ABSTRACT
Introduction: Community Health Workers (CHW) are a critical resource for outbreak preparedness and response. However, CHWs´ ability to respond to outbreaks depends on their accurate knowledge of the disease and proper adoption of disease prevention practices. We explored knowledge and practices related to outbreaks in general, and COVID-19 among CHWs in Rwanda. Methods: this cross-sectional multimethod study used stratified simple random sampling to recruit three cadres of CHWs (agents de santé maternelle, female Binomes, and male Binomes ) from three rural Rwandan districts. We used telephone-based data collection to administer quantitative surveys (N=292) and qualitative interviews (N=24) in September 2020. We calculated descriptive statistics and conducted thematic analysis of qualitative data. We assessed for associations between general outbreak-related knowledge and receipt of training using Chi-square tests and between COVID-19 related knowledge and CHW characteristics and adoption of prevention methods using linear regression models. Results: only 56.2% of CHWs had received training on any health topic in 12 months prior to COVID-19 pandemic and only 19.2% had specifically received training on outbreak preparedness. Almost all CHWs reported preventing COVID-19 by wearing facemasks (98%), washing hands (95%), and social distancing in crowds (89%) with fewer reporting staying at home (50%), sneezing or coughing into an elbow (38%) or using hand sanitizer (18%). Almost all CHWs in our study knew that COVID-19 transmit through respiratory droplets (98%) and by infected surfaces (98%) and that asymptomatic spread is possible (91%). However, fewer than half of community health workers correctly affirmed that children were at low risk of becoming severely ill (48%) and only 32% correctly rejected the misconception that everyone with COVID-19 would become severely ill. There was no association between COVID-19-related knowledge and adoption of COVID-19 preventative practices. Qualitative findings suggested that while CHWs possessed lots of correct information about COVID-19 and reported good adherence to COVID-19 prevention practices, they also commonly held misconceptions that over-exaggerated the dangers of COVID-19. Conclusion: gaps in knowledge, training, and access to information point to a need for additional investment in supervision and credible informational systems to support CHWs.
Subject(s)
Linear Models , Community Health Workers , Knowledge , Hand Sanitizers , Physical Distancing , COVID-19 , Disease OutbreaksABSTRACT
Depuis le début de la crise épidémique liée au virus Covid-19, pour de nombreux citoyens, se laver les mains est devenu un rituel nécessaire. Le gel hydroalcoolique constitue une solution alternative qui a été popularisée par les recommandations des autorités sanitaires dans le cas d'indisponibilité du lavage des mains. Que cela soit en pharmacie, en supermarché, ou sur internet, de nombreux sites de commerce proposent ces produits à la vente. Toutefois l'appellation ne garantit pas l'efficacité de chaque produit vendu. C'est ainsi que la présente étude s'est attelée à l'évaluation de la qualité des gels hydroalcooliques (GHA) utilisés pour la désinfection des mains au cours de la crise sanitaire liée au Coronavirus. Au total, 28 échantillons dont 23 importés et 5 locaux ont été collectés dans 16 supermarchés de la ville de Cotonou. Ils ont été soumis au test d'inspection visuelle, aux tests organoleptiques ainsi qu'aux analyses physico-chimiques et microbiologiques. Au terme de l'étude, 17,86% des GHA ont été déclarés non-conformes par rapport aux inspections visuelles, 39,28% par rapport aux tests organoleptiques, 21% par rapport au pH et à la densité et enfin 21% de non-conformité aux tests microbiologiques. Le taux de non-conformité est plus important dans le camp des gels importés ce qui atteste l'effort des producteurs locaux pour le respect des normes promulguées par les autorités sanitaires
Since the start of the epidemic crisis linked to the Covid-19 virus, for many citizens, washing their hands has become a necessary ritual. Hydroalcoholic gel constitutes an alternative solution which has been popularized by the recommendations of the health authorities in the case of hand washing unavailable. Whether in pharmacies, supermarkets, or on the internet, many shopping sites offered these products for sale. However, this name does not guarantee the effectiveness of each product sold. The present study has been set out to assess the quality of hydroalcoholic gels (GHA) used for hand disinfection during the health crisis linked to the Coronavirus. In total, 28 samples, of which 23 were imported and 5 locals, were collected in 16 supermarkets in the city of Cotonou. They were subjected to visual inspection test, organoleptic tests as well as physico-chemical and microbiological analyzes. At the end of the study, 17.86% of GHAs were declared non-compliant with respect to visual inspections, 39.28% with respect to organoleptic tests, 21% with respect to pH and density and finally 21% of noncompliance with microbiological testing. The rate of non-compliance is higher in the imported gel camp, which attests to the efforts of local producers to comply with the standards promulgated by the health authorities