Modelling COVID-19 vaccination status and adherence to public health and social measures, Eastern Mediterranean Region and Algeria

Objective: To study the link between coronavirus disease 2019 (COVID-19) vaccination status and adherence to public health and social measures in Members of the Eastern Mediterranean Region and Algeria. Methods: We analysed two rounds of a large, cross-country, repeated cross-sectional mobile phone survey in June­July 2021 and October­November 2021. The rounds included 14 287 and 14 131 respondents, respectively, from 23 countries and territories. Questions covered knowledge, attitudes and practices around COVID-19, and demographic, employment, health and vaccination status. We used logit modelling to analyse the link between self-reported vaccination status and individuals' practice of mask wearing, physical distancing and handwashing. We used propensity score matching as a robustness check. Findings: Overall, vaccinated respondents (8766 respondents in round 2) were significantly more likely to adhere to preventive measures than those who were unvaccinated (5297 respondents in round 2). Odds ratios were 1.5 (95% confidence interval, CI: 1.3­1.8) for mask wearing; 1.5 (95% CI: 1.3­1.7) for physical distancing; and 1.2 (95% CI: 1.0­1.4) for handwashing. Similar results were found on analysing subsamples of low- and middle-income countries. However, in high-income countries, where vaccination coverage is high, there was no significant link between vaccination and preventive practices. The association between vaccination status and adherence to public health advice was sustained over time, even though self-reported vaccination coverage tripled over 5 months (19.4% to 62.3%; weighted percentages). Conclusion Individuals vaccinated against COVID-19 maintained their adherence to preventive health measures. Nevertheless, reinforcement of public health messages is important for the public's continued compliance with preventive measures.

Lessons from COVID-19 pandemic: teaching midwifery at the national level in Sierra Leone in the pandemic and post pandemic

The contents of this article are drawn from personal experiences and National response by the Ministry of Health and Sanitation during the COVID-19 pandemic in the midst of teaching in a midwifery training school. Teaching Midwifery in COVID-19 Pandemic and Post Pandemic periods impacted on the way student midwives were taught. Contextual issues are highlighted during the COVID-19 Pandemic in the Midwifery Education profession. But more speciacally, the impact of Covid-19 on midwifery education basically around the way students were taught, classroom spacing rearrangement and institutionalizing national protocols and guidelines on prevention of COVID-19 spread among staff and students.

Implementation and contribution of temperature screening and handwashing practice at points of entry for COVID-19 pandemic response in a humanitarian crisis setting

Introduction: over the last decade, insecurity in the Lake Chad Basin has triggered an unprecedented humanitarian crisis in the Niger´s Diffa Region with a significant population movement. In this humanitarian setting, we reviewed the implementation process and the contribution of temperature screening and handwashing practice at points of entry as part of non-pharmaceutical interventions against COVID-19. Methods: in Diffa, border officers were trained on the fundamentals of infection prevention and control in relation to COVID-19 readiness and response and a 14-day district response team was constituted. To examine the significance of the implementation process of temperature screening and handwashing practices at points of entry, we conducted a secondary analysis of data submitted by the six health districts of the Diffa Region between March and July 2020. Results: travellers screened for fever ranged from 10,499 (in March 2020) to 62,441 (in April 2020) with the health districts of Diffa (mean: standard error of the mean: 25,999: 9,220) and of Bosso (mean: standard error of the mean: 30.4: 19.1) accounting for the most and the least of activities during the entire period, respectively. Overall, 125/169,475 travellers presented fever and were effectively quarantined. Only the Ngourti Health District reported travellers who declined handwashing (54/169,475); this was during the first three months of the first wave of the COVID-19 pandemic. Conclusion: we have documented a successful implementation of measures related to temperature screening with some unsubstantial denial of handwashing. Given the importance of border traffic due to insecurity in the Diffa Region, maintaining temperature screening and handwashing in this humanitarian setting is necessary but requires coordinated actions of all stakeholders involved in the region.

A scoping review to identify the type and effect of hand hygiene interventions on the reduction of infectious diseases (including COVID-19) in preschool children

Background. Proper handwashing can reduce the burden of diseases related to hand hygiene (HH) and so contribute reducing under-5 mortality. Preschoolers can benefit from HH interventions by the burden of disease and absenteeism being reduced. Objective. To perform a scoping review of literature to assess the types and effectiveness of HH interventions at preschools, with a view to providing a guideline for appropriate interventions for South African facilities. Methods. A literature search was conducted through the PubMed database to identify relevant studies. An iterative screening process to focus the review allowed for information on the type and effectiveness of interventions to be collated. An updated PubMed search was conducted to determine whether any interventions related to COVID-19 at preschools could be included. Results. No additional studies relating to COVID-19 were found. Of the 305 studies identified during the initial search, only 12 fitted the specific search criteria. Of these, 10 studies showed improvements in HH-related indicators following the interventions. Only two studies used health education as an intervention, whereas the others included the supply of HH products (to varying extents) as part of the intervention. Conclusion. HH interventions appear successful in reducing diseases spread by poor HH, improving general HH practices and reducing absenteeism among preschoolers. Studies using innovative, entertaining methods of educating children have shown to be successful in improving handwashing techniques and decreasing microbial growth on children's hands. HH interventions are suggested as an effective measure to improve HH during the COVID-19 pandemic.

The use of disinfection tunnels or disinfectant spraying of humans as a measure to reduce the spread of the SARS-CoV-2 virus

In endeavouring to mitigate the spread of the SARS-CoV-2 virus, a concerning practice of spraying individuals with disinfectant via so-called 'disinfection tunnels' has come to light. The Allergy Society of South Africa supports the World Health Organization in strongly condemning all human spraying, owing to lack of efficacy and potential dangers, especially to patients with coexisting allergic conditions

Bacteriocidal activity of handwash products and soaps sold in Port Harcourt, Nigeria ­ An in vitro study

BACKGROUND: Hand hygiene is still noted as one of the most important factors essential for control of infectious diseases particularly in hospital settings and soap and water is still of essence, especially when hands are visibly soiled. The use of medicated handwash products is becoming more widespread. These products sometimes claim a better efficacy than plain soap and water. This study set out to determine trends in antibacterial activity of medicated and non-medicated locally sold soap products and bacteriocidal activity of these products against commonly encountered clinical pathogens (Staphylcoccus aureus, Klebsiella pneumoniae and Escherichia coli).METHODS: Antibacterial activity of 4 handwash and 3 bodywash products was determined using the Agar-well diffusion, minimum inhibitory concentration and minimum bacteriocidal concentration tests.RESULTS: At 100% product concentration, both non-medicated handwash products (Pears and Cussons) gave zones of inhibition ranging from 8 ­ 17 mm and 9 ­ 12 mm respectively, while the medicated products resulted in zones of inhibition ranging from 23 ­ 30 mm and 17 ­ 29 mm. Liquid bodywash products were less inhibitory with 'no inhibition' observed in 66.7% (18/27) of cases than 11.1% (4/36) of cases of the handwash. All handwash products had bacteriocidal activity against all three test strains, while for the bodywash products, no bacteriocidal activity was observed in 4 cases.CONCLUSION: This study highlights the important role soaps particular the medicated versions play in hand hygiene. Further studies involving human volunteers and time-kill assays would be necessary to provide a more complete story of the effectiveness of these products in infection control

Information needs and sources for ebola virus disease among staff of a college of medicine in ENUGU, Nigeria

This study was carried out to ascertain the information needs and sources for Ebola among staff of College of Medicine, Enugu State University of Science and Technology (ESUT) Enugu. The study adopted the descriptive survey design. A total of 200 questionnaires were used to elicit information from the respondents. The 200 questionnaire were administered to the respondents and all the responses were retrieved accordingly for data analysis. The data were analyzed using percentages. Findings showed that a good number of the respondents correctly identified best preventive measures against Ebola as avoiding raw foods especially under cooked meat and washing hands regularly with soap or use of hand sanitizers. This show the respondents are aware of the disease. Information is needed most on the causes of Ebola virus and television and radio were major sources of information on Ebola. In conclusion, the study noted that there is need for planned and proper dissemination of information on of Ebola Virus Disease. This will help the citizens to prevent the disease as well as manage any outbreak.

Hand washing practices and techniques among health professionals in a tertiary hospital in Kano

Background: The simple act of hand washing has been proven to reduce the risk of acquiring hospital infection; especially with the current concern of Ebola viral disease. Hospital acquired infections have contributed significantly to overall mortality and morbidity and health care cost. They report that hand washing remains at an unacceptable low level in most medical environments; with large numbers of doctors and nurses routinely forgetting to wash their hands before touching patients. Transmission of health-care-associated infections often occurs via the contaminated hands of health care workers. Materials and Methods: It was a descriptive cross-sectional study carried out among randomly selected doctors and nurses in Aminu Kano Teaching Hospital; Kano. The questionnaires were administered to the respondents during their ward rounds or clinic sessions. Results: One hundred and forty health professionals comprising 98 nurses and 42 doctors were studied. About 64.4% of them were aware of the World Health Organization (WHO) global hand washing day but only 15% stated the date correctly. About 99.3% of them believed that if hand washing is done correctly it can reduce the risk of infection. All (100%) of the health professionals use water and soap or hand rubs as agents of hand washing. About 93.6% were taught hand washing technique and 47% were aware of the five moments in hand washing but only 17% of them could list the five moments in hand washing. Only 25.7% health professionals knew the correct steps of hand washing (?2 = 2.444; df = 2; P = 0.295). Ninety-one percent of the health professionals had seen posters on hand washing. Majority (72.1%) adhered to principles of hand washing (?2 = 0.015; df = 1; P = 0.902) while 82.1% wash their hands before touching patients (?2 = 2.841; df = 1; P = 0.092). However; most of them (95%) washed their hands after touching patients and 97% washed their hands after handling body fluids or secretions from patients. On the other hand; only 39% health professionals washed hands before wearing hand gloves (?2 = 0.321; df = 1; P = 0.571) but 95% washed hands after removing the hand gloves. Ninety-nine percent washed their hands after visiting or using the restroom. Conclusion: This study underscores the need for continuous information and education of health professionals on the importance WHO global hand washing day. As doctors and nurses are important in the health care team; it is important to provide the appropriate knowledge and training regarding preventive practices of infectious diseases. Training and retraining of health professionals on correct steps of hand washing will encourage and remind them on the importance of washing hands before wearing gloves and before touching patients to reduce the risk of infection and cross infection

L'hygiene des mains en milieu de soin : la frequence mais aussi la qualite !

Le lavage des mains est reconnu depuis plus d'un siecle comme une mesure efficace de prevention des infections associees aux soins.L'objectif de notre travail est d'evaluer l'adhesion du personnel soignant au lavage des mains ainsi que l'observance et la pertinence de cette pratique permettant ainsi de juger de sa conformite aux recommandations. Il s'agit d'une etude prospective realisee a l'hopital universitaire FARHAT HACHED de Sousse aupres du personnel soignant de 4 services qui ont ete choisi au hasard parmi les services classes a haut risque infectieux et ceci par l'observation directe des pratiques professionnelles visant a mesurer l'adhesion et la pertinence du lavage des mains. Au total 254 observations ont ete realisees durant les deux semaines de l'etude. 18;9des personnels observes se lavent les mains avant et apres un acte; alors que 24des personnes auditees se sont laves les mains avant d'effectuer un acte seulement. La conformite avant et apres soin etait uniquement de 16;1. Ce travail nous a permis de faire un constat global sur les pratiques de lavage des mains. Il apparait important de determiner les obstacles au lavage des mains et les moyens de l'amelioration de l'observance des professionnels de la sante

Assessment of Existing Practices in the Operating Theatre in the Khartoum North Teaching Hospital; Sudan

This study; assessing existing practices in the operating theatre regarding hand washing; disinfection and sterilisation; was conducted at Khartoum North Teaching Hospital. As far as we know; this is the first study of its kind since the inauguration of the hospital in 1950. A total of 55 health personnel working in the operating theatre participated in the study. These included nurses and environmental service personnel (housekeepers and sterilisation and disinfection personnel). Knowledge and practice were evaluated using multiple choice and direct interview questions. Operation theatre sterilisation and disinfection practices were monitored using checklists modified from World Health Organization recommendations. A marked lack of knowledge and defective attitudes and practices were observed among a large number of personnel. It was observed that 51of the nurses were 46 years of age or older and that two-thirds had only a primary and intermediate school level education. The study recommends the upgrading of the operating theatres and additional training and education of staff. Theatres should be provided with facilities for proper disinfection and waste disposal. Qualified nurses should be employed. We also recommend the establishment of an infection control committee. The role of the committee would include the planning and execution of hygiene policies. In addition; planning and organising training courses in infection control should be seen as a priority

Assessment of Existing Practices in the Operating Theatre in the Khartoum North Teaching Hospital; Sudan

This study; assessing existing practices in the operating theatre regarding hand washing; disinfection and sterilisation; was conducted at Khartoum North Teaching Hospital. As far as we know; this is the first study of its kind since the inauguration of the hospital in 1950. A total of 55 health personnel working in the operating theatre participated in the study. These included nurses and environmental service personnel (housekeepers and sterilisation and disinfection personnel). Knowledge and practice were evaluated using multiple choice and direct interview questions. Operation theatre sterilisation and disinfection practices were monitored using checklists modified from World Health Organization recommendations. A marked lack of knowledge and defective attitudes and practices were observed among a large number of personnel. It was observed that 51 of the nurses were 46 years of age or older and that two-thirds had only a primary and intermediate school level education. The study recommends the upgrading of the operating theatres and additional training and education of staff. Theatres should be provided with facilities for proper disinfection and waste disposal. Qualified nurses should be employed. We also recommend the establishment of an infection control committee. The role of the committee would include the planning and execution of hygiene policies. In addition; planning and organising training courses in infection control should be seen as a priority

Hospital acquired infection in Obafemi Awolowo University Teaching Hospital, Ile-Ife, Southwest, Nigeria: a ten year review (2000-2009)

Surveillance and proper hygiene have been identified as key components in the fight against HAIs and antimicrobial resistance in hospital setting. This study assesses the pattern of hospital acquired infections (HAIs) and state of hygiene in a tertiary hospital in southwest; Nigeria. Data collected routinely between January 2000 and December 2009 by the infection control committee on HAI and primary data generated on hygiene in the wards were analysed using appropriate statistical techniques. A total of 37;957 patients were admitted during the period under review and 1129 cases (3.0) of HAI were reported. The highest prevalence of 9.0 was reported in 2006. The Intensive Care Unit (ICU) had the highest period prevalence of 14.7 followed by Orthopaedics ward (7.7). Surgical ward contributed the highest number of cases with 433. Gram negative organisms were the most implicated (78) of which Klebsiella species was 38 while Staphylococcus aureus was the only Gram positive organism identified (28). Hand washing was practised universally by health workers but facilities for proper hand washing were inadequate. The pattern of HAI has not changed significantly in the past 10 years and Klebsiella was the most implicated organism in HAIs and ICU. Facilities for proper hand washing are suboptimal. We recommend the introduction of hand washing policy for the hospital and the provision of an environment conducive for its implementation by the hospital management as well as adequate support for the infection control committee in the discharge of her duties

Intérêt de la désinfection chirurgicale des mains par friction alcoolique en milieu tropical

Objectif. Determiner l'efficacite de la desinfection chirurgicale des mains par friction alcoolique en terme de survenue d'infection du site operatoire et en apprecier l'interet economique en milieu tropical. Materiel et methode. Il s'agissait d'une etude prospective de cohorte qui s'est deroulee de mai a septembre 2005 dans le service de gynecologie obstetrique du CHU deYopougon; comparant deux protocoles de desinfection des mains : le lavage chirurgical classique en 3 temps et la friction chirurgicale qui comprenait un lavage simple des mains suivi de deux applications successives d'une solution hydro alcoolique. Resultats. L'etude a porte sur 318 patientes. Les taux d'infection du site operatoire etaient de 13;2pour le groupe lavage et de 11;5pour le groupe friction (sans difference significative). La friction chirurgicale n'a pas expose a plus de risque d'infection et a ete jugee plus facile que le lavage chirurgical classique par 90des utilisateurs. La tolerance cutanee a ete jugee bonne dans 52des cas. Enfin; 69des utilisateurs souhaitaient que les deux protocoles soient maintenus. L'interet economique de la friction etait majeur par rapport au lavage tant en terme d'investissement que sur le prix des consommables; moins cher de 50. Conclusion. La friction chirurgicale s'est montree aussi efficace que le lavage chirurgical dans la prevention des infections du site operatoire tout en etant plus economique. Cette technique est une bonne alternative au lavage chirurgical des mains en milieu tropical

Hand washing as a strategy to prevent spread of antimicrobial - Resistant Microrganism in Hospitals

Hospitals worldwide are facing a crisis due to the increasingly rapid emergence and dissemination of antimicrobial resistant organisms. Resistance to multiple antimicrobial agents; including methicillin and quinolones among Staphylococcus aureus; has been noted to be an endemic problem in Health care settings. This leaves vancomycin as the sole effective antimicrobial agent for many patients. (1). A similar problem has been noted among the coagulase negative Staphylococci (2). The situation in Uganda is quite similar; the only exception being cost availability of Vancomycin. The drug being toxic may also prove difficult to monitor. Increased use of vancomycin has exerted selective pressure on enterococci which have developed resistance to the agent. (3). Vancomycin resistant enterococci have been noted among clinical isolates in Mulago inspite of lack of use of the agent (Najjuka; personal communication). Enterobacteriaceae; pseudomanas species and other gram-negative bacilli have become increasingly resistant to most frontline antimicrobials including third generation cephalosporins; monobactams; aminoglycosides and quinolones (4;5;6). Strains of pseudomonas and serratia that elaborate extended sptectrum B-lactamases capable of inactivating the cabapenems have been recovered in Japan (7;8). Clinical isolates with similar properties have been noted recently in our set up (Najjuka; personal communication). Resistance to topical antimicrobials such as chlorhexidine gluconate and mupirocin has also been documented . Resistance is not confined to bacteria; use of triazole antifungal agents; fluconazole; has been accompanied by a dramatic increase influconazole resistance among candida species

COVID-19 related knowledge, attitudes, practices and needs of households in informal settlements in Nairobi, Kenya

Objective: Urban slums are at high risk of COVID-19 transmission due to the lack of basic housing, water, and sanitation, and overcrowding. No systematic surveys of slum households' experiences exist to date. Methods: A mobile phone knowledge, attitudes, and practices survey was conducted March 30- 31, 2020. Participants were sampled from two study cohorts across five urban slums in Nairobi, Kenya. Findings: 2,009 individuals (63% female) participated. Knowledge of fever and cough as COVID-19 symptoms was high, but only 42% listed difficulty breathing. Most (83%) knew anyone could be infected; younger participants had lower perceived risk. High risk groups were correctly identified (the elderly - 64%; those with weak immune systems - 40%) however, 20% incorrectly stated children.Handwashing and using hand sanitizer were known prevention methods, though not having a personal water source (37%) and hand sanitizer being too expensive (53%) were barriers.Social distancing measures were challenging as 61% said this would risk income.A third worried about losing income, only 26% were concerned about infecting others if themselves sick. Government TV ads and short message service (SMS) were the most common sources of COVID-19 information and considered trustworthy (by >95%) but were less likely to reach less educated households. Conclusion: Knowledge of COVID-19 is high; significant challenges for behavior change campaigns to reach everyone with contextually appropriate guidance remain. Government communication channels should continue with additional efforts to reach less educated households.A strategy is necessary to facilitate social distancing, handwashing and targeted distributions of cash and food