Shortage Of Equipment Research Articles

Effects of World War II on Infectious Diseases in the Persian Gulf.

With the allied invasion, the southern half of Iran became the scene of a large presence of British and American occupation forces. The negative consequences of the styling of foreign elements during all the years of war and even afterward affected these areas in various dimensions of their health. The negative consequences of the occupation of southern Iran, the health and healthcare system of this part of Iran suffered problems in various forms of shortage of medicines, equipment, and treatment staff, especially the spread of various infectious and communicable diseases. The article aims to examine the effects of World War II on the southern, southwestern, and eastern regions of Iran from 1939 to 1945 and its consequences in the spread of infectious diseases in these regions. The research with an analytical-historical method relies on the library method and is based on the study of the data of unpublished documents from the archives of the National Archives and Library Organization, medical and economic social publications, and various local and public newspapers of Iran during this period. The study of documents and publications shows that due to Allied restrictive policies and successive waves of famine and widespread malnutrition, epidemic diseases, and drug monopoly, these areas experienced a period of severe decline in public health and spread of various infectious diseases.

Managing disrupted supply chains in Swedish hospitals during the COVID-19 pandemic

ABSTRACT The COVID-19 pandemic has disrupted global supply chains and caused widespread shortages of healthcare supplies. This mixed-methods study examined the management of supply shortages in Swedish hospitals during the COVID-19 pandemic. The key findings are that the shortage of supplies was initially severe owing to low regional and national contingency inventory levels, a lack of knowledge of supply chain management, and cost-saving measures. The perceived consequences of the shortage of personal protective equipment persisted in emergency and inpatient departments, in the later waves. Although pharmaceutical shortages later decreased, hospital managers were disappointed that they persisted. This study also highlights the effectiveness of consensus-based hourly supply agreements between service organisations and unit managers, which makes the prioritisation of the limited supply more dynamic. Despite these challenges, hospitals were able to adapt to the supply chain disruptions caused by the pandemic; however, the results emphasise the importance of preparedness for future pandemics.

Decoding healthcare teamwork: a typology of hospital teams

ABSTRACT The effectiveness of healthcare depends on successful teamwork. Current understanding of teamwork in healthcare is limited due to the complexity of the context, variety of team structures, and unique demands of healthcare work. This qualitative study aimed to identify different types of healthcare teams based on their structure, membership, and function. The study used an ethnographic approach to observe five teams in an English hospital. Data were analyzed using a combined inductive-deductive approach based on the Temporal Observational Analysis of Teamwork framework. A typology was developed, consisting of five team types: structural, hybrid, satellite, responsive, and coordinating. Teams were challenged to varying degrees with staffing, membership instability, equipment shortages, and other elements of the healthcare environment. Teams varied in their ability to respond to these challenges depending on their characteristics, such as their teamworking style, location, and membership. The typology developed in this study can help healthcare organizations to better understand and design effective teams for different healthcare contexts. It can also guide future research on healthcare teams and provide a framework for comparing teams across settings. To improve teamwork, healthcare organizations should consider the unique needs of different team types and design effective training programs accordingly.

Коммерческая торговля в системе общественного питания Сталинградской области в 1944–1947 годах

Introduction. The article deals with the creation and development of a commercial trade system in public catering in the city of Stalingrad and the Stalingrad region at the end of the Great Patriotic War and in the first post-war years. Methods. In this study, historical-descriptive (idiographic), historical-genetic, and historical comparative methods, as well as quantitative methods, were used in the examination of newspaper sources. Analysis and results. In order to replenish the budget and meet the demand of the population, already in the spring of 1944, free trade in alcoholic beverages began in the canteens of Stalingrad. In the spring and summer of 1945, the first restaurants and commercial halls at canteens opened in the city. The opening of commercial tea houses in the system of state and cooperative trade became widespread in early 1946 after the decrees of the USSR government were issued. This process took place in the face of an acute shortage of inventory, kitchen equipment, and utensils. A feature of Stalingrad was the complete lack of premises for new catering establishments. As a rule, commercial tea houses were opened at or instead of existing canteens. Since a significant part of the products for commercial tea houses were purchased from collective farms and the population at market prices, the cost of even the simplest dishes was 8–10 times higher than in ration canteens. Procurement of products occurred with difficulty due to the priority of mandatory supplies of agricultural products to the state. After the drought in 1946, even commercial tea houses and restaurants limited the sale of bread. At the same time, there was a second wave of the establishment of commercial restaurants and cafes. In 1947, commercial canteens with a small selection of dishes appeared, occupying a middle position between restaurants and tea houses. Having completed the task of attracting funds from the population, commercial catering enterprises, at the same time, did not become centers for cultural leisure. Most of the teahouses were located in adapted premises that needed repair and were poorly maintained. The assortment of dishes was not maintained, and violations of technology and theft by workers flourished. Most of the profits came from the sale of purchased goods, primarily alcoholic beverages.

Impact of the COVID-19 pandemic on the real-world diagnostic infrastructure for tuberculosis-An ESGMYC collaborative study.

We determined the impact of the COVID-19 pandemic on mycobacterial diagnostic services. 40 laboratories from 22 countries completed an online questionnaire covering the redeployment of the laboratory infrastructure and/or staff for SARS-CoV-2 testing, staff shortages and supply chain disruptions. 28 laboratories reported monthly numbers of samples processed for mycobacterial investigations and monthly numbers of M. tuberculosis complex (MTBC) PCRs performed between October 1st 2018 and October 31st 2020. More than half (23/40) of the participating TB laboratories reported having performed COVID-19 diagnostics in the early phase of the pandemic, in part with negative impact on the mycobacterial service activities. All participating laboratories reported shortages of consumables and laboratory equipment due to supply chain issues. Average monthly sample numbers decreased by 24% between January 2020 and October 2020 compared to pre-pandemic averages. At the end of the study period, most participating laboratories had not returned to pre-pandemic average MTBC PCR throughput.

Mobile infrared slit-light scanner for rapid eye disease screening.

Timely detection and treatment of visual impairments and age-related eye diseases are essential for maintaining a longer, healthier life. However, the shortage of appropriate medical equipment often impedes early detection. We have developed a portable self-imaging slit-light device utilizing NIR light and a scanning mirror. The objective of our study is to assess the accuracy and compare the performance of our device with conventional nonportable slit-lamp microscopes and anterior segment optical coherence tomography (AS-OCT) for screening and remotely diagnosing eye diseases, such as cataracts and glaucoma, outside of an eye clinic. The NIR light provides an advantage as measurements are nonmydriatic and less traumatic for patients. A cross-sectional study involving Japanese adults was conducted. Cataract evaluation was performed using photographs captured by the device. Van-Herick grading was assessed by the ratio of peripheral anterior chamber depth to peripheral corneal thickness, in addition to the iridocorneal angle using Image J software. The correlation coefficient between values obtained by AS-OCT, and our fabricated portable scanning slit-light device was notably high. The results indicate that our portable device is equally reliable as the conventional nonportable slit-lamp microscope and AS-OCT for screening and evaluating eye diseases. Our fabricated device matches the functionality of the traditional slit lamp, offering a cost-effective and portable solution. Ideal for remote locations, healthcare facilities, or areas affected by disasters, our scanning slit-light device can provide easy access to initial eye examinations and supports digital eye healthcare initiatives.

Sectoral Value Chain Mapping in Kakamega County, Kenya

The Kenyan agricultural sector will play a pivot role in achieving its national development roadmap, Vision 2030. This report explores the agricultural value chains within Kakamega County, Kenya, focusing on sweet potatoes, bananas, soya beans, vegetables, palm oil, honey, and avocados. Data collection for the study primarily involved direct engagement with stakeholders across the various sub-counties. The study revealed the unique characteristics and challenges faced in each value chain, laying the foundation for understanding the local agricultural dynamics. These challenges included equipment shortage, lack of technical skills, and poor marketing strategies. Recommendations are put forward to address the specific hurdles and optimize opportunities within each value chain. Fostering cooperative formations, exploring value addition and enhancement of technical skills are the common themes across the recommendations for the value chains. Further, training, certification acquisition, research and development and process optimization have been suggested to bolster productivity, quality and market competitiveness. The proposed interventions require collaborative effort from the stakeholders including government agencies, non-governmental organizations and the local communities. By creating an enabling environment and implementing the recommended strategies, sustainable agricultural-based growth and economic development, aligning with the national Vision 2030, can be fostered in Kakamega County, Kenya

History and Current State of Neurosurgery in the Gambia

BackgroundDespite global efforts to improve surgical care access, many low and middle-income countries, especially in neurosurgery, face significant shortages. The Gambia exemplifies this, with only one fully qualified neurosurgeon serving its population of 2.5 million people. This scarcity results in higher morbidity and mortality. ObjectiveWe aim to document the history and current state of neurosurgery in The Gambia to raise awareness and promote neurosurgery development. MethodsThe study reviews The Gambia's healthcare system, infrastructure, neurosurgical history, workforce, disease burden, and progress, with information derived from reference sources as well as author experience and interviews with key partners in Gambian healthcare. ResultsNeurosurgery in The Gambia began in the 1970s, facing constraints due to competing healthcare demands. Significant progress occurred much later in the early 2010s, marked by the initiation of Banjul Neuro-Missions and the establishment of a dedicated neurosurgery unit.We report significant progress with neurosurgical interventions in the past few years showcasing the unit's dedication to advancing neurosurgical care in the Gambia. However, challenges persist, including a lack of trained neurosurgeons, equipment shortages such as ventilators and diagnostic imaging. Financial barriers for patients, particularly related to the costs of CT scans, pose significant hurdles, impacting the timely diagnosis and intervention for neurological conditions. ConclusionNeurosurgery in Gambia is progressing, but challenges like equipment scarcity hinder further progress. We emphasize the need for addressing cost barriers, improving infrastructure, and fostering research. Engaging the government and international collaborations are vital for sustained development in Gambian neurosurgery.

Client and provider experiences with, and approaches to sustain HIV care during the COVID-19 pandemic restrictions at two public hospitals in southwestern Uganda

IntroductionThe COVID-19 pandemic had far-reaching consequences on global health systems, disrupting the delivery of routine healthcare services, and posing new challenges to ongoing disease control efforts. In Uganda, where HIV is endemic, the pandemic threatened to reverse the gains in the country’s HIV response over the past decade. In this study, we explored the effects of the COVID-19 pandemic on the HIV cascade, focusing on the impact of pandemic-related disruptions on retention in HIV care among Persons with HIV (PWH). We further highlighted the key challenges and opportunities for mitigating the adverse effects.MethodsQualitative data were collected from January 2022 to March 2022 using in-depth interviews with PWH (n = 20) and healthcare workers (n = 4) and key informant interviews (n = 6) with healthcare managers. The interviews explored current and previous experiences with HIV care services, including experiences of healthcare providers and managers delivering and PWH receiving HIV care amidst the COVID-19 restrictions and recovery period, strategies implemented to ensure continuity of services and barriers to implementing these strategies. We coded data in Dedoose software and analyzed using the thematic analysis.ResultsThe qualitative findings highlight the effects of the COVID-19 pandemic, including restricted access to HIV care points, sub-optimal clinical management of persons with HIV, loss of livelihoods, and interruptions in adherence. Adaptations to ensure continuity of care included leveraging community-based drug delivery strategies, phone call consultations, modification of clinic workspaces, and linkages to nearby health facilities. Barriers to these adaptations included the increased cost of services, psychological challenges, fear and anxiety surrounding COVID infection, access to treatment, survival, loss to follow-up with no information on patient referral, COVID infection among health workers, depletion of drug stocks due to multi-month scripting, shortage of Personal protective equipment (PPE) supplies and other drugs.ConclusionThe COVID-19 pandemic had a significant impact on HIV care in Uganda, including reduced access to HIV care and support services, interruptions to ART adherence, and changes in HIV care delivery. Our findings highlight the barriers and enablers to HIV care delivery during the COVID-19 pandemic and lockdown and provide valuable lessons on efforts to mitigate interruptions in the future during periods of pandemics/lockdowns.

A Review of Radiotherapy Services in Zambia: Challenges, Opportunities and Way Forward

Cancer significantly contributes to the cause of morbidity and mortality in Zambia 71% of people diagnosed with cancer in Zambia die from the disease; however, access to radiotherapy (RT) services is lacking. More than 50% of cancer patients will require radiotherapy for curative or palliative intent. The country first established RT services in 2006. Prior to that only a few Zambians accessed this specialised treatment abroad, mainly due to the high costs. After a successful run of service for over a decade, in 2022 the country suffered total disruption of RT services due to obsolete equipment that has been earmarked for decommissioning. The country is now in the process of re-establishing the RT services to make them sustainable. This article aims at reviewing how the RT services (RT equipment and personnel) have been managed, the opportunities that exist (demand for RT services, availability of training institutions, support from the government and cooperating partners) and lastly the challenges (equipment shortages and operation, lack of medical physicists and biomedical engineers, financial constraints, procurement and maintenance delays). The insights offered by this work will elicit a data based decision making approach to meticulous RT service provision.

Development of the AI Pipeline for Corneal Opacity Detection.

Ophthalmological services face global inadequacies, especially in low- and middle-income countries, which are marked by a shortage of practitioners and equipment. This study employed a portable slit lamp microscope with video capabilities and cloud storage for more equitable global diagnostic resource distribution. To enhance accessibility and quality of care, this study targets corneal opacity, which is a global cause of blindness. This study has two purposes. The first is to detect corneal opacity from videos in which the anterior segment of the eye is captured. The other is to develop an AI pipeline to detect corneal opacities. First, we extracted image frames from videos and processed them using a convolutional neural network (CNN) model. Second, we manually annotated the images to extract only the corneal margins, adjusted the contrast with CLAHE, and processed them using the CNN model. Finally, we performed semantic segmentation of the cornea using annotated data. The results showed an accuracy of 0.8 for image frames and 0.96 for corneal margins. Dice and IoU achieved a score of 0.94 for semantic segmentation of the corneal margins. Although corneal opacity detection from video frames seemed challenging in the early stages of this study, manual annotation, corneal extraction, and CLAHE contrast adjustment significantly improved accuracy. The incorporation of manual annotation into the AI pipeline, through semantic segmentation, facilitated high accuracy in detecting corneal opacity.

Exploring COVID-19 patient's dignity and satisfaction: A cross-sectional study.

With the outbreak of COVID-19 and associated challenges such as increased workload for health providers and shortage of equipment, it became more challenging to maintain patients' dignity and satisfaction. This study evaluated the patients' dignity and satisfaction with COVID-19 in Kashan, Iran, in 2021. A cross-sectional descriptive study. In total, 385 patients recovered from COVID-19 were selected through sequential sampling method. Data were collected using demographic, patient dignity inventory, and patient satisfaction questionnaires. Data were analysed using descriptive analysis, independent t-test, ANOVA, and Spearman-Brown coefficient. The mean age of patients was 50.57. The mean scores of patients' dignity and satisfaction were 1.622 ± 0.653 and 3.851 ± 0.548 (out of 5), respectively. The dignity rating was associated with age, gender, education, underlying disease, and length of hospital stay (p < 0.05); but patient satisfaction was only associated with education (p = 0.002). The results indicated that dignity and satisfaction have a significant direct correlation (r = -0.23, p < 0.001). This study was designed based on the research priorities and needs in the field of clinical research and patients were involved in conducting the study via participating in data collection.

An intelligent optimization strategy for nurse-patient scheduling in the Internet of Medical Things applications

In the last years, the world has witnessed a potential increasing in the patient number resulted from the increasing number of aged persons along with the emergence of new virus and diseases. This imposes a high pressure on hospitals that suffer from a shortage of medical staff, personal equipment and adequate interventions to overcome such a challenge. Particularly, nurse scheduling is becoming a crucial operation to hospitals in order to efficiently handing the patents and increasing the performance of health system. In this paper, we present an efficient Nurse-Patient Scheduling (NPS) mechanism that is based on the patient classification according to the severity levels of their vital signs. The main goal of NPS is to balance the workload of nurses and it consists of three phases: patient monitoring, patient classification, and nurse scheduling. The first phase aims to periodically monitor the patients using a configurable window time and collect their vital signals through a set of biomedical sensors. The second phase allows for the extraction of prospective features among the collected data then to classify them according to a set of predefined criteria such as patient criticality level, patient age, and the allocated treatment time of each patient. In the last phase, we propose a novel scheduling algorithm that combines both genetic and particle swarm optimization methods in order to find the best scheduling assignment of nurses over patients. We performed simulations based on real health data and we demonstrated the performance of NPS mechanism in terms of obtaining optimal of nurses to patients according to the predefined criteria.

USING INDUCTION HARDENING TO STRENGTHEN CAR PARTS

The war waged by the Russian state against independent Ukraine posed new difficult tasks for society in the production and repair of damaged military equipment. In the conditions of a shortage of military equipment, carrying out repairs becomes a task that must be performed quickly and efficiently in order to replenish the armed forces of the state. In such difficult conditions, methods of high-speed processing should be used, including methods of surface strengthening of machine parts. The work is devoted to the improvement of technological processes of restoration and strengthening of parts of automobile and military equipment at repair factories under conditions of martial law. The efficiency of auto repair production is determined by the number of parts that are restored and continue to perform their functions with even better indicators than before restoration.Most parts have a residual resource and can be reused as a result of carrying out a relatively small amount of work on their restoration. The main methods of surface strengthening of machine parts are chemical and thermal treatment (cementation, nitriding, nitrocementation), surface plastic deformation, application of electrolytic coatings and surface hardening - laser and induction using high frequency current. The processes of chemical and thermal treatment are long-term and are not relevant in repair production in wartime. Modern mobile repair workshops prefer equipment and tools that are not metal-intensive and are able to perform technological processes in a short period of time. The most expedient at present is the introduction of technological processes using installations that produce high-frequency current and processes based on it.In the work, the authors conducted research and developed an inductor for hardening the rocker arm made of steel 45. The choice of the type of inductor and its calculation are based on the relevant conditions described in the work.In the work, the authors conducted research and developed an inductor for hardening the rocker arm made of steel 45. The choice of the type of inductor and its calculation are based on the relevant conditions described in the work.

Low quality of maternal and child nutritional care at the primary care in Mexico: an urgent call to action for policymakers and stakeholders

BackgroundMaternal and child malnutrition represents a public health problem in Mexico Primary care (PC) is responsible for introducing women and children under five to the health system, detecting diseases on time, and providing medical services, including pharmacological treatment if necessary. Providing these services with quality is essential to improve maternal and child health. This study evaluated the quality of nutritional care during preconception, pregnancy, postpartum, infancy, and preschool age at the PC health units across six Mexican states between 2020 and 2021.MethodsWe conducted a cross-sectional study with a mixed approach in units of the Secretary of Health to assess the quality of nutritional care during preconception, pregnancy, postpartum, childhood, and preschool age. The level of quality was calculated by the percentage of compliance with 16 indicators that integrated a Quality Index of Maternal and Child Nutritional Care (ICANMI, by its Spanish acronym). Compliance by indicator, by life stage, and overall was categorized using the following cut-off points: poor quality (≤ 70%), insufficient quality (71-89%), and good quality (≥ 90%). The perceptions of the barriers and facilitators that affect maternal and child nutrition were evaluated through semi-structured interviews with health professionals (HP) and users. All qualitative instruments were developed with a gender and intercultural perspective.ResultsConsidering the whole sample studied, maternal and child nutritional care quality during the five life stages evaluated was bad (compliance: ≤12%), reflected in the ICANMI, which had a compliance of 8.3%. Principal barriers identified to providing high-quality nutritional care were the lack of knowledge and training of health professionals, shortages of equipment, medicine, personnel, and materials, the disappearance of the social cash transfer program Prospera, the absence of local indigenous language translators to support communication between doctor and patient, and the persistence of machismo and other practices of control over women.ConclusionsThese findings underscore the need for initiatives to improve the quality of nutritional care in PC facilities across Chihuahua, State of Mexico, Veracruz, Oaxaca, Chiapas, and Yucatan. It is necessary for government and health authorities, along with various stakeholders, to collaboratively devise, implement, and assess intercultural and gender-oriented policies and programs geared towards ensuring the health infrastructure and enhancing the training of health professionals to diagnose and treat the prevalence and occurrence of diverse forms of malnutrition in both maternal and child populations.

Challenges facing Palestinian crime scene investigators

BackgroundCrime scene investigation (CSI) in general means the standard procedures and techniques used for processing and reconstructing of scene of crime. In Palestine, the competent authorities delegated by law to carry out the task of research and investigation of crimes and inspection at the crime scene are the officers granted by law the status of the judicial police. CSIs face numerous challenges that affect every worker involved. These challenges arise from legal, administrative, security, and technical aspects. This study aimed to point out the challenges faced by field police personnel during CSI in Palestine. To achieve the aims of this study, a validated and reliable questionnaire was developed. The study sample consisted of 354 crime scene investigators and officers affiliated with the Palestinian Civil Police (PCP) across all governorates of the West Bank.ResultsIn addition to the training of CSI officers, and shortage of equipment, the findings of this study indicate that there are many challenges amplified by the Israeli occupation facing PCP officers concerning crime scene management and technical procedures during CSIs such as the collection, transportation, and storage of forensic evidence. Overlapping responsibilities and difficulties in coordinating specialized agencies working at the crime scene are also factors that should be better studied.ConclusionThis study invites decision-makers within the Palestinian police agencies to prioritize efforts to address the significant challenges encountered by workers at crime scenes. They should give special attention on enhancing training programs and providing the necessary tools and devices for effective crime scene work. It also recommends Palestinian representatives at international stage to highlight the obstacles facing workers at crime scenes due to the occupation.

Lived experiences of people living with HIV and hypertension or diabetes access to care in Ethiopia: a phenomenological study

BackgroundPeople living with HIV (PLWH) are more likely to develop hypertension and diabetes than people without HIV. Previous studies have shown that HIV stigma, discrimination and exclusion make it difficult...

Digital Interventions for Stress Among Frontline Health Care Workers: Results From a Pilot Feasibility Cohort Trial.

The COVID-19 pandemic has challenged the mental health of health care workers, increasing the rates of stress, moral distress (MD), and moral injury (MI). Virtual reality (VR) is a useful tool for studying MD and MI because it can effectively elicit psychophysiological responses, is customizable, and permits the controlled study of participants in real time. This study aims to investigate the feasibility of using an intervention comprising a VR scenario and an educational video to examine MD among health care workers during the COVID-19 pandemic and to use our mobile app for longitudinal monitoring of stress, MD, and MI after the intervention. We recruited 15 participants for a compound intervention consisting of a VR scenario followed by an educational video and a repetition of the VR scenario. The scenario portrayed a morally challenging situation related to a shortage of life-saving equipment. Physiological signals and scores of the Moral Injury Outcome Scale (MIOS) and Perceived Stress Scale (PSS) were collected. Participants underwent a debriefing session to provide their impressions of the intervention, and content analysis was performed on the sessions. Participants were also instructed to use a mobile app for 8 weeks after the intervention to monitor stress, MD, and mental health symptoms. We conducted Wilcoxon signed rank tests on the PSS and MIOS scores to investigate whether the VR scenario could induce stress and MD. We also evaluated user experience and the sense of presence after the intervention through semi-open-ended feedback and the Igroup Presence Questionnaire, respectively. Qualitative feedback was summarized and categorized to offer an experiential perspective. All participants completed the intervention. Mean pre- and postintervention scores were respectively 10.4 (SD 9.9) and 13.5 (SD 9.1) for the MIOS and 17.3 (SD 7.5) and 19.1 (SD 8.1) for the PSS. Statistical analyses revealed no significant pre- to postintervention difference in the MIOS and PSS scores (P=.11 and P=.22, respectively), suggesting that the experiment did not acutely induce significant levels of stress or MD. However, content analysis revealed feelings of guilt, shame, and betrayal, which relate to the experience of MD. On the basis of the Igroup Presence Questionnaire results, the VR scenario achieved an above-average degree of overall presence, spatial presence, and involvement, and slightly below-average realism. Of the 15 participants, 8 (53%) did not answer symptom surveys on the mobile app. Our study demonstrated VR to be a feasible method to simulate morally challenging situations and elicit genuine responses associated with MD with high acceptability and tolerability. Future research could better define the efficacy of VR in examining stress, MD, and MI both acutely and in the longer term. An improved participant strategy for mobile data capture is needed for future studies. ClinicalTrails.gov NCT05001542; https://clinicaltrials.gov/study/NCT05001542. RR2-10.2196/32240.

Effect of Environmental Conditions on Management of Juvenile Delinquent in Kiambu County, Kenya

The purpose of this study was to determine how environmental conditions affected the management of juvenile offenders at the rehabilitation facilities located in Kiambu County. Through the use of structured questionnaires, interviews, and targeted focus groups, information was gathered from 90 probation officers, 22 instructors, and 12 managers. The centres’ overpopulation, subpar accommodations, and unfavourable environmental conditions were found to be impeding the effectiveness of rehabilitation operations. Adolescents’ negative opinions of staff made matters worse. There is an urgent need for extensive programme reforms because over 93% of respondents thought the institutional environment was unfavorable. The study recommends modernizing rehabilitation programmes through the integration of life skills development, vocational training, counselling, and education will demand immediate action. For a programme to be implemented effectively, staffing and equipment shortages must be addressed. Furthermore, improving the institutional setting is essential to the juveniles’ effective recovery and ultimate reintegration into society.

Assessing the impact of COVID-19 on tuberculosis detection and treatment in healthcare facilities across Addis Ababa, Ethiopia: A comprehensive mixed-method, multi-center study.

Ethiopia faces a significant burden of Tuberculosis (TB), being one of the high-burden countries, and the emergence of the Coronavirus Disease 2019 (COVID-19) has become a dominant health concern, particularly in resource-limited settings. The repercussions of COVID-19 on TB care are evident, leading to a surge in undiagnosed TB cases, challenges in medication adherence, and an escalation of drug resistance. Consequently, a thorough assessment of the impact of COVID-19 on TB care becomes imperative to devise a tailored program for managing TB amidst future pandemics, natural disasters, and conflict crises. A mixed-methods study design was utilized, encompassing a randomly selected 10 health centers (HCs) and 3 hospitals among government owned 98 HCs and 5 hospitals in Addis Ababa, Ethiopia. All TB patients who were on follow-up during the study period were included. The study period was from March 4, 2020, to December 4, 2020, with the corresponding period of March 4, 2019, to December 4, 2019, serving as the baseline for comparison. Quantitative data were gathered from TB patients' medical registries, laboratory registries, and treatment follow-up charts. Complementary qualitative data were acquired through in-depth interviews. Both qualitative and quantitative data were collected from January 17, 2022 to May 13, 2022. Following the onset of the pandemic, there was a notable and statistically significant decline in both the detection of TB cases and the number of positive results across all study sites. Bacteriological TB tests reduced from 5837 to 2126 patients, and TB-positive cases decreased from 500 to 218, representing declines of 63.6% and 56.4%, respectively. The overall number of TB patients undergoing treatment also experienced a decrease from 1431 to 1051, marking a 26.6% reduction. Additionally, there was a 10% increase in the proportion of extra-pulmonary TB cases. The impact of the pandemic extended to TB treatment outcomes, with adverse effects on cure rates, death rates, loss of follow-up, and medication adherence. The apprehension of contracting COVID-19 and the implementation of isolation measures contributed to a decline in healthcare-seeking behaviors among patients, fostering negative perceptions and practices among healthcare workers. The challenges further exacerbated due to a shortage of personal protective equipment, a lack of rapid diagnostic test tools, clinical presentations resembling COVID-19, and a shift in government policies. These factors collectively posed significant obstacles to effective TB care during the pandemic. The profound impact of COVID-19 on critical TB care service indicators, including TB detection, treatment initiation, and treatment outcomes, underscores the need for immediate and collaborative measures. It is imperative to implement strategies that ensure the resumption of all TB care services concurrently with efforts to control COVID-19. A comprehensive and coordinated approach is essential to mitigate the adverse effects of the pandemic on TB management and safeguard public health.