Depression among Health Care Workers in Khartoum State, Sudan, 2022

Introduction: Depression is a serious issue affecting healthcare workers and is a leading cause of disability for both genders. Furthermore, it is one of the leading causes of mortality and morbidity, responsible for 4.4 percent of global disability. An estimated 350 million people are currently living with depression worldwide. Objectives: to estimate the prevalence of depression among healthcare workers in Khartoum State in 2022 and determine the associated factors. Methods: A cross-sectional survey was conducted among healthcare workers in Khartoum State, Sudan, in 2022 using a self-administered electronic questionnaire. Depression was screened using the self-reporting questionnaire (PHQ-9). Descriptive statistics in the form of frequencies and percentages were used to display the data. Odds ratios (ORs) with a 95% confidence interval were estimated using bivariate and multivariate logistic regression analysis to determine associations between depression and related factors. Results: A total of 341 valid responses were received, with a mean age of 33.91. The overall prevalence of depression (PHQ-9 > 8) was 258 (75.6%). The prevalence was significantly associated with marital status (single and divorced), occupation (psychologist), and working department (Emergency Department), showing a p-value of Conclusion: Depression is a serious mental health disorder that affects all people, including healthcare workers, and is a growing problem in Sudan. To address this, healthcare organizations must implement policies and strategies to reduce inequality and protect healthcare workers. A multidisciplinary approach that includes mental health professionals, the Ministry of Health, and universities is needed to prioritize mental health issues and ensure quality care and the overall well-being of both healthcare workers and patients.

Prevalence of Post-Traumatic Stress Disorder (PTSD) among Healthcare Workers Following COVID-19 Pandemic in Jazan Region, KSA

Background: COVID-19 was declared a worldwide pandemic by the World Health Organization in 2020. Many pieces of research have been published on the virus’s pattern and transmission routes, and a few studies have been published on its psychological repercussions for the general public and health care workers in particular. We aimed in this study to figure out the impact of COVID-19 pandemic on the mental health of health care workers in the Jazan region and compare it to non-health care workers. Results: There were 221 participants in this study conducted in the Jazan region KSA, during the first part of 2022. 117 participants were non-HCWs (Health Care Workers) and 104 participants were HCWs. 31.7% of HCWs had high score of PTSD symptoms which may suppress their immunity, PTSD was a clinical concern in 12.5%, 6.7% had probable PTSD, and 49% had no PTSD. The average PTSD score in HCWs was 26.14. In contrast, the great majority of non-HCWs (69.2%) had no PTSD;PTSD was a clinical concern in 16.2%, 11.1% had a score indicating PTSD had the potential for immunosuppression, and 3.4% had probable PTSD. Conclusion: The COVID-19 pandemic did not affect just those who were infected with the virus, nor was it restricted to the mental health of those afflicted;rather, the influence expanded until it reached the general public and, in particular, those who had contact with patients, such as health care workers. As a result, mental health investigation, follow-up, and therapy are required to preserve the mental health of health care workers as well as the general population.

Effectiveness of Adherence to Standardized Hypertension Management by Primary Health Care Workers in China:a Cross-sectional Survey 3 Years after the Healthcare Reform

The standardized hypertension management provided by primary health care workers is an important part of China＇s recent health care reform efforts. Investigating 5,116 hypertensive patients from a cross-sectional survey conducted by the Chinese Center for Disease Control and Prevention in 2012, this study found that adherence to standardized hypertension management is associated with positive effects on hypertension- related knowledge, healthy lifestyle behavior, antihypertensive medical treatments, and blood pressure control. It will be necessary to provide primary health care workers with sufficient training and reasonable incentives to ensure the implementation and effectiveness of hypertension management.

Efficacy of Shanvac-B recombinant DNA hepatitis B vaccine in health care workers of Northern India

BACKGROUND: Health care workers (HCWs) constitute a high-risk population of HBV infection. There are limited data on the efficacy of vaccination in HCWs in India. This study was to evaluate the efficacy of indigenous recombinant hepatitis B vaccine, Shanvac-B, in HCWs. METHODS: In 597 HCWs screened before the vaccination, 216 (36.2%) showed the presence of at least one of the markers of HBV/HCV infection. Of the remaining 381 (63.8%) HCWs who were considered for vaccination, only 153 (age 18-45 years; 48 males and 105 females) were available for final assessment. These HCWs received 20 μg of vaccine at 0, 1 and 6 months. They were asked for the reactogenicity and monitored for the seroprotective efficacy of the vaccination. Anti-HBs titres were measured after vaccination at 1, 2 and 7 months. The presence of anti-HBs titers equal to 1 MIU/ml was considered as seroconversion and that of titres greater than 10 MIU/ml as seroprotection. RESULTS: After vaccination, 32 males (67%) and 76 females (72%) showed seroconvertion; finally 12 (25%) of the males and 47 (45%) of the females were seroprotected. Seroprotection at 2 and 7 months was more dominant in the females than in the males (96% vs. 56%, P=0.001, 100% vs. 85%, P=0.0001), respectively. Geometric mean titres of anti-HBs after vaccination were also higher in the females than in the males (257±19.7 vs. 29±1.88 MIU/ml, P=0.01, 1802±35.2 vs. 306±13.6 MIU/ml, P≤0.05, 6465±72 vs. 2142±73.6 MIU/ml, P<0.05). Seven male HCWs showed unsatisfactory response, non-response (n=3, 6%) and hypo-response (≤10 MIU/ml, n=4, 8%) at the end of vaccination. Smoking and alcoholism were significantly correlated with unsatisfactory response. No significant adverse effects of vaccination were observed in any HCW.CONCLUSIONS: The presence of HBsAg in HCWs indicates that a high proportion of HCWs are infected with HBV and HCV in India. Recombinant indigenous vaccine Shanvac-B is highly efficacious in HCWs, and its immunogenicity is significantly higher in females than in males. However, prevaccination screening of HCWs is strongly recommended in India.

Knowledge and Attitude of Health Care Workers toward Human Immunodeficiency Virus Infection in King Abdulaziz Medical City

Background: Worldwide data shows that the stigma and discrimination for AIDS patients by health care providers have a negative impact on its epidemic. It discourages people from seeking care or being tested for HIV, thus reducing access to HIV/AIDS prevention. The study aims to evaluate the knowledge of the HCWs (health care workers) in King Abdulaziz Medical City about human immunodeficiency virus infection and their attitudes when?they encounter HIV/AIDS patients. Methodology: A cross-sectional study was designed to collect data using self-administered structured questionnaire from 90 health care workers. It was distributed among HCWs in different wards in King Abdulaziz Medical City in Riyadh in August 2014. Results: The study included a total number of 90 heath care workers, of which 31 were physicians and 59 were nurses. Around 81 (90%) of HCWs knew the causative agent for AIDS. Only 22 (24%) of HCWs knew the level of risk of HIV transmission following needle stick injury. Most of HCWs 66 (73%) knew that sexual practice was the most common mode of transmission. Around 27 (87%) of physicians and 33 (56%) of nurses were able to answer that antiretroviral therapy had the ability to control HIV-infection. In addition, 9 (10%) of HCWs believed that AIDS was curable. Conclusion: It was obvious from our study that there was some amount of general information and knowledge with our HCWs. However, an educational campaign will try to increase the level of awareness and clear any misconception or misleading theories about HIV infection with our health care workers.

Healthcare workers' knowledge towards Zika virus infection in Indonesia:A survey in Aceh

Objective:To assess the knowledge on Zika virus(ZIKV) infection among healthcare providers(doctors) in Aceh province,Indonesia.Methods:A self-administered internet based survey was conducted from 3 May to 3 June 2016 among the members of doctor organizations in Aceh province.A set of validated,pre-tested questionnaire was used to measure knowledge regarding ZIKV infection and to collect a range of explanatory variables.A two-steps logistic regression analysis was employed to assess the association of participants' demographic,workplace characteristics and other explanatory variables with the knowledge.Results:A total of 442 participants included in the final analysis and 35.9% of them(159) had a good knowledge on ZIKV infection.Multivariate model revealed that type of occupation,type of workplace,availability of access to medical journals and experience made Zika disease as differential diagnose were associated with knowledge on ZIKV infection.In addition,three significant source of information regarding ZIKV were online media(60%),medical article or medical news(16.2%) and television(13.2%).Conclusion:The knowledge of the doctors in Aceh regarding ZIKV infection is relatively low.Doctors who have a good knowledge on ZIKV infection are more confident to established ZIKV disease as differential diagnosis in their clinical setting.Therefore,such program to increase healthcare providers' knowledge regarding ZIKV infection is needed to screen potential carriers of ZIKV infection.

Mandatory meningococcal vaccine, and other recommended immunisations: Uptake, barriers, and facilitators among health care workers and trainees at Hajj

AIM To evaluate the uptake of a mandatory meningococcal, a highly recommended influenza, and an optional pneumococcal vaccine, and to explore the key factors affecting vaccination rate among health care workers(HCWs) during the Hajj.METHODS An anonymous cross-sectional online survey was distributed among HCWs and trainees who worked or volunteered at the Hajj 2015-2017 through their line managers, or by visiting their hospitals and healthcare centres in Makkah and Mina. Overseas HCWs who accompanied the pilgrims or those who work in foreign Hajj medical missions were excluded. Pearson's χ2 test was used to compare categorical variables and odds ratio(OR) was calculated by "risk estimate" statistics along with 95% confidence interval(95%CI).RESULTS A total of 138 respondents aged 20 to 59(median 25.6) years with a male to female ratio of 2.5:1 participated in the survey. Only 11.6%(16/138) participants reported receiving all three vaccines, 15.2%(21/138) did not receive any vaccine, 76.1%(105/138) received meningococcal, 68.1%(94/138) influenza and 13.8%(19/138) pneumococcal vaccine. Females were more likely to receive a vaccine than males(OR 3.6, 95%CI: 1.0-12.7, P < 0.05). Willingness to follow health authority's recommendation was the main reason for receipt of vaccine(78.8%) while believing that they were up-to-date with vaccination(39.8%) was the prime reason for non-receipt. CONCLUSION Some HCWs at Hajj miss out the compulsory and highly recommended vaccines; lack of awareness is a key barrier and authority's advice is an important motivator. Health education followed by stringent measures may be required to improve their vaccination rate.

Preconception Care Health Education for Female Workers of Reproductive Age in Japan Evaluation up to 6 Months after the Program

Objectives: The aim of this study was to implement a health education program for education of preconception care (PCC) for female workers of reproductive age through a seminar and to evaluate the program based on PCC knowledge and awareness and behaviors before the seminar and at 3 and 6 months after the seminar. Methods: A small group health education seminar was implemented using leaflets for 84 female workers of reproductive age, age 20 to 35 years old, and an intervention by group discussion and feedback was provided. Of these participants, 60 (71%) who provided valid survey responses were included in the analysis. The primary outcome indicators were PCC knowledge, PCC awareness and behaviors, and a food frequency questionnaire, and the secondary outcome indicators were self-efficacy and the health awareness and stress management subscales of the Health-Promotion Lifestyle Profile scale. The survey was conducted three times, before the seminar and at 3 and 6 months after the seminar, and the results were compared. Results: The percentage of individuals with PCC knowledge was significantly increased at 3 months after the seminar as compared with before the seminar, and it remained at this level even at 6 months after the seminar. The percentage of individuals with PCC awareness and behaviors was significantly increased for the items actively eat foods containing folic acid, prevent sexually transmitted diseases, and conduct self-examinations for breast cancer at 3 months after the seminar and for the items eat well-balanced meals, make the mind active, prevent sexually transmitted diseases, and conduct self-examinations for breast cancer at 6 months after the seminar. Furthermore, the score for the health awareness subscale of the Health-Promotion Lifestyle Profile scale was significantly increased at 6 months after the seminar. Conclusion: The health education program established PCC knowledge at 6 months after the seminar and improved some PCC awareness and behaviors. Therefore, it was suggested that the program would be effective for education of PCC for female workers of reproductive age.

Selection of Health Care Workers for Screening for Latent Tuberculosis Infection

Introduction: The rate of latent tuberculosis infections (LTBIs) in health care workers (HCWs) is higher than that in non-HCWs. We studied to investigate the prevalence and risk factors of LTBIs and the acceptance rate for treatment of LTBI among HCWs in South Korea, a country with an intermediate tuberculosis (TB) burden. Methodology: LTBI screening was conducted for HCWs at a tertiary and a secondary hospital from April 2017 to August 2017. This was a retrospective study included all HCWs who underwent LTBI examination. HCWs were classified by the degree of risk into four groups, based on two factors: possibility of exposure to TB, and impact on patients at the time of TB onset in the HCWs. The interferon-gamma release assay was used for the diagnosis of LTBI. Results: A total of 1326 HCWs were included;they comprised 801 HCWs from a tertiary hospital and 525 from a secondary hospital. A total of 235 (17.7%) HCWs were diagnosed with LTBIs. According to risk classification, there was no significant difference (P = 0.24). In multivariate analysis, age was the only independent risk factor (P Conclusions: HCWs did not show any significant difference in the rate of LTBI by the degree of risk, and age was the independent risk factor. LTBI screening should be conducted for all HCWs regardless of risk classification.

Barriers and Facilitators of Adherence to Anti-Diabetic Therapy in Pregnant Women with Diabetes: Health Care Workers’ Perspectives

Global prevalence of hyperglycaemia in pregnancy in women of 20 - 49 years was estimated to be 16.9% and affecting 21.4 million live births, in 2013, 90% of which occurred in developing countries. The cornerstone of anti-diabetic therapy is diet, physical activity and medications. The study utilized a qualitative descriptive design using key informant interviews from August 2016 to November 2016 to explore challenges of adherence to anti-diabetic therapy in pregnant women with diabetes at a central hospital in Harare, Zimbabwe. Permission to conduct the study was obtained from the respective local and national ethical review boards. All participants gave verbal and written informed consent. A sample of eight key informants directly involved in the care of pregnant women with diabetes was purposively selected for key informant interviews. Key informants should have worked with diabetic pregnant women for at least one year. Sample size was determined by data saturation. Interviews followed a semi structured questionnaire that had sections on the burden of diabetes in pregnancy, challenges of adherence, challenges in management and possible solutions to challenges faced. All interviews were conducted in a private room. Detailed notes were taken during the interviews which were also being audiotaped. Trustworthiness was achieved by observing credibility, dependability, transferability and confirmability. Thematic analysis was done. Thematic analysis was done manually. The stages of data analysis followed were data organization, familiarization, transcription, coding, developing a thematic framework, indexing, displaying and reporting. Major themes identified were barriers and facilitators of adherence to anti-diabetic therapy. Categories under barriers were financial barriers, lack of health education, lack of trained personnel, shortage of staff and lack of collaboration among practitioners. Categories under facilitators of adherence were subsidization of care, formal training of professionals, promoting collaboration and establishment of a unit dedicated to the care of pregnant women with diabetes. Barriers and solutions identified should be utilized to develop frameworks to promote adherence to anti-diabetic therapy incidence of adverse perinatal outcomes.

Hepatitis B Virus and Human Immunodeficiency Virus Infections among Health Care Workers in Some Health Care Centers in Benue State, Nigeria

Introduction: Benue State of Nigeria has a high morbidity and mortality among individuals from HIV/AIDS. HBV is common among people who are at risk of/or living with HIV since both are transmitted in the same ways and in the presence of co-infection, there is increased risk for serious life threatening liver and other health complications. This study was carried out to assess the prevalence of HBV and HIV infections among Health Care Workers (HCWs) in some health care centers in the state. Materials and Methods: A total of 255 randomly collected blood specimen of consenting HCWs from some health care centers located in Benue State were screened by ELISA for Hepatitis B virus markers. Antibodies to HIV 1and 2 were detected in sera using Determine (Alero, Japan) and Stat Pak (USA) test strips. Other information was obtained through administration of structured questionnaire and data generated were analyzed using Chi square (χ2) test. Results: Of the 255 sampled individuals, 221 (86.7%) showed serological evidence of exposure to HBV markers, some through natural infection (21.6%) and others (23.9%) through vaccination;10.6% of the exposed were currently infected, while 30.6% were indeterminate. HIV antibodies were in 43 (16.9%) while 6 (2.4%) had both HBV and HIV infections. HIV significantly (P = 0.027) increased with increasing years of professional service in the health sector, similar to needle stick injury (P = 0.000) in this study. Both HBV and HIV were significantly higher (P = 0.025, P = 0.000 respectively) in individuals with history of previous surgery. Conclusion: Therefore, HBV and HIV infections are common among HCWs in Benue State. Hence, there is need to scale up vaccination coverage for HBV and upgrade the medical facilities especially in rural health care centers as well as intensification of programmes targeting safety and prevention for precautions.

Post-Exposure Prophylaxis against HBV and HIV Infection in Health Care Workers

Healthcare Workers (HCWs) are constantly at risk of exposure to viral infections such as hepatitis B virus (HBV), human immune deficiency virus (HIV) and hepatitis C virus (HCV). We aim at demonstrating the results of a three-year period of a surveillance program in Iran with the prospective follow-up of HCWs exposed to blood-borne viruses. HCWs who had experienced an occupational exposure to HBV, HCV or HIV from September 2005 to 2008 were enrolled in the study. Age, gender, route of exposure, type of fluid, type of virus, job, department, working shift, work experience, wearing gloves when exposed, history of HBV vaccination and the serum level of anti HBs antibody were recorded for all participants through an individual interview. Serum samples were taken from both HCWs and the sources of exposure and were tested by enzyme linked immunosorbent assay (ELISA). The data were gathered through questionnaires completed by a nurse under the supervision of a specialist of infectious diseases. In this study, 100 HCWs who were occupationally exposed to HIV, HCV or HBV were included. Most exposures had occurred among nurses (35%), followed by residents (29%), interns (18%), housekeepers (7%), the lab staff (6%), and specialists (5%). Most of the exposures had occurred in emergency (21%) and surgical (20%) wards. The most common route of exposure was percutaneous injuries (77%) and the most common cases had contacted with needles and angiocaths (71.1%) during injection or opening vein routes (21%). Establishing a surveillance system for registering the occurrence of occupational hazardous exposures, performing prophylactic measures and following up the exposed is a necessity in hospitals so that the number of exposures and occupational diseases among the HCWs can be decreased.

Analysis of Compliance and Barriers for Hand Hygiene Practices among Health Care Workers during COVID-19 Pandemic Management in Tertiary Care Hospital of India—An Important Step for Second Wave Preparedness

Introduction: Hands of health care workers play an important part in infection transmission in a healthcare setting infections. Even though it is a simple and effective procedure, it is many times ignored by the health care workers (HCWs) due to lack of knowledge and interest, time constraints, skin irritation, understaffing, etc. There are no specific drugs and vaccines available for COVID-19 pandemic management, so as control measures, hand hygiene is an essential measure. It will be helpful even for the second wave preparedness. So this study was planned for analysis of barriers and practices of hand hygiene among health care workers which determine the adherence of hand hygiene in medical practice. Methods: This was a cross-sectional study designed during COVID-19 pandemic management to analyze the barriers and knowledge, attitude and practices in health care workers for hand hygiene. Semi-structured questionnaires based study based on previous experience of seasonal flu outbreak was make to know barriers as well as to analyze the knowledge, attitude and practices of Health care workers. 215 participants were enrolled who were doctors, resident doctors, nurses, lab technicians, ward boys and food distributors. Results: The “Barriers” related questions’ analysis showed that hand hygiene facilities, with the supply of soap, hand rub, basins with adequate as well as clean water, are available at various places in the Hospital. In knowledge related questions, major gaps are found in 5 moments of hand hygiene and regarding aspects of alcohol-based hand-rub. Majority HCWs show a good attitude towards questions that hand hygiene is an important thing to do along with other works and they feel frustrated when others or they themselves omit hand hygiene. But the attitude toward hand hygiene when hands are not visibly soiled and when working with gloved hand showed a wrong attitude. There is a major gap in practices of hand hygiene. The majority feel hand hygiene is difficult due to work pressure, sometimes they forgot, they feel it difficult to adhere due to more steps during an emergency. Discussion: Hand hygiene is an essential part of COVID-19 pandemic management. Less compliance was observed due to a lack of knowledge and awareness. Such ignorance leads to an increase in Hospital-acquired infection. Conclusion: Good preparedness by Government and Institute for supplying adequate hand hygiene facilities in the work area for health care workers. But there were few gaps found in knowledge and attitude-related questionnaires and major gaps in practices were found which should be corrected by repeated training, awareness programs, demonstrations for hand hygiene and hands-on training. Conducting Periodic Webinar can be the most useful, convenient and safe method to provide training during the COVID-19 pandemic.

Viral Hepatitis B and C Detection among Ebola Survivors and Health Care Workers in Makeni, Sierra Leone

Viral hepatitis B and C infections are among the leading cause of death in Sub-Saharan Africa. Lack of knowledge and awareness in the general population as in health care settings may enhance the propagation of these diseases. We aimed at determining the prevalence of HBV and HCV in Ebola survivors and health care workers (HCWs) of the Makeni town in Sierra Leone. We conducted a cross-sectional study during the last 2013-2016 Ebola outbreak in Makeni among Ebola survivors (N = 68) and 81 Health care workers from Holy Spirit hospital and Loreto clinic, two health care facilities in Makeni district. Serological markers of HBV (HBs Ag, anti-HBs Ab and anti-HBc Ab) and anti-HCV antibodies detection were done using ELISA techniques. The positive detection rates for HBs Ag, anti-HBs Ab and anti-HBc antibodies in Ebola survivors were 23.53% (16/68), 32.35% (22/68) and 88.89% (16/18) respectively. Survivors with a current HBV infection had a positive rate of 38.89% (7/18) and 16.66% (3/18) of them were considered immune due to past HBV infection. HCV prevalence was 26.47% (18/68) and about 10.29% (7/68) were HBV/HCV co-infected. The positive detection rates of HBsAg, anti-HBs Ab and anti-HBc Ab were 37.07% (30/81), 33.33% (27/81) and 30.86% (25/81) respectively in health care workers. We observed that 4.94% (4/81) of the HCWs were currently infected with HBV. Participants considered as immune due to past infection represented 23.47% (19/81) and those immune due to vaccination represented 2.47% (2/81). The prevalence of HCV infection among health staff was 2.47% (2/81) with 1.23% (1/81) being HBV/HCV co-infection. Our findings showed that viral hepatitis infection is a burden for Sierra Leone government. There is an urgent need to develop and implement strategies that could improve population immunization against HBV and vulgarization of HCV treatment programs.

Practices and Barriers for Personal Protective Equipment among Health Care Workers during COVID-19 Pandemic Management at Tertiary Care Government Hospital of South Gujarat, India

Introduction: The recent COVID-19 pandemic has prompted concern about the compatibility of IPC guidelines with health care workers, their working practices and behaviours. These guidelines can be difficult and time-consuming to adhere to in practice. By identifying barriers and facilitators to IPC guideline adherence, especially using personal protective equipment (PPE), we can identify focussed strategies that will support health care workers to undertake the IPC measures needed at such a critical time in health care internationally. Material & Methods: This was a cross-sectional study designed during the COVID-19 pandemic management in the South Gujarat region, to analyse the knowledge, attitude and practices of health care workers about their usage of personal protective equipment. A semi-structured questionnaire-based study was prepared, deriving pointers from our previous experience of seasonal flu outbreaks. 225 participants enrolled who were doctors, resident doctors, nurses, lab technicians, ward boys and food distributors. Result: Analysis of the barriers-related questions show good preparedness by the medical institution. Overall we found good knowledge, attitude and practice related to PPE during COVID-19 pandemic management. There are few gaps found in the knowledge of donning of PPE (p-0.0075), N-95 mask related knowledge (p-0.01) and the attitude that PPE use causes discomfort while nursing patients (0.0001).

The Precautions Efficacy Taken among Health Care Workers While Performing Tracheostomies on COVID-19 Patients: Systematic Review

Background & objectives: Coronavirus disease 19 (COVID-19) has been declared by World Health Organization as a global pandemic disease in March 2020. Acute respiratory distress syndrome is frequent complication of COVID-19 disease. Tracheostomy is needed in cases of prolonged mechanical ventilation (7 - 10 days) in patients with acute respiratory distress syndrome. Tracheostomies are highly aerosol generating procedures, Otorhinolaryngologists and Health Care Workers (HCWs) are at high risk of virus exposure. The aim of this review is to evaluate the risk of transmission of COVID-19 during tracheostomy procedure, and to review the practical recommendation and scope of the timing to reduce risk of transmission to HCW. Methods: PubMed database was searched between April 2020 to Jan 2021 using the terms “Tracheostomy AND COVID-19 AND Health Care Workers”. All the articles that shared the same aim were screened which resulted in 243 references without duplicates. The title and abstract screening excluded further 202 studies. Eventually 9 full-text studies were included. Results: Five hundred and two COVID-19 patients underwent tracheostomies during the study period. Sixty-three percent of the procedure were done through open technique, while 37% of them were done through percutaneous technique. Seventy-eight percent of them used full Personal Protective Equipment (PPE) and 44.4% used Powered Air Purifying Respirator (PAPR). Negative Pressure Rooms (NPR) were used in 67%. Conclusion: The studies showed similar negative results on HCW infection despite much variance in using PPE. However, there should be global unified recommendations and guidelines regarding tracheostomies in COVID-19 patients to prevent future HCW infection.

Headaches Associated with N95 Mask Usage amongst Healthcare Workers in Operating Theatres during COVID-19 Pandemic: A Cross-Sectional Study

Introduction: N95 respirator masks are a cornerstone in the fight against the ongoing COVID-19 pandemic. However, its use has side effects such as headaches. The primary aim of this study is to identify factors that may contribute to higher occurrences of headaches with wearing N95 masks. Methods: A cross-sectional study was conducted across healthcare providers in operating theatres of a tertiary hospital based in Singapore involved in the care of COVID-19 patients. The study involved a self-administered online questionnaire completed by all participants. Results: 176 participants were included into the study, of which 65 (36.9%) reported headaches associated with wearing N95 masks. Out of the 65 participants who experienced headaches, 28 (43.1%) reported experiencing “mild” headache, 30 (46.2%) reported experiencing “moderate” headache, and 7 (10.7%) reported experiencing “severe” headache. 44 participants (67.7%) reported that the headache has affected their work, and 20 participants (30.8%) required analgesia to relieve the headaches. Other symptoms associated with N95 mask usage include skin damage (12.3%), breathlessness (15.4%), giddiness (6.2%), nausea (6.2%) and ear pain (3.1%). Multivariate logistic regression analysis showed that participants younger than 32 years old (p = 0.001) and history of pre-existing headache disorders (p = 0.001) were associated with higher occurrences of headaches with wearing N95 masks. Conclusion: Our study showed that younger age and history of pre-existing headache disorders contribute to higher occurrences of headaches with N95 mask usage. These associations could be useful in identifying at-risk individuals so that precautions may be taken to reduce the occurrence of headaches when wearing N95 masks.

Health care worker occupational experiences during the COVID-19 outbreak:A cross-sectional study

BACKGROUND Health care workers treating coronavirus disease 2019(COVID-19)patients experience burnout and stress due to overwork and poor working conditions.AIM To investigate the work experiences of frontline health care workers in Wuhan city and Qinghai province,China,during the COVID-19 outbreak.METHODS In this cross-sectional descriptive study,a self-reported questionnaire was designed to evaluate work experiences of medical staff throughout the course of the COVID-19 pandemic.A total of 178 health care workers responded to the questionnaire between February 19 and 29,2020.Higher questionnaire dimensional score confirmed dimensional advantage.RESULTS Of all dimensions evaluated by this questionnaire,the occupational value dimension had the highest mean score of 2.61(0.59),followed by the support/security dimension score of 2.30(0.74).Occupational protection scored lowest at 1.44(0.75),followed by work environment at 1.97(0.81).The social relationships dimension had an intermediate score of 2.06(0.80).Significant differences in working conditions were observed across hospital departments,with the fever ward scoring lowest.Total scores also differed significantly across workplaces;the fever outpatient department scored lowest(P<0.01).This phenomenon was likely due to the fact that work in the fever outpatient department,where many patients present to hospital,necessitates constant contact with a large number of individuals with insufficient provision of resources(such as protective equipment and social support).Medical workers in the fever outpatient department were burdened with a fear of COVID-19 infection and a lower sense of professional value as compared to workers in other hospital departments.Medical staff in Wuhan worked longer hours(P<0.01)as compared to elsewhere.The mean support/security dimension score was higher for tertiary hospital as compared to secondary hospital medical staff as well as for Wuhan area as compared to Qinghai region staff(P<0.01).Staff in Wuhan had a lower mean work environment score as compared to staff in Qinghai(P<0.05).CONCLUSION Medical staff treating COVID-19 patients in China report poor occupational experiences strongly affected by work environment,occupational protection and social relationships.Health care managers must address the occupational needs of medical staff by ensuring a supportive and safe work environment.

Mental Health Predictor of the Sixth Batch Indonesian Nurse and Certified Care Worker Candidates Migrate to Japan under the Japan-Indonesia Economic Partnership Agreement in Pre-migration Stage

Under the JI-EPA （Japan-Indonesia Economic Partnership Agreement）, approximately one thousand nurse and certified care worker candidates have been migrated to Japan since 2008. Migration has been known as a risk factor of mental well-being. Little is known about how the in pre-migration stage may affect the migrant＇s mental health. The study examines the mental health predictor in pre-migration stage using cross sectional design. Gender, Age, EPA course, educational degree, working background, language proficiency, motivation for migration and knowledge about destination country selected as mental health predictor. The results showed that the variable knowledge about living environment is the only independent variable which is correlate with GHQ in the model, β = -0.20, P 〈 0.05. The finding may assume that the knowledge as part of cognitive preparation plays important role in explaining the mental health of the EPA candidates in pre-migration stage.

Effect of Professional Designation on the Level of Task Performance by Community Health Workers in Enugu State

The study aimed at assessment of level of task performance of Primary Health Care Worker （PHCWs） according to their professional designations in selected Local Government Areas （LGA） in Enugu State. Descriptive survey research was used. 291 PHCWs were randomly selected from 9 LGA using a multistage method. Questionnaire was used to collect data and the instrument was validated using test-retest method with correlation coefficient of 0.79. The findings show that Community Health Extension Workers （CHEWs） performed higher than Environmental Health Officer （EVO） and Community Health Officers （CHOs） in the area of health education concerning prevailing health problems and method of control. They scored 66.09% as against 52.8% and 60.61% for EVO and CHEW respectively. The result showed that the professional designation has no significant effect （P 〈 0.05） on the level of task performed by PHCW and their levels of task performance were low. It was recommended that public Health physicians and Nurses should be involved in the PHC in Enugu State to provide the fight supervision to the PHCW.