Measures for protecting health-care workers from tuberculosis in low-income countries

Background: In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death. We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCWs) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection in urban Malawi. Methods: We recruited 500 otherwise asymptomatic HCWs from Blantyre City (Malawi) from 22nd May 2020 to 19th June 2020 and serum samples were collected from all participants. A commercial ELISA was used to measure SARS-CoV-2 IgG antibodies in serum. Results: A total of 84 participants tested positive for SARS-CoV-2 antibodies. The HCWs with positive SARS-CoV-2 antibody results came from different parts of the city. The adjusted seroprevalence of SARS-CoV-2 antibodies was 12.3% [CI 8.2 - 16.5]. Using age-stratified infection fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence, the number of predicted deaths was eight times the number of reported deaths. Conclusions: The high seroprevalence of SARS-CoV-2 antibodies among HCWs and the discrepancy in the predicted versus reported deaths suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.

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High SARS-CoV-2 seroprevalence in Health Care Workers but relatively low numbers of deaths in urban Malawi

10.1101/2020.07.30.20164970 ◽

2020 ◽

Cited By ~ 8

Author(s):

Marah Grace Chibwana ◽

Khuzwayo Chidiwa Jere ◽

Raphael kamng'ona ◽

Jonathan Mandolo ◽

Vincent Katunga-Phiri ◽

...

Keyword(s):

Public Health ◽

Health Care ◽

Health Care Workers ◽

Low Income ◽

Sub Saharan Africa ◽

Low Income Countries ◽

Serum Samples ◽

Public Health Response ◽

Response Planning ◽

Care Workers

Background: In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death. We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCWs) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection in urban Malawi. Methods: We recruited 500 otherwise asymptomatic HCWs from Blantyre City (Malawi) from 22nd May 2020 to 19th June 2020 and serum samples were collected from all participants. A commercial ELISA was used to measure SARS-CoV-2 IgG antibodies in serum. Results: A total of 84 participants tested positive for SARS-CoV-2 antibodies. The HCWs with positive SARS-CoV-2 antibody results came from different parts of the city. The adjusted seroprevalence of SARS-CoV-2 antibodies was 12.3% [CI 8.2 - 16.5]. Using age-stratified infection fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence, the number of predicted deaths was eight times the number of reported deaths. Conclusions: The high seroprevalence of SARS-CoV-2 antibodies among HCWs and the discrepancy in the predicted versus reported deaths suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.

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Evaluation of a Smartphone-Based Training Strategy Among Health Care Workers Screening for Cervical Cancer in Northern Tanzania: The Kilimanjaro Method

Journal of Global Oncology ◽

10.1200/jgo.2015.001768 ◽

2016 ◽

Vol 2 (6) ◽

pp. 356-364 ◽

Cited By ~ 10

Author(s):

Karen E. Yeates ◽

Jessica Sleeth ◽

Wilma Hopman ◽

Ophira Ginsburg ◽

Katharine Heus ◽

...

Keyword(s):

Health Care ◽

Cervical Cancer ◽

Real Time ◽

Health Care Workers ◽

Low Income ◽

Smartphone Application ◽

Mobile Telephone ◽

Low Income Countries ◽

Care Providers ◽

Care Workers

Purpose Almost nine of 10 deaths resulting from cervical cancer occur in low-income countries. Visual inspection under acetic acid (VIA) is an evidence-based, cost-effective approach to cervical cancer screening (CCS), but challenges to effective implementation include health provider training costs, provider turnover, and skills retention. We hypothesized that a smartphone camera and use of cervical image transfer for real-time mentorship by experts located distantly across a closed user group through a commercially available smartphone application would be both feasible and effective in enhancing VIA skills among CCS providers in Tanzania. Methods We trained five nonphysician providers in semirural Tanzania to perform VIA enhanced by smartphone cervicography with real-time trainee support from regional experts. Deidentified images were sent through a free smartphone application on the available mobile telephone networks. Our primary outcomes were feasibility of using a smartphone camera to perform smartphone-enhanced VIA and level of agreement in diagnosis between the trainee and expert reviewer over time. Results Trainees screened 1,072 eligible women using our methodology. Within 1 month of training, the agreement rate between trainees and expert reviewers was 96.8%. Providers received a response from expert reviewers within 1 to 5 minutes 48.4% of the time, and more than 60% of the time, feedback was provided by regional expert reviewers in less than 10 minutes. Conclusion Our method was found to be feasible and effective in increasing health care workers’ skills and accuracy. This method holds promise for improved quality of VIA-based CCS programs among health care providers in low-income countries.

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High incidence of occupationnal blood exposures (OBE) in the health care workers sector of low income countries, using the example of bangui, central African Republic (CAR)

Retrovirology ◽

10.1186/1742-4690-9-s1-p115 ◽

2012 ◽

Vol 9 (S1) ◽

Author(s):

HD Mossoro-Kpinde ◽

CD Mossor-Kpinde ◽

E Gbangba-Ngai ◽

CG Kamalo

Keyword(s):

Health Care ◽

Health Care Workers ◽

Low Income ◽

Central African Republic ◽

Low Income Countries ◽

Care Workers ◽

High Incidence

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High SARS-CoV-2 seroprevalence in health care workers but relatively low numbers of deaths in urban Malawi

Wellcome Open Research ◽

10.12688/wellcomeopenres.16188.1 ◽

2020 ◽

Vol 5 ◽

pp. 199 ◽

Cited By ~ 4

Author(s):

Marah G. Chibwana ◽

Khuzwayo C. Jere ◽

Raphael Kamng'ona ◽

Jonathan Mandolo ◽

Vincent Katunga-Phiri ◽

...

Keyword(s):

Public Health ◽

Health Care ◽

Health Care Workers ◽

Low Income ◽

Sub Saharan Africa ◽

Low Income Countries ◽

Serum Samples ◽

Public Health Response ◽

Response Planning ◽

Care Workers

Background: In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death. We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCWs) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection in urban Malawi. Methods: We recruited 500 otherwise asymptomatic HCWs from Blantyre City (Malawi) from 22nd May 2020 to 19th June 2020 and serum samples were collected from all participants. A commercial ELISA was used to measure SARS-CoV-2 IgG antibodies in serum. Results: A total of 84 participants tested positive for SARS-CoV-2 antibodies. The HCWs with positive SARS-CoV-2 antibody results came from different parts of the city. The adjusted seroprevalence of SARS-CoV-2 antibodies was 12.3% [CI 8.2 - 16.5]. Using age-stratified infection fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence, the number of predicted deaths was eight times the number of reported deaths. Conclusions: The high seroprevalence of SARS-CoV-2 antibodies among HCWs and the discrepancy in the predicted versus reported deaths suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.

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Mobile Phone Tools for Field-Based Health care Workers in Low-Income Countries

Mount Sinai Journal of Medicine A Journal of Translational and Personalized Medicine ◽

10.1002/msj.20256 ◽

2011 ◽

Vol 78 (3) ◽

pp. 406-418 ◽

Cited By ~ 64

Author(s):

Brian DeRenzi ◽

Gaetano Borriello ◽

Jonathan Jackson ◽

Vikram S. Kumar ◽

Tapan S. Parikh ◽

...

Keyword(s):

Health Care ◽

Mobile Phone ◽

Health Care Workers ◽

Low Income ◽

Low Income Countries ◽

Care Workers

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Task-shifted interventions for depression delivered by lay primary health-care workers in low-income and middle-income countries

The Lancet Global Health ◽

10.1016/s2214-109x(19)30197-4 ◽

2019 ◽

Vol 7 (7) ◽

pp. e829-e830 ◽

Cited By ~ 1

Author(s):

Bolanle Adeyemi Ola ◽

Olayinka Atilola

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Care Workers ◽

Low Income ◽

Middle Income ◽

Middle Income Countries ◽

Primary Health ◽

Care Workers

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Health care workers’ experiences of managing foetal distress and birth asphyxia at health facilities in Northern Uganda

Reproductive Health ◽

10.1186/s12978-021-01083-1 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Elizabeth Ayebare ◽

Grace Ndeezi ◽

Anna Hjelmstedt ◽

Jolly Nankunda ◽

James K. Tumwine ◽

...

Keyword(s):

Health Care ◽

Health Care Workers ◽

Low Income ◽

Birth Asphyxia ◽

Structured Interview ◽

Health Facilities ◽

Northern Uganda ◽

Foetal Distress ◽

Care Workers ◽

Intrapartum Stillbirth

Abstract Background Birth asphyxia is one of the leading causes of intrapartum stillbirth and neonatal mortality worldwide. We sought to explore the experiences of health care workers in managing foetal distress and birth asphyxia to gain an understanding of the challenges in a low-income setting. Methods We conducted in-depth interviews with 12 midwives and 4 doctors working in maternity units from different health facilities in Northern Uganda in 2018. We used a semi-structured interview guide which included questions related to; health care workers’ experiences of maternity care, care for foetal distress and birth asphyxia, views on possible preventive actions and perspectives of the community. Audio recorded interviews were transcribed verbatim and analysed using inductive content analysis. Results Four categories emerged: (i) Understanding of and actions for foetal distress and birth asphyxia including knowledge, misconception and interventions; (ii) Challenges of managing foetal distress and birth asphyxia such as complexities of the referral system, refusal of referral, lack of equipment, and human resource problems, (iii) Expectations and blame from the community, and finally (iv) Health care worker’ insights into prevention of foetal distress and birth asphyxia. Conclusion Health care workers described management of foetal distress and birth asphyxia as complex and challenging. Thus, guidelines to manage foetal distress and birth asphyxia that are specifically tailored to the different levels of health facilities to ensure high quality of care and reduction of need for referral are called for. Innovative ways to operationalise transportation for referral and community dialogues could lead to improved birth experiences and outcomes.

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Health Care Workers’ Experiences of Managing Foetal Distress and Birth Asphyxia at Health Facilities in Northern Uganda

10.21203/rs.3.rs-100954/v1 ◽

2020 ◽

Author(s):

Elizabeth Ayebare ◽

Grace Ndeezi ◽

Anna Hjelmstedt ◽

Jolly Nakunda ◽

James K. Tumwine ◽

...

Keyword(s):

Health Care ◽

Health Care Workers ◽

Low Income ◽

Birth Asphyxia ◽

Structured Interview ◽

Health Facilities ◽

Northern Uganda ◽

Foetal Distress ◽

Care Workers ◽

Intrapartum Stillbirth

Abstract BackgroundBirth asphyxia is one of the leading causes of intrapartum stillbirth and neonatal mortality worldwide. We sought to explore the experiences of health care workers in managing foetal distress and birth asphyxia to gain an understanding of the challenges in a low-income setting.MethodsWe conducted in-depth interviews with 12 midwives and four doctors working in maternity units from different health facilities in Northern Uganda in 2018. We used a semi-structured interview guide which included questions related to; health care workers’ experiences of maternity care, care for foetal distress and birth asphyxia, views on possible preventive actions and perspectives of the community. Audio recorded interviews were transcribed verbatim and analysed using inductive content analysis. ResultsFour categories emerged: i) understanding of and actions for foetal distress and birth asphyxia including knowledge, misconception and interventions; ii) Challenges of managing foetal distress and birth asphyxia such as complexities of the referral system, refusal of referral, lack of equipment, and human resource problems, iii) Expectations and blame from the community, and finally iv) Health care worker’ insights into prevention of foetal distress and birth asphyxia. ConclusionHealth care workers described management of foetal distress and birth asphyxia as complex and challenging. Thus, guidelines to manage foetal distress and birth asphyxia that are specifically tailored to the different levels of health facilities to ensure high quality of care and reduction of need for referral are called for. Innovative ways to operationalise transportation for referral and community dialogues could lead to improved birth experiences and outcomes.

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