Prevalence of Work-Aggravated Asthma among Bakery Workers in Abidjan (Cote d’Ivoire)

Introduction: Work-aggravated asthma is pre-existing or concomitant asthma whose symptoms are aggravated by the work environment. The aim of this study was to determine the prevalence of this pathology and its associated factors among bakery workers in Abidjan. Materials and Methods: This descriptive and analytical cross-sectional study was conducted over a period of four (4) months from 18 December 2019 to 18 April 2020. Two questionnaires were used, one on employees and the other on the indoor environment of bakeries. In addition, a spirometry test was performed on all bakery workers. Statistical analysis was performed using stata 15.1 software. Results: A total of 599 bakery employees, including bakers (59.73%), sales assistants/ cashiers (23.52%), cleaners (6.34%) and administrative staff (10.18%), were investigated. The mean age was 30.8 ± 8 years, with a sex ratio (M/F) = 2.2. Asthma symptoms were found in 95 (15.86%) employees, of whom 74 (77.9%) had work-related asthma and 11 (14.9%) had asthma aggravated by work. The factors associated with work-aggravated asthma were personal or family history of allergy or atopy [ORa = 3.75;CI95%: 1.56 - 8.93;p = 0.003], exposure to dust [ORa = 5.01;CI95%: 1.43 - 7.50;p = 0.011] and humidity level (60% - 70%) [ORa = 1.80;CI 95%: 0.99 - 3.28;p = 0.05]. Conclusion: Work-aggravated asthma is a reality in bakeries in Abidjan, with an estimated prevalence of 14.9%. Two of the three factors associated with this condition suggest a link with indoor air pollution. Combating air pollution in these establishments must therefore be a priority for the relevant authorities, in order to provide employees with a working environment that protects their health.

Stakeholders’ Practices and Perspectives on Solid Medical Waste Management: A Community Based Study in Accra, Ghana

Solid medical waste (SMW) is hazardous and requires specific treatment prior to final disposal. Limited information addresses the management of SMW in non-traditional settings such as in households, traditional birth attendants’ (TBAs) homes and chemical seller (CS) shops. A descriptive, exploratory study was conducted to identify major disposal practices and perceived hazards associated with SMW and explore their views regarding segregation as a potential management option. Twenty-nine household members, 10 TBAs and 8 CS who volunteered to participate in the study were involved in 6 focus group discussions (FGDs). Additionally, five key informants in private sector waste management companies were interviewed. FGDs were audio recorded, transcribed and translated, manually coded into themes and sub-themes using an iterative approach, and integrated with data from the interviews. In households, medicines were discarded by dosage forms with solid forms discarded in the household bin, while syrups were mostly emptied into drains. TBAs buried material used for delivery in clients’ compounds and CS tended to burn expired medicines or discard them with general waste. Participants perceived the following as hazards associated with SMW: infection transmission, penetrative injury, poisoning and aesthetic nuisance. Despite this awareness, they reported barriers to source segregation as a potential management option. Barriers included implied consumer costs, lack of supportive logistics and operational knowledge, and possible injury. Reported methods of disposing SMW supported earlier studies and could be potentially hazardous if not addressed. Provision of storage facilities, supportive logistics and public sensitization might encourage source segregation as a potential management option for SMW in the community.

Is There an Association between the Type of Activities and Respiratory Disorders among e-Waste Workers? Case of Two Major Cities in West Africa

Background: Several studies have demonstrated that e-waste workers had a risk to develop the respiratory disorders but this was not specifically differentiated according to the type of the e-waste activities. The main aim of this study was to evaluate if the risk to develop respiratory disorders was different according to the type of activities carried out by the e-waste workers. Methods: A cross sectional study was conducted in Abidjan and Cotonou, two big cities in West Africa. The participants were randomly selected based on the list of e-waste workers provided by the census of different sites of e-waste. The spirometry was performed on all the study participants to assess whether they had respiratory disorders. A regression logistic model was performed to estimate the risk of developing respiratory disorders according to the type of activities carried out by the e-waste workers. Results: In total 308 e-waste workers including 149 at Abidjan and 159 at Cotonou were interviewed. Participants of this study ranged in age from 14 years to 69 years and the mean age was 33.71 ± 10.96. The main activities carried out by the study participants were respectively repairing (44.8%), buying or selling (40.3%), dismantling (31.8%). The prevalence of respiratory disorders was 20.1%. The multivariate analysis had not found a significant association between the type of activities and the presence of respiratory disorders. Conclusion: The effect of exposure to e-waste on respiratory health of workers was not different according to the type of activities. So, any policy that aims to reduce the risk of exposure on respiratory health must take into account all the e-waste workers regardless of the type of activities they perform in this sector.

Mathematical modeling of COVID-19 infection dynamics in Ghana: Impact evaluation of integrated government and individual level interventions

The raging COVID-19 pandemic is arguably the most important threat to global health presently.Although there is currently a vaccine,preventive measures have been proposed to reduce the spread of infection but the efficacy of these interventions,and their likely impact on the number of COVID-19 infections is unknown.In this study,we proposed the SEIQHRS model(susceptible-exposed-infectious-quarantine-hospitalized-recovered-susceptible)model that predicts the trajectory of the epidemic to help plan an effective control strategy for COVID-19 in Ghana.We provided a short-term forecast of the early phase of the epidemic trajectory in Ghana using the generalized growth model.We estimated the effective basic Reproductive number Re in real-time using three different estimation procedures and simulated worse case epidemic scenarios and the impact of integrated individual and government interventions on the epidemic in the long term using compartmental models.The maximum likelihood estimates of Re and the corresponding 95%confidence interval was 2.04[95%CI:1.82e2.27;12th March-7th April 2020].The Re estimate using the exponential growth method was 2.11[95%CI:2.00e2.24]within the same period.The Re estimate using time-dependent(TD)method showed a gradual decline of the Effective Reproductive Number since March 12,2020 when the first 2 index cases were recorded but the rate of transmission remains high(TD:Re=2.52;95%CI:[1.87e3.49]).The current estimate of Re based on the TD method is 1.74[95%CI:1.41 e2.10;(13th May 2020)]but with comprehensive integrated government and individual level interventions,the Re could reduce to 0.5 which is an indication of the epidemic dying out in the general population.Our results showed that enhanced government and individual-level interventions and the intensity of media coverage could have a substantial effect on suppressing transmission of new COVID-19 cases and reduced death rates in Ghana until such a time that a potent vaccine or drug is discovered.