scholarly journals Assessment of cold chain and logistics management practices: a cross sectional study in Bundelkhand region of Madhya Pradesh

Author(s):  
Ram K. Panika ◽  
Amarnath Gupta

Background: Immunization is one of the most effective disease prevention strategies. Potency of vaccine is dependent on effective management of cold chain system at all levels of vaccine handling. This study was carried out to assess the status of cold chain equipment and logistics management practices, Knowledge and practice of CCHs about cold chain equipment and logistics management.Methods: Cross-sectional study was conducted in all functional cold chain points of Damoh district using structured questionnaires provided by UNICEF.Results: Only 57.14% and 71% CCPs had dedicated space for dry storage and for conditioning of ice packs respectably. 50% CCPs had correct placement of ice-packs inside DFs. Functional thermometer inside every equipment was available in 86% CCPs. Twice daily temperature recording and temperature of ILRs was within normal range in 93% CCPs. Record of power failures and defrosting/cleaning in temperature log books was found in 57% and 43% CCPs. Temp log book was countersigned by facility in charge in 43% CCPs. UIP vaccines were stored within basket in 93%. Fractional IPV was stock out in 29% CCPs and in 07% CCPs OPV vials were found with not usable VVM. 86%, 72% and 64% of CCHs had knowledge on freeze/temperature sensitive vaccines, cold chain pray and, Shake test. In 79% CCPs expired/wasted vaccines were not documented in stock.Conclusions: Most of the components of cold chain and logistics management practices were satisfactory while there is a gap in other components which needs to be improved. 

2013 ◽  
Vol 142 (2) ◽  
pp. 314-326 ◽  
Author(s):  
S. KANUNGO ◽  
T. MAHAPATRA ◽  
B. BHADURI ◽  
S. MAHAPATRA ◽  
N. D. CHAKRABORTY ◽  
...  

SUMMARYDiarrhoeal management practices are unsatisfactory in India especially in the slum areas. Dearth of information regarding physicians' diarrhoea-related knowledge and practice in India ncessitated this cross-sectional study of allopathic practitioners in the slums of Kolkata, to assess the distribution and interrelationship between physicians' characteristics, knowledge and practice regarding diarrhoea. A total of 264 randomly selected consenting practitioners were interviewed using a field-tested questionnaire. Nineteen percent had good overall knowledge, 49% and 80% prescribed antibiotics to diarrhoea and cholera patients, respectively, and 55% advised stool examination for every case. Qualified and Government physicians had better knowledge regarding diarrhoea [MBBS: odds ratio (OR) 5·96, P < 0·001; postgraduates: OR 9·33, P < 0·001; Government physicians: OR 11·49, P < 0·0001] and were less likely to prescribe antibiotics for all diarrhoea cases (MBBS: OR 0·30, P = 0·002; postgraduates: OR 0·20, P < 0·001; Government physicians OR 0·24, P < 0·029). Better knowledge was associated with a lower likelihood of prescribing antibiotics for diarrhoea (OR 0·72, P < 0·001), cholera (OR 0·78, P = 0·027) and investigative procedure (OR 0·85, P = 0·028). In the slums of Kolkata, diarrhoea-related knowledge and practice were poor with the exception of qualified physicians, hence an improvement in the knowledge of pharmacists and unqualified practitioners is necessary for the overall improvement of diarrhoeal management in these slums.


Author(s):  
Ashish Kumar Sinha ◽  
A. R. Verma ◽  
Aditi Chandrakar ◽  
Shanta P. Khes ◽  
Prem Sagar Panda ◽  
...  

Background: Immunization is the effective method of preventing childhood diseases. One of the important elements for improving the immunization is cold chain and vaccine logistics management which are the left and right hands of immunization programme. Keeping this in mind, the present study was done with the objectives a) to ascertain the status of cold chain equipment and logistics management using GOI monitoring format and b) to ascertain the awareness and practice of cold chain handlers about cold chain equipment and logistics management in Durg district of Chhattisgarh, India.Methods: A cross sectional study was conducted among randomly selected 20 cold chain points (CCPs) of Durg district using standard GOI structured questionnaires.Results: Out of 20 cold chain points (CCPs), 20% CCPs, vaccine were found in frozen state. Functional thermometer was available in 75% CCPs, out of which 65% had temperature in the recommended range. Twice daily recording of temperature was found only in 95 % CCPs. Record of power failures and defrosting was noted in temperature log books in 70% CCPs. The correct placement of ice packs inside Deep freezer was observed in only one CCPs. T-series vaccine vials were placed properly in ILR in 85% CCPs. With respect to knowledge on freeze sensitive vaccine and shake test, 74 % and 53% of cold chain handlers had correct knowledge.Conclusions: The quality of immunization programme can be increased by proper maintenance of cold chain and management of vaccine logistics at every designated cold chain points. There is need to improve the knowledge level of CCHs regarding cold chain maintenances and handling practices.


Author(s):  
Ram K. Panika ◽  
Pankaj Prasad ◽  
Sunil Nandeshwar

Background: Vaccination is one of the most effective disease prevention strategies and potency of vaccine is dependent on effective management of cold chain at all levels of vaccine handling. An effective cold chain maintenance system is the backbone of success of any immunization program. This study was done to assess the cold chain management and vaccine storage practices in Tikamgarh district of Madhya Pradesh.Methods: Cross-sectional study was carried out using a structured questionnaire.Results: Dedicated room/space for dry storage not available in any of 03 CHCs. Dedicated table for conditioning of icepacks, dedicated clean clothes for wiping of icepacks after conditioning and power back up was available, ILR and DF were connected to separate functional voltage stabilizer and thermometers were placed correctly only in 66.6% CHCs. ILRs and DFs were properly placed, cabinet temperature of ILR and DFs was maintained in normal range in all the three (100%) CHCs. Record of power failure, records of defrosting/cleaning was maintained in temperature log book and cold chain handlers had knowledge of shake test in only 33.3% CHC.Conclusions: Proper vaccine storage and management of cold chain system is essential for immunization. In order to improve quality of immunization services there is a need of space, temperature monitoring and regular defrosting with record keeping and regular training of cold chain handlers to keep their knowledge and skills updated. Monitoring and supervision of cold chain points by DIO should be on regular basis. 


Author(s):  
Nitin H. Kamble ◽  
Daneshwar Singh ◽  
Harshal G. Mendhe ◽  
Kiran Makade

Background: It has been observed that besides intensification of routine immunization, more strategic interventions are essential to strengthen the different aspects of immunization services like cold-chain management and monitoring/supportive supervision. The present study was considered as a part of ongoing UNICEF funded project on Supportive Supervision of Routine Immunization in Jashpur and Sarguja districts undertaken by the Department of Community Medicine, GMC Rajnandgaon with the objectives to assess the status of cold chain equipment and logistics management practices, knowledge and practice of cold chain handler (CCHs) about cold chain equipment and logistics management.Methods: A cross-sectional facility based study was conducted from August 2017 to February 2018. Among 18 cold chain points (CCPs), 9 from Jashpur and 9 from Sarguja district were considered for analysis using structured questionnaires provided by UNICEF.Results: In 83.33% CCPs cold chain technician or annual maintenance contract/computer-mediated communication service provider visit for preventive maintenance in the last 4 months. Vaccine CCHs carries out the daily and weekly planned preventive measures as per the checklist in 83.33% CCPs during our visit. In all CCPs iced line refrigerator (ILR) and deep freezer (DF) were placed as per specified guidelines. In 66.66% CCPs there was documentation of monthly review of temperature records. In all CCPs visited standard vaccine and logistics stock/issue registers were available.Conclusions: Most of the components of cold chain and logistics management practices were satisfactory while there is a gap in other components which needs to be improved by means of ongoing project of strengthening of SSRI in both districts.


Author(s):  
Eduardo Sánchez-Sánchez ◽  
Ylenia Avellaneda-López ◽  
Esperanza García-Marín ◽  
Guillermo Ramírez-Vargas ◽  
Jara Díaz-Jimenez ◽  
...  

The aim of this study was to determine healthcare providers’ knowledge and practices about dysphagia. A descriptive cross-sectional study was carried out based on a self-administered and anonymous questionnaire addressed to healthcare providers in Spain. A total of 396 healthcare providers participated in the study. Of these, 62.3% knew the definition of dysphagia as a swallowing disorder. In addition, up to 39.2% of the participants reported that they did not know whether the EatingAssessmentTool (EAT-10) dysphagia screening test was usedin their own clinical settings. Similarly, up to 49.1% of them did not know the ClinicalExaminationVolume-Viscosity (MECV-V) method. Nearly all participants (98.8%) reported that thickeners must be used forall liquids administered to patients. A higher percentage of respondents based the choice of texture on patient’s tolerance (78.2%) rather than on the MECV-V result (17.3%). In addition,76.4% of the professionals had witnessed a bronchoaspiration; after it, 44.4% (n = 175) of them reported the appearance of pneumonia, and 14.5% (n = 57) the death of the patient (p = 0.005). The participants revealeda moderate/low knowledge ofthe definition, diagnosis, and clinical management of liquid dysphagia, which indicates some room for improvements.


2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S120-S120
Author(s):  
G O Yeabyo

Abstract Introduction/Objective Cancer is one of a great public health problem in developing countries like Ethiopia and scarcity of histopathology laboratory is another burden for diagnosis and follow up of cancer diseases. The main purpose of this study is to evaluate the accessibility of histopathology services in Ethiopia. Methods Cross sectional study design were used to analyze the status of histopathology services in Ethiopia. Results There are 13 histopathology laboratories in the nation and a survey was conducted at these institutions. Out of these 13 Histopathology services seven are located in the capital, Addis Ababa and six found out of the capital located in four different regions. About 40,239,100 habitants have no histopathology service around their catchment area. Conclusion There are very limited histopathology laboratories, as a result diagnosis and prevention of cancer diseases are inadequate throughout the country.


2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Hanne Klith Jensen ◽  
Flemming Konradsen ◽  
Erik Jørs ◽  
Jørgen Holm Petersen ◽  
Anders Dalsgaard

Organophosphates and carbamates (OPs/CMs) are known for their acetylcholinesterase inhibiting character. A cross-sectional study of pesticide handling practices and self-perceived symptoms of acute pesticide poisoning was conducted using questionnaire-based interviews with 89 pesticide sprayers in Boeung Cheung Ek (BCE) Lake, Phnom Penh, Cambodia. The study showed that 50% of the pesticides used belonged to WHO class I + II and personal protection among the farmers were inadequate. A majority of the farmers (88%) had experienced symptoms of acute pesticide poisoning, and this was significantly associated with the number of hours spent spraying with OPs/CMs (OR = 1.14, CI 95%: 1.02–1.28). The higher educated farmers reduced their risk of poisoning by 55% for each extra personal protective measure they adapted (OR = 0.45, CI 95%: 0.22–0.91). These findings suggest that improving safe pesticide management practices among the farmers and enforcing the effective banning of the most toxic pesticides will considerably reduce the number of acute pesticide poisoning episodes.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Anshul Saxena ◽  
Muni Rubens ◽  
Sankalp Das ◽  
Tanuja Rajan ◽  
Gowtham Grandhi ◽  
...  

Objectives: Extensive data suggests that lesbian, gay and bisexual (LGB) adults are more likely to experience adverse cardiovascular outcomes relative to heterosexuals. However, evidence regarding cardiovascular health (CVH) disparities and sexual orientation is scarce. The aim of this study was to examine the distribution of CVH metrics in a US nationally representative population of heterosexual (HT), and LGB adults. Methods: This cross-sectional study analyzed 2445 participants (representing 115 million) adults aged 18 or over years in the 2011-2012 NHANES survey. The CVH factors of smoking, body mass index (BMI), physical activity (PA), diet, blood pressure (BP), total cholesterol (TC) and glucose (GLU) were measured. Each CVH factor was then classified as ideal; intermediate; or poor. Ideal CVH was defined as presence of >=5 ideal CVH metrics. Results: 95.1% of the weighted sample self-identified as HT (95% CI: 93.5%, 96.6%) compared to 4.9% (95%: 3.3%, 6.5%) LGB. The figure illustrates the distribution of each of the 7 CVH categories according to sexual orientation. In age, gender, and race adjusted analysis, LGB individuals were 36% (AOR: 0.64; 95%: 0.29, 1.4; p > 0.05) less likely to have ideal CVH compared to HT. These proportions go higher after adjusting for age. Conclusions: The results suggest that LGB individuals face a higher risk of being in the category for poor cardiovascular health compared to heterosexuals. Evidence suggests that there are sexual orientation disparities among adults. If confirmed in other studies, results point towards disproportionately higher risk for cardiovascular disease among sexual-minority populations. Figure


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