Knowledge and awareness of human mpox infection among healthcare workers:A cross-sectional study in southwestern Nigeria

Objective:To identify the knowledge and awareness level of human mpox viral infection among healthcare workers in southwestern Nigeria.Methods:A cross-sectional study was conducted in Ekiti State,southwest Nigeria among 316 healthcare workers that were selected through a systematic random sampling.Data were collected with the aid of a semi-structured,self-administered questionnaire.The Chi-square test and binary logistic regression were used to find the association between the independent and dependent variables.The significance level was set at P-value<0.05.Results:Two hundred and twenty-two(70.3%)of the respondents were aged≤40 years,mean age(36±9)years,189(59.8%)were female,306(96.8%)were Christians,and 203(64.2%)were married.Three hundred and fourteen(99.4%)of the respondents were aware of mpox infection.Main sources of information about mpox were medical education(44.0%),radio/television(32.0%)and newspaper(21.0%).However,among those aware of the disease,209(67.0%)demonstrated poor knowledge levels.Longer than 5 years’experience of medical practice was the only significant predictor of higher knowledge level of the disease(OR 1.76,95%CI 1.01-3.06;P=0.046).Conclusions:Despite the high awareness level of mpox infection among healthcare workers,there still exists a huge knowledge gap.It is recommended that targeted intervention could be directed towards continuous medical education and simulation exercises on re-emerging infectious diseases like mpox to improve the knowledge of the healthcare workers.

Knowledge and associated factors of healthcare workers on measles vaccine and cold chain management at health institutions in Gondar,Ethiopia

Objective:To assess the knowledge of healthcare workers on the measles vaccine and its cold chain management.Method:An institutional-based cross-sectional study was conducted from February 1 to March 30,2022 in Gondar City Administration public health institutions among 165 healthcare workers.Data were collected using a structured questionnaire.In addition,an on-spot observation checklist was used to assess the availability,status and management of the cold chain.A logistic regression model was used to assess the relationship between the outcome and predictor variables.Crude and adjusted odds ratios were calculated with 95%confidence intervals.Results:Overall,87(52.7%;95%CI 44.8%-60.5%)of the healthcare workers had unsatisfactory knowledge regarding the measles vaccine and its cold chain management.One hundred thirty-six(82.4%)healthcare workers correctly mentioned the recommended range of temperature(2-8℃)for measles vaccine storage.Healthcare workers aged 18-29 years(P=0.001)and 30-44 years(P=0.014)were observed as determinants of unsatisfactory knowledge on the measles vaccine and its cold chain management.One hundred and five(63.6%)of the healthcare workers did not correctly mention the type of measles vaccine used in routine immunization.More than one-third(36.4%)of the healthcare workers perceived that the measles vaccine is not safe and could cause measles.Conclusions:More than half of the healthcare workers in the study area had unsatisfactory knowledge on the measles vaccine and its cold chain management.It is necessary to provide technical support and in-service training for healthcare workers to ensure optimal immunization effectiveness.

Impact of COVID-19 Pandemic on Mental Health of Healthcare Workers–A Perception of Indian Hospital Administrators

Since the coronavirus pandemic,many factors led to the change in the mental well-being of hospital administrators and their staff.The pandemic negatively impacted the availability and capability of health professionals to deliver essential services and meet rising demand.Therefore,this study aimed to understand the perspective of hospital administrators about issues and challenges that negatively impacted their staff’s mental health and hospital administrators’coping response to mitigate those challenges and issues.An exploratory qualitative study was conducted with 17 hospital administrators(superintendents,deputy superintendents,nursing in charge and hospital in charge)working in a government district hospital of Rajasthan state during September 2022 and October 2022.This study revealed various emerging themes on mental health-related issues,challenges and coping strategies reported by the administrators.Themes and sub-themes that emerged from this study were 1)Perceived mental health of HCWs-perceived importance of mental health,2)Impact of COVID-19 on the mental health of HCWs–common mental health issues,changes in mental health pre and post-pandemic,3)Impact of COVID-19 on health behavior of HCWs-increased self-care and awareness,4)Challenges responsible for poor mental health of HCWs-organizational,ethical and societal challenges and 5)Strategies to retain mental health of HCWs-effective coping strategies.The most common problems were increased levels of stress,feeling fatigued,tiredness,weak and anxiety among the HCWs.Keeping their staff motivated was the biggest challenge reported.Social support,counseling through professionals and demystifying myths were the most effective coping strategies adopted by the participants.In conclusion,this study reported poor mental health-related issues,challenges faced by the HCWs and effective strategies adopted by hospital administrators during tough situations.This study will assist hospital administrators in developing interventions such as regular training programs and workshops to teach effective coping skills to address poor mental health during crises.

Epidemiological Patterns of Work-Related Musculoskeletal Disorders among Healthcare Workers in Five Reference Hospitals in the City of Douala, Cameroon

Introduction: Work-related musculoskeletal disorders (WRMSDs) are a public health problem and have forced many workers to quit their jobs prematurely. This study investigated the prevalence and risk factors of WRMSDs among Healthcare workers in five reference hospitals in the City of Douala-Cameroon. Methods: A cross-sectional study was conducted in 2022 among 561 healthcare workers working in five reference hospitals in the city of Douala, Cameroon. Participants were selected using a convenient sampling technique. Data were collected with structured questionnaires;data on the demographics and risk factors were collected using a well-designed questionnaire, while estimation of the prevalence of WRMSDs was done using the Modified Nordic questionnaire. Results: The overall prevalence rate of WRMSDs among healthcare workers in Douala hospitals was 83.4% (468/561). The prevalence per professional groups was as follows: 88.8% (71) for Medical Laboratory Scientists (MLS), 81.9% (289) for nurses, 21 (80.8%) for Physiotherapists (PTs) and 78.8% (41) for Medical Doctors (MDs). There was a significant difference (p = 0.001) in the prevalence of WRMSDs with respect to place of work where healthcare workers from HLD recorded the highest prevalence 89.9%, while Healthcare workers from NBDH were 2.91 times at risk (AOR = 2.91;95% CI: 1.32 - 6.41;p = 0.001) to develop WRMSDs than healthcare workers in the other hospitals. With respect to body region, the highest prevalence of WRMSDs was recorded on the lower back, 58.8% with the lowest at the elbows 11.2%. The age group 30 to 39 years was significantly associated with WRMSDs at level of the shoulder (p = 0.002), upper back (p = 0.019), elbows (p Conclusion: The overall prevalence rate of WRMSDs among healthcare workers in Douala hospitals was high. The prevalence of WRMSDs is highest among MLS and nurses and the most affected body parts are;lower back, neck and upper back. Working on the same posture, stressful job, and repetitive tasks were the major risk factors associated to WRMSDs among healthcare workers in Douala hospitals.

Acceptability of Phone-Based Communication Intervention by Healthcare Workers as an Adjunct to Routine Referral Form: A Qualitative Study in South Western Uganda

Introduction: A functional maternal referral system should encompass a feasible communication system between health facilities. In Uganda, the current paper-based patient referral form is associated with inadequate patient-information and low feedback rates. A recent quasi-experimental study demonstrated that a phone-based communication intervention is feasible for iterative communication between health facilities, and there were improved maternal-fetal outcomes and high rates of feedback. However, the acceptability of the intervention was not assessed. Objective: The study assessed the acceptability of a phone-based communication intervention by the health care workers (HCWs) for iterative communication between the referring and receiving health facilities. Methods: This was a qualitative study conducted in South Western Uganda, in April 2021. The study employed a theoretical framework of acceptability of medical interventions. We conducted in-depth interviews with HCWs and used deductive-inductive analysis. Results: We enrolled a total of 23 HCWs, of whom 69.6% (n = 16) were females while 30.4% (n = 7) were males. Majority (65.2%, n = 15), were midwives and the rest were: doctors (30.4%, n = 7) and a nurse (4.3%). The HCWs were positive towards the intervention: they believed that the intervention reduced delays, promoted professional escort, encouraged sharing of supplies, enabled exchange of relatively more patient details, feedback and improved case management. They believed it was culturally acceptable and had enough skills and experience of operating phones. All participants recommended scale out of the intervention, but advised on the need for dedicated human-resource to coordinate phone calls, ensure availability of airtime and charged battery. Conclusion: This study demonstrates that the phone-based communication intervention was highly accepted by the healthcare workers, and that hospitals can successfully give feedback to lower health centres through iterative phone calls. This provides a possible solution to the long-standing challenge of poor feedback rates and a vicious cycle of poor maternal-fetal outcomes in resource limited settings.

Evolution of Acquired Humoral Immunity after Full Vaccination against SARS-CoV-2. IgG Levels in Healthcare Workers at 6 and 9 Months

Background: The COVID-19 pandemic continues to be a major worldwide health problem. The present study aims to contribute to surveillance of the immune and clinical response of vaccines to SARS-CoV-2. Methods: Observational medication study on acquired immunity and effectiveness of vaccines. Population: 620 workers in the health service of Almansa (Spain). Representative sample of 150 individuals. Sociodemographic, clinical, and epidemiological data and samples were recorded to determine anti-SARS-CoV-2 serum IgG levels 6 and 9 months after vaccination with Pfizer. Results: Mean age 46.45 years;76% women;85.1% working in a hospital. 19.3% had had COVID-19 in the year prior to vaccination. 96.7% were fully vaccinated with Pfizer/BioNTech. At 6 months, 100% seropositivity and mean IgG levels of 3017.2 AU/ml. Significant variations in IgG levels in individuals with prior COVID-19 infection and smokers. At 9 months, 99.3% remained seropositive;2.8% infected after vaccination. The repeated measures analysis showed a difference in means of 669.0 AU/ml (significant decrease in IgG levels of 28.9%). Conclusion: Antibody levels remained positive 6 and 9 months after vaccination, although IgG levels were found to decay.

Knowledge, Attitudes, and Practices (KAP) Regarding Hepatitis B Vaccination among Healthcare Workers in Mongolia

Background: Mongolia is no exception and experiencing the burden of HBV among the population. In the last decade, the prevalence of HBV among the relatively healthy population of Mongolia has ranged between 11.8 percent and 10.6 percent, and acute cases are between 1.7 and 1.1 per 10,000 people. We aimed to determine healthcare workers (HCWs) knowledge, attitude, and practices regarding HBV prevention compared to vaccination coverage. Methods: This cross-sectional study was conducted among HCWs from the selected sites through multi-stage sampling. The study involved 1135 HCWs, including medical doctors, nurses, clinicians in both surgical and medical specialties, laboratory technicians, and other staff working in all departments from primary and referral levels in 36 healthcare facilities in two urban and four rural provinces of Mongolia. Participants who consented to the study completed a standardized self-administered questionnaire between July and Dec 2019. Results: Most participants (82.0%) were born before 1992 or before starting a birth vaccination against HBV in Mongolia. The mean age of the participants was 38 years and the participants’ median employment year in the health sector was seven years. Most participants were medical doctors (29.1%) and nurses (28.0%). Five questions explored HCWs’ knowledge about hepatitis B virus infection and prevention, and the correct response ranged between 15.6% and 95.4%. 2.8% of the respondents answered five questions correctly. Men, those with higher levels of education, those over the age of 30, soum family health center HCWs, and doctors and senior medical professionals answered many questions correctly, which is statistically significant. 98.9% of respondents believe that HCWs should vaccinate against HBV. The younger the age (%), management professionals, and service staff are confident in vaccines. A significant difference between age groups, perception of HBV infection, and formal attendance to the official training positively relate to vaccination coverage. Specially survey respondents who knew about the adverse effects of overdosing, learning about total doses of the vaccine, and the effectiveness of the hepatitis B vaccine were more tent to have full doses of the HBV vaccine. Knowledge and working conditions are increasing factors in receiving full doses of the HVB vaccine. Conclusion: The overall knowledge of HBV and its vaccination is fair among the HCWs;however, there is a need to intensify the training on some of the details and increase the training frequency at the workplace. Attitude and practice on infection protection and vaccination are still essential to be promoted among the HCWs. The low level of vaccination coverage is relevant to the level of KAP among the HCWs of the country.

Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey

Background:Many healthcare workers were infected by coronavirus disease 2019(COVID-19)early in the epidemic posing a big challenge for epidemic control.Hence,this study aims to explore perceived infection routes,influencing factors,psychosocial changes,and management procedures for COVID-19 infected healthcare workers.Methods:This is a cross-sectional,single hospital-based study.We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29,2020.All participants completed a validated questionnaire.Electronic consent was obtained from all participants.Perceived causes of infection,infection prevention,control knowledge and behaviour,psychological changes,symptoms and treatment were measured.Results:Finally,103 professional staff with COVID-19 finished the questionnaire and was included(response rate:98.1%).Of them,87 cases(84.5%)thought they were infected in working environment in hospital,one(1.0%)thought their infection was due to the laboratory environment,and 5(4.9%)thought they were infected in daily life or community environment.Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively.Forty-three(41.8%)thought their infection was related to protective equipment,utilization of common equipment(masks and gloves).The top three first symptoms displayed before diagnosis were fever(41.8%),lethargy(33.0%)and muscle aches(30.1%).After diagnosis,88.3%staff experienced psychological stress or emotional changes during their isolation period,only 11.7%had almost no emotional changes.Arbidol(Umifenovir;an anti-influza drug;69.2%)was the drug most commonly used to target infection in mild and moderate symptoms.Conclusion:The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases.Positive psychological intervention is necessary.

Knowledge and attitude toward COVID-19 among healthcare workers at District 2 Hospital, Ho Chi Minh City

Objective:To assess the knowledge and attitude toward coronavirus disease-2019(COVID-19)among healthcare workers at District 2 Hospital in Ho Chi Minh City(HCMC).Methods:A cross-sectional study was performed between January 2020 and February 2020 at District 2 Hospital.A systematic random sampling strategy was carried out and the data was collected through a self-administered questionnaire of the knowledge and attitude of healthcare workers regarding COVID-19.Descriptive analysis was reported to describe the demographic,mean knowledge and attitude score of healthcare workers.Inferential statistics including t-test,ANOVA and Spearman’s correlation were used to evaluate the relationship between study variables.Results:A total of 327 eligible healthcare workers had a mean score of knowledge and attitude of 8.17±1.3(range 4-10)and 1.86±0.43(range 1-5),respectively.They showed good knowledge and a positive attitude.However,approximately two thirds of the participants knew the mode of transmission,the isolation period and treatment(67.0%,65.8%,and 58.4%,respectively),and 82.3%and 79.8%,respectively,held positive attitude regarding the risk of personal and family members getting illness.There was a negative correlation between knowledge scores and attitude scores(r=-0.21,P<0.001).Additionally,healthcare workerspredominately used social media to inform themselves about COVID-19(91.1%).Conclusions:The majority of healthcare workers had good knowledge and positive attitude toward COVID-19.However,the level of some knowledge and attitude lower than that expected for their position level towards the virus.Additional education interventions and campaigns are required for healthcare workers.

COVID-19 vaccination intention among healthcare workers in Vietnam

Objective:To assess the acceptance of coronavirus disease(COVID-19)vaccine among healthcare workers at two general hospitals in Vietnam when it is available.Methods:A cross-sectional study was conducted using a convenience sampling from January to February 2021 among 410 healthcare workers at two general hospitals in Vietnam via a selfadministered questionnaire.A multivariable regression analysis was performed to determine predictors of vaccine acceptance including the demographic factors,COVID-19 knowledge,and vaccine beliefs based on the domains of Health Belief Model.Results:Among 410 healthcare workers,76.10%showed vaccination willingness.Predictors of acceptance were determined that the group reporting as“vaccine acceptance”was more likely to be positive towards the perceived susceptibility and severity of COVID-19(OR 2.45;95%CI 1.48-4.06,P<0.05),perceived benefits of vaccination,and cues to action(OR 4.36;95%CI 2.35-8.09,and OR 5.49;95%CI 2.84-10.61,respectively,all P<0.001),but less likely to have the perceived barriers to vaccination(OR 0.19;95%CI 0.09-0.38;P<0.001)compared with the no acceptance group.Besides,people who had a good knowledge regarding the severity of illness were 3.37 times more likely to have identified as vaccine acceptance(OR 3.37;95%CI 1.04-10.86,P<0.05).The demographic factors were also associated with willingness to receive the vaccine,with participants who were staff and received COVID-19 information from relatives were less likely to accept the vaccine over those who were doctors and not receiving information from relatives(OR 0.36;95%CI 0.13-0.96,and OR 0.37;95%CI 0.17-0.78,respectively,all P<0.05).Conclusions:A rate of willingness to get vaccinated against COVID-19 was relatively high with discrepancies between occupation,receiving information from relatives,knowledge toward the severity of illness,and the elements of Health Belief Model.The findings will provide information for the management authorities to develop relevant interventions to promote COVID-19 vaccination uptake.

Intention of healthcare workers to accept COVID-19 vaccination and related factors:A systematic review and meta-analysis

Considering medical and economic burden of coronavirus disease 2019(COVID-19), a high COVID-19 vaccination coverage among healthcare workers(HCWs) is an urgent need. The aim of this systematic review and meta-analysis was to evaluate the intention of HCWs to accept COVID-19 vaccination and to identify related factors. We searched Pub Med, MEDLINE, Scopus, Web of Science, Pro Quest, CINAHL and med Rxiv until July 14, 2021. The heterogeneity between results was very high;thus, we applied a random effects model to estimate pooled effects. We performed subgroup and meta-regression analysis to identify possible resources of heterogeneity. Twenty four studies, including 50 940 HCWs, met the inclusion criteria. The overall proportion of HCWs that intend to accept COVID-19 vaccination was 63.5%(95% confidence interval: 56.5%-70.2%) with a wide range among studies from 27.7% to 90.1%. The following factors were associated with increased HCWs’ willingness to get vaccinated against COVID-19: male gender, older age, white HCWs, physician profession, higher education level, comorbidity among HCWs, vaccination against flu during previous season, stronger vaccine confidence, positive attitude towards a COVID-19 vaccine, fear about COVID-19, individual perceived risk about COVID-19, and contact with suspected or confirmed COVID-19 patients. The reluctance of HCWs to vaccinate against COVID-19 could diminish the trust of individuals and trigger a ripple effect in the general public. Since vaccination is a complex behavior, understanding the way that HCWs take the decision to accept or refuse COVID-19 vaccination will give us the opportunity to develop the appropriate interventions to increase COVID-19 vaccination uptake.

Chorioamnionitis caused by Serratia marcescens in a healthcare worker: A case report

BACKGROUND Healthcare workers(HCWs)are at an increased risk for exposure to infections.Serratia marcescens(S.marcescens)is a gram-negative,opportunistic and nosocomial pathogen belonging to the Enterobacterieae family.A few case reports have been published of chorioamnionitis caused by S.marcescens infection.Immunological changes during pregnancy can also affect the risk of infection.However,few studies have examined hospital-acquired bacterial infection in pregnant HCWs.CASE SUMMARY A 33-year-old woman,a resident in anesthesiology,was admitted at 14 wk gestation for fever with chills.She had no medical history other than contact dermatitis of both hands that started from the beginning of the trainee.There was no obvious infection focus and no bacterial growth in blood cultures.She was discharged after 1 wk of empirical antibiotic treatment.At three weeks before the fever started,she had a blister on the site of contact dermatitis on both hands,she applied antibiotic ointment for three days and the blisters had healed.At 19 wk gestation,she had a high fever and was readmitted.Physical examination and image studies were nonspecific and the patient had no other symptoms.S.marcescens grew in blood cultures at 19 wk gestation.Treatment with intravenous antibiotics was started.However,she suffered a miscarriage at 224/7 wk gestation.Pathologically,the amniotic membrane showed chorioamnionitis with a focal infarct.Subsequently,a placenta tissue culture grew S.marcescens.CONCLUSION HCWs can be exposed to pathogens that can cause opportunistic infections such as S.marcescens.Pregnancy affects the immune system,making it susceptible to opportunistic infections.Therefore,pregnant HCWs may require more preventive measures,including hand hygiene and avoid risk factors(ex.wrapping the skin).

Global prevalence of hepatitis B virus serological markers among healthcare workers:A systematic review and meta-analysis

BACKGROUND The hepatitis B virus(HBV)infection is a global public health concern that affects about 2 billion people and causes 1 million people deaths yearly.HBV is a bloodborne disease and healthcare workers(HCWs)are a high-risk group because of occupational hazard to patients’blood.Different regions of the world show a highly variable proportion of HCWs infected and/or immunized against HBV.Global data on serologic markers of HBV infection and immunization in HCWs are very important to improve strategies for HBV control.AIM To determine the worldwide prevalence of HBV serological markers among HCWs.METHODS In this systematic review and meta–analyses,we searched PubMed and Excerpta Medica Database(Embase)to identify studies published between 1970 and 2019 on the prevalence of HBV serological markers in HCWs worldwide.We also manually searched for references of relevant articles.Four independent investigators selected studies and included those on the prevalence of each of the HBV serological markers including hepatitis B surface antigen(HBsAg),hepatitis e antigen(HBeAg),immunoglobulin M anti-HBc,and anti-HBs.Methodological quality of eligible studies was assessed and random-effect model meta-analysis resulted in the pooled prevalence of HBV serological markers HBV infection in HCWs.Heterogeneity(I²)was assessed using theχ²test on Cochran’s Q statistic and H parameters.Heterogeneity’sources were explored through subgroup and metaregression analyses.This study is registered with PROSPERO,number CRD42019137144.RESULTS We reviewed 14059 references,out of which 227 studies corresponding to 448 prevalence data among HCWs(224936 HCWs recruited from 1964 to 2019 in 71 countries)were included in this meta-analysis.The pooled seroprevalences of current HBsAg,current HBeAg,and acute HBV infection among HCWs were 2.3%[95% confidence interval(CI):1.9-2.7],0.2%(95%CI:0.0-1.7),and 5.3%(95%CI:1.4-11.2),respectively.The pooled seroprevalences of total immunity against HBV and immunity acquired by natural HBV infection in HCWs were 56.6%(95%CI:48.7-63.4)and 9.2%(95%CI:6.8-11.8),respectively.HBV infection was more prevalent in HCWs in low-income countries,particularly in Africa.The highest immunization rates against HBV in HCWs were recorded in urban areas and in high-income countries including Europe,the Eastern Mediterranean and the Western Pacific.CONCLUSION New strategies are needed to improve awareness,training,screening,vaccination,post-exposure management and treatment of HBV infection in HCWs,and particularly in low-income regions.

Psychological and mental health impacts of COVID-19 pandemic on healthcare workers in China: A review

The coronavirus disease-19(COVID-19)pandemic has put healthcare workers in an unprecedented situation,increasing their psychological and mental health distress.Much research has focused on the issues surrounding anxiety,depression,and stress among healthcare workers.The consequences of mental health problems on healthcare workers’physical health,health-compromising behaviours,suicide ideation,family relationships,and job satisfaction during the COVID-19 pandemic are not well studied.Enhanced psychological stress has known effects on an individual’s physical health.In healthcare workers with preexisting comorbidities,psychological stressors may exacerbate their current health problems.Healthcare professionals are known to have a high risk of substance use,hence they may be at risk of development of substance use addiction or vulnerable to addiction relapse.Frontline COVID-19 healthcare workers are being pushed above and beyond their limits,possibly resulting in suicidal tendencies.Furthermore,the burden of high workload and burnout may also have serious manifestations in relationships with family and an intention to quit their jobs.Future studies should explore the above-mentioned deleterious consequences to provide insight into the development of mental healthcare strategies to combat the psychological impact of COVID-19 on healthcare workers during the COVID-19 emergency.It is imperative to employ strategies to care for and policies to protect the psychological well-being of healthcare workers.

Effect of In-Service Training Program on the Practice of Healthcare Workers toward Malaria Prevention and Treatment Guidelines during Pregnancy in Health Facilities in Jowhar District, Somalia

Malaria is generally considered a major public health problem in Somalia. Providing early diagnosis and effective treatment is the key element of malaria control strategies in malaria-endemic countries, including Somalia. This required to advocate and ensure health worker’s adherence to the national malaria guidelines at all levels of health care service. A well-designed in-service training program may improve the level of health worker’s adherence to national malaria treatment guidelines, although results have been inconsistent. This is an interventional health facility-based pre and post comparative study aimed to assess the effect of an in-service training program on the practice of healthcare workers toward malaria prevention and treatment guidelines, during in pregnancy in health facilities in Jowhar district, Middle Shabelle region of Somalia. The study was implemented in three phases: pre-intervention phase, intervention phase and post-intervention phase. The sample size consisted of (n = 150) health workers who were selected from ten public health facilities using proportional to size sampling;the data collection adopted in this research is composed of a structured interview questionnaire and observational checklist. Data was analyzed through the application of descriptive statistical analysis that includes frequency and percentage and the Chi-square (x2) test was used to test the associations among variables using SPSS software version 25. The study showed that the level of health workers’ awareness of the national malaria guidelines in the treatment and prevention of malaria in pregnancy was found to be good before the intervention 89 (59.3%) and this proportion increased to 150 (100%) post-intervention of the training program. A significance difference has been observed between health workers’ awareness and their adherence to the malarial guidelines at pre-test and post-test with a p-value 0.000. The proportion of health workers who attended previous training on national malaria guidelines in the treatment and prevention of malaria in pregnancy increased from 46 (30.7%) at the pre-test to 150 (100%) after the post-test. A significant difference was observed in the training status among different categories of health worker and their adherence to the guidelines during the pre- and post-intervention of the training program, with a p-value of 0.000. The result showed that health workers were adhering to the guidelines at the pre-test 33 (22%), this increased after the post-test to 87 (58%). The knowledge of the need to adhere led to an increase in the adherence rate after the training program intervention. The study reveals that inadequate awareness was most reason for the non-adherence in the majority of the health workers as indicated by 89 (59.3%) at the pre-test and 56 (37.3%) in the post-test. However, difference was not significant between the availability of anti-malaria drugs in the facilities and the health workers’ adherence to the guidelines p-value 0.355 at the pretest and p-value 0.258 at post-test. The study concluded that the in-service training program significantly improved health workers’ knowledge and practice to the national malaria guidelines in the treatment, and prevention of malaria in pregnancy. The researcher recommends that the national malaria control programme (NMCP) of the Federal Ministry of Health should provide continuous regular in-service training to frontline healthcare workers at (facility and Community-based) to upgrade their skills and knowledge towards the malaria guidelines, disseminate job aids to the health facilities and undertake regular monitoring to ensure effective implementation of the national malaria treatment guidelines in the treatment and prevention of malaria in pregnancy in achieving desired proper case-management practices of malaria in pregnancy at all levels of health care service.

Psychological Impact of COVID-19 on Healthcare Workers in Africa, Associated Factors and Coping Mechanisms: A Systematic Review

Background: The coronavirus disease 2019 (COVID-19) is a public health problem that has caused harm to the mental health of healthcare workers. In Africa, the COVID-19 pandemic has led healthcare workers to experience mental health disorders such as anxiety, depression, stress, insomnia and burnout. This study aimed to review published studies on the effect of COVID-19 on the mental health of healthcare workers, associated factors and coping strategies that have been employed in Africa. Methods: This was a systematic review that was conducted through searching databases including;PubMed/Medline and Google Scholar. The study included published literature from January 2020 to May 2022 that met the inclusion criteria. The selection of articles was conducted following the 2020 PRISMA guidelines. Results: A total of 39 articles were retrieved, of which only 18 met the inclusion criteria and were used in this study. Our review revealed that healthcare workers experienced mental health disorders such as anxiety, depression, insomnia, stress and burnout that were associated with the COVID-19 pandemic. Coping strategies such as religious practices, support from family members and colleagues and avoiding listening to social media about COVID-19 were used to minimize mental health problems. Conclusion: The COVID-19 pandemic has caused increased mental health disorders among healthcare workers in Africa. Identification of factors associated with mental health problems is cardinal in developing coping mechanisms against the psychological impact of COVID-19. Therefore, there is a need for governments to develop and implement strategies for protecting the mental health of healthcare workers during crises such as the COVID-19 pandemic.

Exploring Gaps in Healthcare Workers Knowledge, Attitude, Perception and Practice of COVID-19 Prevention and Control in Rivers State Nigeria

Background Knowledge, attitude, perception, and practice of Covid-19 prevention affect the effectiveness of healthcare workers in the pandemic response. This study assessed gaps in awareness, knowledge, attitude, perception, and practice of Covid-19 prevention among healthcare workers in Rivers State, Nigeria. Methods This was a descriptive cross-sectional survey carried out six weeks into Rivers State response that commenced on February 20, 2020, in the 23 Local Government Areas (LGAs). State Disease Surveillance and Notification Officers used multistage sampling to recruit 555 healthcare workers for the survey. A self-designed structured interviewer-administered questionnaire built into the Open Data Kit application for android phones was used for data collection. Descriptive data analysis was done, and outputs presented as frequency and percentages. Results There was a total of 372 (67.0%) female respondents. Majority of study participants had tertiary education 453 (81.6%). The mean age of study participants was 40.6 years (Standard Deviation = 7.8 years). Furthermore, 285 (51.4%) were Community Health Workers, and had over ten years practicing experience 393 (70.8%). Most healthcare workers 554 (99.8%) had heard about Covid-19, through radio 539 (97.1%), and television 445 (80.2%) yet 213 (38.4%) respondents did not know that it is caused by a virus. Most respondents 415 (74.8%) had good knowledge about Covid-19. However, only 148 (26.7%) would refer suspected cases to a facility and only 365 (65.8%) respondents demonstrated the correct hand washing technique. Conclusion There are some gaps in health worker knowledge, attitude, perception, and practice of Covid-19 prevention. Interventions to bridge these gaps are needed for effective containment of this pandemic.

Cigarette Smoking and Attitudes Concerning Its Control among Healthcare Workers in Enugu, South-East, Nigeria

Introduction: Cigarette smoking is an established risk factor for many diseases, and according to World Health Organization, health care workers can influence positively or negatively the smoking habits of the community. Objective: The purpose of the study was to investigate the prevalence of cigarette smoking and attitudes regarding its control among healthcare workers in Enugu, South-East Nigeria. Methods: This cross sectional study was conducted among 369 healthcare providers randomly selected in primary, secondary and tertiary health facilities. Data were collected using a self reported questionnaire on cigarette smoking, and were analysed using SPSS Version 21, and statistical significance of association between variables was assessed using chi-square test at p < 0.05. Ethical clearance from University of Nigeria Teaching Hospital, Enugu and informed written consent was obtained from the participants. Results: Overall, 369 respondents returned the completed questionnaires. 54.2% were males, 75.9% were aged between 20 to 40 years, while their mean age was 27.5 ± 6.2 years. Overall life time prevalence of smoking among healthcare workers was 21.1% with (95% confidence interval 17.3 - 25.6), currently smoking was 6.5% with (95% confidence interval 5.8 - 7.4), while life time prevalence among physicians was 31.7% with (95% ci 28.8 - 33.6). The highest smoking rate was among the internists 72.7% in the physicians group. More smokers significantly agreed that the followings should be banned: cigarette sales (X2 = 22.134, df = 6, P = 0.003), advertising cigarettes (X2 = 42.532, df = 28, P = 0.040), cigarettes smoking in restaurants (X2 = 42.560, df = 20, P = 0.001), and smoking in all enclosed places (X2 = 33.257, df = 20, P = 0.025), but not statistically significant for health professionals to serve as role models (X2 = 24.420, df = 8, P = 0.086). Conclusion: Our results showed high percentage of cigarette smoking among healthcare providers. Smoking cessation programs should be introduced among healthcare providers.

An Assessment of Healthcare Workers Knowledge about COVID-19

Introduction: Coronavirus disease 2019 (COVID-19) is caused by a viral infection and considered the third coronavirus emerging among human beings over the past two decades. Healthcare Workers (HCWs) are at high risk of acquiring this serious infection during providing care to patients. Therefore, it’s crucial to assess the knowledge of the HCWs about COVID-19. Methods: A multicenter cross-sectional study was conducted on HCWs working at public hospitals and Primary Healthcare (PHC) centers in the Najran region, KSA to evaluate the staff’s knowledge toward COVID-19. The questionnaire consisted of two parts, the first part included the demographic data, and the second part involved questions related to the COVID-19. Results: 451 HCWs participated in this study and the median of overall knowledge score was 67%. Most HCWs properly identified symptoms (82.9%), mode of transmission (78.5%), the incubation period (96.4%), the way of preventing the infection (91.5%), the COVID-19 is not same as MERS-CoV (74.3%) and availability of a vaccine against the COVID-19 (82%). However, HCWs were less likely to identify the source of COVID-19 when it was discovered in China (22.5%), the mortality rate (44.6%), and the presence of treatment (32.1%). Overall knowledge score was statistically significantly associated with profession (P = 0.034), educational level (P = 0.033), and availability of the infection control in the workplace (P = 0.006). Conclusion: The findings of this study demonstrated an intermediate level of knowledge of HCWs about COVID-19. Intervention programs are urgently needed to raise the knowledge of HCWs about this global public health issue.

Prevalence and Pattern of COVID-19 among Healthcare Workers in Rivers State Nigeria

Introduction: The evaluation of COVID-19 prevalence among healthcare workers (HCW) within the general population of COVID-19 cases is an important epidemiologic variable. The objective of this study is to describe the prevalence and patterns of COVID-19 infection in HCWs amongst a group of patients receiving care for COVID-19 in Rivers state, Nigeria. Methods: This study was a prospective descriptive study of all consenting patients who received care through hospitals, designated for COVID-19 treatment in Rivers state either as in-patient or out-patient following a laboratory-confirmed diagnosis of COVID-19 based on a positive SARS-CoV-2 RT-PCR from April to September 2020. Results: A total number of 646 COVID-19 patients were enrolled over the study period with 98 (15.2%) HCWs in the patient population. The HCWs with COVID-19 consisted largely of Doctors 47 (47.9%), Nurses 30 (30.6%), and socio-sanitary and hygiene workers 10 (10.2%). There were 46 (46.9%) female HCWs, compared to Non-HCWs with 112 (21.1%), females, p = 0.000. Sixty-eight (69.4%) HCWs had a source of contact for infection established compared to Non-HCWs with an established source of contact in 181 (34.2%), p = 0.000. Eight (8.2%) HCWs had Severe disease compared to 52 (9.8%) Non-HCWs with severe disease, p = 0.670. The case fatality in HCWs was 1% compared to 1.9% in Non-HCWs, p = 0.554. Conclusion: The prevalence of COVID-19 among HCWs in the study location is high with clinical and clinical support staff particularly, doctors and nurses are at higher risk of COVID-19 infection. This calls for action to improve and prevent HCWs infections in hospital settings in addition to improving HCW infection prevention behaviour in the community. The intensification of risk communication, provision of protective equipment (PPE), and training on the appropriate use of PPE;in addition to routine surveillance for infection is recommended.