An Assessment of Childhood Tuberculosis Detection in Public Sector Health Facilities in Zimbabwe

2020 ◽  
Vol 8 (4) ◽  
pp. 60-68
Author(s):  
Emmanuel Tachiwenyika
Keyword(s):  
Public Sector ◽  
Diagnostic Testing ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
World Health ◽  
Cross Sectional ◽  
Primary Level ◽  
Treatment Data ◽  
Childhood Tb ◽  
Public Sector Health

Introduction: Zimbabwe has consistently failed to meet the World Health Organization’s target of 10 to 15% of Tuberculosis (TB) notifications being children below 15 years, with the country experiencing a proportionate decline in childhood TB contribution to national notifications from 9% in 2011 to 5% in 2017. Methodology: We conducted a descriptive cross-sectional study in 20 public sector health facilities across 4 districts. We abstracted childhood TB screening, diagnosis and treatment data from facility registers for the year 2019. Study was approved by local ethics committee and a waiver of consent was obtained for accessing patient data. Results: Data for 21,791 children who accessed health services were abstracted, and 1,116 had documented TB management data. Overall, 3.1% of children were screened for TB; 0.8% for children below 5 years, 5.2% for ages 5-9, and 7.3% for ages 10-14 years. TB screening was significantly higher in referral (6.9%) than primary level (1.7%) facilities (p<0.05). About 63.2% of presumptive TB children had TB diagnostic tests; 51.2% for children below 5 years, 55.8% for ages 5-9 and 71.4% for ages 10-14 years. A majority (71.9%) of tests were conducted on GeneXpert MTB Rif platform and 17.9% were by microscopy. About 9.3% of tested children were diagnosed with TB, and 93.5% of these were initiated on treatment. Treatment outcomes for 65% of eligible children were evaluated. Conclusion: TB screening and diagnostic testing for children below 5 years was very low. There is need to screen all children presenting to primary level facilities.

Factors Contributing to Low Tuberculosis Detection Rates among Children Accessing Health Services in Selected Public Sector Health Facilities in Zimbabwe

2020 ◽  
Vol 8 (4) ◽  
pp. 8-17
Author(s):  
Emmanuel Tachiwenyika
Keyword(s):  
Public Sector ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
African Countries ◽  
Cross Sectional ◽  
Detection Rates ◽  
Ethical Approval ◽  
Childhood Tb ◽  
Pediatric Tb ◽  
Public Sector Health

Introduction: Zimbabwe is one of 8 African countries with high per capita incidence of TB, TB/HIV and multi-drug resistant TB. Zimbabwe experienced a proportionate decline in childhood TB contribution to all notifications from 9% in 2011 to 5% in 2017. Methodology: Analytical cross-sectional study was conducted in 20 public sector health facilities. Data were collected from healthcare workers (HCWs) using structured questionnaires, interview guide for health managers and data abstraction tool for childhood TB data in registers. Protocol received ethical approval and written informed consent was obtained from participants. Results: Eighty-one HCWs and 18 managers were interviewed; data for 21,791 children were abstracted. About 3.1% of children were screened for TB, and 63.2% of presumptive TB children had TB diagnostic tests. A majority (71.9%) of TB tests were conducted on the Gen Xpert MTB Rif platform. Thirty-one out of 335 children with TB tests were diagnosed with TB, and 93.5% were initiated on treatment. Seven facilities offered TB testing, 5 had TB guidelines and 5 had pediatric TB job aides. Five out of 7 microscopes and 4/7 GeneXpert machines were functional. About 64.1% of HCWs had childhood TB training, 51% had ever received mentorship on childhood TB management, 53.1% had ever collected childhood TB diagnosis specimen and 23.3% had ever initiated children on TB treatment. Discussion: Childhood TB screening and diagnosis was suboptimal, and this was a result of low healthcare worker capacity, shortage and breakdown of TB diagnostic machines and weak TB diagnostic sample transportation system.

Baseline assessment of therapeutic injection practices in Pakistan in 2020: a cross-sectional study

2021 ◽  
pp. 16-21
Author(s):  
Syed Sharaf Ali Shah ◽  
Safdar Pasha ◽  
Nikhat Iftikar ◽  
Altaf Ahmed Soomro ◽  
Nazia Farrukh ◽  
...  
Keyword(s):  
Public Sector ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Injection Equipment ◽  
Public And Private ◽  
Healthcare Facilities ◽  
The Public ◽  
Injection Safety

Objective: To assess the magnitude of the problem of injection safety in public and private health facilities in two districts of Sindh and Punjab provinces of Pakistan. Methods: A cross-sectional observational study was conducted between October and December 2020 among public and private health facilities of two districts of Pakistan: Gujarat in Punjab and Larkana in Sindh provinces. A convenient sample size of 60 healthcare facilities (30 from each district) was taken due to time and resource constraint. Six data collection tools were used which included structured observations and interviews with injection prescribers and providers based on WHO Revised Tool C, which were finalised after piloting. Results: Reuse of injection equipment was not observed in any of the 60 health facilities. In exit interviews of 120 patients, it was found that 27 (22.5%) patients reported receiving an injection, while 11 (9.2%) were prescribed intravenous (IV) drips. More injections and drips were prescribed in the private sector (n=15; 25.0%) in comparison with the public sector (n=12; 20.0%). Slightly higher proportion of IV drips were prescribed by the private providers when compared to public sector healthcare providers: 6 (10.0%) vs 5 (8.3%) respectively. Most of the prescribers (n=58; 96.7%) reported that patients who attended public and private health facilities demanded injectable medicines. Used syringes and drips were noted to be visible in open containers and buckets for final disposal in 20 (33.3%) assessed health facilities. Continuou...

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

2021 ◽  
Author(s):  
Memory Chimsimbe ◽  
Pride Mucheto ◽  
Tsitsi Patience Juru ◽  
Addmore Chadambuka ◽  
Emmanuel Govha ◽  
...  
Keyword(s):  
Detection Rate ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Childhood Tuberculosis ◽  
Health Concern ◽  
Case Detection ◽  
Sectional Study ◽  
Cross Sectional ◽  
Case Detection Rate ◽  
Childhood Tb

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.

scholarly journals Costs of postabortion care in public sector health facilities in Malawi: a cross-sectional survey

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Janie Benson ◽  
Hailemichael Gebreselassie ◽  
Maribel Amor Mañibo ◽  
Keris Raisanen ◽  
Heidi Bart Johnston ◽  
...  
Keyword(s):  
Public Sector ◽  
Health Facilities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Postabortion Care ◽  
Public Sector Health

scholarly journals Post-Cesarean Section Maternal Health Outcome and its Determinants in Tigray Regional State, North Ethiopia.

2019 ◽  
Author(s):  
Mebrahtu Abay ◽  
Welay Gebremariam ◽  
Mirkuzie Woldie Kurie ◽  
Haileselassie Berhane ◽  
Abraham Mengstu
Keyword(s):  
Cesarean Section ◽  
Cross Sectional Study ◽  
Maternal Outcome ◽  
Health Facilities ◽  
World Health ◽  
Cross Sectional ◽  
Factors Associated ◽  
Regional State ◽  
Health Organization ◽  
Referral Status

Abstract Back ground Cesarean section rate is increasing worldwide. However, the World Health Organization has declared that there is insufficient information on maternal outcome following cesarean section for decision making.Objective The aim of this study was to assess post cesarean section maternal outcome and its associated factors availing evidence for practice and policy.Methods Institution based cross-sectional study was conducted among 357 mothers who underwent cesarean section in six selected public general hospitals of Tigray regional State, Ethiopia. Mothers were followed for the duration of post-operative period until they became safe for discharge. The maternal outcomes were categorized into either adverse or good outcomes depending on whether mothers develop any cesarean section related morbidity or not. Logistic regression model was constructed to determine the AOR and 95% CI of independent factors associated with maternal outcome following cesarean section.Results The proportion of adverse maternal outcome was 19.3% with 95% CI of (15.7% -23.8%). Route of anesthesia administration (AOR = 0.296, 95% CI: 0.126 - 0.695) and referral status (AOR = 0.371, 95%CI: 0.214 - 0.641) were statistically significant factors associated with maternal outcome following cesarean section.Conclusion There was high proportion of adverse maternal outcome. General anesthesia and referral from lower health facilities were associated with higher risk of post-CS adverse maternal outcome. Equipping lower level health facilities with the human and material capacity for timely detection of CS indications and provision of cesarean section services could decrease the number of referrals and subsequent delays that lead to adverse maternal outcome.

scholarly journals Seroconfirmed Typhoid Fever and Knowledge, Attitude, and Practices among Febrile Patients Attending at Injibara General Hospital, Northwest Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Wondemagegn Mulu ◽  
Chalachew Genet Akal ◽  
Kidist Ababu ◽  
Solomon Getachew ◽  
Fenkil Tesfaye ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
General Hospital ◽  
Venous Blood ◽  
Multivariable Analysis ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Health Facilities ◽  
World Health ◽  
Cross Sectional ◽  
Middle Income

Introduction. Typhoid fever (TF) is a febrile global health problem caused by Salmonella enterica serovar Typhi (S. Typhi) with relatively high prevalence in low- and middle-income countries including Ethiopia. Identifying local prevalence and gaps in knowledge, attitude, and practice (KAP) towards TF is recommended by the World Health Organization to implement preventive measures. Therefore, this study determined the prevalence of S. Typhi and KAP of febrile patients towards TF in Injibara General Hospital, Northwest Ethiopia. Methods. Hospital-based cross-sectional study was conducted from January to March 2020. A total of 237 patients were included conveniently. Data on KAP and demographic variables were collected using a structured questionnaire by face-to-face interview. After the interview, 5 ml venous blood was collected and processed using the Widal test following the manufacturer’s instruction. Mean scores and percentages were used to determine the level of KAP. Multivariable analysis was done to correlate KAPs with TF. P value < 0.05 was considered statistically significant. Results. The overall prevalence of S. Typhi was 25.7%. The highest seroprevalence was observed among the age group of 30-34 years (33.3%) and patients with no education. The majority of participants know the major ways of TF transmission (59.1-90.7%) and prevention (81.4%) methods. However, the misconception on the route of TF transmission was observed in 13.5-36.7% of participants. About 65.4% and 67.5% of study participants were considered knowledgeable and had good preventive practice towards TF, respectively. Being a student ( AOR = 0.227 , CI = 0.053 − 0.965 ) and considering mosquito bite as transmission routes ( AOR = 2.618 , CI = 1.097 − 6.248 ) were significantly associated with TF. Conclusion. High S. Typhi prevalence was observed in the study area. Moreover, the misconception on the transmission of typhoid fever and educational level was a risk factor for TF. Thus, health facilities should incorporate topics on typhoid fever as part of their health education system within health facilities and in the community.

scholarly journals A comparative study of drug prescribing indicators in various hospitals of West Bengal, India

2018 ◽  
Vol 6 (6) ◽  
pp. 2063
Author(s):  
Arijit Ghosh ◽  
Anjan Adhikari ◽  
Rania Indu ◽  
Srijita Ghosh ◽  
Santosh Banik ◽  
...  
Keyword(s):  
West Bengal ◽  
Essential Medicine ◽  
Minimum Cost ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
World Health ◽  
Cross Sectional ◽  
Prescribing Indicators ◽  
Rational Therapy ◽  
Health Organization

Background: Rational use of drugs is essential to ensure safety and welfare of patients. Thus, prescription audits are conducted to monitor the practice of writing prescriptions. Various standard parameters have been rationalized by World Health Organization (WHO) in order to regulate drug utilization, globally. Present study aimed to compare the pattern of prescriptions generated in different healthcare centres of West Bengal.Methods: A cross-sectional study was conducted in the inpatient and outpatient departments of RG Kar Medical College, Kolkata, in order to evaluate the prescriptions. Literature was also surveyed with the keywords “prescription audit”, “West Bengal”, to extract data on prescription audits conducted in various other hospitals of West Bengal. The WHO prescribing indicators of all these health facilities were then compared to estimate the rationality of drug prescribed by different physicians.Results: Seven published reports of prescription audits were published from the period of 2013 to 2017, the distribution being- 2 health facilities from Kolkata, 2 from Burdwan, 1 each from Bankura, Murshidabad and North Bengal. WHO standards were not strictly followed by any of the hospitals. Polypharmacy level were higher in all the hospitals. Drugs were mostly prescribed from the essential medicine list (EML).Conclusions: Present study clearly indicated that it is essential to improve these parameters for most of the healthcare centres in order to prevent irrational use of drugs. Prescription audits should also be implemented regularly so that the patients can receive better treatment at minimum cost with suitable rational therapy.

scholarly journals Assessing service availability and readiness to manage cervical cancer in Bangladesh

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shagoofa Rakhshanda ◽  
Koustuv Dalal ◽  
Hasina Akhter Chowdhury ◽  
Cinderella Akbar Mayaboti ◽  
Progga Paromita ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Health Facilities ◽  
World Health ◽  
Accurate Information ◽  
Service Availability ◽  
Cross Sectional ◽  
Middle Income ◽  
Primary Level ◽  
Cancer Management ◽  
Service Readiness

Abstract Background The second most common cancer among females in Bangladesh is cervical cancer. The national strategy for cervical cancer needs monitoring to ensure that patients have access to care. In order to provide accurate information to policymakers in Bangladesh and other low and middle income countries, it is vital to assess current service availability and readiness to manage cervical cancer at health facilities in Bangladesh. Methods An interviewer-administered questionnaire adapted from the World Health Organization Service Availability and Readiness Assessment Standard Tool was used to collect cross-sectional data from health administrators of 323 health facilities in Bangladesh. Services provided were categorized into domains and service readiness was determined by mean readiness index (RI) scores. Data analysis was conducted using STATA version 13. Results There were seven tertiary and specialized hospitals, 118 secondary level health facilities, 124 primary level health facilities, and 74 NGO/private hospitals included in the study. Twenty-six per cent of the health facilities provided services to cancer patients. Among the 34 tracer items used to assess cancer management capacity of health facilities, four cervical cancer-specific tracer items were used to determine service readiness for cervical cancer. On average, tertiary and specialized hospitals surpassed the readiness index cutoff of 70% with adequate staff and training (100%), equipment (100%), and diagnostic facilities (85.7%), indicating that they were ready to manage cervical cancer. The mean RI scores for the rest of the health facilities were below the cutoff value, meaning that they were not prepared to provide adequate cervical cancer services. Conclusion The health facilities in Bangladesh (except for some tertiary hospitals) lack readiness in cervical cancer management in terms of guidelines on diagnosis and treatment, training of staff, and shortage of equipment. Given that cervical cancer accounts for more than one-fourth of all female cancers in Bangladesh, management of cervical cancer needs to be available at all levels of health facilities, with primary level facilities focusing on early diagnosis. It is recommended that appropriate standard operating procedures on cervical cancer be developed for each level of health facilities to contribute towards attaining sustainable developmental goals.

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

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.

Women and Continuous Labour Support in Public Health Facilities in Nigeria

2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Olabisi Fatimo Ibitoye ◽  
Deliwe R Phetlhu
Keyword(s):  
Public Health ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Public Hospitals ◽  
World Health ◽  
Cross Sectional ◽  
Public Health Facilities ◽  
Childbirth Experience ◽  
Health Organization ◽  
The Right

Childbirth is a multifaceted process that is influenced by several factors resulting in an unsatisfactory or satisfactory childbirth experience. Continuous labour support (CLS) has been identified as a positive contributor to a satisfactory birthing experience, and consequently positive maternal health outcomes. The World Health Organization recommended the right of a pregnant woman to have a companion of her choice during labour, but CLS practice remains a mirage in Nigerian hospitals. This descriptive cross-sectional study explores the perceptions, attitudes and preferences of 368 randomly selected women regarding CLS in public hospitals in South West Nigeria. Data were collected using a pretested questionnaire developed from the literature review and analysed with descriptive and inferential statistics using SPSS Version 20. The findings revealed that the participants perceived support from midwives during labour as inadequate but that they were satisfied with professional care at birth. The participants perceived the inclusion of a familiar person for support as beneficial and expressed positive disposition to the introduction of persons from their social network for labour support in public health facilities. The preference for husbands and mothers as labour support persons was higher among the study participants.

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