An Evaluation of Childhood Tuberculosis Program in Chegutu District, Zimbabwe, 2020: A Descriptive Cross-Sectional Study

Abstract Background Childhood tuberculosis (TB) is a major global public health concern contributing to significant child morbidity and mortality. A records review of the TB notification for Chegutu District Health Information System 2 (DHIS2) showed a low childhood TB case detection rate. For 2018 and 2019, childhood TB notifications were 4% and 7% respectively against the national 12% case detection rate. We evaluated the performance of the childhood TB program in Chegutu. Methods We conducted a descriptive cross-sectional study. Sixty-six health workers (HW) participated in the study. Interviewer-administered questionnaires and checklists were used to collect data on reasons for low TB case detection, HW childhood TB knowledge, program inputs, processes and outputs. Strengths, Weaknesses, Opportunities and Threats analysis was used to assess the childhood TB processes. We analyzed the data using Epi Info 7TM to generate frequencies, proportions and means. A Likert scale was used to assess health worker knowledge. Results The majority 51/66(77%) of HW were nurses and 51/66(67%) of respondents were females. Reasons for the low childhood TB case detection were lack of HW confidence in collecting gastric aspirates 55/66(83%) and HW’s negative attitudes towards gastric aspirate collection 23/66(35%). HW 24/66 (37%) had a fair childhood TB notification knowledge. The district had only one functional X-ray machine for 34 health facilities. Only 6/18 motorcycles were functional with inadequate fuel supply. No desk guide for the management of TB in children for HW (2018) was available in 34 health facilities. Ethambutol 400mg was out of stock and adult 800mg tablets were used. Funds allocated for motor vehicle and motorcycles service ($1612USD/year) were inadequate. The district failed to perform planned quarterly TB review meetings, contact tracing and childhood TB training due to funding and COVID-19 lockdown restrictions. Conclusion The childhood TB program failed to meet its targets due to inadequate inputs and suboptimal HW childhood TB knowledge. Case detection and notification can be improved through on-job training, mentorship, support and supervision and adequate resources.

Download Full-text

Delay of TB patients in diagnosis in a conflict setting of Mogadishu, Somalia - a cross-sectional study

10.1101/2021.11.24.21266678 ◽

2021 ◽

Author(s):

Naima Said Sheikh ◽

Abdiwahab Moallim Salad ◽

Abdi Gele

Keyword(s):

Detection Rate ◽

Local Community ◽

Health Workers ◽

Cross Sectional Study ◽

Case Detection ◽

Sectional Study ◽

Total Delay ◽

Cross Sectional ◽

Case Detection Rate ◽

Poor Knowledge

BBackground. The TB case detection rate in Somalia is 42%, which is much lower than the WHO target of detecting 70% of new TB cases. Understanding the factors contributing to the delay of TB patients in the diagnosis, and reducing the time between the onset of TB symptoms to diagnosis, is a prerequisite to increase the case detection rate and to ultimately bring the TB epidemic in Somalia under control. The aim of this study is to examine the duration of delay, and factors associated with the delay among patients in TB management centers in Mogadishu, Somalia. Methods. An institution-based, cross-sectional study was conducted in TB management clinics providing directly observed treatments (DOTS) programs in Mogadishu. A total of 276 patients were interviewed using a structured questionnaire from June-October 2018. We analyzed data using descriptive statistics and different logistic regression models. Results. Approximately 78% of study participants were male. Nearly a third (36.5%) came from a household of nine individuals or more, while 73% were unemployed. The median patient and provider delays were 50 days and one day, respectively. The median total delay was 55 days, with an inter-quartile range of 119 days. Patients who had a poor knowledge of the symptoms of TB had 3.16 times higher odds of delay over 50 days than their counterparts. Furthermore, a poor knowledge of the symptoms of TB (aOR 4.22, CI 2.13-8.40), not making ones own decisions in seeking TB treatment (aOR 2.43, CI 1.22-4.86) and a poor understanding of the fact that TB can be treated with biomedical treatment, as opposed to traditional treatment (aOR 2.07, CI 1.02-4.16), were predictors of a patient delay over 120 days. Conclusions. The duration in the delay of TB patients under diagnosis in Mogadishu is one of the highest reported in developing countries, exceeding two years in some patients. Training local community health workers to detect suspected TB cases, and referring the cases of prolonged cough over three weeks for TB care centers for diagnosis, is imperative to help break the transmission and reduce the infectious pool in the population of Mogadishu. This may not only increase the community awareness of TB disease, but it may also facilitate the early referral of TB patients to diagnostic and treatment care centers.

Download Full-text

Diagnostic performance of GeneXpert in tuberculosis–HIV co–infected patients at Asella Teaching and Referral Hospital, Southeastern Ethiopia: A cross sectional study

PLoS ONE ◽

10.1371/journal.pone.0242205 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0242205

Author(s):

Abebe Sorsa ◽

Muhammedawel Kaso

Keyword(s):

Detection Rate ◽

Diagnostic Performance ◽

Screening Tool ◽

Cross Sectional Study ◽

Smear Microscopy ◽

People Living With Hiv ◽

Case Detection ◽

Sectional Study ◽

Cross Sectional ◽

Case Detection Rate

Background GeneXpert is a new introduction in the diagnostic modality to fight tuberculosis (TB) among people living with HIV (PLHIV) under the program of intensified TB case finding. This study aimed to evaluate the diagnostic performance of GeneXpert under the program of intensified TB cases finding among PLHIV. Methods Cross-sectional study was conducted by recruiting individuals attending an HIV clinic from February 2018 to January 2019. Data on clinical parameters were collected using a standardized tool. Two-morning sputum samples were collected and processed for smear microscopy and GeneXpert. SPSS 21 used for data analysis. Proportion, percentage, and mean with SD were used to describe variables. Univariate and multivariable logistic regressions were used to assess factors associated with the GeneXpert. Values for which the 95% CI interval not includes 1 and for which P<0.05 were considered significant. Result A total of 384 presumptive TB-HIV co-infection cases were included, of which 166 (43%) were diagnosed to have TB. Fifty-four (32.5%) TB cases were smear AFB positive while 79 (47.7%) TB cases were GeneXpert positive. The GeneXpert detection rate was almost two-fold of that of smear microscopy and all smear positive TB cases were detected by GeneXpert. Moreover, GeneXpert was able to detect an additional third of TB confirmed cases among smear AFB negative cases. Advanced stage of the disease, high viral load and presence of anemia were significantly associated with TB. The WHO TB screening tool remained least sensitive with the lowest positive predictive value. Conclusion GeneXpert demonstrated two-fold case detection rate compared to the sputum smear microscopy and additional third TB case detection rate among smear AFB negative cases. Clinical screening tool for evaluation of TB-HIV co-infection showed poor performance in TB case notification.

Download Full-text

Knowledge, Attitude, and Practices Regarding Childhood Tuberculosis Detection and Management Among Health Care Providers in Cambodia: A Cross-Sectional Study

10.21203/rs.3.rs-1052066/v1 ◽

2021 ◽

Author(s):

Yom An ◽

Alvin Kuo Jing Teo ◽

Chan Yuda Huot ◽

Sivanna Tieng ◽

Kim Eam Khun ◽

...

Keyword(s):

Healthcare Providers ◽

Cross Sectional Study ◽

Health Centers ◽

World Health ◽

Case Detection ◽

Care Providers ◽

Sectional Study ◽

Cross Sectional ◽

Attitudes And Practices ◽

Childhood Tb

Abstract Background The World Health Organization (WHO) estimated that 29% of global tuberculosis (TB) and almost 47% of childhood TB cases were not reported to national TB programs in 2019. In Cambodia, most childhood TB cases were reported from health facilities supported by the Global Fund to Fight AIDS, Tuberculosis, and Malaria in 2019. This study aimed to compare the healthcare providers' KAP on childhood TB case detection in ODs with high and low childhood TB case detection in Cambodia. Methods We conducted a cross-sectional study between November and December 2020 among healthcare providers in 10 purposively selected operational districts (ODs) with high childhood TB case detection and 10 ODs with low childhood TB case detection. A total of 110 healthcare providers from referral hospitals and 220 from health centers were interviewed. We collected information on socio-demographic characteristics, training, and KAP on childhood TB. Pearson's Chi-square or Fisher's exact and Student's t-tests were performed to explore the differences in KAP of healthcare providers from ODs with low vs. high childhood TB detection. Results Of the 330 respondents, 193 were from ODs with high childhood TB case detection, and 66.67% were from health centers. A significantly higher proportion (46.11%) of respondents from ODs with high childhood TB case detection received training on childhood TB within the past two years than those from low childhood TB case detection ODs (34.31%) (p=0.03). Key knowledge on childhood TB was not significantly different among respondents from ODs with high and low childhood TB case detection. A significantly higher proportion of respondents from ODs with high childhood TB case detection had a good attitude (98.96% v.s. 97.08%, p=0.002) and performed good practices (58.55% v.s. 45.26%, p=0.02) on contact investigation in the community than those from low childhood TB case detection ODs. Conclusions Healthcare providers from ODs with high childhood TB detection had better attitudes and practices towards childhood TB. The attitudes and practices need to be improved among healthcare providers in ODs with low case detection. Further investment in training and experience sharing on childhood TB case detection among healthcare providers is needed to improve childhood TB case detection.

Download Full-text

Comparison of capillary, venous and buffy coat blood samples in detecting Plasmodium species among malaria suspected patients attending at Hamusite health center. A cross-sectional study

BMC Infectious Diseases ◽

10.1186/s12879-021-06290-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Getu Abeje ◽

Woyneshet Gelaye ◽

Getaneh Alemu

Keyword(s):

Health Center ◽

Detection Rate ◽

Venous Blood ◽

Cross Sectional Study ◽

Buffy Coat ◽

Blood Film ◽

Capillary Blood ◽

Sectional Study ◽

Cross Sectional ◽

Blood Samples

Abstract Background Both capillary and venous blood samples have been interchangeably used for the diagnosis of malaria in Ethiopia. However, Plasmodium parasites are thought to be more concentrated in capillary than in venous blood. Hence, selecting a sample source where parasites are more concentrated is indispensable approach in order to maximize the accuracy of blood film microscopy. Therefore, the present study aimed to compare the detection rate and the parasitemia level of Plasmodium species from conventional capillary and venous blood films, and buffy coat preparations. Methods A facility based cross-sectional study was conducted from Feburary to March 2020 among 210 febrile patients attending Hamusite health center, northwest Ethiopia. Capillary and venous blood samples were collected and buffy coat was prepared from each sample. Thin and thick blood films were prepared, stained, and examined microscopically following standard protocol. Data were analysed using Statistical Package for Social Sciences Software version 20 and Med-Calc software version 19.3. Results Capillary blood buffy coat (61/210, 29.0%) had significantly higher detection rate as compared to capillary (48/210, 22.9%) and venous (42/210, 20.0%) blood films (p < 0.001). However, no significant difference was observed between capillary and venous blood films (p = 0.070) in detecting Plasmodium species. The highest and the lowest mean asexual stage parasite counts were found in capillary blood buffy coat (4692.88) and venous blood (631.43) films, respectively showing significant variations (p < 0.001). Mean gametocyte count was also highest in capillary blood buffy coat (3958.44). As compared to capillary blood buffy coat, the sensitivity of venous blood buffy coat, capillary blood film and venous blood film were 73.8, 78.7, 68.9%, respectively. Conclusion Capillary blood buffy coat samples showed the highest sensitivity in detecting and quantitating malaria parasites that its use should be promoted in clinical settings. However, conventional capillary and venous blood films could be used interchangeably.

Download Full-text

Hepatitis B virus infection and its associated factors among medical waste collectors at public health facilities in eastern Ethiopia: a facility-based cross-sectional study

BMC Infectious Diseases ◽

10.1186/s12879-021-05918-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Degu Abate Mengiste ◽

Abebe Tolera Dirbsa ◽

Behailu Hawulte Ayele ◽

Tewodros Tesfa Hailegiyorgis

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Cross Sectional Study ◽

Medical Waste ◽

Health Facilities ◽

Sectional Study ◽

Cross Sectional ◽

Eastern Ethiopia ◽

B Virus ◽

History Of

Abstract Background The risk of hepatitis B virus infection among medical waste handlers who undergo collection, transportation, and disposal of medical wastes in the health institutions is higher due to frequent exposure to contaminated blood and other body fluids. There is limited evidence on the seroprevalence of hepatitis B among medical waste handlers in eastern Ethiopia. The study was aimed at studying the seroprevalence of Hepatitis B Virus and associated risk factors among medical waste collectors at health facilities of eastern Ethiopia. Methods A facility-based cross-sectional study was conducted among randomly selected medical waste collectors from public health facilities in eastern Ethiopia from March to June 2018. A pre-tested and well-structured questionnaire was used to collect data on socio-demographic characteristics and hepatitis B infection risk factors. A2.5ml venous blood was also collected, centrifuged and the serum was analyzed for hepatitis B surface antigen using the instant hepatitis B surface antigen kit. Descriptive summary measures were done. Chi-square and Fisher exact tests were used to assess the risk of association. Multivariate logistic regression was conducted with 95% CI and all value at P-value < 0.05 was declared statistically significant. Results From a total of 260 (97.38%) medical waste collectors participated, HBV was detected in 53 (20.4%) of the participants [95%CI; 15.8, 25.6]. No significant differences were observed in the detection rates of HBV with respect to socio-demographic characteristics. In both bivariate and multivariable logistic regression analysis, being unvaccinated (AOR = 6.35; 95%CI = [2.53–15.96], P = 0.001), history of blood transfusion (receiving) (AOR; 3.54; 95%CI; [1.02–12.24], P = 0.046), history of tattooing (AOR = 2.86; 95%CI = [1.12–7.27], p = 0.03), and history of multiple sexual partner (AOR = 10.28; 95%CI = [4.16–25.38], P = 0.001) remained statistically significantly associated with HBsAg positivity. Conclusion This cross-sectional study identified that HBV infection is high among medical waste collectors in eastern Ethiopia. Immunization and on job health promotion and disease prevention measures should be considered in order to control the risk of HBV infection among medical waste collectors in eastern Ethiopia.

Download Full-text

Occupational exposure of health care workers to blood and body fluids in West Shewa Zone, Oromia, Ethiopia, 2018: A cross-sectional study

10.21203/rs.3.rs-587725/v2 ◽

2021 ◽

Author(s):

Tesfaye Solomon ◽

Dejene Lemessa

Keyword(s):

Health Care ◽

Health Care Workers ◽

Work Experience ◽

Cross Sectional Study ◽

Body Fluids ◽

Health Facilities ◽

Needle Stick Injury ◽

Sectional Study ◽

Cross Sectional ◽

Care Workers

Abstract Background: Health care workers are susceptible to acquiring blood and body fluids borne infections due to their occupations involving contact with patients and their body fluids, although studies conducted in Ethiopia are scarce. Therefore, the aim of this study was to investigate the magnitude of exposure to blood and body fluids among health care workers in governmental health facilities in West Shewa Zone, Ethiopia.Materials and methods: A facility-based cross-sectional study was conducted from May 19 to June 25, 2018. A total of 381 health care workers were selected by simple random sampling from 31 sampled governmental health facilities using proportional to size allocation. Data were collected through self-administered questionnaires, entered into Epi-info version 7, and analyzed by SPSS version 21. Adjusted odds ratio (AOR) with 95% confidence intervals (CI) calculated for variables retained in the multivariable logistic regression and significance declared at p<0.05.Results: Of 377 health care workers who participated, the study found that 233 (61.2%) were exposed to blood and body fluids in their lifetime. Previous needle stick injury (AOR=0.30; 95%CI: 0.12-0.75), type of health facility (AOR=0.42; 95%CI: 0.26-0.68), handwashing practice (AOR=0.15; 95%CI: 0.07, 0.31), and perceiving at risk (AOR=0.16; 95%CI: 0.03, 0.98) were protective factors whereas long work experience (AOR=1.47; 95%CI: 1.13-1.93) was a risk factor for the exposure.Conclusions: Exposures to blood and body fluids during patient care were common among health care workers in the study area. Therefore, health care workers especially those newly hired and working in hospitals should pay due attention to their occupation's safety and regularly practice hand washing during critical times.

Download Full-text

Pattern of Thalassemia and Hemoglobinopathies Among Anemic Under-Five Children of Northern Bangladesh: A Hospital Based Cross Sectional Study

10.21203/rs.3.rs-157764/v1 ◽

2021 ◽

Author(s):

Md. Abdur Rafi ◽

M. Morsed Zaman ◽

Md. Golam Hossain

Keyword(s):

Cross Sectional Study ◽

Severe Form ◽

Health Concern ◽

Sectional Study ◽

Cross Sectional ◽

Hemoglobin E ◽

Under Five ◽

Under Five Children ◽

Thalassemia Minor ◽

Different Types

Abstract Background Congenital hemoglobin defects are significant global health concern affecting more than 330,000 newborns every year. In Bangladesh more than half of the under-five children are anemic, but the contribution of hemoglobin disorders to childhood anemia is quite unexplored. Hence, the objective of the present study was to investigate the prevalence and pattern of hemoglobinopathies among anemic under-five (age 6–59 months) children visiting the hematology department of Rajshahi Medical College Hospital (RMCH). Methods This was a retrospective cross-sectional study among anemic patients aged between 6 to 59 months conducted in the hematology department of RMCH from July 2018 to June 2020. The guideline of WHO was used to define the severity of anemia. Hemoglobinopathies was measured using standard methods. Chi-square test was used to find the association between two categorical factors. Results Female and younger children included in the study were more likely to suffer from moderate to severe form of anemia compared to their counterparts. Out of 534 patients 183 were suffering from different types of hemoglobinopathies (prevalence 34.3%). E-β-Thalassemia was the most common type of hemoglobinopathy (14%) followed by Hemoglobin E trait (11%) and β-Thalassemia minor (5.6%). Prevalence of these hemoglobin disorders was comparatively higher among female and older children (p < 0.05). Patients with E-β-Thalassemia and β-Thalassemia major of our study were mostly suffering from severe form of anemia while patients with hemoglobin E trait and β-Thalassemia minor were mostly suffering from mild anemia (p < 0.01). Conclusions A remarkable number of children were suffering from severe anemia and different types of hemoglobinopathies. Gender and age group were the risk factors of anemia and hemoglobinopathies among under-five children. Health authorities of Bangladesh should especially take care of anemic children in this country.

Download Full-text

Sputum smear positivity grade and chest X-ray findings in tuberculosis: A cross-sectional study

Russian Journal of Infection and Immunity ◽

10.15789/2220-7619-ssp-1709 ◽

2021 ◽

Author(s):

R. Behzadmehr ◽

E. Nejadkehkha

Keyword(s):

Cross Sectional Study ◽

Health Concern ◽

Sputum Smear ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Radiographic Findings ◽

X Ray ◽

High Prevalence ◽

Chest X Ray

Despite many advances in the diagnosis, screening, and rapid treatment of tuberculosis, it is still a public health concern in the world. Due to the importance of this issue in diagnosis and reduction of transmission of infection and treatment of the disease especially where this study is conducted due to the high prevalence of tuberculosis, this study was done to determine The relationship between sputum smear positivity grade and chest X-ray findings in pulmonary tuberculosis patients in a hospital in southeast of Iran. This cross-sectional study was performed on all patients with pulmonary TB referencing the health centers in Zabol city, southeast of Iran from 1 January 2015 to 30 December 2020. Sputum smear and radiographic findings of the chest X-ray were evaluated. Data was collected using a form of information and finally analyzed by SPSS 22. Out of 101 patients examined in the present study, 71 were women and 30 were men. The mean age of the patients was 62.68 ± 13.61 years. The frequency of opacity in patients with grades 1, 2, and 3 was 71.4, 78.5, and 76.5%, respectively. Frequency of cavitation in patients with Grade 1, 2 and 3 was 11.5%, 28.5% and 52.9% respectively (P value 0.001). The frequency of reticulonodular presentations in patients with grade 1, 2, and 3 was 24.2, 7.1, and 0%, respectively. In general, the results of this study showed that, with increasing grading of smears (1+, 2+, and 3+), the frequency of cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. In general, the results of this study showed that, with increasing grading of smears (, the frequency of Cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. The findings of the present study can help physicians better diagnose TB.

Download Full-text

Perception of mucormycosis infection among Bangladeshi healthcare workers: an exploratory cross-sectional study in the year following the COVID-19 pandemic

Bulletin of the National Research Centre ◽

10.1186/s42269-022-00696-1 ◽

2022 ◽

Vol 46 (1) ◽

Author(s):

Humayun Kabir ◽

Md. Kamrul Hasan ◽

Mamunur Rahman ◽

Shimpi Akter ◽

Golam Ishraque Chowdhury ◽

...

Keyword(s):

Public Health ◽

Fungal Infection ◽

Healthcare Workers ◽

Associated Factors ◽

Cross Sectional Study ◽

Health Concern ◽

Sectional Study ◽

Monthly Income ◽

Public Health Concern ◽

Cross Sectional

Abstract Background Mucormycosis, a severe fungal infection, is an emerging public health concern during the COVID-19 pandemic. This study aimed to investigate the perception of mucormycosis among Bangladeshi healthcare workers. Results An exploratory cross-sectional study was carried out among the Bangladeshi healthcare workers from May 25, 2021, to June 5, 2021. The study found 422 responses from the healthcare workers of Bangladesh. Among the respondents, nearly half of them (45.26%) were doctors (n = 191). This study explored that the healthcare workers’ mucormycosis perception scores were significantly associated with their age, gender, profession, monthly income, marital status, job type, and death of friends and family members due to COVID-19. Conclusions This study emphasized the healthcare workers’ mucormycosis perception along with other associated factors. The findings could help policymakers to mitigate mucormycosis and related infectious diseases emergencies in the post-COVID-19 situation.

Download Full-text

Telework during the COVID-19 epidemic in Portugal and determinants of job satisfaction: a cross-sectional study

BMC Public Health ◽

10.1186/s12889-021-12295-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mafalda Sousa-Uva ◽

António Sousa-Uva ◽

Marta Mello e Sampayo ◽

Florentino Serranheira

Keyword(s):

Work Environment ◽

Health And Safety ◽

Cross Sectional Study ◽

Work Life ◽

Health Concern ◽

Sectional Study ◽

Physical And Mental Health ◽

Online Questionnaire ◽

Cross Sectional ◽

Health Organization

Abstract Background Telework satisfaction is a Public Health concern, intensified by the COVID-19 pandemic, and its determinant factors may be related with the negative health effects of teleworking. However, there is still little research exploring this issue. This study aimed to characterize telework during the first wave of the COVID-19 epidemic in Portugal and to identify the major predictors of telework satisfaction. Methods This is a cross-sectional study aimed at all teleworkers working in Portugal, during the first wave of the COVID-19 epidemic. Data were collected through a Google Forms platform online questionnaire distributed by a snowball method on social networks. Descriptive statistics included crude and relative frequency data. The associations between sociodemographic characteristics, self-perceived health, organization of working time, concentration at work, work-life balance, work disconnection, working conditions, and organizational demands (flexibility and organizational trust based on E-work Life Scale) with telework satisfaction were estimated through logistic regression. Results This study included 1004 participants. Teleworkers satisfaction levels were high (69%). Better concentration at work (OR = 1.54; 95%CI 1.01–2.34); the satisfaction with the balance between work life and extra work when teleworking (OR = 1.79; 95%CI 1.17–2.74); and higher work flexibility (OR = 2.26; 95%CI 1.46–3.49) were good predictors of greater levels of satisfaction with telework. However, its major predictors were the company’s trust in teleworkers (OR = 4.50; 95%CI 2.89–7.02) and feeling good in the workspace at home (OR = 3.72; 95%CI 1.46–9.49). Conclusions Our findings point that work environment and organizational culture play a crucial role in affecting telework satisfaction. More studies are needed to monitor telework satisfaction and its effects on physical and mental health, so that Public and Occupational Health (and Safety) can be able to identify and implement the best interventions that allow promoting individual health and foster a healthy work environment for teleworkers.

Download Full-text