Household Readiness to Care for Mild and Asymptomatic COVID-19 Cases at Home, Southwest Ethiopia: A Community-based CrossSectional Stud

BACKGROUND: Corona virus disease (COVID-19) continued with its notorious effects overwhelming health institutions. Thus, home-based identification and care for asymptomatic and mild cases of COVID-19 has been recommended. Therefore, the objective of this study was to assess the level of household readiness for caring asymptomatic and mild cases of COVID-19 at home. METHODS: A community-based cross-sectional study was conducted from March-June 2021 on randomly selected 778 households. Data entry and analysis were carried out using EpiData and SPSS version 25, respectively. Multivariable logistic regression was modeled to identify independent predictors of community readiness. RESULTS: Overall readiness of the community was very low (43.8%). Factors positively affecting household readiness were male household heads (AOR = 1.6; 95%CI: 1.05, 2.45), primary (AOR=2.0; CI:.62, 1.59) and higher (AOR = 1.90; 95%CI: 1.04, 3.45) educational level of the respondents, number of rooms within household (AOR = 1.22; CI: 1.03, 1.46), having additionally house (AOR = 2.61; CI: 1.35, 5.03), availability of single use eating utensils (AOR = 2.76; 95%CI: 1.66, 4.56), availability of community water supply (AOR = 8.21; 95% CI: 5.02, 13.43), and community participation and engagement (AOR = 2.81; 95% CI: 1.93, 4.08) in accessing transport, water and sanitation. CONCLUSIONS: The community was less prepared in terms of housing, infection prevention, water and sanitation. Considering alternative options including universal coverage of vaccine is important; designed behavioral change communications can enhance community participation and engagement in improving access to transport, water and sanitation to reduce risk of infections

La pneumopathie aigue bactérienne communautaire du sujet âge en pneumologie au centre hospitalier et universitaire du point-g, Bamako-mali / Community acute bacterial pneumonitis of the subject age in pulmonology at the Point-g hospital and university center, Bamako- Mali

Introduction : Les pneumopathies aiguës bactériennes (PAB) communautaires sont des infections respiratoires basses aiguës, non suppurées, non tuberculeuses du parenchyme pulmonaire acquises au sein de la communauté. Elles ont une présentation clinique atypique et un mauvais pronostic chez le sujet âgé. Matériels et Méthodes : Il s'agissait d'une étude transversale prospective menée au service de pneumologie du centre hospitalier universitaire (CHU) du Point-G, du 30 Octobre 2018 au 30 Septembre 2019. L'objectif était de déterminer les particularités cliniques, étiologiques, thérapeutiques et évolutives de la PAB chez le sujet âgé. Ont été inclus tout âge ≥ 65 ans, présentant des signes cliniques et radiologiques d'une PAB Résultats : Durant la période d'étude 85 patients répondaient aux critères d'inclusion sur 178 hospitalisés. Le sex-ratio était de 3/1. Environ 2/3 étaient tabagiques et 11% était positif au VIH. La fièvre n'était pas constante enregistrée dans 51,76% des cas. Les signes respiratoires étaient dominés par la toux (96, 47%), la dyspnée (94, 11%) et extra respiratoires par le trouble de la conscience. Le Klebsiellapneumoniae était le germe le plus retrouvé. L'antibiotique le plus utilisé était l'amoxicilline-acide clavulanique. La durée moyenne d'hospitalisation était de 9 jours. La mortalité était de 19%. Conclusion: La PAB chez le sujet âgé est d'une symptomatologie clinique frustre. Elle est grave avec une surmortalité

Introduction: Community-acquired acute bacterial pneumonia (ABP) is an acute, non-suppurative, non-tuberculosis lower respiratory infection of the lung parenchyma acquired within the community. They have an atypical clinical presentation and a poor prognosis in the elderly. Materials and Methods: This was a prospective cross-sectional study conducted in the Pneumology department of the University Hospital Center (CHU) of Point-G, from October 30, 2018, to September 30, 2019. The objective was to determine the clinical, etiological, therapeutic and progression of BAP in the elderly. Were included any age ≥ 65 years, presenting clinical and radiological signs of a PAB. Results During the study period, 85 patients met the inclusion criteria out of 178 hospitalized. The sex ratio was 3/1. About 2/3 were smokers and 11% were HIV positive. Fever was not constant recorded in 51.76% of cases. Respiratory signs were dominated by cough (96.47%), dyspnea (94.11%) and extra respiratory by impaired consciousness. Klebsiella pneumoniae was the most found germ. The most commonly used antibiotic was amoxicillin-clavulanic acid. The average length of hospitalization was 9 days. Mortality was 19%. Conclusion: The PAB in the elderly is of a frustrating clinical symptomatology. It is serious with excess mortality

Comparative assessment of infection prevention and control practice among maternity unit health workers in public and private secondary health facilities in Kaduna state, Nigeria

OBJECTIVES: Infection prevention and control (IPC) practice in health facility (HF) is abysmally low in developing countries, resulting in significant preventable morbidity and mortality. This study assessed and compared health workers' (HWs) practice of IPC strategies in public and private secondary HFs in Kaduna State. MATERIAL AND METHODS: A cross-sectional comparative study was employed. Using multistage sampling, 227 participants each were selected comprising of doctors, midwives, and nurses from public and private HF. Data were collected using interviewer-administered questionnaire and observation checklist and analyzed using bivariate and multivariate analysis. Statistical significance determined at P < 0.05. RESULTS: The practice of infection prevention was poor. Overall, 42.3% of the HWs did not change their gowns in-between patients, with the significantly higher rates in 73.1% of private compared to 42.3% of public HF workers (P < 0.001). In addition, 30.5% and 10.1% of HWs do not use face mask and eye goggle, respectively, when conducting procedures likely to generate splash of body fluids, however, there was no significant difference in these poor practices in public compared to private HFs. The mean IPC practice was 51.6 ± 12.5%, this was significantly lower among public (48.8 ± 12.5%) compared to private (54.5 ± 11.9%) HF workers (P < 0.0001). Private HF workers were 3 times more likely to implement IPC interventions compared to public HF workers. CONCLUSION: IPC practice especially among public HF workers was poor.

Comparative assessment of infection prevention and control practice among maternity unit health workers in public and private secondary health facilities in Kaduna state, Nigeria

Objectives: Infection prevention and control (IPC) practice in health facility (HF) is abysmally low in developing countries, resulting in significant preventable morbidity and mortality. This study assessed and compared health workers' (HWs) practice of IPC strategies in public and private secondary HFs in Kaduna State. Material and Methods: A cross-sectional comparative study was employed. Using multistage sampling, 227 participants each were selected comprising of doctors, midwives, and nurses from public and private HF. Data were collected using interviewer-administered questionnaire and observation checklist and analyzed using bivariate and multivariate analysis. Statistical significance determined at P < 0.05. Results: The practice of infection prevention was poor. Overall, 42.3% of the HWs did not change their gowns in-between patients, with the significantly higher rates in 73.1% of private compared to 42.3% of public HF workers (P < 0.001). In addition, 30.5% and 10.1% of HWs do not use face mask and eye goggle, respectively, when conducting procedures likely to generate splash of body fluids, however, there was no significant difference in these poor practices in public compared to private HFs. The mean IPC practice was 51.6 ± 12.5%, this was significantly lower among public (48.8 ± 12.5%) compared to private (54.5 ± 11.9%) HF workers (P < 0.0001). Private HF workers were 3 times more likely to implement IPC interventions compared to public HF workers. Conclusion: IPC practice especially among public HF workers was poor. Keywords: Hospital-acquired infection, Infection prevention and control, Maternity unit, Practice

Characterisation of Staphylococcus Aureus Bacteraemia at Tygerberg Hospital

To elucidate the local epidemiology of Staphylococcus aureus bacteraemia; we characterised blood culture isolates using molecular methods and prospectively collected clinical data to determine the occurrence of community-acquired; methicillin-resistant S. aureus (MRSA). Consecutive S. aureus blood culture isolates were collected over a one-year period from patients who were admitted to Tygerberg Academic Hospital in the Western Cape. A multiplex polymerase chain reaction (PCR) was used for the detection of spa; mecA and lukS/F-PV genes. Strain typing was performed using spa typing. Multiplex PCR for staphylococcal cassette chromosome mec (SCCmec) typing was also performed; as well as multilocus sequence typing (MLST) on selected isolates. Cases were categorised by clinical data as either hospital-acquired; healthcare-associated or community-acquired. One hundred and thirteen S. aureus isolates (30 MRSA) were collected from 104 cases of bacteraemia. According to clinical data; all community-acquired infections; 54 of hospital-acquired cases and the majority of healthcare-associated cases were due to methicillin-sensitive S. aureus (MSSA). Furthermore; all Panton-Valentine leukocidin (PVL)-positive isolates (15.9 of all S. aureus) were MSSA. MRSA strains were isolated from hospital-acquired cases (with a minority of healthcare-associated cases) and clustered mainly in spa-CC701 and CC012. SCCmec type IV was predominant. MLST clones included ST239-MRSAIII; ST36-MRSA-II and ST612-MRSA-IV. The predominant source for S. aureus bacteraemia was catheter-related infection (39). Community-acquired S. aureus infections in our setting remain sensitive to methicillin and current treatment guidelines suffice. The majority of hospital-acquired and healthcare-associated infections were catheter-related. Prevention and treatment should be targeted accordingly

Gestion d'une epidemie d' infections associees aux soins

L'objectif de cet article etait de detailler les differentes etapes de l'investigation et de la gestion d'une epidemie d'infections associees aux soins. Une epidemie est la survenue en exces; par rapport a ce qui est observe habituellement; de cas de maladie en un lieu et une periode de temps. Dans le contexte d'infections associees aux soins; l'epidemie peut toucher un service ou plusieurs services d'un meme hopital; et contrairement aux epidemies communautaires; plusieurs micro-organismes peuvent etre a l'origine d'une meme epidemie. L'investigation d'epidemies d'infections associees aux soins comporte plusieurs etapes que sont la confirmation du diagnostic d'infection; la definition de cas; la confirmation du caractere epidemique et la recherche active des cas. Une enquetedescriptive est realisee en premier permettant d'enoncer des hypotheses sur le mode de transmission de l'infection et sur les causes de l'epidemie. Ces hypotheses pourront etre testees dans un deuxieme temps par une enquete epidemiologique analytique; le plussouvent par des enquetes cas-temoins. Parallelement; la mise en place de mesures de controle a pour objectif d'enrayer le phenomene epidemique. Un travail collaboratif entre les differents professionnels de sante est necessaire a la bonne investigation de toute epidemie et conditionne son controle

Review Diagnosis; Aetiology; and Severity in Adult Community-Acquired Pneumonia

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Nosocomial and Community Acquired Infections in Korle Bu Teaching Hospital; Accra

BACKGROUND: Nosocomial or hospital acquired infection has been recognized as a serious public health problem in the last twenty years. In most hospitals in Africa-South of the Sahara; although the types of community acquired infections are known; neither the magnitude; nor the common types of nosocomial infections has been documented. OBJECTIVE: This study was carried out to find the prevalence of hospital and community acquired infections in hospitals; and to estimate the overall prevalence of HAI and CAI in Korle Bu Teaching Hospital. METHODS: A one-day prevalence survey of nosocomial and community acquired infection in a tertiary-care hospital in Accra was performed using the 1980 British national protocol and the result was analyzed using computerized gargets. RESULTS: Of the 907 patients on admission (on the day of the study); 61 (6.7) had hospital-acquired infection and 287 (31.6) had community acquired infection. The commonest hospital acquired infection was wound infection followed by skin and lower respiratory infections. Of the community infections; the most common cases were lower respiratory and skin infections. Fifty-three percent of all patients were on antimicrobial treatment. Patients on metronidazole were 212 (44); ampicillin/amoxicillin 199 (41.6); cloxacillin 163 (34) and gentamicin 135 (28). Approximately 20of patients were on three or more drugs. CONCLUSION: This study has shown that the prevalence of community acquired infections in our hospital is much higher than that from nosocomial infections and that the British national survey protocol can be used in countries with limited resources

HIV/AIDS Surveillence Report

The HIV/AIDS infection rates from the major sentinel surveillance sites continue to show declining trends. In the major urban areas where this trend has been observed since 1992; antenatal prevalence rates in Nsambya and Rubaga; for example have continued to decline from 13.4and 14.2in 1998 to 12.4and 10.5respectively in 1999. In Jinja and Mbarara sentinel sites; the rates have remained relatively stable between 1998 and 1999 while clear declines were recorded in both Mbale and Tororo sentinel sites. The declines in all these situations continue to be most significant in the young age groups 15-24 years. In rural areas; where trends have in the past exhibited a mixed pattern of stablisation and decline; prevalence rates now appear to be on a clear downward trend. Antenatal prevalence rates for example in Matany and Mutolere sentinel sites have steadily declined from 2.8and 4.2in 1993 to 0.9and 2.3respectively in 1999. Similar observations were made in Lacor Hospital; Gulu; Northern Uganda where trends have fallen from 27.1in 1993 to notable among the young age cohorts. Data from the Kyamulibwa general population cohort continue to show declining prevalence rates for both young males and females. The greatest decline was observed among males aged 20-24 years. There has also been an observed decline in incidence for adults of all years (PY) of observation in 1990 to 3.2/1000 PY in 1998. The decline among males was from 9.4/1000 PY in 1990 tp 2.4/1000 PY in 1998 compared with 6.0/1000 PY in 1990 and 4.0/1000 PY in 1998 for females. Likewise; data from the AIDS Information Centre continues to show declining HIV sero-prevalence among young persons seeking voluntary counselling and testing. among the 15-24 year olds; the prevalence rates have declined from 11among males and 29in females in 1992 to 2.5and 12.1respectively in 1999. In this report; we also present trends of HIV infection rates among STD patients attending a major referral STD clinic in Kampala. The prevalence rates among STD patients have continued to decline from 20.4in 1998 t0 23.0in 1999. These rates have always been higher ona verage than those of antenatal mothers from any of the antenatal sentinel sites. In spite of the observed dent in the HIV/AIDS epidemic; it is important to note that the HIV infection rates are still unacceptably high. Clearly; this points out the need for continued concerted efforts to sustain and improve the existing AIDS prevention and control initiatives. The programme needs to sustain the achievements of the high levels of awareness and knowledge and ensure that they transform into higher levels of behaviour change