Assessment of Organizational Measures to Prevent Nosocomial Tuberculosis in Health Facilities of 4 Sub-Saharan Countries in 2010

2013 ◽  
Vol 34 (2) ◽  
pp. 190-194 ◽  
Author(s):  
Jérôme Robert ◽  
Dissou Affolabi ◽  
Fantché Awokou ◽  
Désiré Nolna ◽  
Bilé Adou Philippe Manouan ◽  
...  
Keyword(s):  
Local Level ◽  
Multidrug Resistant ◽  
University Hospitals ◽  
African Countries ◽  
Control Plan ◽  
Healthcare Facilities ◽  
Staff Members ◽  
Healthcare Settings ◽  
Previously Treated ◽  
Sub Saharan

Background.The prevention of tuberculosis (TB) transmission in healthcare settings is a major issue, particularly because of the interaction between human immunodeficiency virus and TB and the emergence of multidrug-resistant TB.Setting.Healthcare facilities involved in TB management in 4 African countries (Benin, Cameroon, Cote d'Ivoire, and Togo).Methods.A questionnaire was developed by representatives of the 4 countries to evaluate the organizational measures implemented in facilities involved in TB management. On-site visits were performed between July 2010 and July 2011.Results.A total of 115 facilities, including 10 university hospitals and 92 basic management units, were visited. None had a TB infection control plan, and only 5.2% provided education for staff about nosocomial TB. Overall, 48.3% of the facilities performed triage of suspected TB cases on hospital arrival or admission, 89.6% provided education for TB cases on cough etiquette, 20.0% segregated smear-positive TB cases, and 15.7% segregated previously treated cases. A total of 15.5% of the facilities registered TB among staff, for a global prevalence rate of 348 cases per 100,000 staff members.Conclusion.This survey identified simple and mostly costless administrative measures to be urgently implemented at the local level to prevent nosocomial TB, such as staff education, triage on admission, and segregation of previously treated patients.

scholarly journals Bacteremia Among Febrile Patients Attending Selected Healthcare Facilities in Ibadan, Nigeria

2019 ◽  
Vol 69 (Supplement_6) ◽  
pp. S466-S473 ◽  
Author(s):  
Oluwafemi Popoola ◽  
Aderemi Kehinde ◽  
Veronica Ogunleye ◽  
Oluwafemi J Adewusi ◽  
Trevor Toy ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Bacterial Infections ◽  
Common Species ◽  
Epidemiological Studies ◽  
Multidrug Resistant ◽  
African Countries ◽  
Healthcare Facilities ◽  
Relative Contribution ◽  
Polymerase Chain ◽  
Ibadan Nigeria

Abstract Background The relative contribution of bacterial infections to febrile disease is poorly understood in many African countries due to diagnostic limitations. This study screened pediatric and adult patients attending 4 healthcare facilities in Ibadan, Nigeria, for bacteremia and malaria parasitemia. Methods Febrile patients underwent clinical diagnosis, malaria parasite testing, and blood culture. Bacteria from positive blood cultures were isolated and speciated using biochemical and serological methods, and Salmonella subtyping was performed by polymerase chain reaction. Antimicrobial susceptibility was tested by disk diffusion. Results A total of 682 patients were recruited between 16 June and 16 October 2017; 467 (68.5%) were <18 years of age. Bacterial pathogens were cultured from the blood of 117 (17.2%) patients, with Staphylococcus aureus (69 [59.0%]) and Salmonella enterica (34 [29.1%]) being the most common species recovered. Twenty-seven (79.4%) of the Salmonella isolates were serovar Typhi and the other 7 belonged to nontyphoidal Salmonella serovarieties. Thirty-four individuals were found to be coinfected with Plasmodium falciparum and bacteria. Five (14.7%) of these coinfections were with Salmonella, all in children aged <5 years. Antimicrobial susceptibility testing revealed that most of the Salmonella and Staphylococcus isolates were multidrug resistant. Conclusions The study demonstrates that bacteria were commonly recovered from febrile patients with or without malaria in this location. Focused and extended epidemiological studies are needed for the introduction of typhoid conjugate vaccines that have the potential to prevent a major cause of severe community-acquired febrile diseases in our locality.

Determinants of Implementation of Isolation Precautions Against Infections by Multidrug-Resistant Microorganisms: A Hospital-Based, Multicenter, Observational Study

2017 ◽  
Vol 38 (10) ◽  
pp. 1188-1195
Author(s):  
Thomas Bénet ◽  
Raphaele Girard ◽  
Solweig Gerbier-Colomban ◽  
Cédric Dananché ◽  
Elisabeth Hodille ◽  
...  
Keyword(s):  
Clinical Sample ◽  
Generation Cephalosporin ◽  
Multidrug Resistant ◽  
University Hospitals ◽  
Medical Prescription ◽  
Multicenter Observational Study ◽  
Factors Associated ◽  
Healthcare Settings ◽  
Microbiological Laboratory ◽  
Main Factor

OBJECTIVESWe aimed to ascertain the factors associated with lack of isolation precautions (IP) in patients infected or colonized by third-generation cephalosporin-resistant Enterobacteriaceae (3GCR-E) and methicillin-resistant Staphylococcus aureus (MRSA) in hospital settings.DESIGNProspective surveillance and audit of practices.SETTINGThe study included 4 university hospitals in Lyon, France.PARTICIPANTSAll patients hospitalized between April and June in 2013 and 2015 were included. Case patients had ≥1 clinical sample positive for MRSA and/or 3GCR-E.METHODSFactors associated with the lack of IP implementation were identified using multivariate logistic regression. The incidence of MDRO infections was expressed per 10,000 patient days.RESULTSOverall, 57,222 patients accounting for 192,234 patient days of hospitalization were included, and 635 (1.1%) MDRO cases were identified. MRSA incidence was 2.5 per 10,000 patient days (95% confidence interval [95% CI], 2.1–3.0) and 3GCR-E incidence was 10.1 per 10,000 patient days (95% CI, 9.2–11.0), with no crude difference between 2013 and 2015 (P=.15 and P=.11, respectively). Among 3GCR-E, the main species were Escherichia coli (43.8%) and Klebsiella pneumoniae (31.0%). Isolation precautions were implemented in 78.5% of cases. Lack of IP implementation was independently associated with patient age, year, specialty, hospital, colonization compared with infection, and lack of medical prescription for IPs (adjusted odds ratio, 17.4; 95% CI, 8.5–35.8; P<.001).CONCLUSIONSMRSA and 3GCR-E infections and/or colonizations are frequent in healthcare settings, and IPs are implemented in most cases. When IPs are lacking, the main factor is the absence of medical prescription for IPs, underscoring the need for alerts to physicians by the microbiological laboratory and/or the infection control team.Infect Control Hosp Epidemiol 2017;38:1188–1195

scholarly journals Fertile Ground for Conflict

2019 ◽  
Author(s):  
Nicolas Berman ◽  
Mathieu Couttenier ◽  
Raphael Soubeyran
Keyword(s):  
Civil Wars ◽  
Local Level ◽  
Soil Productivity ◽  
African Countries ◽  
Civil Conflicts ◽  
Fertile Ground ◽  
Sub Saharan ◽  
Using Data ◽  
Combine Information ◽  
Input Prices

Abstract We investigate how variations in soil productivity affect civil conflicts. We first present a model with heterogeneous land in which variations in input prices (fertilizers) affect appropriable rents and the opportunity costs of fighting. The theory predicts that spikes in input prices increase the likelihood of conflicts through their effect on income and inequality, and that this effect is magnified when soil fertility is naturally more heterogeneous. We test these predictions using data on conflict events covering all Sub-Saharan African countries at a spatial resolution of 0.5 $\times$ 0.5 degree latitude and longitude over the 1997–2013 period. We combine information on soil characteristics and worldwide variations in fertilizer prices to identify local exogenous changes in input costs. As predicted, variations in soil productivity triggered by variations in fertilizer prices are positively associated with conflicts, especially in cells where land endowments are more heterogeneous. In addition, we find that the distribution of land fertility both within and across ethnic groups affects violence, and that the effect of between-group heterogeneity in soil quality is magnified in densely populated areas. Overall, our findings imply that inequality in access to fertile areas—an issue largely neglected in the literature dealing with the roots of Sub-Saharan African civil wars—constitutes a serious threat to peace at the local level.

Backstage Staff Communication: The Effects of Different Levels of Visual Exposure to Patients

2019 ◽  
Vol 13 (3) ◽  
pp. 54-69
Author(s):  
Lisa Lim ◽  
Ruth Kanfer ◽  
Robert J. Stroebel ◽  
Craig M. Zimring
Keyword(s):  
Healthcare Professionals ◽  
The Other ◽  
Healthcare Facilities ◽  
Core Group ◽  
Primary Care Clinics ◽  
Staff Members ◽  
Visual Exposure ◽  
Healthcare Settings ◽  
Exposure Levels ◽  
Different Levels

Objective: This article examines how visual exposure to patients predicts patient-related communication among staff members. Background: Communication among healthcare professionals private from patients, or backstage communication, is critical for staff teamwork and patient care. While patients and visitors are a core group of users in healthcare settings, not much attention has been given to how patients’ presence impacts staff communication. Furthermore, many healthcare facilities provide team spaces for improved staff teamwork, but the privacy levels of team areas significantly vary. Method: This article presents an empirical study of four team-based primary care clinics where staff communication and teamwork are important. Visual exposure levels of the clinics were analyzed, and their relationships to staff members’ concerns for having backstage communication, including preferred and nonpreferred locations for backstage communication, were investigated. Results: Staff members in clinics with less visual exposure to patients reported lower concerns about having backstage communication. Staff members preferred talking in team areas that were visually less exposed to patients in the clinic, but, within team areas, the level of visual exposure did not matter. On the other hand, staff members did not prefer talking in visually exposed areas such as corridors in the clinic and visually exposed areas within team spaces. Conclusions: Staff members preferred talking in team areas, and they did not prefer talking in visually exposed areas. These findings identified visually exposed team areas as a potentially uncomfortable environment, with a lack of agreement between staff members’ preferences toward where they had patient-related communication.

scholarly journals Gastrointestinal endoscopy capacity in Eastern Africa

2021 ◽  
Vol 09 (11) ◽  
pp. E1827-E1836
Author(s):  
Michael Mwachiro ◽  
Hillary M. Topazian ◽  
Violet Kayamba ◽  
Gift Mulima ◽  
Elly Ogutu ◽  
...  
Keyword(s):  
Online Survey ◽  
Healthcare Professionals ◽  
Gastrointestinal Disease ◽  
Sub Saharan Africa ◽  
Eastern Africa ◽  
Therapeutic Modality ◽  
African Countries ◽  
Healthcare Facilities ◽  
Material Resources ◽  
Sub Saharan

Abstract Background and study aims Limited evidence suggests that endoscopy capacity in sub-Saharan Africa is insufficient to meet the levels of gastrointestinal disease. We aimed to quantify the human and material resources for endoscopy services in eastern African countries, and to identify barriers to expanding endoscopy capacity. Patients and methods In partnership with national professional societies, digestive healthcare professionals in participating countries were invited to complete an online survey between August 2018 and August 2020. Results Of 344 digestive healthcare professionals in Ethiopia, Kenya, Malawi, and Zambia, 87 (25.3 %) completed the survey, reporting data for 91 healthcare facilities and identifying 20 additional facilities. Most respondents (73.6 %) perform endoscopy and 59.8 % perform at least one therapeutic modality. Facilities have a median of two functioning gastroscopes and one functioning colonoscope each. Overall endoscopy capacity, adjusted for non-response and additional facilities, includes 0.12 endoscopists, 0.12 gastroscopes, and 0.09 colonoscopes per 100,000 population in the participating countries. Adjusted maximum upper gastrointestinal and lower gastrointestinal endoscopic capacity were 106 and 45 procedures per 100,000 persons per year, respectively. These values are 1 % to 10 % of those reported from resource-rich countries. Most respondents identified a lack of endoscopic equipment, lack of trained endoscopists and costs as barriers to provision of endoscopy services. Conclusions Endoscopy capacity is severely limited in eastern sub-Saharan Africa, despite a high burden of gastrointestinal disease. Expanding capacity requires investment in additional human and material resources, and technological innovations that improve the cost and sustainability of endoscopic services.

scholarly journals Tuberculosis infection control measures in healthcare facilities in Moyen-Ogooué Province, Gabon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anja Vigenschow ◽  
Bayodé Romeo Adegbite ◽  
Jean-Ronald Edoa ◽  
Abraham Alabi ◽  
Akim A. Adegnika ◽  
...  
Keyword(s):  
Infection Control ◽  
Health Workers ◽  
Focal Point ◽  
Regional Hospital ◽  
Control Measures ◽  
Control Plan ◽  
Healthcare Facilities ◽  
Healthcare Settings ◽  
Mdr Tb ◽  
Tb Infection Control

Abstract Background Healthcare workers (HCW) are at higher risk of tuberculosis (TB) than the general population. We assessed healthcare facilities for their TB infection control standards and priorities. Methods A standardised tool was applied. The assessment was conducted by direct observation, documents review and interviews with the facility heads. Results Twenty healthcare facilities were assessed; 17 dispensaries, an HIV-clinic, a private not-for-profit hospital and a public regional hospital. In both hospitals, outpatient departments, internal medicine wards, paediatric wards, emergency departments; and the MDR-TB unit of the public regional hospital were assessed. In Gabon, there are currently no national guidelines for TB infection control (TBIC) in healthcare settings. Consequently, none of the facilities had an infection control plan or TBIC focal point. In three departments of two facilities (2/20 facilities), TB patients and presumed TB cases were observed to be consistently provided with surgical masks. One structure reported to regularly test some of its personnel for TB. Consultation rooms were adequately ventilated in six primary care level facilities (6/17 dispensaries) and in none of the hospitals, due to the use of air conditioning. Adequate personal protective equipment was not provided regularly by the facilities and was only found to be supplied in the MDR-TB unit and one of the paediatric wards. Conclusions In Moyen-Ogooué province, implementation of TBIC in healthcare settings is generally low. Consequently, HCW are not sufficiently protected and therefore at risk for M. tuberculosis infection. There is an urgent need for national TBIC guidelines and training of health workers to safeguard implementation.

The implications of traditional authority contest for local-level stability – Evidence from South Africa

2020 ◽  
pp. 073889422095965
Author(s):  
Katariina Mustasilta
Keyword(s):  
South Africa ◽  
Spatial Data ◽  
Qualitative Data ◽  
Local Level ◽  
Theoretical Argument ◽  
Traditional Authority ◽  
African Countries ◽  
Social Unrest ◽  
Sub Saharan ◽  
Traditional Authorities

How do state-recognized traditional authorities (TAs) influence local-level stability? Policies that recognize and give TAs public authority, particularly in many sub-Saharan African countries, have attracted growing scholarly interest in TAs. Drawing empirical evidence from South Africa, I test a proposition that internally contested TA structures contribute to grievances and opportunities that give rise to social unrest. The statistical analysis combines spatial data on municipality-level protests with new data on contested and uncontested TA structures. The results support the theoretical argument. Qualitative data further demonstrate how contested TAs fuel grievances and facilitate mobilization against the local authorities.

scholarly journals Fit-for-Purpose Land Administration from Theory to Practice: Three Demonstrative Case Studies of Local Land Administration Initiatives in Africa

Land ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 476
Author(s):  
Uchendu Eugene Chigbu ◽  
Tobias Bendzko ◽  
Menare Royal Mabakeng ◽  
Elias Danyi Kuusaana ◽  
Derek Osei Tutu
Keyword(s):  
Case Studies ◽  
Local Level ◽  
Critical Factor ◽  
African Countries ◽  
Tenure Security ◽  
Land Administration ◽  
Hands On ◽  
Fit For Purpose ◽  
Sub Saharan ◽  
Core Features

Land is a critical factor of production for improving the living conditions of people everywhere. The search for tools (or approaches or strategies or methods) for ensuring that land challenges are resolved in ways that quickly respond to local realities is what led to the development of the fit-for-purpose land administration. This article provides evidence that the fit-for-purpose land administration—as a land-based instrument for development—represents an unprecedented opportunity to provide tenure security in Africa. The article presents case studies from three sub-Saharan African countries on local-level experiences in the applications of fit-for-purpose guidelines as an enabler for engaging in tenure security generating activities in communities. These case studies, drawn from Ghana, Kenya, and Namibia, are based on hands-on local land administration projects that demonstrate how the features of the fit-for-purpose guideline were adopted. Two of the case studies are based on demonstrative projects directly conducted by the researchers (Ghana and Kenya), while the other (Namibia) is based on their engagement in an institutional project in which the Global Land Tool Network (GLTN) and other local partners were involved. This work is relevant because it paves a path for land administration practitioners to identify the core features necessary for land-based projects.

COVID-19: The Importance of Adequate Personal Protective Equipment in Healthcare Medical Staff

2020 ◽  
Author(s):  
Anne Weissenstein
Keyword(s):  
Health Care ◽  
Personal Protective Equipment ◽  
Health Care Services ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
Emotional Resilience ◽  
Healthcare Facilities ◽  
Care Services ◽  
Healthcare Settings ◽  
And Control

We present an update on infection prevention and control for COVID-19 in healthcare settings. This update focuses on measures to be applied in settings with increasing community transmission, growing demand for concern about COVID-19 patients, and subsequent staffing issues in the event of shortages of personal protective equipment for healthcare facilities worldwide. The comfort and emotional resilience of health care workers are key components in maintaining essential health care services during the COVID-19 virus (coronavirus) outbreak.

Crowdsourcing Covid-19 signals in sub-Saharan Africa: Leveraging digital contributor networks for participatory surveillance of Covid-19 symptoms and deaths (Preprint)

2020 ◽  
Author(s):  
Ngozi A Erondu ◽  
Sagal A Ali ◽  
Mohamed Ali ◽  
Schadrac C Agbla
Keyword(s):  
Public Health ◽  
Sub Saharan Africa ◽  
Specific Information ◽  
Surveillance Systems ◽  
Health Seeking ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Local Networks ◽  
The World ◽  
Sub Saharan

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.

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