Absence Of Hand Washing Research Articles

Environmental and behavioural exposure pathways associated with diarrhoea and enteric pathogen detection in 5-month-old, periurban Kenyan infants: a cross-sectional study

ObjectivesThe aim of this study was to test whether household environmental hygiene and behavioural conditions moderated associations between diarrhoea and enteric pathogen detection in infants 5 months of age in...

The Prevalence of Soil-Transmitted Helminths and Associated Risk Factors among School Children at Sekela Primary School, Western Ethiopia.

Soil-transmitted helminth (STH) infections are a major public health problem in tropical and developing countries in relation to poverty, inadequate hygiene, and sanitation. This study was aimed at assessing the status of STH and associated risk factors among school children in the case of Sekela primary school. Cross-sectional descriptive studies were conducted in May 2019 and from 384 children, both males and females of equal proportion were used. A stool sample was collected randomly and examined in the laboratory under a microscope. The quantitative data were analyzed using SPSS version 20. The difference was considered statistically significant at p value = 0.05. The overall STH infections observed in the study area were about 25.78% and were moderate transmission. The predominant helminth was A. lumbricoides (9.86%) followed by hookworm 6.25%, T. trichiura 5%, H. nana 3.10%, and H. diminuta 1.56%. Infections were generally more in males than females, in which 15.36% males and 10.41% females. In the case of age group, age groups between 7-8 years were more infected (13.28%). Infection rate decreases with increasing ages. Multivariate logistic regression analysis result indicated that wearing shoes, hand washing practice, family member, and residence were found to be associated risk factors for STH infections. Being urban dwellers and having family members with less than 2 children were found to be preventive. Lack of latrine, playing barefoot, untrimmed fingernail, eating raw vegetables, and absence of hand washing were major risk factors. In conclusion, the study showed that there was moderate transmission of infection among the study participants. Community-based health education using media, morbidity control through deworming, and improving sanitation should be strengthened as a measurement to control the transmission rate.

Lavado de manos y contaminación de estetoscopios en dos hospitales de Huánuco, Perú

Introducción: El estetoscopio es la herramienta universal del médico y personal de salud, está en contacto directo con numerosos pacientes y es un posible vector de infecciones asociadas a la atención de salud. El presente estudio buscó determinar la asociación del lavado de manos y la limpieza de estetoscopios con su contaminación.
 Métodos: Estudio de tipo observacional, descriptivo y transversal. Se cultivó muestras del diafragma de 70 estetoscopios y se aplicó un cuestionario al personal de salud que los utilizaba.
 Resultados: La contaminación de estetoscopios fue del 90% y el microorganismo más frecuente fue Staphylococcus coagulasa negativo. En el análisis bivariado, se encontró asociación significativa entre la contaminación de estetoscopios, la ausencia de lavado de manos, y la frecuencia de limpieza menor a diez veces al mes.
 Conclusión: El lavarse las manos y limpiar el estetoscopio más de 10 veces al mes, son factores protectores para evitar la contaminación de los estetoscopios.

Individual and community-level risk factors in under-five children diarrhea among agro-ecological zones in southwestern Ethiopia.

Under-five children diarrhea remains a major public health problem in resource-limited areas, including Ethiopia, due to multiple risk factors. This study aimed to identify individual and community-level risk factors affecting under-five children diarrhea (UFCD) in five districts of the Bench Maji Zone, southwestern Ethiopia. A community-based cross-sectional study was conducted from February to April 2018. A total of 826 households were recruited from five randomly selected districts using stratified sampling. A multivariable logistic regression model was fitted to identify risk factors associated with UFCD. The prevalence of UFCD in the study area was found to be 18.3%. Children less than six months of age are more at risk for diarrhea (95% CI for AOR2.5;1.23-4.90). Most probably initiating supplementary feedings before six months of age is one of the main risk factor for diarrhea (95% CI for AOR 0.65; 0.45-0.98). Similarly, mothers with low educational status (95% CI for AOR 0.30; 0.10-0.84), limited knowledge of mothers' about diarrhea (95% CI for AOR 0.24; 0.15-0.40), absence of hand washing among mothers/caregivers at critical times (95% CI for AOR 4.6; 2.88-7.67), and sharing of the residence with domestic animals (95% CI for AOR 2.87, 1.75-4.67) were the predictors of UFCD at individual-level. Children living in semi pastoral areas (95% CI for AOR 0.22; 0.10-0.50) unvaccinated children for rotavirus prevention (95% CI AOR 5.22, 3.33-8.20), households obtaining water from unimproved sources (95% CI for AOR 2.53; 1.60-4.40), and households with unimproved latrine facilities (95% CI for AOR 0.60; 0.33-0.99) were the risk factors of UFCD at the community-level. The study revealed that UFCD is a critical health concern in southwestern Ethiopia, where integrated intervention approach at individual and community level could help to alleviate the problem. At individual level, behavioral change intervention on handwashing, exclusive breast-feeding before the age of six months, and awareness on diarrhea prevention methods are critical areas of intervention. Likewise, provision of safe and adequate water source combined with household water chlorination, and vaccination for rotavirus are interventions at community that need to be integrated with the individual-level of intervention. This could significantly contribute for the reduction of UFCD in the resource limited areas through intersectoral collaboration of the health and other sectors.

Intestinal parasite infections and associated factors among inmates of Arba Minch prison, southern Ethiopia: cross sectional study

BackgroundIntestinal parasitic infection is one of the parasitic infections affecting people living in prison. Helminths and intestinal protozoan infections are the most common parasitic infection that may cause serious life-threatening diseases in inmates living in developing countries. This study was aimed to investigate the prevalence and associated factors of intestinal parasitic infections (IPIs) among inmates living in Arba Minch prison, southern Ethiopia.MethodsInstitutional based cross sectional study was conducted on Arba Minch inmates, southern Ethiopian. Pre-tested semi-structured questionnaire was used to gather the data of socio-demographic characteristics, hygiene status of the prisoners, sanitation condition of the prison, and associated factors for IPIs by face to face interview. Direct wet-mount examination and formol-ether sedimentation techniques were used to examine intestinal parasitic infection from stool specimens. Binary logistic regression analysis was used to see the association between different variables and the IPI. Odds ratio with 95% CI was computed to determine the presence association and strength of the associated factors.ResultA total of 320 prisoners were participated in this study. Of these, 154(48.1%) of them were infected with one or more intestinal parasites. Eight different intestinal parasites species were identified and Giardia lamblia was the predominant parasite. Among infected inmates, nearly one out of four of them had multiple parasitic infections dominated by Giardia lamblia and E. histolytica/dispar co-infection. Sleeping in group [AOR = 1.9; 95% CI: (1.0–3.8)], married prisoners [AOR = 1.8; 95% CI: (1.1–2.9)], and hand washing habits after handling soil [AOR = 2.4; 95% CI: (1.0–5.6)] were independently associated with IPI.ConclusionHigh prevalence of intestinal parasitic infection was detected in Arba Minch inmates, southern Ethiopian. Absence of hand washing, marital status, and way of sleeping were the factors associated with the IPI. Implementation of mass drug administration, education on water, sanitation and hygiene (WASH) and periodic screening of intestinal parasitic infection is very important to reduce the high prevalence IPIs in prison.

Prevalence and antimicrobial susceptibility patterns of Salmonella and Shigella isolates among children aged below five years with diarrhea attending Robe General Hospital and Goba Referral Hospital, South East Ethiopia

BackgroundDiarrheal diseases are responsible for high level of morbidity and mortality, particularly in children below 5 years. Salmonella and Shigella spp. are pathogenic microbes responsible for the major diarrheal associated mortality. The purpose of this study was to determine the prevalence, factors associated with Salmonella and Shigella isolates infections and their antimicrobial susceptibility patterns among diarrheic children aged below 5 years attending BRGH and GRH, Ethiopia.MethodsA health institution based cross-sectional study was conducted from April to July 2016. One stool samples was collected from 422 diarrheic children under the ages of five and were cultured on to Hektoen Enteric (HE) and Salmonella-Shigella agar. Isolation identification of the Salmonella and Shigella isolates were conducted using standard bacteriological methods. Antibiotic susceptibility was done by Kirby–Bauer disk diffusion method. The isolates were defined as multidrug resistant if it was resistant to two or more antimicrobial agents. Descriptive statistics were employed and logistic regression models were constructed to determine factors associated with Shigella/Salmonella prevalence.ResultsThe prevalence of Salmonella and Shigella isolates were 6.9 and 4.3%, respectively. Children aged between 1 to 3 years were significantly associated with Salmonella infection [AOR = 19.08, 95% CI (2.68–135.86)]. The odd of prevalence of Salmonella/Shigella isolates was significantly associated with absence of latrine, absence of hand washing after latrine, and in unimmunized children in adjusted odd ratio. Unimproved water sources and hand washing before meal had also higher odd of prevalence although the difference was not significant. All Salmonella and Shigella isolates were resistant to amoxicillin (100%). In addition, all Shigella isolates were completely resistant to chloramphenicol, and tetracycline, and were multidrug resistant. However, all Salmonella and Shigella isolates were susceptible to ciprofloxacin and ceftriaxone.ConclusionThere was a relatively low prevalence of Salmonella and Shigella species in the study areas and were significantly associated with lack of personal hygiene and environmental sanitation. There were also higher drug resistance and multidrug resistant pattern. Personal hygiene and environmental sanitation, including access to latrine and supply of safe drinking water are suggested. Checking susceptibilities of Shigella and Salmonella isolates causing diarrhea is also suggested.

Assessment of the hygiene-related risks of child illness at selected elementary schools in Nablus city: a cross-sectional survey

BackgroundThe health and safety of children at schools in Palestine are not paid the attention they require. Our objective was to assess the major risks and patterns associated with hygiene and sanitation at selected schools in Nablus in the West Bank. MethodsA two-layer cross-sectional survey was implemented to collect data on hygiene, sanitation, and bacterial contamination from pupils and staff at ten urban schools in Nablus. We took swab samples from 199 children's and eight food handlers' dominant hands and from 82 school bathrooms and classrooms. We observed and recorded variables related to school hygiene on a pre-prepared form. Bacterial identification for each sample was done at An-Najah National University. Using univariate and multivariate analysis, risk factors related to hygiene and sanitation were tested for individual and combined association with the presence of bacterial species transmitted primarily through fecal-oral contamination. Approval was obtained from the institutional review board committee at An-Najah University and consent forms were signed by children's parents and by food handlers. FindingsOur findings showed non-statistically significant associations between the presence of bacterial species that indicate a substantial risk of fecal-oral contamination (Listeria, Streptococcus, Microccocus, Bacillus subtilis, and Gram-negative bacilli) and the following factors: school address (univariate analysis, p=0·384), absence of soap in the school, absence of hand washing after use of bathroom, increased number of children per classroom, and decreased numbers of teachers, toilets, and sinks per number of students at school (ordinal logistic regression, p=0·084). InterpretationThis pilot study highlights the presence of several risk factors for bacterial contamination, including child behaviour and aspects of the school environment, favouring the possible spread of fecal-oral transmitted diseases. Policy makers' efforts should be turned towards new policies rendering schools a safer place for Palestinian children. This study has to be validated on a larger scale and in other cities in the occupied Palestinian territories. FundingThis research was funded by An-Najah University as a support for research projects of medical students.

Helicobacter pylori infections in Ethiopia; prevalence and associated factors: a systematic review and meta-analysis

BackgroundHelicobacter pylori (H.pylori) infections are prevalent and recognized as major cause of gastrointestinal diseases in Ethiopia. However, Studies conducted on the prevalence, risk factors and other clinical forms of H.pylori on different population and geographical areas are reporting conflicting results. Therefore, this review was conducted to estimate the pooled prevalence of H.pylori infections and associated factors in Ethiopia.MethodsPubMed, Embase, Google scholar, and Ethiopian Universities’ repositories were searched following the Preferred Items for Systematic review and Meta-analysis (PRISMA) guideline. The quality of included studies was assessed using the Newcastle-Ottawa Scale in meta-analysis. Heterogeneity between studies was assessed using Cochrane Q test and I2 test statistics based on the random effects model. Comprehensive meta-analysis (CMA 2.0) and Review Manager (RevMan 5.3) were employed to compute the pooled prevalence and summary odds ratios of factors associated with of H.pylori infection.ResultsThirty seven studies with a total of 18,890 participants were eligible and included in the analysis. The overall pooled prevalence of H.pylori infection was 52.2% (95% CI: 45.8–58.6). In the subgroup analysis by region, the highest prevalence was found in Somalia (71%; 95% CI: 32.5–92.6) and the lowest prevalence was reported in Oromia (39.9%; 95% CI: 17.3–67.7). Absence of hand washing after toilet (OR = 1.8, 95% CI; 1.19–2.72), alcohol consumption (OR = 1.34, 95% CI; 1.03–1.74) and gastrointestinal (GI) symptoms (OR = 2.23, 95% CI; 1.59–3.14) were associated with H.pylori infection. The trend of H.pylori infection showed a decreasing pattern overtime from 1990 to 2017 in the meta-regression analysis.ConclusionThe prevalence of H.pylori infection remains high; more than half of Ethiopians were infected. Although the trend of infection showed a decreasing pattern; appropriate use of eradication therapy, health education primarily to improve knowledge and awareness on the transmission dynamics of the bacteria, behavioral changes, adequate sanitation, population screening and diagnosis using multiple tests are required to reduce H.pylori infections. Recognizing the bacteria as a priority issue and designing gastric cancer screening policies are also recommended.

Evaluation of lead poisoning in children age ranged 2-10 years old

Background: Lead poisoning is one of the major environmental diseases among children in developing countries. The present study was conducted to assess lead level in children. Materials & Methods: The present study was conducted on 156 cases of lead poisoning of both genders of age ranged 2-10 years. In all children, symptom suggestive of lead poisoning like pallor, unexplained fatigue, abdominal pain, constipation or anorexia, deteriorating school performance, and recently acquired irritability or hyperactive behaviour was recorded. Reasons for lead poisoning were recorded. Results: Out of 156 patients, boys were 80 and girls were 76. Age group 2-4 years had 26 children, 4-6 years had 67, 6-8 years had 35 and 8-10 years had 28 children. Possible reasons seen in children were thumb sucking (26), use of colored toys (68), pets (34), absence of hand washing (65), use of herbal medications (35) and pencil biting (82). The difference was significant (P< 0.05). Conclusion: Lead poisoning in children is a serious issue. The possible reasons found was thumb sucking, use of colored toys, pets, absence of hand washing, use of herbal medications and pencil biting.

Relationships between the weaning period and the introduction of complementary foods in the transmission of gastrointestinal parasitic infections in children in Honduras.

PurposeThis study was to investigate weaning practices used by mothers when transitioning infants from breast milk to complementary foods and to determine the role these foods have in the transmission of gastrointestinal parasites.Participants and methodsOn average, of the 175 mothers extensively interviewed, 93% said they had breast-fed their infants. Approximately 20.8% of mothers had added some other liquid to their infant’s diet at 3 months, while most mothers had added other liquids at 6 months (39.0%) and >6 months (32.1%). Some mothers expanded food offerings to infants before 3 months. The percentage of mothers who had added other liquids to their infants’ diet was reported by age of the infant: as early as 1 day (2.5%), <1 week (1.9%), first month (3.1%), 3 months (20.8%), 6 months (39.0%), and >6 months (32.1%). These foods included fruit, vegetables, meat, and grains. The maximum age a child was found to be still breastfeeding was 13 years.ResultsForty percent of mothers involved in this survey reported that their children were diagnosed and/or treated for gastrointestinal parasitic infection. Routes of infection of protozoan and helminth parasites likely resulted from contaminated complementary foods and water given to infants while still breast-feeding or from contaminated foods after breast-feeding had been completed. Contaminated water is a likely source of protozoan parasites. Contaminated water was fed to infants, mixed with formula or complementary foods, or used to wash bottles for infant feeding. There was an absence of hand-washing by children and mothers before eating or while preparing foods.ConclusionThe major source of soil-transmitted helminth infections was likely the result of unwashed or uncooked pureed fruit or vegetables used as complementary foods, unpasteurized animal milk, insanitary food storage, poor living conditions with exposed dirt floors, and exposure to roaming domestic animals.

Investigating an outbreak of staphylococcal food poisoning among travellers across two Australian states.

Staphylococcus aureus is a common cause of staphylococcal food poisoning in Australia with several outbreaks associated with foods prepared by commercial caterers. Laboratory testing on cases of gastrointestinal illness caused by enterotoxin-producing S. aureus is not routinely done as this condition is self-limiting. Hence outbreaks of such illness may go undetected. A retrospective cohort study was conducted among a group of tourists who were hospitalized in Sydney shortly after flying from Queensland. The group had consumed food prepared by a restaurant on the Gold Coast before transit. Laboratory analyses on stool specimens were conducted in Sydney. An environmental assessment of the restaurant in the Gold Coast was conducted, and environmental specimens were assessed for contamination. Epidemiological investigations linked the outbreak to a restaurant in the Gold Coast where the suspected food was produced. Stool samples from two of the hospitalized cases were confirmed to have enterotoxin-producing S. aureus, and several environmental samples were found to be contaminated with S. aureus as well. Investigations suggested that absence of hand washing and other unhygienic food handling at the implicated restaurant was the likely cause of this outbreak. Food poisoning due to toxin-mediated S. aureus is frequently undetected and underreported. Public health units should consider toxin-producing pathogens such as S. aureus when investigating outbreaks where vomiting is the predominant symptom and occurs rapidly after consuming food.

ASPIRAÇÃO ENDOTRAQUEAL: ESTUDO EM PACIENTES DE UMA UNIDADE DE URGÊNCIA E TERAPIA INTENSIVA DE UM HOSPITAL DA REGIAO METROPOLITANA DE NATAL – RN

ABSTRACT: Intratracheal suction is a simple and important mechanical procedure on hospital routine. It’s largely used on patients in Intensive Care Units (ICU), under mechanical ventilation or not. This study seeks to characterize the professionals that perform the procedure of upper air tracts aspiration and identify how this procedure is being performed. The research is of the descriptive exploratory type with prospective data and quantitative approach, performed on the Emergency Room and ICU of a hospital in the greater Natal-RN. The population is comprised of 14 nurses, 22 nursing technicians, 14 nursing auxiliaries, 03 physicians and 07 physiotherapists. The structure observation technique was employed in the data collection. The instrument was comprised of a suction protocol based on the directives of the Agencia Nacional de Vigilância Sanitaria, Ministerio da Saude, and of the Guidelines for Prevention of Nosocomial Pneumonia of the Center for Disease Control (CDC, 1997). We’ve discovered that the guidelines for this procedure were not taken into consideration in almost every step of this care. The most outstanding discovery was the absence of hand washing before (92,81%) and after (50,29%) this care. The small participation of the nurse (3,59%) on this activity is also considered a point of extreme relevance, since it’s a unit for care of extreme complexity. The data indicate the need to intensify the educating activities that promote a change of behavior on these professionals, thus improving the quality of assistance and prevention of nosocomial infections. KEYWORDS: Intensive Care; Quality of Health Care; Nursing Care.