SARS-CoV-2 transmission among health care workers in Iran: an urgent need for early identification and management

2021 ◽  
Vol 21 ◽  
Author(s):  
Mohammad Reza Abdolsalehi ◽  
Shima Mahmoudi ◽  
Reza Shervin Badv ◽  
Babak Pourakbari ◽  
Keyvan Mirnia ◽  
...  
Keyword(s):  
Service Providers ◽  
Health Workers ◽  
Medical Center ◽  
Gastrointestinal Symptoms ◽  
Hospital Staff ◽  
X Rays ◽  
Prevention Measures ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Pcr Test

Introduction: By increasing the rate of COVID-19, particularly in developing countries such as Iran, high numbers of frontline service providers, including doctors and nurses, die and makes frontline healthcare workers (HCWs) more vulnerable to the psychological disorders, fear and anxiety of secondary transmission to others, especially their family members. In this study, we aimed to report the incidence of COVID-19 infection among HCWs in an Iranian referral pediatrics hospital between April 2020 and July 2020. Material and Methods: In this retrospective cross-sectional study, HCWs and hospital staff working at Children's Medical Center, Tehran, Iran with positive SARS-CoV-2 RT-PCR test results were evaluated between April 2020 and July 2020. Results: Sixty-one out of the 1085 personnel (5.6%) including 14 pediatricians (23%), 24 nurses (39%), 9 paramedics (15%), and 14 HCWs without direct patient contact (23%) had a nasopharyngeal specimen positive SARS-CoV-2 RT-PCR test. The mean age was 39.8±10.6 years. Eleven cases (18%) had underlying diseases such as hypertension and asthma. The most common symptoms were fatigue (67%, n=41), dry cough (61%, n=37), fever (52%, n=32), headache (46%, n=28), dyspnea (43%, n=24), anosmia (28%, n=17), chills (26%, n=16), sore throat (26%, n=16), gastrointestinal symptoms (23%, n=14), and productive cough (3%, n=2). Eleven cases (18%) showed lung involvement in their chest X-rays and/or CT scans. Eighteen cases (29.5%) had lymphopenia, and 20 individuals (33%) had a high level of C-reactive protein. Conclusion: In conclusion, in the early phase of the COVID-19 outbreak, a substantial proportion of HCWs with fever, respiratory, and other prevalent symptoms including fatigue and headache were infected with SARS-CoV-2. Therefore, implementation of infection prevention measures, isolation of confirmed HCWs, disinfection of the environment, and regular COVID-19 prevention training for HCWs are strongly recommended for the wellbeing of health workers and minimizing the spread of infection.

Hospital-acquired infection awareness and control practices among healthcare staff: an evaluation

2021 ◽  
Vol 27 (11) ◽  
pp. 296-302
Author(s):  
Pallavi Saraswat ◽  
Rajnarayan R Tiwari ◽  
Muralidhar Varma ◽  
Sameer Phadnis ◽  
Monica Sindhu
Keyword(s):  
Infection Control ◽  
Healthcare Facility ◽  
Hospital Staff ◽  
Control Measures ◽  
Prevention Measures ◽  
Cross Sectional ◽  
Control Policies ◽  
Hospital Acquired Infection ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

Background/Aims Hospital-acquired infections pose a risk to the wellbeing of both patients and staff. They are largely preventable, particularly if hospital staff have adequate knowledge of and adherence to infection control policies. This study aimed to assess the knowledge, awareness and practice of hospital-acquired infection control measures among hospital staff. Methods A cross-sectional study was conducted among 71 staff members in a tertiary healthcare facility in Karnataka, India. The researchers distributed a questionnaire containing 33 questions regarding knowledge of hospital-acquired infections, awareness of infection control policies and adherence to control practices. The results were analysed using the Statistical Package for the Social Sciences, version 16.0 and a Kruskal–Wallis test. Results Respondents' mean percentage score on the knowledge of hospital-acquired infections section was 72%. Their mean percentage scores on the awareness and practice of infection prevention measures sections were 82% and 77% respectively. Doctors and those with more years of experience typically scored higher. Conclusion The respondents had an acceptable level of knowledge, awareness and adherence to infection control practices. However, continued training is essential in the prevention of hospital-acquired infections. The majority of the respondents stated that they were willing to undertake training in this area, and this opportunity should be provided in order to improve infection control quality.

scholarly journals Prevenção da infecção pelo zika vírus nas gestantes

2017 ◽  
Vol 11 (12) ◽  
pp. 5339
Author(s):  
Daiane Santos ◽  
Mariana Alves Pimenta ◽  
Flavio Bittencourt ◽  
Murilo Cesar Nascimento ◽  
Silvana Maria Coelho Leite Fava ◽  
...  
Keyword(s):  
Aedes Aegypti ◽  
Zika Virus ◽  
Health Workers ◽  
Family Health ◽  
Cross Sectional Study ◽  
Prevention Measures ◽  
Cross Sectional ◽  
Exact Test ◽  
Quantitative Descriptive ◽  
Virus Zika

RESUMOObjetivo: avaliar as competências dos ACS no desenvolvimento das atribuições esperadas e definidas pelo Ministério da Saúde nas ações de pré-natal de risco habitual, desenvolvidas no âmbito da ESF, em relação à prevenção da infecção pelo zika vírus na gestação. Método: estudo quantitativo, descritivo, transversal, com coleta de dados em 14 equipes da Estratégia de Saúde da Família, mediante um questionário com três partes: A (enfrentamento ao Aedes aegypti); B (pré-natal de baixo risco) e C (medidas de prevenção pessoal contra o Zika vírus), analisadas por agrupamentos e pelo Teste Exato de Fisher. Resultados: melhor desempenho foi observado em B, seguido de A. As maiores dificuldades estavam relacionadas com a atividade C. Conclusão: há um panorama favorável de atuação desses profissionais, embora com dificuldades quanto à alimentação dos sistemas de informação, à baixa participação comunitária e à pouca integração com o trabalho das equipes. Descritores: Enfermagem; Agente Comunitário de Saúde; Zika Vírus.ABSTRACT Objective: to evaluate the competences of the ACS in the development of the attributions expected and defined by the Ministry of Health in the habitual, risk prenatal actions, developed within the scope of the FHS, in relation to the prevention of infection by the zika virus during pregnancy. Method: quantitative, descriptive, cross-sectional study with data collection in 14 teams of the Family Health Strategy, through a questionnaire with three parts: A (coping with Aedes aegypti); B (low risk prenatal) and C (personal prevention measures against Zika virus), analyzed by clusters and Fisher's Exact Test. Results: better performance was observed in B, followed by A. The greatest difficulties were related to activity C. Conclusion: there is a favorable panorama of these professionals, although with difficulties in feeding information systems, low community participation and little integration with the work of the teams. Descritores: Nursing; Community Health Workers; Zika Virus.RESUMEN Objetivo: evaluar las competencias de los ACS en el desarrollo de las atribuciones esperadas y definidas por el Ministerio de Salud en las acciones de prenatal de riesgo habitual, desarrolladas en el marco de la ESF, en relación a la prevención de la infección por el zika virus en la gestación. Método: estudio cuantitativo, descriptivo, transversal, con recolección de datos en 14 equipos de la Estrategia de Salud de la Familia, mediante un cuestionario con tres partes: A (enfrentamiento al Aedes aegypti); B (prenatal de bajo riesgo) y C (medidas de prevención personal contra el Zika virus), analizadas por agrupaciones y por la prueba exacta de Fisher. Resultados: mejor desempeño fue observado en B, seguido de A. Las mayores dificultades estaban relacionadas con la actividad C. Conclusión: hay un panorama favorable de actuación de estos profesionales, aunque con dificultades en cuanto a la alimentación de los sistemas de información, a la baja participación comunitaria y a la poca integración con el trabajo de los equipos. Descritores: Enfermería; Agentes Comunitarios de Salud; Vírus Zika.

scholarly journals Faktor – Faktor Yang Berhubungan Dengan Disiplin Kerja Karyawan Non Medis Di Rumah Sakit Pekanbaru Medical Center (PMC) Tahun 2020

2021 ◽  
Vol 1 (2) ◽  
pp. 170-181
Author(s):  
Nurhafiza Fiza(Fiza) ◽  
Aldiga Rienarti Abidin ◽  
Arief Wahyudi
Keyword(s):  
Health Workers ◽  
Medical Center ◽  
Univariate Analysis ◽  
Sampling Technique ◽  
Bivariate Analysis ◽  
P Value ◽  
Cross Sectional ◽  
Leadership Models ◽  
Center Hospital ◽  
Medical Center Hospital

ABSTRAK Keberhasilan suatu rumah sakit dipengaruhi oleh tenaga kesehatan atau sumber daya manusia yang disiplin, yang mencerminkan kesadaran dan kesediaan mentaati semua peraturan perusahaan dan norma-norma sosial yang berlaku. Faktor-faktor yang mempengaruhi disiplin  kerja diantaranya ketepatan waktu, pemanfaatan sarana, balas jasa, tanggung jawab dan ketaatan terhadap aturan. Tujuan penelitian untuk mengetahui faktor-faktor yang berhubungan dengan disiplin kerja karyawan non medis di Rumah Sakit Pekanbaru Medical Center. Jenis penelitian kuantitatif dengan desain analitik Cross Sectional study.Populasi dalam penelitian ini adalah seluruh tenaga non medis di Rumah Sakit Pekanbaru Medical Center (PMC) yang berjumlah 70 orang . Teknik sampling yang digunakan adalah teknik total sampling. Analisis Univariat dilakukan untuk mendeskripsikan karakter masing-masing variabel yang diteliti, sedangkan analisis Bivariat dilakukan untuk mengetahui hubungan kedua variabel independen dan dependen. teladan pemipin P value 0.016, balas jasa P value 0.000, keadilan P value 0.000, pengawasan melekat P value 0.011, sanksi hukuman P value 0.008 dengan disiplin kerja. Ada hubungan antara teladan pemipin, balas jasa, keadilan, sanksi hukuman. Di sarankan agar Rumah Sakit Pekanbaru Medical Center (PMC) dapat meningkatkan penerapan prinsip keadilan dalam lingkungan kerjanya untuk dapat meningkatkan disiplin kerja karyawan ABSTRACT The success of a hospital is influenced by health workers or human resources who are disciplined, which reflects the awareness and willingness to obey all company regulations and applicable social norms. Factors affecting work discipline include timeliness, utilization of facilities, remuneration, responsibility and adherence to rules. The purpose of this study was to determine the factors related to the work discipline of non-medical employees at Pekanbaru Medical Center Hospital. This type of quantitative research is analytic cross sectional study design. The population in this study is all non-medical staff at Pekanbaru Medical Center Hospital, amounting to 70 people. The sampling technique used was total sampling technique. Univariate analysis was carried out to describe the character of each variable under study, while Bivariate analysis was carried out to see the relationship between the two independent and dependent variables. leadership models P value 0.016, reward P value 0.000, fairness P value 0.000, supervision attached P value 0,11, sanctions P value 0.008. There is a relationship between leadership models, reward, fairness, supervision attached, sanctions. it is recommended that Pekanbaru Medical Center Hospital to increase the implementation of fairness principle in the work environment in order to improve employee’s discipline Pekanbaru Medical Center Hospital  

scholarly journals Assessing community health governance for evidence-informed decision-making: a cross-sectional study across nine districts of India

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Shantanu Sharma ◽  
Sucheta Rawat ◽  
Faiyaz Akhtar ◽  
Rajesh Kumar Singh ◽  
Sunil Mehra
Keyword(s):  
Community Health ◽  
Service Providers ◽  
Health Workers ◽  
Uttar Pradesh ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Health Governance ◽  
Cross Sectional ◽  
Content Type ◽  
Community Monitoring

PurposeThe authors intend to assess the village health sanitation and nutrition committees (VHSNC) on six parameters, including their formation, composition, meeting frequencies, activities, supervisory mechanisms and funds receipt and expenditures across nine districts of the three states of India.Design/methodology/approachThe cross-sectional study, conducted in the states of Uttar Pradesh (five districts), Odisha (two districts) and Rajasthan (two districts), used a quantitative research design. The community health workers of 140 VHSNCs were interviewed using a semi-structured questionnaire. The details about the funds' receipt and expenditures were verified from the VHSNC records (cashbook). Additionally, the authors asked about the role of health workers in the VHSNC meetings, and the issues and challenges faced.FindingsThe average number of members in VHSNCs varied from 10 in Odisha to 15 in Rajasthan. Activities were regularly organized in Rajasthan and Odisha (one per month) compared to Uttar Pradesh (one every alternate month). Most commonly, health promotion activities, cleanliness drives, community monitoring and facilitation of service providers were done by VHSNCs. Funds were received regularly in Odisha compared to Rajasthan and Uttar Pradesh. Funds were received late and less compared to the demands or needs of VHSNCs.Research limitations/implications This comprehensive analysis of VHSNCs' functioning in the selected study areas sheds light on the gaps in many components, including the untimely and inadequate receipt of funds, poor documentation of expenditures and involvement of VHSNC heads and inadequate supportive supervision.Originality/value VHSNCs assessment has been done for improving community health governance.

scholarly journals Sero-prevalence of anti-SARS-CoV-2 Antibodies in Addis Ababa, Ethiopia

2020 ◽  
Author(s):  
Berhanu Nega Alemu ◽  
Adamu Addissie ◽  
Gemechis Mamo ◽  
Negussie Deyessa ◽  
Tamrat Abebe ◽  
...  
Keyword(s):  
Serological Test ◽  
Addis Ababa ◽  
Rapid Test ◽  
Cross Sectional Study ◽  
Rt Pcr ◽  
Serological Tests ◽  
Cross Sectional ◽  
History Of ◽  
Community Transmission ◽  
Pcr Test

AbstractBackgroundAnti-SARS-CoV-2 antibody tests are being increasingly used for sero-epidemiological purposes to provide better understanding of the extent of the infection in the community, and monitoring the progression of the COVID-19 epidemic. We conducted sero-prevalence study to estimate prior infection with with SARS-CoV-2 in Addis Ababa.MethodsA cross-sectional study was done from April 23 to 28, 2020 among 301 randomly selected residents of Addis Ababa; with no known history of contact with confirmed COVID-19 person. Interviews on socio demographic and behavioural risk factor followed by serological tests were performed for SARS-CoV-2 IgM, and IgG antibodies, using COVID-19 IgG/IgM Rapid Test Cassette. The test has sensitivity of 87·9% and specificity of 100% for lgM; and a sensitivity of 97·2% and specificity of 100% for IgG. RT-PCR test was also done on combined nasopharyngeal and oropharengeal swabs as an important public health consideration.FindingsThe unadjusted antibody-based crude SARS-CoV-2 prevalence was 7·6% and the adjusted true SARS-CoV-2 prevalence was estimated at 8·8% (95% CI 5·5%-11·6%) for the study population. Higher sero-prevalence were observed for males (9.0%), age below 50 years (8.2%), students and unemployed (15.6%), those with primary education (12.1%), smokers (7.8%), alcohol consumers (8.6%), chatt-chewers (13.6%) and shish smokers (18.8%). Seroprevalence was not significantly associated neither with socio-demographic not behavioral characteristics. According to the findings, possibly more individuals had been infected in Addis Ababa than what was being detected and reported by RT-PCR test suggestive of community transmission. The use of serological test for epidemiological estimation of the extent of SARS-CoV-2 epidemic gives a more precise estimate of magnitude which would be used for further monitoring and surveillance of the magnitude of the SARS CoV-2 infection.

scholarly journals Antibodies to SARS-CoV2 detectable for less than 50 days in polymerase chain reaction confirmed COVID-19 patients

2020 ◽  
Vol 7 (9) ◽  
pp. 3378
Author(s):  
Nishant Kumar ◽  
Shibal Bhartiya ◽  
Tarundeep Singh
Keyword(s):  
Polymerase Chain Reaction ◽  
Healthcare Workers ◽  
Health Workers ◽  
Natural Infection ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Cross Sectional Survey ◽  
Polymerase Chain ◽  
Roche Diagnostics ◽  
Pcr Test

Background: A seroprevalence study for COVID-19 antibodies was conducted amongst health workers in Mumbai, India, in June 2020.Methods: Healthcare workers (n=801) underwent a cross sectional survey through electrochemiluminescence immunoassay (Roche diagnostics’ Elecsys anti-SARS-CoV-2 assay, Roche diagnostics, Rotkreuz, Switzerland).Results: Of the 801 healthcare workers, 62 who had been previously diagnosed with a real time-polymerase chain reaction (RT-PCR) proven SARS-CoV-2 infection, 45 (73.6%) were found to be seronegative during the study. The duration between the positive RT-PCR test and the serological testing ranged from 15 to 49 days for 34 (54.8%), and was >50 days in 28 subjects. Up to 28 days after a positive PCR test, 90% of the subjects were found to be seropositive, but this reduced to less than half over the next two weeks (38.5% between 29 and 42 days).Conclusions: Our findings are in agreement with previous reports that demonstrate a peak antibody formation after 3 weeks, and also an early antibody decay that is almost exponential. This may also have a significant effect on the protection vaccines are able to provide considering that a natural infection has such a transient antibody response. 

scholarly journals The value of anal swab RT-PCR for COVID-19 diagnosis in adult Indonesian patients

2021 ◽  
Vol 8 (1) ◽  
pp. e000590
Author(s):  
Murdani Abdullah ◽  
Dedy Gunawanjati Sudrajat ◽  
Virly Nanda Muzellina ◽  
Juferdy Kurniawan ◽  
Aulia Rizka ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Gastrointestinal Symptoms ◽  
High Specificity ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Severe Condition ◽  
Hospitalised Patients ◽  
Anal Swab ◽  
Low Sensitivity ◽  
Pcr Test

ObjectiveThis study will test the performance of the anal swab PCR test when compared with the nasopharyngeal swab PCR test as a diagnostic tool for COVID-19.DesignAn observational descriptive study which included hospitalised suspected, or probable cases of hopitalised COVID-19 patients, conducted in Dr. Cipto Mangunkusumo National Hospital, Ciputra Hospital, Mitra Keluarga Depok Hospital and Mitra Keluarga Kelapa Gading Hospital, Indonesia. Epidemiological, clinical, laboratory and radiology data were obtained. Nasopharyngeal and anal swabs specimens were collected for SARS-CoV-2 RNA detection.ResultsWe analysed 136 subjects as part of this study. The clinical spectrum of COVID-19 manifesation in this study was typical of hospitalised patients, with 25% classified as mild cases, 14.7% in severe condition and 12.5% of subjects classified as having acute respiratory distress syndrome. When compared with nasopharyngeal swab as the standard specimen for reverse transcription polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 antigen, the sensitivity and specificity of the anal swab was 36.7% and 93.8%, respectively. The positive and negative predictive value were 97.8% and 16.5 %, respectively. The performance of the anal swab remained similar when only the subgroup of patients with gastrointestinal symptoms (n=92, 67.6%) was analysed (sensitivity 40% and specificity 91.7%). Out of all the subjects included in analysis, 67.6% had gastrointestinal symptoms. Similarly, 73.3% of patients in the anal swab-positive group had gastrointestinal symptoms. The two most common gastrointestinal symptoms in the subjects’ population were nausea and anorexia.ConclusionAnal swab specimen has low sensitivity (36.7%) but high specificity (93.8%) for detecting SARS-CoV-2 antigen by RT-PCR. Only one additional positive result was found by anal swab among the nasopharyngeal swab-negative group. Anal swab may not be needed as an additional test at the beginning of a patient’s diagnostic investigation and nasopharyngeal swab RT-PCR remains as the standard diagnostic test for COVID-19.

scholarly journals Association of Anosmia and Positive SARS-CoV-2 (COVID-19) RT-PCR Test Results Among Patients in the Quezon City General Hospital

2021 ◽  
Vol 36 (1) ◽  
pp. 33
Author(s):  
Jeff James Alega ◽  
Emmanuel Tadeus Cruz
Keyword(s):  
General Hospital ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
The Philippines ◽  
Test Results ◽  
Government Hospital ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Quezon City ◽  
Pcr Test

ABSTRACT Objective: To determine the association of anosmia and positive SARS-CoV-2 (COVID-19) RT-PCR test results among patients in a tertiary government hospital in Metro Manila.   Methods: Design: Cross-Sectional Study Setting: Tertiary Government Hospital Participants: Patients aged 18 years old and above who consulted or were admitted with COVID-19 symptoms at the Quezon City General Hospital in the Philippines from July to September 2020 answered an offline version of the American Academy of Otolaryngology-Head and Neck Surgery AAO-HNS COVID-19 Anosmia Reporting Tool prior to undergoing (COVID-19) RT-PCR testing.   Results: Out of 172 participants, 63 (36.6%) presented with anosmia. Sixty (95.2%) out of 63 of those with anosmia had a positive COVID-19 RT-PCR test result. Forty-one (65%) participants reported anosmia as the first symptom while the most common associated symptoms were fever (59%), cough (50%), and rhinorrhea (31%). There was a significant association between anosmia and positive SARS-CoV-2 (COVID-19) RT-PCR tests (X2 =33.85, df=1, p<.0001).   Conclusion: Anosmia was associated with a positive SARS-CoV-2 (COVID-19) RT-PCR test in more than 95% of those who reported the symptom. Anosmia should be considered as a red flag sign which should be included in the screening of persons suspected of being infected with COVID-19 to help mitigate further spread of the virus.

scholarly journals Acute Pancreatitis as a Possible Unusual Manifestation of COVID-19 in Children

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Niloufar Bineshfar ◽  
Alireza Mirahmadi ◽  
Fereshteh Karbasian ◽  
Elham Pourbakhtyaran ◽  
Abdollah Karimi ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pediatric Patients ◽  
Gastrointestinal Symptoms ◽  
Amylase Level ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Unusual Manifestation ◽  
The World ◽  
Polymerase Chain ◽  
Pcr Test

Coronavirus disease-2019 (COVID-19) which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread throughout the world causing problems for millions of people. Symptoms of COVID-19 in pediatric patients include both respiratory and gastrointestinal symptoms. The most common symptoms are fever, cough, and fatigue. In this report, we describe a case of a previously well 14-year-old boy, who presented to our emergency department with a complaint of abdominal pain, nausea, and vomiting without fever or respiratory symptoms. He was diagnosed with acute pancreatitis based on an abnormal amylase level and abdomen computed tomography (CT) and later found to be infected by SARS-CoV-2, by a positive reverse transcriptase-polymerase chain reaction (RT-PCR) test.

scholarly journals Problem evaluation of service recipient and service provider at out patient departments of a tertiary level hospital

2015 ◽  
Vol 9 (2) ◽  
pp. 26-31 ◽  
Author(s):  
Mohammad Ali ◽  
Mushtaq Ahmad ◽  
Latifa Rahman ◽  
Sharmeen Sultana ◽  
Md Abdus Samad Al-Azad
Keyword(s):  
Patient Satisfaction ◽  
Service Providers ◽  
Outpatient Service ◽  
Armed Forces ◽  
Hospital Staff ◽  
Tertiary Level ◽  
Cross Sectional ◽  
Administrative Personnel ◽  
Level Hospital

Introduction: It is easier to evaluate the patient’s satisfaction towards the service than to evaluate the quality of medical services that they receive. Therefore, a probe into patient satisfaction can provide an important tool to improve the quality of services. Patient satisfaction is a multi-dimensional healthcare issue affected by many factors. Healthcare quality affects patient satisfaction and results in positive influences on patient behaviour such as confidence in hospital care. Objectives: The objective of the study was to evaluate the problems of recipients and service providers during service delivery at out patient departments of a tertiary level hospital. Materials and Methods: This cross sectional descriptive study was conducted on the patients attending the medical out patient departments along with the service providers, administrative personnel and supportive staffs of a government hospital during the period of February 2007 to June 2007. Results: A total of 299 patients, 5 service providers, 8 administrative personnel and 11 supporting staffs were purposively selected in the study. Among 299 respondents,169 (56%) identified patient overload as the most common problem. As many as, 70(24%) patients experienced more than 4 hours delay in the hospital. Less than half 117(39%) of the patients experienced the problem of not getting proper consultancy due to absence 26 JAFMC Bangladesh. Vol 9, No 2 (December) 2013 of physician in their chambers. Although 117(39%) patients faced multiple problems during undergoing investigation in the hospital, 21% patients were ‘satisfied partially’ with hospital staff support. Out of 5 service providers 3(60%) worked in a congested space. As many as 20% service providers reported that patients were not satisfied by the service of MOPD. Monthly pay and allowances were not sufficient (as observed by 80% of respondents). The study also revealed that lack of co-operation amongst the staffs and inadequate pay and salary were the main problems in 75% of the administrative personnel. Moreover, 55% supportive staff faced patient overload. All the service providers opined that improvement of medical outpatient service requires adequate manpower. Conclusion: Most of the service providers, administrative personnel and supportive staffs are facing hardship with the present pay and allowances leading to extra work after office hour. Most common suggestions of the patients, service providers, administrative personnel and supportive staffs were to employ more health personnel. They also suggested strengthening of supervisory system to ensure strict discipline at all levels. DOI: http://dx.doi.org/10.3329/jafmc.v9i2.21822 Journal of Armed Forces Medical College Bangladesh Vol.9(2) 2013

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