Infectious Waste Management in the Face of COVID-19 in a Rural Health Facility in Eastern Uganda

Aim: This study aimed to assess Infectious Waste Management in face of COVID-19, among Health care workers in Rural Health Facilities in Amuria district, Eastern Uganda. Little evidence exists of the challenges that occur while implementing Infectious waste management in the face of COVID-19 in resource-limited settings in Eastern Uganda. Our findings will close this apparent research gap and inform current district and national policies in Infectious Waste Management. Materials and Methods: We conducted cross-sectional survey in five health facilities in Amuria district, using modified CDC Infection Control Assessment Tool for health facility, and a validated structured questionnaire to assess the knowledge of health care workers present on Infectious waste management in the face of COVID-19. Observation and in-depth interviews were also conducted in addition to assess the practice and attitude of staff towards infectious waste management. Results: The five (100%) of the Health Facilities assessed in Amuria district lacked written infection prevention policies and procedures that are current, and are based on evidence-based guidelines. The facilities also had no competency-based training program that provides job-specific training on infection prevention policies and procedures to health care personnel. In terms of knowledge, Waste handlers had poor knowledge in infection control only 8.3% of the medical waste handlers could identify biohazard symbols and knew how infectious waste is segregated into the different categories at the point of generation. All (100%) of the health care workers were knowledgeable about the COVID-19 standard operating procedures. Conclusion: The doctors, nurses, clinical officers, and laboratory personnel had good knowledge of infectious waste Management and were up to date with COVID-19 standard operating procedures. The Medical Waste handlers had poor knowledge of Infectious Waste Management and COVID-19 standard operating procedures. Medical Waste handlers also had a poor attitude, towards the use of personal protective gear while on duty. All the Medical Waste handlers were willing to be trained in Infectious Waste Management. The facilities assessed had no enabling environment for infection control (no policies and in-service training in infection control for staff).We recommend Medical Waste Handlers to be trained in infection control and prevention before and after they are employed.

Occupational Health Hazards Among Medical Waste Handlers in Ahmadu Bello University Teaching Hospital Zaria Northwest Nigeria

Background: Occupational injuries are important public health issues, especially among healthcare workers. The medical waste handler is at risk of hazards posed by medical waste as well as from the environment. The aim of the study was to determine occupational hazards that hospital waste handlers in Ahmadu Bello University Teaching Hospital, Zaria, were exposed to and to assess their knowledge and practice of safety measures. Methods: A cross-sectional descriptive study was conducted among 79 medical waste handlers in Ahmadu Bello University Zaria using a multistage sampling technique. Data were collected using structured self-administered and interviewer administered questionnaire and analyzed using SPSS version 20 software with significance set at P < .05. Results: More than half of the respondents (56.4%) were men, and most (70.3%) had <5 years work experience. Most of the respondents (60.8%) had had an injury in the previous 6 months. The most common injuries were falling on a slippery floor (48.1%), contact/irritant dermatitis (40.5%), and 34.2% from stress. Only 45.6% received treatment following injury at the work place. Most respondents (75.9%) were aware of safety devices, and more than half (51.9%) received their information from special safety training. More than half of the respondents (51.1%) had poor knowledge of use of safety devices, and 60% had special training in occupational safety. Most respondents (89.9%) used heavy-duty rubber hand gloves, but only 5.1% used aprons. Also, 82.3% of respondents used these devices regularly at work, and more than half of respondents (62%) had been immunized against hepatitis. Also, 65.8% practiced universal precautions. Occupational injury was higher among those aged 15–19 years (occupational injury rate, 75%) compared to those aged 34–39 years (occupational injury rate, 16%). A positive association was detected between gender and injury in the last 6 months; injury was more common among men (43%) than among women (15%). Conclusions: Among respondents, there was a high level of injury and poor knowledge of the use of protective devices. Regular use of protective measures was not commensurate with the reported level of awareness. Concerted efforts are needed to ensure the safety of the medical waste handlers in his work place.Funding: NoneDisclosures: None

Frequency of Hepatitis B and C Viral Infection among the Medical Waste Handlers

Background: Chronic viral hepatitis is a major health problem worldwide. Medical waste handlers (MWH) are particularly vulnerable to such hepatitis due to nature of their job.Objective: The purpose of the present study was to see the prevalence of hepatitis B virus and hepatitis C virus infection among the medical waste handlers.Methodology: This cross-sectional study was done from January 2015 to June 2015 to know the frequency Hepatitis B and Hepatitis C among medical waste handlers in SSMC Mitford Hospital, Dhaka. Result: 96 medical waste handlers were enrolled. The mean age was 38.39 (SD ±10.057) years (range: 20 to 60 years). The leading age group was 31-40 years (32%). Most of them had little educational attainment and more than half of the respondents (53.1%) were working in the hospital for more than 10 years. Prevalence of HBV and HCV were 6.3%% and 1% respectively in MWH. More percentage of HBsAg was identified in female (8.1%), in age group between 30-39 years (17.9%), in MWH who were in the service for 7-10 years. 7.2% of the MWHs were found to have needle stick or sharp injuries while 7.7% had mucous membrane contamination. More than three-fourths of the MWHs wore thick disposable gloves, 30 (31.3%) protective gown and only 14 (14.6%) wore boots. Male MWHs were significantly more likely to wear Boots (OR: 1.505: P < 0.002) compared to Female. Conclusion: Due to needle stick puncture infectious disease like Hepatitis B & C can be transmitted to the health care workers. Health education, prophylaxis by vaccination, universal precautions and proper hospital waste management are crucial in the prevention of HBV and HCV infection. Bangladesh Journal of Infectious Diseases 2017;4(1):3-9