Training Of Healthcare Workers Research Articles

Comparison of the yield of two tuberculosis screening approaches among household contacts in a community setting of Silti Zone, Central Ethiopia: a prospective cohort study

BackgroundHousehold contacts of tuberculosis (TB) patients are at a greater risk of infection and developing TB as well. Despite recommendations to actively screen such high-risk groups for TB, it is poorly implemented in Ethiopia. A community-based household contact screening was conducted to compare the yield of two different screening approaches and to identify factors associated with TB occurrence.MethodsSmear-positive pulmonary TB index cases from six health facilities in six districts of Silti Zone were identified and enrolled prospectively between September 2020 and December 2022. Trained healthcare workers conducted house visits to screen household contacts for TB. WHO (World Health Organization) recommended symptom-based screening algorithms were used. The yield of screening was compared between a two-time screening at study site I and a single baseline screening at study site II, which is the current programmatic approach. Generalized estimating equation was used to run multivariate logistic regression to identify factors associated with TB occurrence.ResultsA total of 387 index TB cases (193 at site I and 194 at site II) with 1,276 eligible contacts were included for analysis. The TB yield of repeat screening approach did not show a significant difference compared to a single screening (2.3% at site I vs. 1.1% at site II, p < 0.072). The number needed to screen was 44 and 87 for the repeat and single screening, respectively, indicating a high TB burden in both settings. The screening algorithm for patients with comorbidities of asthma and heart failure had a 100% sensitivity, 19.1% specificity and a positive predictive value of 5.6%. Cough [AOR: 10.9, 95%CI: 2.55,46.37], fatigue [AOR: 6.1, 95%CI: 1.76,21.29], daily duration of contact with index case [AOR: 4.6, 95%CI; 1.57,13.43] and age of index cases [AOR: 0.9, 95%CI; 0.91–0.99] were associated with the occurrence of TB among household contacts.ConclusionOur study showed that the yield of TB was not significantly different between one-time screening and repeat screening. Although repeat screening has made an addition to case notification, it should be practiced only if resources permit. Cough, fatigue, duration of contact and age of index cases were factors associated with TB. Further studies are needed to establish the association between older age and the risk of transmitting TB.

Health Care Worker Education for Palliative Care in Africa: Narrative Review.

The demand for palliative care for terminally ill patients is rising globally. This review examines the potential of health worker education to enhance palliative care in Africa. A search of PubMed yielded 32 relevant articles published in English from 2013 to 2023 focused on African countries with WHO-categorized palliative care development and health care worker training. The findings underscore the pivotal role of health care worker education in elevating palliative care standards. Targeted initiatives equip health care workers with vital skills in pain management, symptom control, and communication. The integration of palliative care into public health systems is important for the sustainability of end-of-life care for terminally ill patients in Africa and around the world.

Prevalence of hypertension, diabetes mellitus, and their risk factors in an informal settlement in Freetown, Sierra Leone: a cross-sectional study

BackgroundNoncommunicable diseases (NCDs), especially hypertension and diabetes mellitus are on the increase in sub-Saharan Africa (SSA). Informal settlement dwellers exhibit a high prevalence of behavioural risk factors and are highly vulnerable to hypertension and diabetes. However, no study has assessed the prevalence of hypertension, diabetes, and NCDrisk factors among informal settlement dwellers in Sierra Leone. We conducted a study in June 2019 to determine the prevalence of hypertension, diabetes, and NCD risk factors among adults living in the largest Sierra Leonean informal settlement (KrooBay).Methods and materialsWe conducted a community-based cross-sectional survey among adults aged ≥ 35 years in the KrooBay community. Trained healthcare workers collected data on socio-demographic characteristics and self-reported health behaviours using the World Health Organization STEPwise surveillance questionnaire for chronic disease risk factors. Anthropometric, blood glucose, and blood pressure measurements were performed following standard procedures. Logistics regression was used for analysis and adjusted odd ratios with 95% confidence intervals were calculated to identify risk factors associated with hypertension.ResultsOf the 418 participants, 242 (57%) were females and those below the age of 45 years accounted for over half (55.3%) of the participants. The prevalence of smoking was 18.2%, alcohol consumption was 18.8%, overweight was 28.2%, obesity was 17.9%, physical inactivity was 81.5%, and inadequate consumption of fruits and vegetables was 99%. The overall prevalence of hypertension was 45.7% (95% CI 41.0-50.5%), systolic hypertension was 34.2% (95% CI 29.6–38.8%), diastolic blood pressure was 39.9% (95% CI 35.2–44.6), and participants with diabetes were 2.2% (95% CI 0.7–3.6%). Being aged ≥ 55 years (AOR = 7.35, 95% CI 1.49–36.39) and > 60 years (AOR 8.05; 95% CI 2.22–29.12), separated (AOR = 1.34; 95% 1.02–7.00), cohabitating (AOR = 6.68; 95% CL1.03-14.35), vocational (AOR = 3.65; 95% CI 1.81–7.39 ) and having a university education (AOR = 4.62; 95% CI 3.09–6.91) were found to be independently associated with hypertension.ConclusionThe prevalence of hypertension,and NCD risk factors was high among the residents of the Kroobay informal settlement. We also noted a low prevalence of diabetes. There is an urgent need for the implementation of health education, promotion, and screening initiatives to reduce health risks so that these conditions will not overwhelm health services.

The Outcomes of Emergency Admissions and Associated Factors Among Children Admitted to the Pediatric Emergency Unit at Selected Public Hospitals in Addis Ababa, Ethiopia — A Retrospective Cross-Sectional Study

BACKGROUND: A pediatric emergency condition is a life-threatening process that, without timely and standard clinical intervention, may lead to death. Therefore, this study aimed to assess the outcomes of emergency admissions and associated factors among children admitted to the pediatric emergency of selected public hospitals. METHODS: An institutional-based retrospective cross-sectional study design was conducted on children admitted to the emergency unit/ward from January 02, 2020, to January 08, 2022, in the emergency units of randomly selected public hospitals. Data were extracted with prepared checklists from February 1 to March 1, 2022. RESULT: A total of 303 admitted children’s charts were reviewed with 100% coverage. The mean age of children was 37.47 months, and the male-to-female ratio was 1.16:1. The study revealed that the most common causes of emergency admission were pneumonia (22.4%), surgical emergencies (14.5%), and late-onset sepsis (9.2%), respectively. More than half (53.8%) of children were admitted to the Pediatric Emergency Department for less than 24 hours, and the mean length of stay was 2 days. 39.6% of children were discharged with clinical improvement. Known comorbidity (AOR=4.65, 95% CI (1.23-17.64)) and length of stay less than 24 hours (AOR=4.2, 95% CI (1.2-14.7)) were strongly associated with the outcome. CONCLUSION: Pneumonia is still the most common cause of pediatric emergency admission, and the mortality rate of children at the Pediatric Emergency Department is high, with known comorbidity showing a significant association with mortality. FMOH recommended developing national pediatric emergency care guidelines and providing skill gap training for healthcare workers.

Insights of Healthcare Workers and Community Members on Mental Health Perception and Practices in Meru County, Kenya

Mental health is a neglected field in many low and middle-income countries, such as Kenya, where information on the prevalence of mental health conditions is scarce. This problem is aggravated by an uneven distribution of mental health service providers and widespread ignorance and stigma around mental illness in the general population. The study in Meru County, Kenya, aimed to assess the knowledge, attitudes, and practices of healthcare workers and community members regarding mental health. The study, a descriptive cross-sectional survey, involved 535 community members and 109 healthcare workers, employing both qualitative and quantitative methods. Data was collected through household surveys, key informant interviews, and focus group discussions and analysed using univariate frequencies, descriptive statistics, and thematic analysis. The study revealed that 39% of community members had a family member with a mental health condition, while 68% of HCWs had been diagnosed with such conditions. Mental illness was often attributed to supernatural causes, genetics, substance abuse, and socio-economic pressures. A significant gap was found in the availability of counselling services in health facilities, with only 29.4% of HCWs reporting their presence. The perception of the affordability and accessibility of mental health services varied greatly between HCWs and community members. Additionally, while HCWs reported the availability of free medication, community members experienced shortages. The study also noted differing attitudes towards patients with mental illness in terms of respect and dignity and highlighted the use of traditional healers and religious leaders for mental health issues. This study contributes valuable insights into the state of mental health in Kenya, highlighting the high burden of mental illness, limited availability of services, and prevalent myths and misconceptions. It underscores the need for improved healthcare worker training, public awareness, and stronger health systems to address mental health issues effectively in Kenya and similar rural environments

Medication Adherence of School Personnel in Public Secondary Schools of Tigaon District, Philippines

This study used the descriptive-correlational research method to determine the medication adherence of school personnel of select public schools in Tigaon, Camarines Sur. The respondents include 213 school personnel from public secondary schools of Tigaon, Camarines Sur. The data collected were classified and tabulated systematically and statistically treated using various statistical tools. The study concluded that most of the school personnel who participated in this study were 46 years old and above. The majority were female college graduates with a gross income of 22,000 to 44,000 pesos, assigned as classroom teachers, with no known illness or comorbidities, and had outpatient consultation more than 12 months ago; majority of the respondents were adherent to their medications; socio-economic factors, healthcare team and system-related factors, therapy-related factors, and patient-related factors are significant barriers to medication adherence; and there is significant relationship between medication adherence and sex, educational level, gross income per month, illness or comorbidities, and date of last outpatient consultation. Primary actions include strengthening health education that fosters a positive attitude towards medication adherence, additional resources for medicine supplies in schools and training for healthcare workers, improving the implementation of Gulayan sa Paaralan, and exploring options to simplify treatment regimens and affordable medications. With these, the researcher proposed measures and recommendations that school administrators and public school nurses can adopt to improve the health and safety of school personnel.

An Assessment of Individual Preference for a Novel Capillary Blood Collection System.

Typical barriers to venous blood collection for wellness testing include discomfort, time spent, and collection site accessibility. This study assessed individuals' experience, satisfaction, and preference associated with a FDA-cleared blood-collection device, the BD MiniDraw™ Capillary Blood Collection System (BD MiniDraw), in retail locations. A total of 113 individuals (≥18 years) with venous blood collection experience were enrolled; 107 completed the study. A pre-collection survey gathered information on demographics and past experiences with healthcare and venous blood collection settings. BD MiniDraw collection was conducted at three retail sites (two pharmacies and one grocery store) by trained healthcare workers using the Babson BetterWay blood testing service model. A follow up survey was performed two weeks later to determine experience with, and preference for, BD MiniDraw in terms of staff professionalism, blood collection location, blood collection time, and staff trustworthiness. Among the 107 participants, 74 (69%) were female and 33 (31%) were male; the mean age was 49 years (range=18-71 years). Sixty-six (62%) participants viewed their prior venipuncture experience as "somewhat" or "very" positive. Following capillary collection, 96 (90%) participants expressed a "somewhat" or "very" positive experience with BD MiniDraw at a retail location. In particular, "very satisfied" responses were given for location (87/107; 81%) and collection time (78/1407; 73%). In a subset of respondents (n=89), those reasons (location and time savings) were most frequent for likelihood of future use. Ninety-nine participants (92%) rated the retail blood collection team as "very" or "extremely" trustworthy. Overall, 90 participants (84%) "strongly preferred" (56/107; 52%), "somewhat preferred" (14/107; 13%), or had "no preference" (20/107; 19%) for BD MiniDraw, compared to traditional venous blood collection. Most participants conveyed a preference for BD MiniDraw, primarily based on the blood collection retail location, perceived time savings, and professionalism and trustworthiness of the staff.

From COVID-19 Reflections: Crucial Strategies for Ensuring Healthcare Worker and Patient Safety in Developing Countries

Globally, as millions of individuals stopovered at home to curtail the spread of COVID 19, healthcare workers (HCWs) remained in field to save mankind from the deadly virus. They attended the hospitals as well as clinics, exposed themselves to risk of COVID 19. Despite multiple steps taken by global health agencies, about 704,301,493 individuals were infected and 7,006,979 died around the globe. A significant proportion of transmissions was reported from health care settings among the health care workforce and patients. About 20% of the health care workforce of Italy was infected and many died in that outbreak, along with significant ratio of disease transmission to thir families. Physical and mental health of HCWs were affected badly because of the nuisance of hard triage verdicts and expiry of patients and colleagues. The frequency of HCWs who have acquired COVID 19 was high among the endemic countries. The key causative factors for the healthcare-associated COVID 19 spreads included lack of personal protective equipment availability, improper use of PPEs, lack of training of HCWs, overcrowding in hospitals and lack of proper acquiescence to and acceptance of the significance of fulfilling infection prevention and control (IPC) strategies. This credence was reinforced by globally renowned agencies i.e., WHO and the CDC. The agencies facilitated and implemented adopting IPC measures

Profile of the patients suffering from non-communicable diseases attending outpatient department of an urban health training center- a cross sectional study

Background: Non-communicable diseases continue to be an important public health problem in India. These diseases are responsible for a major proportion of morbidity and mortality. In view of this, study was conducted among patients suffering from non-communicable diseases attending outpatient department of an urban health training center of a medical college to know their profile. Methods: A cross-sectional study was conducted in the month of September, 2023 at an urban health training center. All the patients suffering from non-communicable diseases attending outpatient department during above month were included in the study using purposive sampling method. Predesigned and pretested proforma was used to collect the data. Data was analyzed using Microsoft Excel and appropriate statistical methods. The statistical level of significance was fixed at p&lt;0.05. Results: 4670 new patients attended outpatient department, of which 269 (05.76%) were suffering from non-communicable diseases. 136 (52.92%) were suffering from hypertension, 105 (40.86%) were of diabetes, 07 (02.72%) were of stroke and 09 (03.50%) were of other non-communicable diseases. 12 (04.46%) patients were suffering from both hypertension and diabetes. 131 (50.97%) were above 60 years of age. 139 (54.09%) were males and 118 (45.91%) were females. 50 (19.46%) patients were illiterate while 207 (80.54%) were literate (p&lt;0.05). 42 (16.34%) patients were having family history of non-communicable diseases. 40 (15.56%) and 62 (24.12%) patients were doing yoga and exercise respectively. 77 (29.96%) patients were smokers or consuming tobacco or alcohol. Conclusions: The growing problem of non-communicable diseases can be effectively controlled by empowerment of community through effective health education, utilizing services of trained health care workers, advanced health care services and social insurance.

Psychological Preparedness of Psychologists during the COVID-19 Emergency: Are There Any Individual Differences?

The COVID-19 outbreak has posed an unprecedented global challenge. However, despite the large amount of evidence on the psychological consequences of the pandemic, very few studies have focused on psychologists themselves. (1) Background: The present study aimed to characterise the professional and clinical profile of psychologists facing the COVID-19 outbreak and to investigate the relationship between psychological preparedness and a series of potential predictors (e.g., sociodemographic and professional variables and psychological distress). (2) Methods: A total of 1115 psychologists fully completed an online survey. The data collection period started with the first wave of the pandemic. Participants were asked to provide sociodemographic and professional data and to complete three questionnaires assessing psychological preparedness, worry, and anxiety symptoms. (3) Results: Descriptive results showed that the COVID-19 outbreak did not cause an interruption to the psychological practice of professionals (both in the public and in private sectors) and that psychologists accepted the introduction of technological devices within their regime of work in order to guarantee their service to clients. Only a minority of participants reported clinically significant levels of symptoms of anxiety and worry. Regression analyses revealed that being older, having taken part in training courses on the COVID-19 emergency, and experiencing lower levels of worry and anxiety were all significant predictors of both cognitive and affective psychological preparedness. (4) Conclusions: Taken together, these findings seem to highlight that specific factors can enhance psychological preparedness among psychologists. Therefore, it is vital to inform authorities about the importance of providing emergency programmes to train healthcare workers, especially psychologists, on how to develop psychological preparedness when facing the negative consequences of critical incidents at a universal level, given their crucial role in promoting mental health.

Racism, Equity, and Inclusion: Can Clinical Simulation Train Health Care Workers to Build an Anti-Racism Culture?

Clinical care delivery continues to suffer from biased social norms, stigma, and racism. Innovative approaches to being prepared for these experiences when they arise are needed. The goal of the HealthPartners Institute’s Clinical Simulation program is, in part, to train clinicians and newly graduated registered nurses entering clinical practice to be prepared for racist care delivery encounters and to implement anti-racism interventions as part of their daily work. A component of the initiative is an educational, instructor-led clinical simulation modality that includes a curriculum with application scenarios. In addition, after the simulation scenarios, a debrief session ensures the opportunity for reflection (as individuals and care team members), discussion (to tease apart distinct ideas/elements), and dialogue (to bring together insights for a shared perspective). Participants express support for this simulation methodology in trainings designed to support anti-racism as well as other stigmas and biases.

Psychological adaptation among health care workers who work with trauma-exposed refugees in Greece.

Greek health care workers (HCWs) working with refugee and asylum-seeker populations may be at risk of trauma exposure and related distress. The current study sought to further understand the factors that may promote or hinder psychological adaptation among HCWs working with trauma-exposed refugee populations in Greece. Participants were HCWs (N = 20) who completed semistructured interviews. Thematic analysis procedures identified three main themes: vicarious traumatization, (b) mismatch of expectations, and (c) difficulty coping. Our study findings highlight the need to provide adequate training, supervision, and mental health support for HCWs to prevent mental health issues in this population. Additional studies are necessary to understand the long-term consequences of working with refugee populations and explore ways to assist HCWs with self-care.

Characteristics of tuberculosis in Marrakech (Morocco): Epidemiology and related factors

BackgroundTuberculosis remains (TB) a major public health problem; it is the first cause of death due to a single infectious agent, both for the world and the Moroccan population. In the city of Marrakech this infectious disease affected 853 cases in 2021 (Report of the Ministry of Health of Morocco). The aim of this paper is to investigate the epidemiology, diagnosis, evolution and associated factors of pulmonary tuberculosis compared to extra-pulmonary tuberculosis in Marrakesh city. MethodsA retrospective study was conducted between 2020 and 2021 on 240 patient's medical records with TB. FindingsPulmonary tuberculosis represented about half (49.58%) of the cases with a mean age of 37.17 (SD = 18.73) and a sex ratio (M/F) of 1.11. The age group most affected was 15–34 years (nearly 43% of the population). More than 23% of the patients were smokers and about 64% of them were not affiliated to any medical-social insurance. 19% of patients had a medical history in which diabetes predominated (46.2% of cases). Overall, only 58.9% of the patients had all the required medical check-ups and the weight decreased in 23% of the patients. Resistance to drugs was found in 9 cases and the HIV testing was positive in 4 cases. ConclusionsIn conclusion, enhancing population education and bolstering healthcare worker training are imperative for achieving early and effective diagnosis and monitoring of tuberculosis. Additional concerted efforts are needed on a national and international scale to address this pressing public health challenge.

Health Care Worker Perception on HIV Pre-Exposure Prophylaxis and Service Delivery among Health Care Workers in South-East Nigeria

Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention among health care workers (HCWs) remains a key issue. Infection with the human immunodeficiency virus endangers public health and kills a large number of individuals, including medical staff. There is now a genuine danger of HIV transmission among HCWs during work exposure. This study aims to assess health care worker perception on HIV pre-exposure prophylaxis and service delivery among health care workers in South-East Nigeria. Descriptive cross sectional study design using multistage sampling techniques was used to select four hundred respondents. Data was analyzed using the SPSS software version 25.0. Mean scores were generated for the major outcome variables of knowledge, attitude and practice of immunization schedule. P value was assumed significant at values less than 0.05. The findings of this study shows that 218 (54.5%) were male and 182 (45.5%) were female, 312 (78.0%) have good knowledge , 109 (27.3%) had history of occupational exposure to HIV, 234 (58.5%) had high, 85 (21.3%) had moderate and 81 (20.3%) had low level of exposure to occupational HIV, socio demographic variable based on age, religion, tribe, marital status and tear of practice shows a significant association with perceived level of exposure to occupational HIV at (ꭓ2=45.511, p=0.000), (ꭓ2=67.189, p=0.000), (ꭓ2=692.874, p=0.000), (ꭓ2=35.331, p=0.000) and (ꭓ2=34.899, p=0.000) respectively as p&lt;0.05 and non-significant association with gender of the respondents at p&lt;0.05. The findings from this study shows that there is a high level of Pre-Exposure Prophylaxis among health care workers in the study area, larger proportion perceived level of exposure to occupational HIV and at significant risk of acquiring occupational infections, even though majority were satisfied with service delivery. Health authorities in the study area need to improve the training of HCWs and provision of infection prevention equipment.

The Role of Primary Healthcare in Improving the Maternal and Infant Mortality in Pakistan

Background: Maternal and neonatal mortality remains a significant public health challenge globally, particularly in countries like Pakistan, which exhibit some of the highest rates of such mortalities. Effective primary healthcare interventions are crucial for mitigating these rates, focusing on enhancing the quality of care provided to mothers and newborns. Understanding the scope and impact of these interventions can inform future strategies to improve maternal and neonatal health outcomes. Objective: This review aims to evaluate the existing literature on primary healthcare interventions targeting maternal and neonatal mortality, identifying the types of interventions employed, their focus areas, and the outcomes achieved, with a specific interest in the context of Pakistan. Methods: A scoping review methodology was employed, analyzing studies that investigated primary healthcare interventions designed to reduce maternal and neonatal mortality. The review included studies published in English, utilizing a mix of research methodologies, and focused on interventions such as morbidity and mortality review processes, healthcare worker training, and community engagement strategies. Databases searched included Google Scholar, OVID, and the WHO Global Health Library, among others. Results: Out of 25 studies reviewed, a majority concentrated on healthcare team and program-level interventions rather than systemic healthcare reforms. Key areas of focus included enhancing review processes for maternity and neonatal care, training and education for healthcare workers, and community development initiatives. However, there was a noted lack of interventions directly improving the healthcare experiences of mothers and newborns. Mixed methods were the most common research approach, aligning with the complexity of evaluating health system interventions. Conclusion: To improve maternal and neonatal health outcomes in Pakistan, a comprehensive approach addressing the entire health system is required. This involves not only focusing on the delivery of healthcare services but also incorporating community insights, continuous education programs, and leadership modifications in healthcare services. Future strategies should prioritize the application of standardized and relevant methods to enhance the quality of maternity and newborn care initiatives, aiming for scalable improvements in healthcare outcomes.

Neonatal Transport Network Services: Preparedness of healthcare systems in Southern Nigeria.

Nigeria remains a major contributor to neonatal deaths worldwide, yet little consideration has been given to intra/inter health facility transfer of sick neonates. The dearth of Neonatal Transport Network Services (NNTS) is probably an underappreciated driver of the abysmally high national neonatal mortality indices. This study aimed to evaluate neonatal transport services and the healthcare workers' preparedness among health facilities in Port Harcourt Metropolis, Rivers State, Nigeria. Twenty-eight selected health facilities (tertiary, private hospitals Primary Health Centers] were assessed on the availability, modality and practice of NNTS. Data was analyzed using SPSS Version 23. Routine transfer of high-risk pregnant mothers to higher levels of care occurred always in 14 (50%) and sometimes in 6 (21.4%) facilities; Private cars and taxis were the most common mode of transport in 24 (85.7%) facilities. Two facilities (7.2%) had ambulances equipped with transport incubators. Nurses and nurse attendants with no formal training in NNTS accompanied referred neonates in 2 (7.2%) facilities. Most referring facilities (78.6%) neither rarely or never contacted receiving centres before the arrival of neonates and most nor gave back referrals after offering neonatal care. None (100%) of the facilities had a trained emergency transport team. Health facilities in Southern Nigeria lack a standardized Neonatal Transport Network and are characterized by poor communication between health facilities and inadequately trained personnel for inter-facility transfer of sick neonates. Urgent action is required to address these gaps, including training of healthcare workers on neonatal transport and sharing findings with relevant stakeholders/policymakers to establish a functional neonatal transport network among health facilities.

Acute Poisoning Emergencies at Gulu University Teaching Hospitals in Northern Uganda: Prevalence, Outcomes and Clinical Challenges

Acute poisonings, including envenomation as well as toxicological emergencies stemming from accidental or intentional ingestion of poisonous substances or drug overdose, are significant worldwide causes of morbidity and mortality. The study aimed to characterise acute poisoning emergencies admitted to two major hospitals in Northern Uganda. We conducted a retrospective review of charts of all patients admitted with acute poisoning emergencies between January and December 2021, as well as a structured interview of hospital staff working in these hospitals on challenges faced while managing these emergencies. Of the total 40,653 patient admissions, 416 (1%) were due to acute poisonings. The majority were admitted to SMHL (71.4%), 43.3% were between 20 and 40 years of age, and 59.9% were males. The average length of hospital stay was 1 (0-3). The most frequent diagnoses were acute alcohol intoxications (27.2%, n=113), snake bites (26.0%, n=108), and organophosphate poisonings (21.2%, n=88). Only 29.6% (n=123) of patients received antidotes. Peak admissions were observed in February, May, and July. The majority of poisonings were intentional (61.3%), resulting in a Case Fatality Rate of 6.3%. In the qualitative findings, participants highlighted key challenges in managing these conditions, including the lack of antidotes, patients presenting late at the hospital, economic barriers, staff shortages, and limited community awareness. Acute poisoning, especially acute alcoholic intoxication, snake bites and organophosphate poisoning, are common in northern Uganda, with significant numbers dying from it. The lack of antidotes remains a problem in these hospitals. Restriction of alcohol consumption use of agricultural organophosphates, and training of healthcare workers in managing these emergencies are recommended

Infection prevention and control practices in the Pediatrics and Child Health Department of Tikur Anbessa Specialized Hospital, Ethiopia.

Infection prevention and control (IPC) is a set of practices that are designed to minimize the risk of healthcare-associated infections (HAIs) spreading among patients, healthcare workers, and visitors. Implementation of IPC is essential for reducing infection incidences, preventing antibiotic use, and minimizing antimicrobial resistance (AMR). The aim of the study was to assess IPC practices and associated factors in Pediatrics and Child Health at Tikur Anbessa Specialized Hospital. In this study, we used a cross-sectional study design with a simple random sampling method. We determined the sample size using a single population proportion formula with the assumption of a 55% good IPC practice, a 5% accepted margin of error, and a 15% non-response rate and adjusted with the correction formula. The final sample size was 284 healthcare workers. The binary logistic regression model was used for analysis. The World Health Organization (WHO) Infection Prevention and Control Assessment Framework (IPCAF) tool was used to assess IPC core components. A total of 272 healthcare workers participated in the study, with a response rate of 96%. Of the total participants, 65.8% were female and 75.7% were nurses. The overall composite score showed that the prevalence of good IPC practices among healthcare workers was 50.4% (95% CI: 44.3-56.5). The final model revealed that nursing professionals and healthcare workers who received IPC training had AORs of 2.84 (95% CI: 1.34-6.05) and 2.48 (95% CI: 1.36-4.52), respectively. The final average total IPCAF score for the IPC level was 247.5 out of 800 points. The prevalence of good IPC practice was suboptimal. The study participants, who were nursing professionals and healthcare workers who received IPC training, showed a statistically significant association with the IPC practice level. The facility-level IPCAF result showed a "Basic" level of practice based on the WHO categorization. These evidences can inform healthcare workers and decision-makers to identify areas for improvement in IPC practice at all levels. Training of healthcare workers and effective implementation of the eight IPC core components should be strengthened to improve suboptimal practices.

Implementation considerations for a point-of-care Neisseria gonorrhoeae rapid diagnostic test at primary healthcare level in South Africa: a qualitative study

BackgroundSouth Africa maintains an integrated health system where syndromic management of sexually transmitted infections (STI) is the standard of care. An estimated 2 million cases of Neisseria gonorrhoeae (N. gonorrhoeae) occur in South Africa every year. Point-of-care diagnostic tests (POCT) may address existing STI control limitations such as overtreatment and missed cases. Subsequently, a rapid lateral flow assay with fluorescence-based detection (NG-LFA) with a prototype reader was developed for N. gonorrhoeae detection showing excellent performance and high usability; however, a better understanding is needed for device implementation and integration into clinics.MethodsA qualitative, time-series assessment using 66 in-depth interviews was conducted among 25 trained healthcare workers involved in the implementation of the NG-LFA. Findings were informed by the Normalization Process Theory (NPT) as per relevant contextual (strategic intentions, adaptive execution, and negotiation capacity) and procedural constructs (coherence, cognitive participation, collective action, reflexive monitoring) to examine device implementation within primary healthcare levels. Interviews were audio-recorded, transcribed, and then analyzed using a thematic approach guided by NPT to interpret results.ResultsOverall, healthcare workers agreed that STI POCT could guide better STI clinical decision-making, with consideration for clinic integration such as space constraints, patient flow, and workload. Perceived NG-LFA benefits included enhanced patient receptivity and STI knowledge. Further, healthcare workers reflected on the suitability of the NG-LFA given current limitations with integrated primary care. Recommendations included sufficient STI education, and appropriate departments for first points of entry for STI screening.ConclusionsThe collective action and participation by healthcare workers in the implementation of the NG-LFA revealed adaptive execution within the current facility environment including team compositions, facility-staff receptivity, and STI management experiences. User experiences support future clinic service integration, highlighting the importance of further assessing patient-provider communication for STI care, organizational readiness, and identification of relevant departments for STI screening.

Challenges associated with the availability, accessibility, and use of antivenoms for treating snakebite envenoming in Ghana: A MaxDiff experiment design

Successful snakebite envenoming (SBE) treatment requires safe, effective, and quality-assured antivenom products specifically tailored to combat endemic venomous snake species. This study aims to identify the challenges associated with the availability, accessibility, and use of antivenoms for treating SBE. The data for this study were obtained from a cross-sectional study involving healthcare workers from two districts (namely Afram Plains North and Afram Plains South) in the Eastern Region of Ghana. Through the MaxDiff design methodology, we quantify the challenges associated with the availability, accessibility, and use of antivenoms. Responses from a simple random sample of 203 healthcare workers were included in this study. Participants identified the high cost of antivenoms as the most challenging factor that limits the availability, accessibility, and use of antivenoms for treating SBE. Other important challenges were the lack of access to effective antivenoms in remote areas when needed and the increased use of unorthodox and harmful practices, followed by resort to unorthodox and harmful practices and the lack of effective antivenoms to address envenoming from local species in some instances. However, poor outcomes from using substandard antivenoms, stock-outs, inadequate number of manufacturers, and the resort to substandard, cheap, and harmful antivenoms were traded off. Also, poor utilization of antivenoms, suboptimal utilization of antivenoms (low quality, under-dose), use of ineffective, substandard antivenoms, and flooding of the market with products that have not been evaluated thoroughly were underscored. Our findings provide essential data to guide discussions on barriers to the availability, accessibility, and use of antivenoms for treating SBE to improve the supply of antivenoms, enhance the effectiveness of snakebite treatment, and improve patient care quality in Ghana. Multi-component strategies are needed to address the challenges identified, such as intensified advocacy, ongoing education and community engagement, healthcare worker training, and leveraging institutional and governance structures.