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.

Occupational health protection for health workers during the coronavirus disease 2019(COVID-19)pandemic:6P-approach in China

Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 response in China.Occupational health protection of HWs was one of the key strategies of the public health measures adopted against the COVID-19 outbreak from the earliest stage in China.This prioritization of HWs health protection was based on the technical and policy guidance of WHO and International Labor Organization as well as the experiences from previous outbreaks in China.The comprehensive measures in China can be summarized as‘6P-approach’:public health emergency response,prompt learning from lessons,proactive measures of occupational health,precaution strategies against occupational hazards,personal protective equipment and medical devices supply,and professional networking.Through this 6P-approach,China was able to minimize the incidence of COVID-19 infection among HWs,while successfully containing the outbreak dxuing the first quarter of 2020.Although the COVID-19 vaccines have been rolled out,however,the COVID-19 pandemic is still under rapidly evolving situation.Experiences from China may provide other countries with an example of prioritizing and incorporating occupational health protection of HWs in their public health measures responding to the COVID-19 pandemic.

Assessment of Health Workers’ Concern about COVID-19 Pandemic: Implication for Surveillance Activities among Primary Health Care Workers in Oyo State, South-Western Nigeria

Background: The outbreak of COVID-19 has continued to threaten the existence of the human race. The novelty and unstable epidemiologic pattern of the virus had generated so much concern among the global health experts. These concerns were found to be escalated among the frontline health care workers to the extent of impeding the timeliness of the response activities. To slow down the spread of the already established community transmission through the surveillance activities, the concern of the health workers at the community level needs to be addressed. Therefore, this study assessed the concern about COVID-19 pandemic among primary health workers in Oyo State, Nigeria. Methods: This was an online cross-sectional survey conducted among primary health care workers in Oyo State between March and April 2020. Using a two-stage sampling technique, we recruited 284 respondents. A semi-structured questionnaire linked to the Google form was used to collect data. Data were analyzed using IBM SPSS version 25;bivariate analysis was done using Chi-square and binary logistic regression was used to identify the predictors of health workers’ concern at 5% level of significance. Results: The mean age of respondents was 45.0 ± 9.0 years. The proportion of the respondents who had good knowledge of COVID-19 was 52.5%. In the domains of concern, 66.9%, 53.2%, 51.4%, and 46.5% of the respondents expressed government-related, self-satisfaction related, work-related and social-status related concerns respectively. Male respondents were less likely to express concern about COVID-19 compared with their female counterparts (aOR = 0.39, 95% CI = 0.20 - 0.76). Nurses/midwives (aOR = 0.21, 95% CI = 0.05 - 0.85) had lesser likelihood of expressing concern about COVID-19 while middle staff (aOR = 2.5, 95% CI = 1.18 - 5.39) and income earner of ≥N200,000 (aOR = 2.3, 95% CI = 1.34 - 3.92) had higher likelihood of expressing concern about COVID-19. Conclusion: The study highlights an average knowledge of COVID-19 among the respondents. Government-related and self-satisfaction related concerns were expressed by the majority of the Primary Health Care (PHC) workers. Now that the second wave of COVID-19 is moving with much more fatality across much of Africa, including Nigeria, it is therefore imperative to address these concerns through a holistic policy that addresses the welfare, safety and capacity building of the health care workers (HCWs).

Socio-economic, Environmental and Health Aspects of Farm Workers Engaged in Mango Plantations

A cross-sectional survey of 489 male subjects in the age group 15 to 65 years engageddirectly or indirectly in mango cultivation along with 208 control subjects was carried out to find their socio-economic, environmental and health conditions. The conditions like high illiteracy rate (49.5%), poverty (PCI less than Rs 100 per month, 52.2%), poor housing (mud houses, 66.7%) unsafe water supply (78.6%) were prevailing in the surveyed population. The high respiratory morbidity may be attributed to high prevalence of smoking andprolonged inhalation of organic dusts during farming operation associated with illiteracyand poor socio-economic status. Gastrointestinal disorders were related to poor hygienic conditions, smoking and consumption of contaminated water. The symptoms pertaining to CNS, skin and eyes were found to be associated with exposure to pesticides

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.

Examination of Common Occupational Hazards among Healthcare Workers in a University Healthcare Center in Southeastern Nigeria

Background: Healthcare workers are challenged by an imposing group of occupational hazards. These hazards include exposure to biological and non-biological hazards like ionizing radiation, stress, injury, infectious agents, and chemicals. The aim of this study was to assess common occupational hazards among health workers at the Department of Health Services (DHS), Federal University of Technology, Owerri. Methods: A hospital-based cross-sectional study design was employed for the study, and a self-administered questionnaire was used for data collection. The SPSS Version 22.0 software was used for the analysis of the descriptive statistics obtained from the study. This study included both clinical and non-clinical health workers. A purposive sampling technique was used in recruiting a total of 94 respondents who participated in the study from September 2020 to April 2021. Results: A total of 94 respondents who participated in the study and among the participants, 33.3% (31) of the respondents were aged 31 - 40 years, and the majority of the health workers, 43.6% (41) had stayed between 1 - 5 years. Also, 92.6% (87) of the health workers have heard of occupational hazards. The study showed that 84.0% (79) of health workers had good knowledge of common occupational hazards. Biological hazards among health workers are 47.9% (45) cuts and wounds, 29.8% (28) direct contact with contaminated specimens/hazardous materials, and 26.6% (26) sharp related injuries, while for non-biological hazards, 44.7% (42) have slipped, tripped or fallen, and 35.1% (33) have been stressed. Common safety measures include 86.2% (81) washing their hands regularly;78.7% (74) using hand gloves;and 85.1% (80) agreeing they use face masks. Conclusion: Despite good knowledge of occupational hazards, participants at DHS were faced with certain hazards. It is recommended that the university, government, and policymakers revise and implement actions to provide health workers at DHS with equipment to encourage safety in work activity.

The Perception of Health Workers and Stakeholders Involved in the Process of Selecting Indigent in Burkina Faso

Background: Indigent selected for their health care is complex and poses enormous challenges. The actors involved have an influence on health actions and their perception is decisive for better care for the indigent. Little evidence exists on these perceptions and this paper has captured this. Methods: A case study involved 163 participants with a questionnaire and an interview guide. The quantitative responses were classified according to a measurement scale, proportions and overall indices of perception (Ip) and satisfaction (CSAT) were calculated. The relationship between variables was investigated using chi-square. Thematic analysis was used with qualitative data. The study met ethical requirements. Results: The participants had a positive perception of the selection: Ip = 0.77, but a minority (1/5) were dissatisfied with the selection. The perception of selection did not differ significantly depending on the experience of the actors. For the vast majority, the definition of indigent was satisfactory (CSAT = 91.4). The selection was done in a top down fashion and steps such as setting up committees, informing stakeholders, had shortcomings which negatively impacted the effectiveness of the selection. The needs of the participants included transparency in the indigent select process, matching the tools for selecting the indigent to the context, strengthening of local action, deconstruction of prejudices in terms of the indigent, power of actors to act, and importance for health services to reach out to the indigent. Conclusion: Considering the perception of the actors as well as their needs will improve the selection for effective care of the indigent.

Assessment of Pig Disease Prevention of Smallholder Farmers and Village Animal Health Workers in Rural and Peri-Urban Cambodia

Biosecurity measures are essential for protecting pig health, however, these practices are not always utilized by smallholder farmers in Cambodia. This study aimed to assess the knowledge and practices, in terms of pig biosecurity measures, of individual stakeholders involved in pig production in rural and peri-urban households in Cambodia. A survey tool was developed and administered using Kobotoolbox, an online electronic survey tool. Surveys were conducted in the provinces of Kampong Thom, Siem Reap, and Battambang during December 2017 to September 2018. There were 225 pig farmers, 43 village animal health workers (VAHWs), 3-district veterinarians (DVs), and 81 feed store owners enrolled in the study. Results showed that several biosecurity guidelines are not followed or well understood by farmers. Specific concerning practices included using natural boars, sharing pig equipment (e.g. scales), feeding kitchen waste, managing other livestock, handling manure, and not restricting access by visitors (VAHWs or DVs, boar owners, pig buyers, neighbors, and meat sellers). Thus, education of pig smallholder farmers and VAHWs on pig biosecurity is needed for improving pig health and production, economic value, and livelihood of smallholder farmers in Cambodia.

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.

Understanding Health Worker Perspectives on Risk Screening for HIV Testing—A Qualitative Study from Zimbabwe

Background: Zimbabwe recorded a 55% increase in HIV testing from 2011 to 2018 but with decreasing HIV-testing yields from 20% to 6% respectively as we aim to identify the narrowing gap of undiagnosed people living with HIV. As such adoption of screening tools during targeted HIV testing services improves efficiency by identifying individuals who are likely to test positive. Effective utilization of screening tools requires an understanding of health care worker perception and willingness to use the tools. Methods: We conducted a qualitative study among healthcare workers at 8 selected primary healthcare facilities in Zimbabwe. Interviewer-guided, in-depth interviews were conducted with healthcare workers and their immediate supervisors. Thematic analysis was performed following a framework built around the grounded theory model to describe perspectives that influence the utilization of HIV screening tools and suggestions for improved eligibility screening. Results: Behavioural factors facilitating the utilisation of the screening tool included motivation to adhere to standard practice, awareness of screening in targeting testing, and its ability to manage workload through screening out ineligible clients. This was evident across service delivery levels. Barriers included limited healthcare capacity, confidentiality space, multiple screening tools and opaque screening in/out criteria and the potential of clients not responding to screening questions truthfully. Conclusions: Across geographical and service delivery levels, placing screening tools at HIV testing entry points, healthcare worker knowledge on screening in/out criteria emerged as enablers for correct and consistent utilization. Further, standardizing the tools and adopting a decision aid algorithm would improve the accurate utilisation of screening tools.

Perceived stress and coping capacities among frontline healthcare workers of AIIMS during COVID-19 pandemic:A cross-sectional study

Objective:To assess perceived stress and coping capacity of frontline health workers from AIIMS during COVID-19 pandemic.Methods:This cross-sectional study conducted from May to July 2021 enrolled 694 participants.An online questionnaire based on Google Forms was developed to collect the data.Participants were assessed using the validated Perceived Stress Scale and the Coping Resources Inventory Scale.Results:The age of participants were 27(23-52)years old.The majority of respondents(73.5%)felt moderately stressed.Of the 694 participants,83.0%of the 576 participants had average stress management skills.Sex,marital status,and profession were significantly associated with perceived stress.In addition,marital status and profession were significantly associated with coping capacity.Conclusions:The majority of participants have moderate stress levels and average coping skills.Frontline healthcare workers have to maintain mental and physical health.Achieving this requires early screening and stress management for healthcare workers.

Factors Affecting the Knowledge and Practice of Drug Management among Healthcare Workers in Primary Health Centers in South-East, Nigeria

The knowledge of health workers regarding their management of drugs is very important in ensuring good health. One of the major indices of the performance of primary health care (PHC) remains improved access to essential drugs as they are the link between patients and health services. Consequently, their availability or absence will contribute to a positive or negative impact on health. This was a quasi-experimental study, carried out in Anambra state, which compared the intervention and control groups following the training and provision of drug management tools to PHC workers in the intervention group. A multi-stage sampling technique was used to select 264 health workers from 132 health centers from two senatorial zones in the State, one acting as a control group and the other as an intervention group. Data was collected using a pre-tested in-depth interview guide and semi-structured interviewer administered questionnaire. Statistical analysis was conducted using SPSS at a statistical significance level of p value less than 0.05, while qualitative data was analyzed using N-Vivo. Several factors such as age, sex, educational qualification, cadre of staff, years of practice and PHC workers’ previous training were identified as affecting the knowledge and practice of drug management. The majority (72.0% and 71.2%) in intervention and control groups respectively said inadequate information or lack of knowledge was the main reason for poor practices while the proportion with low interest of health workers for drug management was (38.5%) for intervention and (59.8%) for the control group and the difference between the groups was statistically significant (p = 0.034). In conclusion, this study has shown that age, sex, educational qualification, cadre of staff, years of practice and PHC workers’ previous training were factors associated with health workers’ knowledge and practice of drug management. The study recommends the development of Aide Memoire and conduct of training and retraining on drug management to improve both knowledge and practice of drug management in PHCs in Nigeria.

Health Workers’ Preparedness towards Integrating Mental Healthcare into Primary Health Settings: Evidence from Nigeria

Background: The global drive to scale up mental health services and eliminate the treatment gap requires incorporating mental health services into primary health care (PHC). Primary health care provides comprehensive, continuous, and coordinated care and if need be provides referrals to higher levels of care. However, for these services to meet the basic objective of PHC, it is necessary to determine healthcare workers’ preparedness for caring for the mentally ill. Therefore, this study aimed to examine health workers’ preparedness for integrating mental healthcare into primary settings in a rural community in Nigeria. Methodology: A descriptive research design was used to conduct the study among all 215 primary healthcare workers within Nkanu West Local Government Area (LGA). The instrument for data collection was a structured questionnaire constructed by the author. A pilot study was conducted on 10% of the sample population. Cronbach’s Alpha formula was used to estimate the reliability coefficient (0.85). The collected data were analysed with descriptive statistical frequencies and percentages. Results: Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Findings show that healthcare workers’ preparedness to care for the mentally ill at the primary healthcare centre is quite low. It was also found that mental illness is still shredded by stigma as a result of poor awareness. Consequently, there is still a persistent pervasive belief system that Mental illness is a form of retribution from the gods for one’s wrong deed in the study area. Conclusion: It was concluded that few of the respondents were prepared for the care of the mentally ill which might be a result of poor awareness about mental health and the negative stereotype given about mental health. From the analysis, it can be deduced that health workers exhibit some degree of positive attitude towards care of the mentally ill, though, mental illness is associated with stigmatization due to a lack of public understanding of mental disorders. There was strong support for integrating mental health into primary health care by health care providers. Therefore there is a need for community education and building of the capacity of healthcare workers for integration of the care of the mentally ill to be feasible in PHC centres.

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.

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.

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.

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.