Compliance and perception towards COVID-19 preventive protocols among hospital staff in a tertiary health facility, Southwest Nigeria

Background: The COVID-19 outbreak response in Nigeria was challenged by the existing weak health sector and the frontline health workers for COVID-19 pandemic response are exposed to the pathogen. One militating factor undermining the control and prevention of COVID-19 in Nigeria was poor compliance to preventive measures. This study assessed the compliance with COVID-19 prevention protocols among healthcare workers in Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria. Methods: A cross sectional study and subjects were selected through a multi-stage sampling technique. Data collection was done using interviewer-administered semi-structured questionnaire over a period of five months (JuneOctober, 2021). Data was analyzed using IBM, Statistical Package for Social Sciences (SPSS) version 27.0 and p value was set at <0.05 as the threshold for statistical significance. Results: Majority (60.1%), of the respondents got information on COVID-19 protocols through seminars and workshops. However, more than a quarter (28.8%) of the respondents said the use of available PPE was suboptimal. More than one-third, (35.8%), of respondents believe the protocols are too strict. There is, however, good perception (93.3%), but relatively lower compliance (58.7%) of COVID-19 protocols among the staff. Age, marital status and sex were associated with compliance towards COVID-19 protocols in this study (P<0.05). Identified significant predictors (p<0.05) of compliance include age (AOR=1.944), female sex (AOR=7.829). Conclusion: Most respondents had good knowledge of availability, perception of effectiveness, but relatively lower compliance with the COVID-19 protocols in this facility. The government or hospital authority make sure that necessary steps to further boost compliance are taken

Assessment of Variation in Clinical Presentation of Visceral Leishmaniasis Among Patients Attending the Tropical Diseases Teaching Hospital in Sudan

Background: Visceral leishmaniasis (also known as Kala-azar) is a systemic parasitic infection with many clinical presentations. The present study assesses the variation in presentations among patients who attended the Tropical Diseases Teaching Hospital (TDTH) in Khartoum, Sudan. Methods: This analytical cross-sectional, hospital-based study was conducted at the TDTH between November 2019 and September 2020. Medical records of patients who presented at the TDTH were reviewed using a structured data extraction checklist. The Chi-square test was used to determine the associations between sociodemographic and clinical presentations of patients. P-value < 0.05 was considered as statistically significant. Results: Out of 195 patients, 79.5% were male and 48.2% were <31 years old. Fever was the main clinical presentation (90.2%) while 53.3% presented with weight loss and 72.3% and 39% presented, respectively, with splenomegaly and hepatomegaly. HIV was detected in 4.6% of the patients. RK39 was the main diagnostic test. We found a significant association between the abdominal distention and the age of the patients (P < 0.05) ­ age groups 11­20 and 41­50 years were more likely to present with abdominal distention than other age groups. Conclusion: There is no exact clinical presentation or routine laboratory findings that are pathognomonic for visceral leishmaniasis; therefore, it should be considered in the differential diagnosis of any patient with fever, weight loss, and abdominal distention, and among patients with HIV.

Mastering your fellowship

The series, "Mastering your Fellowship", provides examples of the question format encountered in the FCFP(SA) examination. The series aims to help family medicine registrars and their supervisors prepare for this examination. Model answers are available online

Mastering your Fellowship

The series, "Mastering your Fellowship", provides examples of the question format encountered in the FCFP(SA) examination. The series aims to help family medicine registrars and their supervisors prepare for this examination. Model answers are available online

The prevalence of burnout among registrars in the school of clinical medicine at the University of the Witwatersrand, Johannesburg, South Africa

Background. Burnout is a response to prolonged stress and consists of three elements: emotional exhaustion (EE), depersonalisation (DP), and feelings of personal accomplishment (PA). The existence of burnout in doctors is often not acknowledged but has major consequences for personal and professional life. Only limited research has been done on the prevalence of burnout among registrars in South Africa (SA).Objectives. To describe the prevalence of burnout in a cohort of SA registrars, and assess relationships between burnout and sociodemographic factors.Methods. A cross-sectional descriptive internet survey was conducted. Respondents were registrars in departments of the School of Clinical Medicine at the University of the Witwatersrand, Johannesburg, SA. The Maslach Burnout Inventory (MBI) was used to measure burnout. Relationships were assessed by the independent-samples t-test and analysis of variance.Results. A total of 585 emails were delivered to registrars, of whom 201 started the survey (response rate 34%); 170 questionnaires were analysed. The mean age of the respondents was 33 years, and the male/female ratio was 1:1.8. The mean (standard deviation) score for EE was 3.5 (1.2), for DP 2.7 (1.1) and for PA 4.1 (1.1). The overall level of burnout was 84%. None of the respondents scored low over all categories. No significant association between sociodemographics (age, sex, discipline, year in the programme and experience) and MBI dimensions wasfound.Conclusions. The prevalence of burnout in this study was higher than that reported in the national and international literature. Levels of DP were extremely high and are worrying, as DP affects professionalism and engagement of doctors. In keeping with the literature, no associations were found between sociodemographic factors and burnout, suggesting that the cause of burnout should be sought in the work environment. Efforts to improve autonomy in the workplace, development opportunities and promoting peer collaboration are needed to prevent burnout

Legalising physician-assisted suicide in South Africa: Should it even be considered?

For many years, euthanasia and physician-assisted suicide (PAS) have been topics that no one dared to mention.However, over the past few decades, the subject has emerged as a very pertinent issue around the world, for a number of reasons ­ so much so that these life-ending practices have already been legalised or decriminalised in some developed countries, such as Belgium, the Netherlands and Switzerland,and within certain states of the USA. In the states and countries where the practices have been legalised, or at least decriminalised, the effects of the legalisation have been relatively well documented. On the other hand, in countries like South Africa (SA), where they are illegal,whether or not they should be legalised (taking into consideration all the associated benefits and consequences) should be discussed, and a consensus reached, sooner rather than later. A consensus regarding the feasibility of legalising euthanasia and/or PAS in SA is needed because these practices (or mere requests for them) are becoming increasingly common, especially among people with terminal illnesses.Furthermore, the relative ease with which patients who desperately seek to end their life through either of the aforementioned methods, and are able to access them ­ by applying for them in countries where the pertinent laws and regulations are adjudged to be more liberal ­ is alarming. This highlights the importance and need for each country to set clear laws or parameters (and regulations, where applicable) that relate to these life-ending practices

Professional library services in federal neuropsychiatric hospital, YABA Lagos

This paper is a review of professional library services in Federal Neuropsychiatric Hospital, Yaba. The paper noted that the important role of Medical Librarians in facilitate access to the medical literature for health professionals and students. Data from the library statistics show there is increase in patronage from 4040 library visits in 2011 to 6395 in 2015. Students use the library most. Hospital staff and researchers also use the library. Information services performed in library include current awareness services, Strategic dissemination of information. It was recommended that availability and utilization of ICT or e- library in library should be a priority. Adequate funding, infrastructures development and provision of uninterrupted electricity for conducive learning environment were highly recommended.

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