Nosocomial infections in neonatal intensive care unit in pediatric Assiut University Hospital: incidence and risk factors

Nosocomial infections [Nis] have become a matter of major concern in neonatal intensive care units [NICUs]. Nosocomial infections are the result of the interaction of several risk factors. To identify risk factors for nosocomial infections among neonates admitted to neonatal intensive care unit in Pediatric Assiut University Hospital [AUH]. Knowledge of modifiable risk factors could be used to guide the design of interventions to prevent the problem. Incidence [surveillance] study for identification of new nosocomial infections for one year and 9 days from [17 of April 2007 to 26 of April 2008]. The total population: All neonates attending NICU in pediatric AUH from the Obstetric Department of Maternal-Healthcare Assiut University Hospital. The target population is all neonates that developed nosocomial infections within 72 hrs of admission. The presence of risk factors was studied. A practical guide completed for each patient, which included: Demographic risk factors as age, birth weight, sex, single or multiple births, type of delivery, premature rupture of membranes, variables recorded daily as enteral feeding, parentral feeding, mechanical ventilation and indwelling catheter. Differences between patients with and without NI for discrete variables were estimated by the chi-square test. The association between risk factors and the presence of NIs were estimated by relative risk. From a total of 990 admitted neonates, the incidence rate and the incidence density rate were 16% and 24.45% infections per 1000 patient-days, respectively. Case fatality rate was 91.8%. The following risk factors were associated with Nis [P<0.05]: mechanical ventilation, umbilical catheter, prematurity, birth weight less than 1500 g, use of ryle, transport outside NICU, premature rupture of membrane and peripheral vascular catheter. The risk of NIs increases with increasing invasive devices, decreasing birth weight, and gestational age. There is an increased mortality rate associated with NI. Strategies to minimize the impact of risk factors must be identified

Knowledge and practices of dentists and nurses about cross-infection control measures in dental clinics in Assiut city

The aim of this study was to assess the knowledge and practice of dentists and nurses toward cross-infection control measures in dental clinics at Assiut City. All dentists and nurses working in the 28 clinics were included in the study. They included 52 dentists, and 51 nurses working in dentist clinic. Data collection tools was Structured self-administered questionnaire. The questionnaire consisted of three parts. The first part was concerned with socio-demographic and job information. The second part was for assessment of subjects' knowledge about cross-infection control measures in dental clinics. The third part included subjects' exposure to occupational hazards in the last year. An observation checklist to assess actual practices of subjects in their workplaces, data was collected in the period from the first of June 2006 until the end of November 2006. The study has shown that slightly less than half of the dentists were less than 30 years old [48.1%], slightly less than half of the nurses were 40 years old or more [49.0%]. About two thirds of the dentists [65.4%] were males, while the majority of the nurses [92.2%] were females. Similarly, less than two thirds of the dentists [59.6%] were married, compared to 92.2% of the nurses. As regards work experience, the mean years of experience of the dentists were slightly higher than those of the nurses, 9.3 +/- 7.7 years and 7.4 +/- 4.4 years. Less than half of the dentists [44.2%] and the nurses [45.1%] had attended conferences or educational training courses about infection control during last year. Most of dentists [82.7%] and nurses [72.5%] had satisfactory knowledge. Conversely, the majority of dentists and nurses had poor practice [84.6% and 86.3%] respectively. The study revealed no statistically significant differences were revealed between dentists and nurses in either knowledge or practice It is concluded that although dentists and nurses in dental clinics in Assiut city possess good knowledge about cross-infection and their control measures in these settings, their practice was mostly inadequate. It is recommended that continuing education to dental health care workers be mandatory and include a specific practical component on cross-infection control in dental practices. Enforcement of strict cross-infection control measures practices must be implemented, with provision of needed supplies and equipment. Additionally, every dental clinic must have a written infection control policy, and an active infection control team

Health advice seeking behavior during childhood diarrhoea in a semi-urban area in Assiut

To describe the pattern and determinants of health services utilization in case of childhood diarrhea. A cohort of 257 infants, aged 0-9 months was selected from a semi-urban area in Assiut, Egypt, followed up for 12 months from October 1999 to October 2000. Diarrhoeal morbidity data was collected biweekly. Initially a baseline household survey was conducted to collect baseline data on the sociodemographic background of the family and the household environment. When diarrhoea was reported in a child, the mother was asked a standard series of questions on her child's stool frequency, consistency associated symptoms, perception of severity of the attack, her behavior toward her child ot home, the use of health care services, type of provider used and perception of quality of care. Utilization of health services was categorized into outpatient visits; emergency care visits, and hospital admissions. In 53.1% of diarrhoeal episodes mothers sought a health care provider outside the house; mainly from outpatient clinics [87.5%]. Emergency services were used in 7.1% of the episodes and hospital admission occurred in 5.4%. Multivariate analysis revealed that mothers' perception of severity of their children's diarrhoeal episodes held the major determinant for utilization of health services [OR=13.09, P=0.000]. Other determinants of using health services during diarrhoea included factors related to episode characteristics as presence of vomiting [OR=3.1. P=0.000] or fever [OR=2.63, P=0.000] and using of self-prescribing drugs [OR=0.224, P=0.000] for treatment of the episode at home. Mothers also sought medical care for younger infants than older ones [OR=2.42, P=0.001]. No association between utilization of health services and socioeconomic factors was found. Health services utilization in case of childhood diarrhoea interact with multiple factors, but mothers' perception of their children's health status during diarrhoea held the major influence on the utilization of health services. Furthermore, public health services were the most frequent type of services utilized for treatment of diarrhoea