- Senesie Margao
- National Infection Prevention and Control Coordinating Unit, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (C.K.); (R.E.N.)
| | - Bobson Derrick Fofanah
- World Health Organization Country Office, Freetown 00232, Sierra Leone; (I.F.K.); (R.M.); (V.K.)
| | - Pruthu Thekkur
- Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, 75001 Paris, France;
| | - Christiana Kallon
- National Infection Prevention and Control Coordinating Unit, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (C.K.); (R.E.N.)
| | - Ramatu Elizabeth Ngauja
- National Infection Prevention and Control Coordinating Unit, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (C.K.); (R.E.N.)
| | - Ibrahim Franklyn Kamara
- World Health Organization Country Office, Freetown 00232, Sierra Leone; (I.F.K.); (R.M.); (V.K.)
| | - Rugiatu Zainab Kamara
- US Centre for Disease Control and Prevention Country Office, Freetown 00232, Sierra Leone;
| | - Sia Morenike Tengbe
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (S.M.T.); (M.F.); (J.S.K.); (S.L.); (S.S.T.K.K.); (K.N.K.); (M.T.M.)
| | - Matilda Moiwo
- Republic of Sierra Leone Armed Forces, HIV/AIDS/TB Control Program Coordinator, 34th Military Hospital, Wilberforce, Western Area Urban 00232, Sierra Leone;
| | - Robert Musoke
- World Health Organization Country Office, Freetown 00232, Sierra Leone; (I.F.K.); (R.M.); (V.K.)
| | - Mary Fullah
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (S.M.T.); (M.F.); (J.S.K.); (S.L.); (S.S.T.K.K.); (K.N.K.); (M.T.M.)
| | - Joseph Sam Kanu
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (S.M.T.); (M.F.); (J.S.K.); (S.L.); (S.S.T.K.K.); (K.N.K.); (M.T.M.)
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone;
| | - Sulaiman Lakoh
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (S.M.T.); (M.F.); (J.S.K.); (S.L.); (S.S.T.K.K.); (K.N.K.); (M.T.M.)
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone;
| | - Satta Sylvia T. K. Kpagoi
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (S.M.T.); (M.F.); (J.S.K.); (S.L.); (S.S.T.K.K.); (K.N.K.); (M.T.M.)
| | - Kadijatu Nabie Kamara
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (S.M.T.); (M.F.); (J.S.K.); (S.L.); (S.S.T.K.K.); (K.N.K.); (M.T.M.)
| | - Fawzi Thomas
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone;
- National Pharmacovigilance Center, Pharmacy Board of Sierra Leone, Freetown 047235, Sierra Leone
| | - Margaret Titty Mannah
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (S.M.T.); (M.F.); (J.S.K.); (S.L.); (S.S.T.K.K.); (K.N.K.); (M.T.M.)
| | - Victoria Katawera
- World Health Organization Country Office, Freetown 00232, Sierra Leone; (I.F.K.); (R.M.); (V.K.)
| | - Rony Zachariah
- UNICEF, UNDP, World Bank, WHO Special Programme for Research and Training in Tropical Diseases (TDR), 1211 Geneva, Switzerland;
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Meziane S, Taous M, Bourkhiss B. Mitigating the risk of COVID-19 infection in the operating room: Using healthcare failure mode and effect analysis. PERIOPERATIVE CARE AND OPERATING ROOM MANAGEMENT 2023; 31:100319. [PMID: 37131868 PMCID: PMC10140677 DOI: 10.1016/j.pcorm.2023.100319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/19/2023] [Accepted: 04/26/2023] [Indexed: 05/04/2023]
Abstract
Context The process of caring for patients requiring surgery exposes them to a high risk of COVID-19 infection during the pre-operative, operative, and post-operative phases, as these procedures are known to be modes of transmission for the virus. Objective We conducted this study to prevent the risk of COVID-19 infection by identifying potential failure modes during the patient care process, determining critical activities, and defining mitigation measures to reduce transmission. Materials and methods Through a quality and a priori risk management method, which is Healthcare Failure Mode and Effect Analysis (HFMEA), applied in the patient care process in the Central Operating Room of Mohammed VI University Hospital in Morocco. Results We identified 38 potential failure modes in the patient care process during the three phases (preoperative, operative, and postoperative) that could increase the risk of COVID-19 infection. Of these, 61% are classified as critical, and we have identified all their possible causes. To reduce the risk of transmission, we have proposed 16 mitigation actions. Conclusion The use of HFMEA has been effective in the new pandemic context, improving patient safety during the care process in the operating room and reducing the risk of COVID-19 infection.
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Affiliation(s)
- Sara Meziane
- Department of Biology, Faculty of Science, IBN TOFAIL University. B.P: 133 Kenitra, 14000, Morocco
| | - Mohammed Taous
- The ophthalmology department, CHU Mohammed VI Oujda, Morocco
| | - Brahim Bourkhiss
- Department of Biology, Faculty of Science, University IBN TOFAIL, Kenitra, Morocco
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Weldetinsae A, Alemu ZA, Tefaye K, Gizaw M, Alemahyehu E, Tayachew A, Derso S, Abate M, Getachew M, Abera D, Mebrhatu A, Kefale H, Habebe S, Assefa T, Mekonnen A, Tollera G, Tessema M. Adherence to infection prevention and control measures and risk of exposure among health-care workers: A cross-sectional study from the early period of COVID-19 pandemic in Addis Ababa, Ethiopia. Health Sci Rep 2023; 6:e1365. [PMID: 37359411 PMCID: PMC10288972 DOI: 10.1002/hsr2.1365] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
Background and Aim Healthcare workers (HCWs) are considered a high-risk group for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure, ascribed to the amount of time they spend in health-care facilities (HCFs). This study aimed to assess HCWs' compliance with Infection Prevention and Control (IPC) procedures and the risk of exposure during the early period of the pandemic in Addis Ababa, Ethiopia. Methods A descriptive cross-sectional survey was conducted from June to September 2020. With a response rate of 79.2%, a standardized questionnaire was administered among 247 HCWs, working in eight HCFs. Descriptive and multivariate regression analysis was carried out in STATA version 16. Results About 22.5% (55) of the HCWs had proper adherence to IPC procedures. Of the total participants, 28.2% (69) had proper use of Personal Protective Equipment (PPE), 40% (98) had proper hand hygiene practices, and 33.1% (81) had frequently cleaned their working environment. HCWs who received training on IPC protocols were four times more likely to follow IPC standards than those with no training (adjusted odds ratio [AOR] = 3.93; 95% confidence interval [CI]: 1.46, 10.58). Besides, HCWs working in treatment centers were four times more likely to follow IPC standards than those working in conventional hospitals (AOR = 3.61; 95% CI:1.63, 8.02). Nurses were four times more likely to have adherence to IPC measures than cleaners and runners (AOR = 4.37; 95% CI: 1.38-13.88). Conclusion The nature and magnitude of the pandemic did not introduce the required degree of adherence to IPC procedures, per se does not match the level of diligence needed to halt SARS-CoV-2 transmission. Our finding suggested that providing periodic training of HCWs with particular emphasis on nonclinical staff is commendable. Furthermore, it is necessary to maintain resilent IPC in HCF through continous follow up and safety drills, to assess the readiness of HFCs' adherance to IPC measures under normal circumstances, which could improve prepardeness for an effective response during epidemics.
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Affiliation(s)
| | | | | | - Melaku Gizaw
- Ethiopian Public Health Institute Addis Ababa Ethiopia
| | | | | | - Sisay Derso
- Ethiopian Public Health Institute Addis Ababa Ethiopia
| | - Moa Abate
- Ethiopian Public Health Institute Addis Ababa Ethiopia
| | | | - Daniel Abera
- Ethiopian Public Health Institute Addis Ababa Ethiopia
| | | | - Higu Kefale
- Ethiopia Ministry of Health Addis Ababa Ethiopia
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Kessy SJ, Gon G, Alimi Y, Bakare WA, Gallagher K, Hornsey E, Sithole L, Onwekwe EVC, Okwor T, Sekoni A, Vahanian A, Vorndran A, Niyoyitungira T, Raji T, Ihekweazu C, Abdulaziz M, Ogunsola F. Training a Continent: A Process Evaluation of Virtual Training on Infection Prevention and Control in Africa During COVID-19. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:GHSP-D-22-00051. [PMID: 37116932 PMCID: PMC10141425 DOI: 10.9745/ghsp-d-22-00051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 02/14/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND Strengthening infection prevention and control (IPC) capacity was identified as a key intervention to prepare African Union member states to curb the COVID-19 pandemic. As part of the Africa Taskforce for Coronavirus, which helped implement the Africa Joint Continental Strategy for COVID-19 Outbreak response, the IPC Technical Working Group (IPC TWG) was convened to coordinate the development of IPC core components for preparedness, response, and recovery from COVID-19. As part of the IPC TWG's work, the Africa Centres for Disease Control and Prevention, in collaboration with the Infection Control Africa Network, delivered virtual IPC training sessions targeted to African Union member states. We aimed to undertake a process evaluation of this training to inform and improve both ongoing and future programming. METHODS The scope of the evaluation was agreed upon through discussion with the training organizers and advisory members and a design workshop. A mixed-methods approach was used; data collection was partly prospective and partly retrospective due to the rapid start of some of the training activities. Existing available data included: usage analytics, the content of questions posed during the webinar and community of practice, and participant feedback survey results. In addition, in-depth qualitative interviews were conducted with a sample of webinar participants. RESULTS The rapid development of this training was efficient and responsive. The training reached more than 3,000 participants across the 2 rounds, but the numbers varied substantially by location. Participants engaged well during the question period during each webinar, but the asynchronous community of practice was less utilized during the evaluation time frame. Many participants appreciated the African focus of the webinars and gave positive feedback on the practical and context-specific content. CONCLUSIONS The move toward online training provides an important opportunity to improve IPC across the African continent.
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Affiliation(s)
| | - Giorgia Gon
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Yewande Alimi
- Africa Centres for Disease Control, Addis Ababa, Ethiopia
| | | | | | | | - Lizzi Sithole
- Infection Control Africa Network, Cape Town, South Africa
| | | | - Tochi Okwor
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | | | - Anna Vorndran
- Infection Control Africa Network, Cape Town, South Africa
| | | | - Tajudeen Raji
- Africa Centres for Disease Control, Addis Ababa, Ethiopia
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Krishnamoorthy Y, M K, Kuberan D, Krishnan M, Tondare D. Compliance with hand hygiene practices and its appropriateness among healthcare workers during COVID-19 pandemic in public health facilities of Tamil Nadu, India. Heliyon 2023; 9:e15410. [PMID: 37089396 PMCID: PMC10104598 DOI: 10.1016/j.heliyon.2023.e15410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/25/2023] Open
Abstract
Background Compliance with appropriate hand hygiene practises is the most efficient and cost-effective intervention that can be implemented in the healthcare setting. Given its importance, we tried to capture the compliance with hand hygiene practises and their appropriateness among healthcare workers during the COVID-19 pandemic in public health facilities in Tamil Nadu. Methods This cross-sectional study involved doctors, nurses, and allied healthcare professionals from various departments in 18 public healthcare facilities spanning six districts in Tamil Nadu. A random-intercept model was employed for the multivariable logistic regression analysis to evaluate the factors influencing hand hygiene compliance and its adequacy. The effect size was presented as an adjusted odds ratio (aOR) accompanied by a 95% confidence interval (CI). Results In total, 2733 hand hygiene observations were made. Only during 19.4% (95%CI: 17.9%-20.9%) of these observations, hand washing was done. Only during 37.9% (95%CI: 33.9%-42.1%) of these observations, hand washing was done appropriately by following all the essential steps of hand hygiene. Nurses (aOR = 2.49; 95%CI: 1.90-3.26), healthcare workers in General Surgery (aOR = 2.18; 95%CI: 1.53-3.10) and Obstetrics & Gynaecology departments (aOR = 1.75; 95%CI: 1.26-2.43), working in inpatient departments (aOR = 2.64; 95%CI: 1.38-5.04) had significantly higher compliance to hand hygiene practices. Nurses (aOR = 2.58; 95%CI: 1.33-5.01) and General Medicine department healthcare workers (aOR = 1.98; 95%CI: 1.09-3.61) had significantly higher compliance to appropriate hand hygiene practices. Conclusion Our study shows that only during one-fifth of the observations did healthcare workers do hand washing, and less than 10% did it appropriately by following all the essential steps of hand hygiene.
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Affiliation(s)
- Yuvaraj Krishnamoorthy
- Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India
| | - Kala M
- Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India
| | - Deivasigamani Kuberan
- Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India
| | - Murali Krishnan
- Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India
| | - Devidas Tondare
- Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India
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Fereidouni A, Teymoori E, Maleki Z, Ghanavati M, Vizeshfar F. Relationships Between Job Satisfaction of Operating Room Nurses and Hospital's Compliance With Protective Guidelines During the Covid-19 Pandemic: A Cross-Sectional Study, Iran. J Perianesth Nurs 2023; 38:51-57. [PMID: 35752524 PMCID: PMC9058135 DOI: 10.1016/j.jopan.2022.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/24/2022] [Accepted: 03/27/2022] [Indexed: 01/28/2023]
Abstract
PURPOSE The Covid-19 pandemic is considered the biggest threat to human health in the recent century. During emergency surgeries, the possibility of infection of members of the surgical team with Covid-19 increases due to the direct contact with patients. The present study has been conducted aimed to investigate the relationships between job satisfaction of operating room nurses and the hospital's compliance with protective guidelines (guidance) during Covid-19 pandemic from the perspective of operating room nurses. DESIGN This was a descriptive and cross-sectional study conducted from September 22, 2020 to April 21, 2021. METHODS This study was conducted on 926 nurses working in operating rooms in 15 metropolises of Iran. The sampling method in this study was multistage clustering. The questionnaire was sent to the target group through social apps (WhatsApp and Telegram). The collected data were analyzed by SPSS software version 26 using descriptive and analytical statistics. FINDINGS The mean age and job satisfaction of the participants were 28.81 ± 5.64 years and 51.15 ± 11.45, respectively. Participants (n = 259; 27.97%) reported very good job satisfaction. Also, the mean hospital's compliance with protective guidelines during Covid-19 pandemic from the perspective of operating room nurses was 42.29 ± 7.11. The results of the present study showed a significant relationship between job satisfaction and hospital's compliance with protective guidelines during Covid-19 pandemic (P-value ≤ .001). CONCLUSIONS Optimization of infrastructure, improvement of management decisions and increasing human resources in a crisis can affect the quality of performance and job satisfaction of operating room nurses. The researchers suggest that health system managers can contribute to the safety and efficiency of the existing human resources by taking measures to increase job satisfaction.
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Affiliation(s)
- Armin Fereidouni
- Department of Operating Room Technology, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran,Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Esmaeil Teymoori
- Department of Operating Room Technology, Faculty of Paramedical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | - Zahra Maleki
- Department of Epidemiology, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Ghanavati
- Department of Nursing, School of Nursing and Midwifery, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Vizeshfar
- Associate Professor, Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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17
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Keleb A, Lingerew M, Ademas A, Berihun G, Sisay T, Adane M. The magnitude of standard precautions practice and its associated factors among healthcare workers in governmental hospitals of northeastern Ethiopia. FRONTIERS IN HEALTH SERVICES 2023; 3:1071517. [PMID: 37033899 PMCID: PMC10073742 DOI: 10.3389/frhs.2023.1071517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 02/28/2023] [Indexed: 04/12/2023]
Abstract
Background Non-compliance with infection control guidelines of healthcare workers may increase their risk of exposure to infectious diseases but can be prevented through adherence to standard precautionary practices in healthcare settings. Objective This study aimed to assess the magnitude of standard precautions practice and its associated factors among healthcare workers in government hospitals of South Wollo Zone, northeastern Ethiopia. Methods An institutional-based cross-sectional study was conducted among 1,100 healthcare workers. Proportional sample size allocation for each selected government hospital was conducted followed by simple random sampling to select study participants using human resource records from each hospital. Data were collected using structured and self-administered pretested questionnaires. The data were analyzed using descriptive statistics, bivariable binary, and multivariable logistic regression models. Variables with a p-value <0.05 with a 95% CI were considered as having statistical significance. Results The overall magnitude of compliance with standard precautions among healthcare workers was 19.2%. The result indicated that work experience of <5 years (AOR = 2.51; 95% CI: 1.07-5.89), absence of continuous water supply (AOR = 2.24; 95% CI: 1.95-5.29), and negative attitude (AOR = 2.37; 95% CI: 1.17-4.79) were significantly associated with poor compliance of standard precautions practice. Conclusion The overall magnitude of compliance with standard precautions among healthcare workers was low compared to the national magnitude of infection prevention practice. Interventions including consistent and effective training on infection prevention healthcare workers should be given regularly. Providing continuous water supply and building a positive attitude toward infection prevention practices among healthcare workers are also required.
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Corredor SM, Abrahamyan A, Thekkur P, Reyes J, Celis Y, Cuellar C, Zachariah R. High level of infection prevention and control in surveyed hospitals in Colombia, 2021. Rev Panam Salud Publica 2023; 47:e70. [PMID: 37089786 PMCID: PMC10120385 DOI: 10.26633/rpsp.2023.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/14/2023] [Indexed: 04/25/2023] Open
Abstract
Objective This study aimed to determine the performance of infection prevention and control (IPC) programs in eight core components in level 2 and level 3 hospitals across all provinces in Colombia. Methods This cross-sectional study used self-assessed IPC performance data voluntarily reported by hospitals to the Ministry of Health and Social Protection during 2021. Each of the eight core components of the World Health Organization's checklist in the Infection Prevention and Control Assessment Framework contributes a maximum score of 100, and the overall IPC performance score is the sum of these component scores. IPC performance is graded according to the overall score as inadequate (0-200), basic (201-400), intermediate (401-600) or advanced (601-800). Results Of the 441 level 2 and level 3 hospitals, 267 (61%) reported their IPC performance. The median (interquartile range [IQR]) overall IPC score was 672 (IQR: 578-715). Of the 267 hospitals reporting, 187 (70%) achieved an advanced level of IPC. The median overall IPC score was significantly higher in private hospitals (690, IQR: 598-725) than in public hospitals (629, IQR: 538-683) (P < 0.001). Among the core components, scores were highest for the category assessing IPC guidelines (median score: 97.5) and lowest for the category assessing workload, staffing and bed occupancy (median score: 70). Median overall IPC scores varied across the provinces (P < 0.001). Conclusions This countrywide assessment showed that 70% of surveyed hospitals achieved a self-reported advanced level of IPC performance, which reflects progress in building health system resilience. Since only 61% of eligible hospitals participated, an important next step is to ensure the participation of all hospitals in future assessments.
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Affiliation(s)
- Sandra Milena Corredor
- Ministry of Health and Social ProtectionBogotáColombiaMinistry of Health and Social Protection, Bogotá, Colombia
- Sandra Milena Corredor,
| | - Arpine Abrahamyan
- Tuberculosis Research and Prevention CenterYerevanArmeniaTuberculosis Research and Prevention Center, Yerevan, Armenia
| | - Pruthu Thekkur
- Center for Operational ResearchInternational Union Against Tuberculosis and Lung DiseaseParisFranceCenter for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
| | - Jorge Reyes
- Central University of EcuadorQuitoEcuadorCentral University of Ecuador, Quito, Ecuador
| | - Yamile Celis
- Communicable Diseases and Environmental Determinants of Health DepartmentPan American Health OrganizationBogotáColombiaCommunicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization, Bogotá, Colombia
| | - Claudia Cuellar
- Ministry of Health and Social ProtectionBogotáColombiaMinistry of Health and Social Protection, Bogotá, Colombia
| | - Rony Zachariah
- Special Programme for Research and Training in Tropical DiseasesGenevaSwitzerlandSpecial Programme for Research and Training in Tropical Diseases, Geneva, Switzerland
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Ardiani EL, Hartono RK. Development of an infectious disease prevention behavior model for public health center workers in a rural area of Indonesia. J Public Health Afr 2022. [PMID: 37497147 PMCID: PMC10367035 DOI: 10.4081/jphia.2022.2405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The Infection Prevention Behavior (IPB) for health personnel at the Surade Public Health Center has not reached the target. The purpose of this study was to develop the IPB model for health personnel which is suitable to be applied in rural areas in Indonesia. The model was developed through a literature review from online journal database in the last 10 years. The model was tested using a cross-sectional design by the Structural Equation Model Partial Least Square (SEM-PLS). Six selected variables had direct and indirect influences on the IPB of health personnel. They were supervision (27.50%), facilities (9.87%), training (10.44%), compensation (16.97%), work climate (10.78%), and work motivation (8.15%). The model was valid and significant. The Q2 showed 95.7% which mean 95.7% of the components in the model could be applied to other Public Health Centers in the rural area. The development of IPB models for health personnel which wass measured from the direct and indirect effects of six variables proved valid and significant to help achievement Public Health Center reach the target of protecting health workers from infectious diseases.
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20
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Kazibwe J, Shah HA, Kuwawenaruwa A, Schell CO, Khalid K, Tran PB, Ghosh S, Baker T, Guinness L. Resource use, availability and cost in the provision of critical care in Tanzania: a systematic review. BMJ Open 2022; 12:e060422. [PMID: 36414306 PMCID: PMC9684998 DOI: 10.1136/bmjopen-2021-060422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Critical care is essential in saving lives of critically ill patients, however, provision of critical care across lower resource settings can be costly, fragmented and heterogenous. Despite the urgent need to scale up the provision of critical care, little is known about its availability and cost. Here, we aim to systematically review and identify reported resource use, availability and costs for the provision of critical care and the nature of critical care provision in Tanzania. DESIGN This is a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES Medline, Embase and Global Health databases were searched covering the period 2010 to 17 November 2020. ELIGIBILITY CRITERIA We included studies that reported on forms of critical care offered, critical care services offered and/or costs and resources used in the provision of care in Tanzania published from 2010. DATA EXTRACTION AND SYNTHESIS Quality assessment of the articles and data extraction was done by two independent researchers. The Reference Case for Estimating the Costs of Global Health Services and Interventions was used to assess quality of included studies. A narrative synthesis of extracted data was conducted. Costs were adjusted and reported in 2019 US$ and TZS using the World Bank GDP deflators. RESULTS A total 31 studies were found to fulfil the inclusion and exclusion criteria. Critical care identified in Tanzania was categorised into: intensive care unit (ICU) delivered critical care and non-ICU critical care. The availability of ICU delivered critical care was limited to urban settings whereas non-ICU critical care was found in rural and urban settings. Paediatric critical care equipment was more scarce than equipment for adults. 15 studies reported on the costs of services related to critical care yet no study reported an average or unit cost of critical care. Costs of medication, equipment (eg, oxygen, personal protective equipment), services and human resources were identified as inputs to specific critical care services in Tanzania. CONCLUSION There is limited evidence on the resource use, availability and costs of critical care in Tanzania. There is a strong need for further empirical research on critical care resources availability, utilisation and costs across specialties and hospitals of different level in low/middle-income countries like Tanzania to inform planning, priority setting and budgeting for critical care services. PROSPERO REGISTRATION NUMBER CRD42020221923.
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Affiliation(s)
- Joseph Kazibwe
- Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Hiral A Shah
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
- Center for Global Development, Washington, DC, USA
| | - August Kuwawenaruwa
- Health System Impact Evaluation and Policy Unit, Ifakara Health Institute, Ifakara, United Republic of Tanzania
| | - Carl Otto Schell
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Karima Khalid
- Department of Anaesthesia and Critical Care, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Phuong Bich Tran
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Srobana Ghosh
- Global Health Department, Center for Global Development, Washington, DC, USA
| | - Tim Baker
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
- Department of Emergency Medicine, Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania
| | - Lorna Guinness
- Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
- Center for Global Development, Washington, DC, USA
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21
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Sertcelik A, Cakir B, Metan G. Evaluation of risk factors for developing COVID-19 in healthcare professionals working at two university hospitals in Turkey. Work 2022; 74:799-809. [PMID: 36442185 DOI: 10.3233/wor-220053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND: Healthcare workers (HCWs) were seriously affected by the coronavirus disease 2019 (COVID-19). It is a priority to protect HCWs against COVID-19 and ensure the continuity of the health care system. OBJECTIVE: To evaluate the risk factors for COVID-19 in HCWs and the effectiveness of the measures taken on protection. METHODS: A nested case-control study was conducted in two hospitals serving on the same campus which are affiliated with a university from Turkey, between 03.12.2020 and 05.22.2020. We aimed to recruit three controls working in the same unit with the cases diagnosed with COVID-19 by polymerase chain reaction (PCR) and whose SARS-CoV-2 PCR test is negative. Self-reported data were collected from the HCWs by the face-to-face method. Descriptive and analytical methods were used and a logistic regression model was built. Results: The study was completed with 271 HCWs, 72 cases, and 199 controls. Household contact with a COVID-19 patient or a patient with symptoms compatible with COVID-19 was found to be significantly higher in the cases than in the controls (p = 0.02, p < 0.001). When the measures for control the COVID-19 were analyzed, using a medical mask (OR = 0.28, 95% confidence interval = 0.11–0.76, p = 0.01) by COVID-19 patient and using the respiratory mask by HCWs (OR = 0.13, 95% CI = 0.03–0.52, p = 0.004) during close contact was found to be protective against COVID-19 transmission. Conclusion: This study showed an association with using medical masks by the patients as an important protective precaution for the transmission of COVID-19 to HCWs. Respiratory masks should be used by HCWs while in close contact with COVID-19 patients regardless of aerosol-producing procedures.
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Affiliation(s)
- Ahmet Sertcelik
- Department of Public Health, Division of Epidemiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Banu Cakir
- Department of Public Health, Division of Epidemiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gokhan Metan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- Hospitals Infection Control Committee, Hacettepe University, Ankara, Turkey
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22
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Okeke EN. Playing defense? Health care in the era of Covid. JOURNAL OF HEALTH ECONOMICS 2022; 85:102665. [PMID: 35952443 PMCID: PMC9358334 DOI: 10.1016/j.jhealeco.2022.102665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/15/2022] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
Health workers have to balance their own welfare vs. that of their patients particularly when patients have a readily transmissible disease. These risks become more consequential during an outbreak, and especially so when the chance of severe illness or mortality is non-negligible. One way to reduce risk is by reducing contact with patients. Such changes could be along the intensive or extensive margins. Using data on primary care outpatient encounters during the early months of the Covid-19 pandemic, I document important changes in the intensity of provider-patient interactions. Significantly, I find that adherence to clinical guidelines, the probability that routine procedures such as physical examinations were completed, and even the quality of information given by health providers, all declined sharply. I present evidence that these effects likely reflect risk mitigation behavior by health providers.
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Affiliation(s)
- Edward N Okeke
- Department of Economics, Sociology and Statistics, RAND, 1200 South Hayes, Arlington, VA 22202, United States of America.
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23
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El Sharif N, Ahmead M, Imam A. COVID-19 infection prevention and control procedures and institutional trust: Perceptions of Palestinian healthcare workers. Front Public Health 2022; 10:947593. [PMID: 36062099 PMCID: PMC9437519 DOI: 10.3389/fpubh.2022.947593] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/03/2022] [Indexed: 01/21/2023] Open
Abstract
Background Lack of trust in institutional control measures during Coronavirus disease 2019 (COVID-19) outbreaks may affect healthcare workers' (HCWs) levels of stress and wellbeing, and as a consequence, may influence their trust and confidence in their organization. This study aims to understand factors associated with healthcare workers perceptions of trust in organizational preparedness, communication, and infection risk during the COVID-19 pandemic. Methods A cross-sectional study was conducted among HCWs (n = 876) in 16 COVID 19 healthcare facilities between October and December 2020 in Palestine (Gaza Strip, West Bank and East Jerusalem). A stratified purposive sample using an online self-administered Arabic version of a questionnaire was used for data collection. The questionnaire used for this study was adapted from the World Health Organization Blueprint Novel Coronavirus Perceptions of healthcare workers regarding local infection prevention and control procedures for a COVID-19 research protocol.Data were analyzed using Statistical Package for Social Sciences software version 23. In the bivariate analysis, T-test, one-way ANOVA and χ2 test were used at a significant p-value < 0.05. In the multivariable logistic regression analyses, the adjusted odds ratios and its 95% confidence intervals are presented. Results Findings showed that confidence in the systems' ability to manage COVID-19 cases, encouragement and support from senior medical/nursing staff to apply recommended IPC measures, and good levels of mental health increased trust in the organization. Additionally, receiving proper training on IPC procedures for other communicable diseases, having access to clear policies and procedures related to IPC procedures for COVID-19, and providing PPE during the previous clinical shift also increased trust. However, the intention to use recommended PPE when treating patients with suspected or confirmed COVID-19 when having access to it and feeling emotional was negatively correlated with this trust. Conclusions HCWs should be provided with clear, accessible communications about policies and protocols, as well as training about infection prevention and control, personal protective equipment, and support during pandemics to increase their trust in the healthcare system. Additionally, the improvement in HCWs' wellbeing can be attributed to a greater sense of trust in institutions.
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24
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Wang Z, An C, Lee K, Chen X, Zhang B, Yin J, Feng Q. Physicochemical change and microparticle release from disposable gloves in the aqueous environment impacted by accelerated weathering. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 832:154986. [PMID: 35395312 DOI: 10.1016/j.scitotenv.2022.154986] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 05/24/2023]
Abstract
The explosive growth of disposable gloves usage in cities around the world has posed a considerable risk to municipal solid management and disposal during the COVID-19 pandemic. The lack of the environmental awareness leads to glove waste being discarded randomly and ending up in the soil and/or the ocean ecosystem. To explore the physicochemical changes and environmental behaviors of disposable glove wastes in the aqueous environment, three kinds of glove (latex, nitrile and vinyl) were investigated. The results showed that the physicochemical characteristics of disposable gloves made of different materials were altered to different degrees by UV weathering. Nitrile gloves were more stable than latex and vinyl gloves after being exposed to weathering conditions. Although the chemical structures were not clearly demonstrated through FTIR after weathering, the SEM results showed significant microscopic changes on the surfaces of the gloves. Analysis of the leachate results showed that UV weathered gloves released leachable substances, including microparticles, organic matter, and heavy metals. Latex gloves were more likely to release microparticles and other substances into the water after UV weathering. The release of microparticles from gloves can also be impacted by sand abrasion. The appropriate strategy needs to be developed to mitigate the environmental impact caused by the discarded gloves.
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Affiliation(s)
- Zheng Wang
- Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, H3G 1M8, Canada
| | - Chunjiang An
- Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, H3G 1M8, Canada.
| | - Kenneth Lee
- Fisheries and Oceans Canada, Ecosystem Science, Ottawa, K1A 0E6, Canada
| | - Xiujuan Chen
- Northern Region Persistent Organic Pollutant Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University, St. John's, A1B 3X5, Canada
| | - Baiyu Zhang
- Northern Region Persistent Organic Pollutant Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University, St. John's, A1B 3X5, Canada
| | - Jianan Yin
- Institute for Energy, Environment and Sustainable Communities, University of Regina, Regina, S4S 0A2, Canada
| | - Qi Feng
- Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, H3G 1M8, Canada
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Fofanah BD, Abrahamyan A, Maruta A, Kallon C, Thekkur P, Kamara IF, Njuguna CK, Squire JS, Kanu JS, Bah AJ, Lakoh S, Kamara D, Hermans V, Zachariah R. Achieving Minimum Standards for Infection Prevention and Control in Sierra Leone: Urgent Need for a Quantum Leap in Progress in the COVID-19 Era! INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5642. [PMID: 35565037 PMCID: PMC9102022 DOI: 10.3390/ijerph19095642] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/11/2022] [Accepted: 04/20/2022] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Good Infection prevention and control (IPC) is vital for tackling antimicrobial resistance and limiting health care-associated infections. We compared IPC performance before (2019) and during the COVID-19 (2021) era at the national IPC unit and all regional (4) and district hospitals (8) in Sierra Leone. METHODS Cross-sectional assessments using standardized World Health Organizations IPC checklists. IPC performance scores were graded as inadequate = 0-25%, basic = 25.1-50%, intermediate = 50.1-75%, and advanced = 75.1-100%. RESULTS Overall performance improved from 'basic' to 'intermediate' at the national IPC unit (41% in 2019 to 58% in 2021) and at regional hospitals (37% in 2019 to 54% in 2021) but remained 'basic' at district hospitals (37% in 2019 to 50% in 2021). Priority gaps at the national IPC unit included lack of: a dedicated IPC budget, monitoring the effectiveness of IPC trainings and health care-associated infection surveillance. Gaps at hospitals included no assessment of hospital staffing needs, inadequate infrastructure for IPC and lack of a well-defined monitoring plan with clear goals, targets and activities. CONCLUSION Although there is encouraging progress in IPC performance, it is slower than desired in light of the COVID-19 pandemic. There is urgent need to mobilize political will, leadership and resources and make a quantum leap forward.
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Affiliation(s)
- Bobson Derrick Fofanah
- World Health Organization Country Office, 21A-B Riverside Drive, Brookfields, Freetown 00232, Sierra Leone; (A.M.); (I.F.K.); (C.K.N.)
| | - Arpine Abrahamyan
- Tuberculosis Research and Prevention Center (TBRPC), Yerevan 0014, Armenia;
| | - Anna Maruta
- World Health Organization Country Office, 21A-B Riverside Drive, Brookfields, Freetown 00232, Sierra Leone; (A.M.); (I.F.K.); (C.K.N.)
| | - Christiana Kallon
- National Infection Prevention and Control Coordinating Unit, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone;
| | - Pruthu Thekkur
- Centre for Operational Research, International Union against Tuberculosis and Lung Disease, 75001 Paris, France;
| | - Ibrahim Franklyn Kamara
- World Health Organization Country Office, 21A-B Riverside Drive, Brookfields, Freetown 00232, Sierra Leone; (A.M.); (I.F.K.); (C.K.N.)
| | - Charles Kuria Njuguna
- World Health Organization Country Office, 21A-B Riverside Drive, Brookfields, Freetown 00232, Sierra Leone; (A.M.); (I.F.K.); (C.K.N.)
| | - James Sylvester Squire
- Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (J.S.S.); (J.S.K.)
| | - Joseph Sam Kanu
- Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (J.S.S.); (J.S.K.)
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (A.J.B.); (S.L.)
| | - Abdulai Jawo Bah
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (A.J.B.); (S.L.)
- Institute of Global Health and Development, Queen Margaret University, Edinburgh EH21 6UU, UK
| | - Sulaiman Lakoh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (A.J.B.); (S.L.)
- Department of Medicine, University of Sierra Leone Teaching Hospitals Complex, Freetown 00232, Sierra Leone
| | - Dauda Kamara
- Water, Sanitation, and Hygiene (WASH) Program, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone;
| | - Veerle Hermans
- Médecins Sans Frontières, Operational Centre Brussels, 68, Rue de Gasperich, 1617 Luxembourg, Belgium;
| | - Rony Zachariah
- UNICEF, UNDP, World Bank, WHO Special Programme for Research and Training in Tropical Diseases (TDR), Avenue Appia 20, 1211 Geneva, Switzerland;
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Ward C, Phillips A, Oresanya O, Olisenekwu G, Arogunade E, Moukénet A, Beakgoubé H, De Paul Allambademel V, Compaoré CS, Traoré A, Ouedraogo JB, Compaoré YD, Zongo I, Donovan L, Decola MA, Smith H, Baker K. Delivery of seasonal malaria chemoprevention with enhanced infection prevention and control measures during the COVID-19 pandemic in Nigeria, Burkina Faso and Chad: a cross-sectional study. Malar J 2022; 21:103. [PMID: 35331248 PMCID: PMC8943494 DOI: 10.1186/s12936-022-04091-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background Seasonal malaria chemoprevention (SMC) is a WHO-recommended intervention for children aged 3–59 months living in areas of high malaria transmission to provide protection against malaria during the rainy season. Operational guidelines were developed, based on WHO guidance, to support countries to mitigate the risk of coronavirus disease 2019 (COVID-19) transmission within communities and among community distributors when delivering SMC. Methods A cross-sectional study to determine adherence to infection prevention and control (IPC) measures during two distribution cycles of SMC in Nigeria, Chad and Burkina Faso. Community distributors were observed receiving equipment and delivering SMC. Adherence across six domains was calculated as the proportion of indications in which the community distributor performed the correct action. Focus group discussions were conducted with community distributors to understand their perceptions of the IPC measures and barriers and facilitators to adherence. Results Data collectors observed community distributors in Nigeria (n = 259), Burkina Faso (n = 252) and Chad (n = 266) receiving IPC equipment and delivering SMC. Adherence to IPC indications varied. In all three countries, adherence to mask use was the highest (ranging from 73.3% in Nigeria to 86.9% in Burkina Faso). Adherence to hand hygiene for at least 30 s was low (ranging from 3.6% in Nigeria to 10.3% in Burkina Faso) but increased substantially when excluding the length of time spent hand washing (ranging from 36.7% in Nigeria to 61.4% in Burkina Faso). Adherence to safe distancing in the compound ranged from 5.4% in Chad to 16.4% in Nigeria. In Burkina Faso and Chad, where disinfection wipes widely available compliance with disinfection of blister packs for SMC was low (17.4% in Burkina Faso and 16.9% in Chad). Community distributors generally found the IPC measures acceptable, however there were barriers to optimal hand hygiene practices, cultural norms made social distancing difficult to adhere to and caregivers needed assistance to administer the first dose of SMC. Conclusion Adherence to IPC measures for SMC delivery during the COVID-19 pandemic varied across domains of IPC, but was largely insufficient, particularly for hand hygiene and safe distancing. Improvements in provision of protective equipment, early community engagement and adaptations to make IPC measures more feasible to implement could increase adherence. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04091-z.
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Affiliation(s)
- Charlotte Ward
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Helen Smith
- International Health Consulting Services Ltd, Wirral, UK
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Buowari DY, Emeribe N, Ogbonna VI, Esievoadje ES, Odimegwu C, Isokariari OMA, Agoyi MO, Emeagui OD, Jimoh AO. A Cross-Sectional Survey of Doctors in Nigeria Regarding Local Infection Prevention and Control Procedures for Coronavirus Disease 2019 (COVID-19). Niger Med J 2022; 63:169-175. [PMID: 38803703 PMCID: PMC11128162 DOI: 10.60787/nmj-63-2-78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Background Worldwide COVID-19-related mortalities have included healthcare workers in the frontline caring for COVID-19 infected patients. This necessitates the practice of infection prevention and control procedures to protect health professionals from contracting the virus at the workplace. We investigated the knowledge and practice of doctors working in Nigeria regarding infection prevention and control procedures in the workplace. Methodology This is a cross-sectional study of doctors and dentists working in Nigeria using a semi-structured self-administered questionnaire adapted from the World Health Organization "Perception of health workers regarding local infection prevention and control procedures for the Coronavirus Disease 2019" tool. Data were analyzed using SPSS version 25. Results 302 doctors participated in this survey. Most were female 195 (64.6%); 80.50% provided direct care to patients; 267 (88.4%) worked in hospitals with suspected or confirmed cases of COVID-19 while 179 (59.3) directly cared for patients with suspected or confirmed cases of COVID-19 infection. 137 (70.6%) had close contact with confirmed cases of COVID-19. Hand hygiene and gloves were the most common procedure/material available for the prevention of infections for the respondents in the healthcare settings, followed by other types of medical facemasks, N95 respirator masks, eye protection like goggles and disposable aprons. Conclusion In 2020, during the period of the COVID-19 pandemic, doctors in Nigeria were knowledgeable about infection prevention procedures but do not have access to personal protective equipment.
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Affiliation(s)
- Dabota Yvonne Buowari
- Department of Accident and Emergency, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria
| | - Nana Emeribe
- Department of Community Medicine, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Vivian Ifeoma Ogbonna
- Department of Community Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | | | - Chioma Odimegwu
- Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu, Enugu State
| | | | - Mary Oluwakemisola Agoyi
- Safer Hands Health Initiative, Association of Medical Students of University of Lagos Secretariat, Room 3, College Library Alley, College of Medicine of the University of Lagos, Lagos University Teaching Hospital, Idi-Araba, Lagos. Nigeria
| | - Omoadoni D Emeagui
- Department of Paediatrics, Federal Medical Centre, Asaba, Delta State, Nigeria
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García Balaguera C, Yesenia García O, Gutiérrez MV. Public perception of healthcare system response to COVID-19: Findings from a web based observational study in Villavicencio, Colombia. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000702. [PMID: 36962561 PMCID: PMC10021575 DOI: 10.1371/journal.pgph.0000702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/24/2022] [Indexed: 11/19/2022]
Abstract
This study explores the community perceptions of COVID-19 and the healthcare system's response to it.: A web-based descriptive observational study was conducted on the general population during the third quarter of 2020 through the application of a survey via social media. Of the sample, 55% have minimal connection with prevention programs, while 66.3% received little or no information about COVID-19, and 69.62% were considered at risk of getting sick from COVID-19. Further, 73.14% were afraid to go to healthcare centers fearing the risk of becoming infected by COVID-19. The low-income population is at greater risk (OR 4.32), as well as those who have not been informed by their insurer of the risks of COVID-19 (OR 2.18). There is a need to strengthen the healthcare system and the quality and design of effective self-care educational interventions during the pandemic.
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Affiliation(s)
- César García Balaguera
- Public Health, School of Medicine, Cooperative University of Colombia, Villavicencio, Colombia
| | - Olga Yesenia García
- Research Incubator of the GRIVI Group, School of Medicine, Cooperative University of Colombia, Villavicencio, Colombia
| | - María Victoria Gutiérrez
- Research Incubator of the GRIVI Group, School of Medicine, Cooperative University of Colombia, Villavicencio, Colombia
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Nwakasi C, Esiaka D, Uchendu I, Bosun-Arije S. Factors Influencing Compliance with Public Health Directives and Support for Government's Actions Against COVID-19: A Nigerian Case Study. SCIENTIFIC AFRICAN 2021; 15:e01089. [PMID: 34957353 PMCID: PMC8692243 DOI: 10.1016/j.sciaf.2021.e01089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/22/2021] [Accepted: 12/20/2021] [Indexed: 12/24/2022] Open
Abstract
Because COVID-19 is a novel viral pandemic, there is a dearth of research in the body of evidence that explore factors that can influence compliance with public health recommendations and Nigerian government's actions to prevent the spread of COVID-19. Hence, this study's aim is to address this gap to help inform policymakers and the actions of public health leaders in Nigeria. The study included a sample of 336 adult Nigerians who responded to an online Qualtrics survey. Descriptive and linear regression analyses were conducted to determine the predictors of compliance with COVID-19 public health directives and support for government's action against COVID-19 spread. Perceived risk of stigmatization, perceived threat of COVID-19, town/city, gender, and confidence in government's ability to curb the spread and impact of COVID-19 were found to be significantly associated with compliance with COVID-19 public-health directives, and support for governments action against COVID-19. Given Nigeria's weak health system and high level of poverty, there is need to ensure the public health responses to the pandemic are effective and contextually relevant. Nigerians and other concerned global health stakeholders will benefit from research that provides more information on issues of non-compliance with COVID-19 public health directives and government actions.
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Affiliation(s)
- Candidus Nwakasi
- Department of Health Policy and Management, Providence College, 1 Cunningham Square, Providence, RI, United States
| | - Darlingtina Esiaka
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Life Sciences II, Newark, NJ, United States
| | - Iheanyi Uchendu
- Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Castle Ln E, Bournemouth, BH7 7DW, United Kingdom
| | - Stella Bosun-Arije
- Department of Nursing, Manchester Metropolitan University, All Saints Building, All Saints, Manchester, M15 6BH, United Kingdom
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Hirose R, Itoh Y, Ikegaya H, Miyazaki H, Watanabe N, Yoshida T, Bandou R, Daidoji T, Nakaya T. Evaluation of the Residual Disinfection Effects of Commonly Used Skin Disinfectants against Viruses: An Innovative Contact Transmission Control Method. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:16044-16055. [PMID: 34841856 DOI: 10.1021/acs.est.1c05296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Lasting disinfection effects, that is, the residual disinfection effects (RDEs), of skin-coated disinfectants have rarely been considered for infection control owing to the challenges involved in the accurate evaluation of RDEs. In this study, we constructed a new skin evaluation model and determined the RDEs of existing disinfectants against viruses. Our results showed that ethanol and isopropanol had no RDE, whereas povidone-iodine, chlorhexidine gluconate, and benzalkonium chloride (BAC) exhibited RDEs, with 10% povidone-iodine and 0.2% BAC showing particularly strong RDEs. The RDE of 0.2% BAC was strong enough to reduce the median survival times of severe acute respiratory syndrome coronavirus-2, human coronavirus-OC43, and influenza virus from 670 to 5.2, 1300 to 12, and 120 to 4.2 min, respectively. Additionally, this strong RDE was maintained even 4 h after coating the skin. Clinical data also showed that the strong RDE of 0.2% BAC was maintained for more than 2 h. Thus, applying disinfectants with strong RDEs on the skin correlates with a reduction in virus survival time and appears to create a skin surface environment that is not conducive to virus survival. A prolonged reduction in virus survival decreases the contact transmission risk, thereby enabling stronger infection control.
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Affiliation(s)
- Ryohei Hirose
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hiroshi Ikegaya
- Department of Forensic Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hajime Miyazaki
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Naoto Watanabe
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Takuma Yoshida
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Risa Bandou
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Forensic Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tomo Daidoji
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Takaaki Nakaya
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
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Keleb A, Ademas A, Lingerew M, Sisay T, Berihun G, Adane M. Prevention Practice of COVID-19 Using Personal Protective Equipment and Hand Hygiene Among Healthcare Workers in Public Hospitals of South Wollo Zone, Ethiopia. Front Public Health 2021; 9:782705. [PMID: 34926394 PMCID: PMC8674420 DOI: 10.3389/fpubh.2021.782705] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/02/2021] [Indexed: 01/06/2023] Open
Abstract
Objective: The use of personal protective equipment and hand hygiene are often the most recommended line of defense against coronavirus disease-19 (COVID-19). The purpose of this study is to determine the magnitude of compliance and associated factors of personal protective equipment (PPE) utilization and hand hygiene practice among healthcare workers in public hospitals of South Wollo Zone, Northeastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted among 489 healthcare workers in public hospitals of South Wollo Zone, Northeastern Ethiopia from June 15 to July 30, 2021. Proportional sample size allocation to each selected hospital followed by simple random sampling techniques were used to select the study participants using human resource records from each hospital. A pre-tested and structured self-administered questionnaire with WHO's standardized hand hygiene and PPE utilization observational checklist were used to collect data. Bivariate and multivariable analyses with 95% CI and p-value < 0.05 were employed to identify the associated factors of personal protective equipment utilization. Results: About 32 and 22.3% of healthcare workers were compliant with personal protective equipment utilization and hand hygiene practice, respectively. Feedback for safety (AOR = 2.05; 95% CI: 1.26-3.35), training on COVID-19 prevention (AOR = 3.43; 95% CI: 2.01-5.86), and perception to infection risk (AOR = 1.98; 95% CI: 1.18-3.33) were significant factors of good compliance with personal protective equipment utilization. Conclusion: The magnitude of good compliance with personal protective equipment utilization and hand hygiene was low. Interventions to promote personal protective equipment utilization and hand hygiene should focus on feedback for safety, training on COVID-19 prevention, and perception of infection risk.
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Affiliation(s)
- Awoke Keleb
- Department of Environmental Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Wang S, Li LZ, van Antwerpen N, Suparman S, Gayatri M, Sari NP, Zhang SX. Hand Hygiene and Mask-Wearing Practices during COVID-19 among Healthcare Workers: Misinformation as a Predictor. Am J Trop Med Hyg 2021; 105:1483-1489. [PMID: 34678760 PMCID: PMC8641349 DOI: 10.4269/ajtmh.21-0463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 09/09/2021] [Indexed: 11/07/2022] Open
Abstract
Poor public health information is a hurdle in infectious disease control. The study aims to examine whether healthcare workers adhere to hand hygiene and mask-wearing guidelines during the COVID-19 pandemic and to explore their exposure to misinformation about the pandemic as a predictor. A cross-sectional survey was sent to 518 healthcare workers across Indonesia, the fourth largest nation in the world, in September 2020 during the COVID-19 pandemic. The respondents reported whether they adhered to the guidelines of hand hygiene and mask wearing and whether they believed in four pieces of misinformation about the origin, severity, contagion, and prevention of COVID-19. The association between misinformation and hand hygiene and mask wearing was tested with logistic regression models controlling for demographic and health-related covariates. Approximately 25% of healthcare workers did not always adhere to hand hygiene guidelines and approximately 5% did not adhere to mask-wearing guidelines. There are significant associations between all four pieces of misinformation and hand hygiene and mask wearing. It is important to improve public health information about COVID-19, which may hold key to healthcare workers' hand hygiene and mask wearing and to protect their health and patients' safety.
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Affiliation(s)
- Senhu Wang
- Department of Sociology, National University of Singapore, Singapore;
| | - Lambert Zixin Li
- Graduate School of Business, Stanford University, Stanford, California
| | | | - Sutrisno Suparman
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, Indonesia
| | - Mergy Gayatri
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, Indonesia
| | | | - Stephen X. Zhang
- Faculty of the Professions, University of Adelaide, Adelaide, Australia
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Souza LAB, Neves HCC, Aredes NDA, Medeiros ICLJ, Silva GO, Ribeiro LCM. Nursing supervised curricular internship in the Covid-19 pandemic: experience in the program Brasil Conta Comigo. Rev Esc Enferm USP 2021; 55:e20210003. [PMID: 34515724 DOI: 10.1590/1980-220x-reeusp-2021-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/06/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To report the experience of the nursing supervised curricular internship in the program "O Brasil Conta Comigo" carried out in the Covid-19 pandemic. METHOD Experience report of activities developed in Primary Health Care in a municipality in the southern region of the state of Goiás during the Covid-19 pandemic, from April to November 2020. RESULTS The inclusion in the government program allowed the strengthening of the student's active role in the teaching-learning process and teaching-service approximation, with the student as the point of connection, which resulted in the implementation of actions for the fight against the pandemic in the municipality, such as elaboration, implementation, and evaluation of the service flowchart for people with suspected Covid-19. CONCLUSION The experience was successful, as it consolidated knowledge regarding leadership and autonomy, integration between theory and practice, critical thinking, and evidence-based problem solving. The participation in the program allowed for contributions to assistance and management in the actions to combat the new coronavirus in the scope of primary care, as well as for the contribution to the training of the student tutored by nurses in the field and supervised by professors from the federal university of origin.
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Affiliation(s)
- Lara Arcipreti Boel Souza
- Hospital Sírio Libanês, Gestão dos Serviços em Saúde e Redes de Atenção à Saúde, São Paulo, SP, Brazil
| | | | | | | | - George Oliveira Silva
- Universidade Federal de Goiás, Faculdade de Enfermagem, Goiânia, GO, Brazil.,Secretaria Municipal de Saúde de Goiânia. Goiânia, Goiás, Brazil
| | - Luana Cássia Miranda Ribeiro
- Universidade Federal de Goiás, Faculdade de Enfermagem, Goiânia, GO, Brazil.,Secretária Executiva da Secretaria Municipal de Saúde de Goiânia. Goiânia, GO, Brazil
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King JJC, Powell-Jackson T, Makungu C, Spieker N, Risha P, Mkopi A, Goodman C. Effect of a multifaceted intervention to improve clinical quality of care through stepwise certification (SafeCare) in health-care facilities in Tanzania: a cluster-randomised controlled trial. Lancet Glob Health 2021; 9:e1262-e1272. [PMID: 34363766 PMCID: PMC8370880 DOI: 10.1016/s2214-109x(21)00228-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Quality of care is consistently shown to be inadequate in health-care settings in many low-income and middle-income countries, including in private facilities, which are rapidly growing in number but often do not have effective quality stewardship mechanisms. The SafeCare programme aims to address this gap in quality of care, using a standards-based approach adapted to low-resource settings, involving assessments, mentoring, training, and access to loans, to improve clinical quality and facility business performance. We assessed the effect of the SafeCare programme on quality of patient care in faith-based and private for-profit facilities in Tanzania. METHODS In this cluster-randomised controlled trial, health facilities were eligible if they were dispensaries, health centres, or hospitals in the faith-based or private for-profit sectors in Tanzania. We randomly assigned facilities (1:1) using computer-generated stratified randomisation to receive the full SafeCare package (intervention) or an assessment only (control). Implementing staff and participants were masked to outcome measurement and the primary outcomes were measured by fieldworkers who had no knowledge of the study group allocation. The primary outcomes were health worker compliance with infection prevention and control (IPC) practices as measured by observation of provider-patient interactions, and correct case management of undercover standardised patients at endline (after a minimum of 18 months). Analyses were by modified intention to treat. The trial is registered with ISRCTN, ISRCTN93644888. FINDINGS Between March 7 and Nov 30, 2016, we enrolled and randomly assigned 237 health facilities to the intervention (n=118) or control (n=119). Nine facilities (seven intervention facilities and two control facilities) closed during the trial and were not included in the analysis. We observed 29 608 IPC indications in 5425 provider-patient interactions between Feb 7 and April 5, 2018. Health facilities received visits from 909 standardised patients between May 3 and June 12, 2018. Intervention facilities had a 4·4 percentage point (95% CI 0·9-7·7; p=0.015) higher mean SafeCare standards assessment score at endline than control facilities. However, there was no evidence of a difference in clinical quality between intervention and control groups at endline. Compliance with IPC practices was observed in 8181 (56·9%) of 14 366 indications in intervention facilities and 8336 (54·7%) of 15 242 indications in control facilities (absolute difference 2·2 percentage points, 95% CI -0·2 to -4·7; p=0·071). Correct management occurred in 120 (27·0%) of 444 standardised patients in the intervention group and in 136 (29·2%) of 465 in the control group (absolute difference -2·8 percentage points, 95% CI -8·6 to -3·1; p=0·36). INTERPRETATION SafeCare did not improve clinical quality as assessed by compliance with IPC practices and correct case management. The absence of effect on clinical quality could reflect a combination of insufficient intervention intensity, insufficient links between structural quality and care processes, scarcity of resources for quality improvement, and inadequate financial and regulatory incentives for improvement. FUNDING UK Health Systems Research Initiative (Medical Research Council, Economic and Social Research Council, UK Department for International Development, Global Challenges Research Fund, and Wellcome Trust).
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Affiliation(s)
| | | | | | | | - Peter Risha
- PharmAccess Tanzania, Dar es Salaam, Tanzania
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Mojtahedzadeh N, Neumann FA, Rohwer E, Nienhaus A, Augustin M, Harth V, Zyriax BC, Mache S. The Health Behaviour of German Outpatient Caregivers in Relation to the COVID-19 Pandemic: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8213. [PMID: 34360505 PMCID: PMC8346166 DOI: 10.3390/ijerph18158213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic has affected outpatient caregivers in a particular way. While the German population becomes increasingly older, the number of people in need of care has also increased. The health and, thus, the health behaviour of employees in the outpatient care become relevant to maintain working capacity and performance in the long term. The aims of the study were (1) to examine the health behaviour and (2) to explore pandemic-related perceived change of health behaviour among outpatient caregivers during the COVID-19 pandemic. In a mixed-methods study, 15 problem-centred interviews and a web-based cross-sectional survey (N = 171) were conducted with outpatient caregivers working in Northern Germany. Interviewees reported partially poorer eating behaviour, higher coffee consumption, lower physical activity, skipping breaks more often and less sleep duration and quality during the pandemic. Some quantitative findings indicate the same tendencies. A majority of participants were smokers and reported higher stress perception due to the pandemic. Preventive behaviour, such as wearing PPE or hand hygiene, was increased among interviewees compared to the pre-pandemic period. Our findings indicate that the COVID-19 pandemic could negatively affect outpatient caregivers' health behaviour, e.g., eating/drinking behaviour and physical activity. Therefore, employers in outpatient care should develop workplace health promotion measures to support their employees in conducting more health-promoting behaviours during the COVID-19 pandemic.
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Affiliation(s)
- Natascha Mojtahedzadeh
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
| | - Felix Alexander Neumann
- Midwifery Science—Health Services Research and Prevention, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (F.A.N.); (B.-C.Z.)
| | - Elisabeth Rohwer
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
- Midwifery Science—Health Services Research and Prevention, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (F.A.N.); (B.-C.Z.)
| | - Albert Nienhaus
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany;
- Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Matthias Augustin
- Competence Center for Health Services Research in Vascular Diseases (CVvasc), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany;
| | - Volker Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
| | - Birgit-Christiane Zyriax
- Midwifery Science—Health Services Research and Prevention, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (F.A.N.); (B.-C.Z.)
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
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Tsuboi M, Hachiya M, Ohtsu H, Akashi H, Miyoshi C, Umeda T. Epidemiology and risk of COVID-19 among travelers at airport and port quarantine stations across Japan: a nationwide descriptive analysis and an individually matched case-control study. Clin Infect Dis 2021; 74:1614-1622. [PMID: 34318872 PMCID: PMC8406868 DOI: 10.1093/cid/ciab659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Indexed: 01/03/2023] Open
Abstract
Background The epidemiology and risk of coronavirus disease 2019 (COVID-19) among
travelers at international borders remain unclear. Methods We conducted descriptive and individually matched case-control studies using
a nationwide register for COVID-19 testing of travelers from 3 August to 31
October 2020 at airport/port quarantine stations across Japan. Case
patients, defined as travelers positive for COVID-19 on arrival, were
individually matched with 4 controls for arrival date and airport or port.
We assessed associations between test positivity and traveler
characteristics using conditional logistic regression analysis. Results Overall, 157 507 travelers arriving from 146 countries/areas at 17 quarantine
stations across Japan were tested for COVID-19. The percentage of test
positivity during the study period was 0.35%. In the case-control study,
with 536 case patients and 2144 controls, we found evidence of lower test
positivity in travelers aged 3–19 years, female travelers, and travel
corridor users (adjusted odds ratio [95% confidence interval], 0.36
[.22–.60], 0.71 [.56–.89], and 0.48 [.30–.77],
respectively), whereas higher positivity was associated with arrival from
South-East Asia (1.88 [1.33–2.65]) or lower-middle- or low-income
countries (2.46 [1.69–3.58] and 7.25 [2.22–23.66],
respectively), any symptom (4.08 [1.43–11.65]), and nasopharyngeal
compared with saliva sampling (2.75 [1.85–4.09]). A higher 14-day
average incidence in the countries of stay was also associated with higher
test positivity (1.64 [1.16–2.33] and 3.13 [1.88–5.23] for those
from countries and areas where the 14-day average incidence was from 10 to
<100 and ≥100 cases per million, respectively). Conclusions These findings justify travel restrictions based on the epidemic situation in
countries of stay, although underestimation of the epidemic in lower-income
countries should be considered. A strict travel corridor could also reduce
the risk of COVID-19 importation.
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Affiliation(s)
- Motoyuki Tsuboi
- Department of Human Resource Development, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Japan
| | - Masahiko Hachiya
- Department of Global Health Policy and Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Japan
| | - Hiroshi Ohtsu
- Department of Data Science, Center for Clinical Sciences, National Center for Global Health and Medicine, Japan
| | - Hidechika Akashi
- Department of Health Planning and Management, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Japan
| | - Chiaki Miyoshi
- Department of Human Resource Development, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Japan
| | - Tamami Umeda
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Japan
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Kim S, Lee S. Effects of Government-Driven Smartphone Text Messages on Public Compliance With COVID-19 Preventative Measures. Comput Inform Nurs 2021; 39:527-537. [PMID: 34623337 DOI: 10.1097/cin.0000000000000799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The new pandemic situation caused by a highly infectious virus has prompted the government of many countries to strengthen epidemic prevention measures. An unprecedented action was taken by the Korean government by sending text messages on COVID-19 preventative measures and the movement routes of confirmed-positive persons to the entire nation's smartphones. This study aimed to examine how effective the government-driven smartphone text messages were for public compliance with the measures. A total of 489 participants completed an online questionnaire or a pencil-and-paper questionnaire between September and October 2020. A self-reported questionnaire was used to measure the degree of compliance with the measures, the perceptions of the role of smartphone text messages in compliance with the measures, and the overall feelings toward smartphone text messages. The data were analyzed using descriptive statistics and two-way analysis of variance. The written responses were grouped by meaning. The participants presented a high degree of compliance with the measures and perceived the importance of the role of continuous smartphone text messages in complying with the measures. Positive feelings toward smartphone text messages predominated over negative feelings. Using smartphone text messages in nursing practice is recommended for patients requiring the continuous management of their disease.
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Affiliation(s)
- Suhyun Kim
- Author Affiliations: Department of Nursing, Nambu University (Dr Kim); and College of Nursing, Chonnam National University (Dr Lee), Gwangju. Republic of Korea
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Chen C, Chen J, Fang R, Ye F, Yang Z, Wang Z, Shi F, Tan W. What medical waste management system may cope With COVID-19 pandemic: Lessons from Wuhan. RESOURCES, CONSERVATION, AND RECYCLING 2021; 170:105600. [PMID: 33821099 PMCID: PMC8011665 DOI: 10.1016/j.resconrec.2021.105600] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/26/2021] [Accepted: 03/27/2021] [Indexed: 05/22/2023]
Abstract
The global pandemic caused by the 2019 coronavirus (COVID-19) has led to a dramatic increase in medical waste worldwide. This tremendous increase in medical waste is an important transmission medium for the virus and thus poses new and serious challenges to urban medical waste management. This study investigates the response of medical waste management to the COVID-19 pandemic and subsequent changes in Wuhan City based on the most detailed data available, including waste generation, storage, transportation, and disposal. The results show that despite a 5-fold increase in the demand for daily medical waste disposal in the peak period, the quick responses in the storage, transportation, and disposal sectors during the pandemic ensured that all medical waste was disposed of within 24 hours of generation. Furthermore, this paper discusses medical waste management during future emergencies in Wuhan. The ability of the medical waste management system in Wuhan to successfully cope with the rapid increase in medical waste caused by major public health emergencies has important implications for other cities suffering from the pandemic and demonstrates the need to establish resilient medical emergency systems in urban areas.
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Affiliation(s)
- Chang Chen
- State Environmental Protection Key Laboratory of Soil Health and Green Remediation, 430070 Hubei, Wuhan, China
- College of Resource and Environment, Huazhong Agricultural University, 430070 Hubei, Wuhan, China
| | - Jiaao Chen
- School of Resource and Environment Science, Wuhan University, 430072 Hubei, Wuhan, China
| | - Ran Fang
- School of Resource and Environment Science, Wuhan University, 430072 Hubei, Wuhan, China
| | - Fan Ye
- School of Resource and Environment Science, Wuhan University, 430072 Hubei, Wuhan, China
| | - Zhenglun Yang
- State Environmental Protection Key Laboratory of Soil Health and Green Remediation, 430070 Hubei, Wuhan, China
- College of Resource and Environment, Huazhong Agricultural University, 430070 Hubei, Wuhan, China
| | - Zhen Wang
- State Environmental Protection Key Laboratory of Soil Health and Green Remediation, 430070 Hubei, Wuhan, China
- College of Resource and Environment, Huazhong Agricultural University, 430070 Hubei, Wuhan, China
| | - Feng Shi
- Lishui Institute of Ecology and Environment, Nanjing University, Nanjing 211200, China
| | - Wenfeng Tan
- State Environmental Protection Key Laboratory of Soil Health and Green Remediation, 430070 Hubei, Wuhan, China
- College of Resource and Environment, Huazhong Agricultural University, 430070 Hubei, Wuhan, China
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Yang Q, Wang X, Zhou Q, Tan L, Zhang X, Lai X. Healthcare workers' behaviors on infection prevention and control and their determinants during the COVID-19 pandemic: a cross-sectional study based on the theoretical domains framework in Wuhan, China. ACTA ACUST UNITED AC 2021; 79:118. [PMID: 34193306 PMCID: PMC8242273 DOI: 10.1186/s13690-021-00641-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 06/17/2021] [Indexed: 11/10/2022]
Abstract
Background Infection prevention and control (IPC) measures are crucial to combat the COVID-19 pandemic. This study aimed to explore the levels and determinants of HCWs’ IPC behaviors based on the theoretical domains framework (TDF), which has been shown to be effective in guiding behavior change. Methods A cross-sectional survey was conducted in Wuhan, China in January 2020. Self-reported hand hygiene and droplet isolation behaviors (including the use of masks, gloves, goggles and gowns) were set as dependent variables. TDF domains and HCWs’ characteristics were independent variables. Negative binomial regression analyses were performed to explore their relationships. Results HCWs reported good IPC behaviors, while the compliance with goggle and gown use was relatively low (below 85%). Environmental context and resources domain was significantly related to hand hygiene (β = 0.018, p = 0.026), overall droplet isolation behaviors (β = 0.056, p = 0.001), goggle (β = 0.098, p = 0.001) and gown use (β = 0.101. p < 0.001). Knowledge domain was significantly related to goggle (β = 0.081, p = 0.005) and gown use (β = 0.053, p = 0.013). Emotion domain was a predictor of overall droplet isolation behaviors (β = 0.043, p = 0.016), goggle (β = 0.074, p = 0.026) and gown use (β = 0.106, p < 0.001). Social influences domain was a predictor of overall droplet isolation behaviors (β = 0.031, p = 0.029) and gown use (β = 0.039, p = 0.035). HCWs in high-risk departments had better behaviors of gown use (β = 0.158, p = 0.032). HCWs who had encountered confirmed or suspected patients reported worse behaviors of goggle (β = − 0.127, p = 0.050) and gown use (β = − 0.153, p = 0.003). Conclusions Adequate personal protective materials and human resources, education and training, as well as supervision and role model setting are necessary to improve IPC behaviors regarding the COVID-19 pandemic. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00641-0.
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Affiliation(s)
- Qiuxia Yang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, Hubei Province, China
| | - Xuemei Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, Hubei Province, China
| | - Qian Zhou
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, Hubei Province, China
| | - Li Tan
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei Province, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, Hubei Province, China.
| | - Xiaoquan Lai
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei Province, China.
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Kanyangarara M, Allen S, Jiwani SS, Fuente D. Access to water, sanitation and hygiene services in health facilities in sub-Saharan Africa 2013-2018: Results of health facility surveys and implications for COVID-19 transmission. BMC Health Serv Res 2021; 21:601. [PMID: 34172045 PMCID: PMC8231746 DOI: 10.1186/s12913-021-06515-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/10/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has highlighted important needs in water, sanitation and hygiene (WASH) services and standard practices for infection prevention and control in sub-Saharan Africa. We assessed the availability of WASH and standard precautions for infection prevention in health facilities across 18 countries in sub-Saharan Africa, as well as inequalities by location (rural/urban) and managing authority (public/private). Data from health facility surveys conducted between 2013 and 2018 in 18 sub-Saharan African countries were used to estimate the access to an improved water source within 500 m, an improved toilet, soap and running water or alcohol-based hand rub, and standard precautions for infection prevention at health facilities. Rural-urban differences and public-private differences in access to services were calculated. We also compared population level access to health facility access to services. RESULT Overall, 16,456 health facilities from 18 countries were included. Across countries, an estimated 88 % had an improved water source, 94 % had an improved toilet, 74 % had soap and running water or alcohol-based hand rub, and 17 % had standard precautions for infection prevention available. There was wide variability in access to water, sanitation and hygiene services between rural and urban health facilities and between public and private facilities, with consistently lower access in both rural and public facilities. In both rural and urban areas, access to water, sanitation and hygiene services was ubiquitously better at health facilities than households. CONCLUSIONS Availability of WASH services in health facilities in sub-Saharan Africa has improved but remains below the global target of 80 % in many countries. Ensuring adequate access to WASH services and enforcing adherence to safety and hygiene practices in health facilities will be essential to minimize the risk of COVID-19 transmission.
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Affiliation(s)
- Mufaro Kanyangarara
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, SC 29201 Columbia, USA
| | - Savannah Allen
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, SC 29201 Columbia, USA
| | - Safia S Jiwani
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - David Fuente
- School of Earth, Ocean and the Environment, University of South Carolina, Columbia, SC USA
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Nalule Y, Buxton H, Ir P, Leang S, Macintyre A, Pors P, Samol C, Dreibelbis R. Hand hygiene during facility-based childbirth in Cambodia: a theory-driven, mixed-methods observational study. BMC Pregnancy Childbirth 2021; 21:429. [PMID: 34139995 PMCID: PMC8212449 DOI: 10.1186/s12884-021-03901-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/26/2021] [Indexed: 12/14/2022] Open
Abstract
Background Despite current efforts to improve hand hygiene in health care facilities, compliance among birth attendants remains low. Current improvement strategies are inadequate, largely focusing on a limited set of known behavioural determinants or addressing hand hygiene as part of a generalized set of hygiene behaviours. To inform the design of a facility –based hand hygiene behaviour change intervention in Kampong Chhnang, Cambodia, a theory-driven formative research study was conducted to investigate the context specific behaviours and determinants of handwashing during labour and delivery among birth attendants. Methods This formative mixed-methods research followed a sequential explanatory design and was conducted across eight healthcare facilities. The hand hygiene practices of all birth attendants present during the labour and delivery of 45 women were directly observed and compliance with hand hygiene protocols assessed in analysis. Semi-structured, interactive interviews were subsequently conducted with 20 key healthcare workers to explore the corresponding cognitive, emotional, and environmental drivers of hand hygiene behaviours. Results Birth attendants’ compliance with hand hygiene protocol was 18% prior to performing labour, delivery and newborn aftercare procedures. Hand hygiene compliance did not differ by facility type or attendants’ qualification, but differed by shift with adequate hand hygiene less likely to be observed during the night shift (p = 0.03). The midwives’ hand hygiene practices were influenced by cognitive, psychological, environmental and contextual factors including habits, gloving norms, time, workload, inadequate knowledge and infection risk perception. Conclusion The resulting insights from formative research suggest a multi-component improvement intervention that addresses the different key behaviour determinants to be designed for the labour and delivery room. A combination of disruption of the physical environment via nudges and cues, participatory education to the midwives and the promotion of new norms using social influence and affiliation may increase the birth attendants’ hand hygiene compliance in our study settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03901-7.
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Affiliation(s)
- Yolisa Nalule
- Disease Control Department, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
| | - Helen Buxton
- Division of Psychiatry, University College London, London, W1T 7BN, UK
| | - Por Ir
- National Institute of Public Health, Phnom Penh, Cambodia
| | - Supheap Leang
- National Institute of Public Health, Phnom Penh, Cambodia
| | | | | | | | - Robert Dreibelbis
- Disease Control Department, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
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Torkashvand J, Jonidi Jafari A, Godini K, Kazemi Z, Kazemi Z, Farzadkia M. Municipal solid waste management during COVID-19 pandemic: a comparison between the current activities and guidelines. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2021; 19:173-179. [PMID: 33456781 PMCID: PMC7801771 DOI: 10.1007/s40201-020-00591-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 12/07/2020] [Indexed: 05/21/2023]
Abstract
The COVID-19 pandemic has affected everyone's lifestyle and this has resulted in a change in the quantity and composition of municipal solid wastes. Moreover, the post-pandemic waste management is very important as a bad management may lead to the more spread of the disease. The objective of this study was to evaluate the application of guidelines presented for the era of the COVID-19 pandemic in proper solid waste management. To this end, the data were collected by using interviews and field researches and then the obtained data were compared with the international guidelines presented by international organizations. By investigating the municipal waste management during this pandemic and its changes compared to pre-COVID-19, coordination of the plans with the guidelines was investigated. The activities of storage, collection, transportation, recycling, final landfill, as well as the observation of the health instructions by staff and informal sections were assessed in the current research. Although the results showed that the situation was satisfactory in the sections like health and safety of waste management operators due to the existence of protocols and general educations, the waste management plans have not been changed much from before the epidemic of the Coronavirus. The absence of a national policy and plan for waste management in the era of a pandemic and ignoring the guidelines developed by other countries and organizations were observable. Therefore, the codification of new policies for municipal waste management during an epidemic is necessary.
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Affiliation(s)
- Javad Torkashvand
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran
- Student Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Jonidi Jafari
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Kazem Godini
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Zahra Kazemi
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Zohre Kazemi
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Mahdi Farzadkia
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran
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Kalantary RR, Jamshidi A, Mofrad MMG, Jafari AJ, Heidari N, Fallahizadeh S, Hesami Arani M, Torkashvand J. Effect of COVID-19 pandemic on medical waste management: a case study. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2021; 19:831-836. [PMID: 33758671 PMCID: PMC7970745 DOI: 10.1007/s40201-021-00650-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/09/2021] [Indexed: 05/09/2023]
Abstract
Covid-19 Pandemic leads to medical services for the society all over the world. The Covid-19 pandemic influence the waste management and specially medical waste management. In this study, the effect of the Covid-19 outbreak on medical waste was evaluated via assessing the solid waste generation, composition, and management status in five hospitals in Iran. The results indicated that the epidemic Covid-19 leads to increased waste generation on average 102.2 % in both private and public hospitals. In addition, the ratio of infectious waste in the studied hospitals increased by an average of 9 % in medical waste composition and 121 % compared with before COVID-19 pandemic. Changes in plans and management measurement such as increasing the frequency of waste collection per week leads to lower the risk of infection transmission from medical waste in the studied hospitals. The results obtained from the present research clearly show the changes in medical waste generation and waste composition within pandemic Covid-19. In addition, established new ward, Covid-19 ward with high-infected waste led to new challenges which should be managed properly by change in routine activities.
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Affiliation(s)
- Roshanak Rezaei Kalantary
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Arsalan Jamshidi
- Department of Environmental Health Engineering, School of Health and Nutrition Sciences, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mohammad Mehdi Golbini Mofrad
- IHE Delft Institute for Water Education, Delft, The Netherlands
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Jonidi Jafari
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Neda Heidari
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Saeid Fallahizadeh
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Mohsen Hesami Arani
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Javad Torkashvand
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran
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Yousefi M, Oskoei V, Jonidi Jafari A, Farzadkia M, Hasham Firooz M, Abdollahinejad B, Torkashvand J. Municipal solid waste management during COVID-19 pandemic: effects and repercussions. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:10.1007/s11356-021-14214-9. [PMID: 33942263 PMCID: PMC8092713 DOI: 10.1007/s11356-021-14214-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/27/2021] [Indexed: 04/15/2023]
Abstract
The COVID-19 pandemic has an adverse effect on the environment. This epidemic's effect on the waste composition and management and the impacts of municipal solid waste management (MSWM) on disease transmission or controlling are considered a compelling experience of living in the COVID-19 pandemic that can effectively control the process. This systematic review research was conducted to determine the effects of COVID-19 on the quantity of waste and MSWM. Searches were conducted in three databases (using keywords covid 19, coronaviruses, and waste), and among the published articles from 2019 to 2021, 56 ones were selected containing information on the quantity and waste management during the COVID-19 pandemic. The results showed that COVID-19 caused the quantity variation and composition change of MSW. COVID-19 also has significant effects on waste recycling, medical waste management, quantity, and littered waste composition. On the other hand, the COVID-19 pandemic has changed waste compounds' management activities and waste generation sources. Recognizing these issues can help plan MSWM more efficiently and reduce virus transmission risk through waste.
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Affiliation(s)
- Mahmood Yousefi
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Vahide Oskoei
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Jonidi Jafari
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdi Farzadkia
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Hasham Firooz
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Behnaz Abdollahinejad
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Javavd Torkashvand
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran.
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Liu H, Chen C, Cruz-Cano R, Guida JL, Lee M. Public Compliance With Social Distancing Measures and SARS-CoV-2 Spread : A Quantitative Analysis of 5 States. Public Health Rep 2021; 136:475-482. [PMID: 33909541 DOI: 10.1177/00333549211011254] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE We quantified the association between public compliance with social distancing measures and the spread of SARS-CoV-2 during the first wave of the epidemic (March-May 2020) in 5 states that accounted for half of the total number of COVID-19 cases in the United States. METHODS We used data on mobility and number of COVID-19 cases to longitudinally estimate associations between public compliance, as measured by human mobility, and the daily reproduction number and daily growth rate during the first wave of the COVID-19 epidemic in California, Illinois, Massachusetts, New Jersey, and New York. RESULTS The 5 states mandated social distancing directives during March 19-24, 2020, and public compliance with mandates started to decrease in mid-April 2020. As of May 31, 2020, the daily reproduction number decreased from 2.41-5.21 to 0.72-1.19, and the daily growth rate decreased from 0.22-0.77 to -0.04 to 0.05 in the 5 states. The level of public compliance, as measured by the social distancing index (SDI) and daily encounter-density change, was high at the early stage of implementation but decreased in the 5 states. The SDI was negatively associated with the daily reproduction number (regression coefficients range, -0.04 to -0.01) and the daily growth rate (from -0.009 to -0.01). The daily encounter-density change was positively associated with the daily reproduction number (regression coefficients range, 0.24 to 1.02) and the daily growth rate (from 0.05 to 0.26). CONCLUSIONS Social distancing is an effective strategy to reduce the incidence of COVID-19 and illustrates the role of public compliance with social distancing measures to achieve public health benefits.
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Affiliation(s)
- Hongjie Liu
- 1685911068 Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Chang Chen
- 1685911068 Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Raul Cruz-Cano
- 1685911068 Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Jennifer L Guida
- 3421 Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Minha Lee
- 229386 Department of Civil and Environmental Engineering, A. James Clark School of Engineering, University of Maryland, College Park, MD, USA
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Arrais M, Dias W, Gama JMR, Brito M. Physicians' perceptions of their knowledge and the preparedness of health facilities in Angola to diagnose and manage COVID-19. Int Health 2021; 14:103-110. [PMID: 33845486 PMCID: PMC8083292 DOI: 10.1093/inthealth/ihab017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 01/26/2021] [Accepted: 03/10/2021] [Indexed: 12/23/2022] Open
Abstract
Background Healthcare professionals represent a vulnerable group in terms of responding to COVID-19. Knowledge can influence healthcare professionals through adoption of the correct attitudes and practices. The aim of this study was to evaluate, by a questionnaire, the perceptions of physicians about their level of knowledge as well as conditions in their workplaces for dealing with COVID-19. Methods A cross-sectional study of Angolan physicians took place from 11 May to 23 June 2020. A questionnaire was electronically shared across social media and via email. Results The sample consisted of 637 valid questionnaires; 53% of respondents were female, 41% were aged 31–40 y and 79% were from Luanda province. About 51% of physicians perceived that they had adequate knowledge about COVID-19 and 64% used personal protective equipment. These figures were higher among specialists from the province of Luanda. About 81% stated that their health units lacked the technical capacity to diagnose COVID-19. Only 35% of health units have chest tomography equipment; 44% are prepared for the care and/or isolation of patients. Only 33% of units are running intensive care units. The main concerns of physicians were training opportunities and limited access to personal protective equipment. Conclusion The results show that it is necessary to strengthen physicians’ knowledge about COVID-19, as well as to improve the conditions of the health units, so as to promote safe practices.
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Affiliation(s)
- Margarete Arrais
- Department of Pulmonology , Military Hospital, Luanda, Angola.,CISA - Health Research Centre of Angola, Caxito, Bengo, Angola
| | | | - Jorge M R Gama
- Centre of Mathematics and Applications, Faculty of Sciences, University of Beira Interior, Covilhã, Portugal
| | - Miguel Brito
- CISA - Health Research Centre of Angola, Caxito, Bengo, Angola.,Health and Technology Research Centre (H&TRC), Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Portugal
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47
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Baral P. Health Systems and Services During COVID-19: Lessons and Evidence From Previous Crises: A Rapid Scoping Review to Inform the United Nations Research Roadmap for the COVID-19 Recovery. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2021; 51:474-493. [DOI: 10.1177/0020731421997088] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This rapid scoping review has informed the development of the November 2020 United Nations Research Roadmap for the COVID-19 Recovery, by providing a synthesis of available evidence on the impact of pandemics and epidemics on (1) essential services and (2) health systems preparedness and strengthening. Emerging findings point to existing disparities in health systems and services being further exacerbated, with marginalized populations and low- and middle-income countries burdened disproportionately. More broadly, there is a need to further understand short- and long-term impacts of bypassed essential services, quality assurance of services, the role of primary health care in the frontline, and the need for additional mechanisms for effective vaccine messaging and uptake during epidemics. The review also highlights how trust—of institutions, of science, and between communities and health systems—remains central to a successful pandemic response. Finally, previous crises had repeatedly foreshadowed the inability of health systems to handle upcoming pandemics, yet the reactive nature of policies and practices compounded by lack of resources, infrastructure, and political will have resulted in the current failed response to COVID-19. There is therefore an urgent need for investments in implementation science and for strategies to bridge this persistent research–practice gap.
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Affiliation(s)
- Prativa Baral
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Griswold DP, Gempeler A, Kolias A, Hutchinson PJ, Rubiano AM. Personal protective equipment for reducing the risk of COVID-19 infection among health care workers involved in emergency trauma surgery during the pandemic: An umbrella review. J Trauma Acute Care Surg 2021; 90:e72-e80. [PMID: 33433175 PMCID: PMC7996059 DOI: 10.1097/ta.0000000000003073] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/30/2020] [Accepted: 12/26/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Health care facilities in low- and middle-income countries are inadequately resourced to adhere to current COVID-19 prevention recommendations. Recommendations for surgical emergency trauma care measures need to be adequately informed by available evidence and adapt to particular settings. To inform future recommendations, we set to summarize the effects of different personal protective equipment (PPE) on the risk of COVID-19 infection in health personnel caring for trauma surgery patients. METHODS We conducted an umbrella review using Living Overview of Evidence platform for COVID-19, which performs regular automated searches in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and more than 30 other sources. Systematic reviews of experimental and observational studies assessing the efficacy of PPE were included. Indirect evidence from other health care settings was also considered. Risk of bias was assessed with the AMSTAR II tool (Assessing the Methodological Quality of Systematic Reviews, Ottawa, ON, Canada), and the Grading of Recommendations, Assessment, Development, and Evaluation approach for grading the certainty of the evidence is reported (registered in International Prospective Register of Systematic Reviews, CRD42020198267). RESULTS Eighteen studies that fulfilled the selection criteria were included. There is high certainty that the use of N95 respirators and surgical masks is associated with a reduced risk of COVID-19 when compared with no mask use. In moderate- to high-risk environments, N95 respirators are associated with a further reduction in risk of COVID-19 infection compared with surgical masks. Eye protection also reduces the risk of contagion in this setting. Decontamination of masks and respirators with ultraviolet germicidal irradiation, vaporous hydrogen peroxide, or dry heat is effective and does not affect PPE performance or fit. CONCLUSION The use of PPE drastically reduces the risk of COVID-19 compared with no mask use in health care workers. N95 and equivalent respirators provide more protection than surgical masks. Decontamination and reuse appear feasible to overcome PPE shortages and enhance the allocation of limited resources. These effects are applicable to emergency trauma care and should inform future recommendations. LEVEL OF EVIDENCE Review, level II.
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The Implications and Effects of Medical Waste on Development of Sustainable Society—A Brief Review of the Literature. SUSTAINABILITY 2021. [DOI: 10.3390/su13063300] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The sustainable development of humanity imposes precise norms regarding the management of natural resources, their extraction, use, and the introduction in a complex, innovative circuit of the waste resulting from exploitation. The paper deals with some aspects related to the sustainable management of general medical waste on the one hand and the medical waste specific to the COVID-19 pandemic, on the other hand. Medical waste requires special treatment given its impact on the environment and on humanity. The management of activities related to its storage, transport, destruction is an important point in the sustainable development of mankind, especially in the current context of the pandemic. Medical waste is in a continuous increase in quantity and involves many effects in various activity fields. Through a scientometric study in the Web of Science—WOS database, the authors identify clusters of keywords, analyze the articles identified in the WOS and identify the main research directions and existing concepts. Corroborating and interpreting the results obtained, three significant trends of approach to medical waste are identified: M—management (1); E—exposure (2); and D—distribution (3). An extensive map of the concepts is made, a narrow map of the concepts used, and a theoretical map of the concepts. The link between medical waste and the development of a sustainable society is demonstrated, and it is possible to open new research directions. The scientometric research undertaken on 1192 WOS articles that were published in 2020 led to the selection of 32, focused on issues related to hazardous medical waste, especially of COVID-19 patients. Following this approach, the authors were able to see, by comparison, the different forms of management of this waste in different countries, thus being able to contribute to the creation of procedures for the collection, storage, and destruction of this hazardous waste, with direct influence on the environment.
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Abstract
The World Health Organization (WHO) on December 31, 2019, was informed of several cases of respiratory diseases of unknown origin in the city of Wuhan in the Chinese Province of Hubei, the clinical manifestations of which were similar to those of viral pneumonia and manifested as fever, cough, and shortness of breath. And, the disease caused by the virus is named the new coronavirus disease 2019 and it will be abbreviated as 2019-nCoV and COVID-19. As of January 30, 2020, the WHO classified this epidemic as a global health emergency (Chung et al. in Radiology 295(1):202-207, 2020). It is an international real-life problem. Due to deaths, globally everyone is under fear. Now, it is the responsibility of researchers to give hope to the people. In this article, we aim to better protect people and general pandemic preparedness by predicting the lifetime of the disease-causing virus using three mathematical models. This article deals with a complex real-life problem people face all over the world, an international real-life problem. The main focus is on the USA due to large infection and death due to coronavirus and thereby the life of every individual is uncertain. The death counts of the USA from February 29 to April 22, 2020, are used in this article as a data set. The death counts of the USA are fitted by the solutions of three mathematical models and a solution to an international problem is achieved. Based on the death rate, the lifetime of the coronavirus COVID-19 is predicted as 1464.76 days from February 29, 2020. That is, after March 2024 there will be no death in the USA due to COVID-19 if everyone follows the guidelines of WHO and the advice of healthcare workers. People and government can get prepared for this situation and many lives can be saved. It is the contribution of soft computing. Finally, this article suggests several steps to control the spread and severity of the disease. The research work, the lifetime prediction presented in this article is entirely new and differs from all other articles in the literature.
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