Dataset Information

Prevalence of active tuberculosis disease among healthcare workers and support staff in healthcare settings of the Amhara region, Ethiopia.

ABSTRACT:

Background

Health care workers (HCWs) are at an increased risk of acquiring tuberculosis (TB) compared to the general population, because of the frequent face to face contact or potential exposure to TB through shared air or space with infectious patient(s), regardless of economic setting and local TB incidence. Information on the burden of active TB disease among HCWs will help guide control measures, can be utilized to evaluate the effectiveness of TB infection prevention programs in the health care setting, and guide necessary actions. However, data on TB among HCW in Ethiopia is limited. Therefore, this study aimed to determine the prevalence of active TB disease among healthcare workers and support staff in healthcare settings in the Amhara region of Ethiopia.

Methods

A cross-sectional study design was used to recruit a total of 580 randomly selected study participants in the Amhara region. Data were collected over four months in selected hospitals and health centers. Implementation of TB prevention and control measures was evaluated using a standardized checklist. The main outcome indicator was active TB as measured by a laboratory diagnosis using GeneXpert technology.

Results

A total of 580 study participants were enrolled. The mean age was 31.3 (±7.8 standard deviation) years, with about two-thirds (65.3%) aged between 18-24 years. A total of 9 (1.6%) MTB cases were detected, 4 (1.4%) in HCWs and 5 (1.7%) in support staff, which did not significantly differ (P = 0.50). About 90% of the participants had not received TB infection prevention and control training ever. More than half (54%) of the study participants worked in poorly ventilated rooms. Triage of coughing patients was not practiced in 32% of the studied facilities (health centers and hospitals).

Conclusions

The magnitude of TB among healthcare workers and support staff in healthcare settings was higher than in the general population (140 per 100000 population). The status of implementation of tuberculosis prevention and control measures indicated missed opportunities. Hence, strict implementation of developed infection control plans of TB in healthcare settings needs to be improved.

SUBMITTER: Shiferaw MB

PROVIDER: S-EPMC8195404 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundHealthcare workers (HWs) are at the highest risk of getting CIVID-19. This study aimed to assess factors determining the knowledge and prevention of HWs towards COVID-19 in the Amhara Region, Ethiopia.MethodsA cross-sectional online survey was conducted among 442 HWs using email and telegram addresses. The knowledge and practice of HWs were estimated using 16 knowledge and 11 practice questions. A multivariable logistic regression analysis was used on SPSS version 25 to identify factors related to the knowledge and prevention practice of HWs on COVID-19. Significance was determined at a p value of < 0.05 and association was described by using odds ratio at 95% CI.ResultsOf 442 HWs, 398 (90% response rate) responded to the online interview questionnaire. From 398 HWs, 231(58%), 225(56%), 207(53%), and 191(48%) were males, from rural area, aged ≥ 34 years and nurses, respectively. About 279(70%) HWs had good knowledge of COVID-19 followed by 247(62%) good prevention practices. Age < 34 years (AOR = 2.14, 95% CI = 1.25-3.62), rural residence (AOR = 0.44, 95% CI = 0.26-0.70), access to infection prevention (IP) training (AOR = 2.4, 95% CI = 1.36-4.21), presence of IP guideline (AOR = 2.82, 95% CI = 1.64-4.62), and using social media (AOR = 2.51, 95% CI = 1.42-4.53) were factors of knowledge about COVID-19. Whereas, rural residence (AOR = 0.45, 95% CI = 0.31-0.75), facility type (AOR = 0.40, 95% CI = 0.28-0.89), access to IP training (AOR = 2.32, 95% CI = 1.35-4.16), presence of IP guidelines (AOR = 2.10, 95% CI = 1.21-3.45), knowledge about COVID-19 (AOR = 2.98, 95% CI = 2.15-5.27), having chronic illnesses (AOR = 2.0, 95% CI = 1.15-3.75), lack of protective equipment (PPE) (AOR = 0.42, 95% CI = 0.32-0.74), and high workload (AOR = 0.40, 95% CI = 0.36-0.87) were factors of COVID-19 prevention.ConclusionIn this study, most of the HWs had good knowledge but had lower prevention practice of COVID-19. Socio-demographic and access to information sources were factors of knowledge on COVID-19. Similarly, residence, shortage of PPE, high workload, comorbidities, knowledge, and access to IP training and guideline were factors limiting prevention practices. Thus, a consistent supply of PPE and improving health workers' knowledge, making IP guidelines and information sources available, and managing chronic illnesses are crucial to prevent COVID-19 among HWs.

Project description:BackgroundLiteratures revealed that healthcare-associated infections are still a great concern in many developing countries including in Ethiopia. Despite the development of detailed guidelines for infection control, they remain as a critical challenge for the public health sectors and the knowledge of standard precautions among healthcare workers in many developing countries is low and not properly applied. Hence, the present study tried to determine the level of knowledge about standard precautions among healthcare workers of Amhara region, Ethiopia.MethodsInstitutional based cross-sectional study was conducted on a randomly selected public hospitals of Amhara region, Northwest Ethiopia from March 01-April 01/2017. A multistage sampling strategy was utilized to select 795 sampled healthcare workers. Data were collected using pretested self-administered questionnaire. The collected data entered using EpiData Version 3.1 statistical software and analyzed using SPSS version 20 statistical package. After using binary logistic regression, multivariable logistic regression analysis used to form the model. Variables which had statistically significant association with the outcome variable (P < 0.05) were identified as significant in the multivariable logistic regression analysis.ResultsAlmost half (49.2%) of the study participants were female healthcare workers. Three-fourth (74.3%) of the healthcare workers involved in the current study had good knowledge towards standard precautions. Good knowledge towards standard precautions refers to scoring correct responses to > 60% of knowledge items from the survey. Year of service (AOR: 0.27, 95% CI: 0.16 to 0.44), educational status (AOR: 1.7, 95% CI: 1.13 to 2.56) were among the predictor variables. In addition, physicians were 6.97 times more likely to be knowledgeable (AOR: 6.97, 95% CI 2.42 to 20.12) than laboratory technician/technology counterparts. Study participants working in medical, Gyn/obs, pediatrics wards, and OPD were about 2.23, 4.27, 2.81 and 2.52 times more likely to be knowledgeable than study participants working in surgical ward.ConclusionsOverall, the majority of healthcare workers had good knowledge of standard precautions. But variation in knowledge was detected across healthcare workers by hospital type and ward/units. This may help to design a solution by prioritizing the problem.

Project description:BackgroundSocial protection programmes have effectively reduced poverty and improved food security. However, the effects of poverty require an intersectoral approach to adequately address poor nutrition and health. Identifying gaps in knowledge and access to frontline workers who oversee these integrations is critical for understanding the potential for integrated social protection programming to improve these outcomes. We measured levels of social protection programme participants' knowledge of and interaction with social workers (SWs) and health extension workers (HEWs) in rural Ethiopia.MethodsThis mixed-methods study uses cross-sectional data from the baseline survey of a quasi-experimental impact evaluation among a sample of 5,036 households participating in Ethiopia's Productive Safety Net Programme. Qualitative interviews include key informant interviews, in depth interviews and focus group discussions with caregivers, community members, frontline agents, and stakeholders. Using data from household questionnaires administered to household heads, quantitative analyses include univariate and bivariate descriptive statistics as well as mutually-adjusted multivariable logistic regression analyses to estimate adjusted odds ratios and 95% confidence intervals for household sociodemographic characteristics associated with 1) knowledge of SWs and HEWs and 2) interaction with SWs and HEWs in their communities. Qualitative data were analysed using thematic analysis combining both a fluid and more structured coding processes to unpack the important topics within the data supported by illustrative quotes.ResultsOur results show that knowledge of and interaction with SWs is limited while many knew of and interacted with HEWs quite regularly. Interactions with SWs were negatively associated with increased household size and living in Dewa Chefa. Factors associated with increased knowledge of and interaction with HEWs include having children under the age of 5 years in the household, having health insurance, and having a formal education. Qualitative analyses suggest that SWs are limited by overwhelming caseloads, limited resources to carry out their work, and high staff turnover. However, SWs are considered highly valuable in the communities where they work.ConclusionsWhile most of the participants reported knowing their HEW, there is room for improvement, especially around household engagement with HEWs. Although SWs support the ISNP in the treatment districts only and not formally incorporated into the structure in the region, our findings highlight a need to provide greater support to SWs to effectively facilitate improvements in health and nutritional outcomes among vulnerable households.Trial registrationPan African Clinical Trial Registry (PACTR201902876946874) and the Registry for International Development Impact Evaluations (RIDIE-STUDY-ID-5bf27eb0404a0).

Project description:BackgroundDelayed presentation is a major problem contributing to the high burden and transmission of tuberculosis (TB) in developing countries. The delay may be due to patient delay if the patient visits health-facility for diagnosis after the onset of symptoms of more than 3 weeks or health system delay if the patient is not diagnosed and treated at the time of the first visit. Ethiopia, where no more than two-thirds of TB cases are detected is no exception. Therefore, the aim of this study was to assess delay in diagnosis of tuberculosis among patients taking anti-TB treatment in North Shoa Zone, Ethiopia.MethodsInstitution based cross-sectional study was conducted from 01 to 30 December 2017. All TB patients who took their treatment in the health facilities of the seven selected districts of North Shoa Zone were included. Data was entered into EPI INFO version 3.5.1 statistical software and transferred into SPSS version 20.0 for further analysis. Bivariate and multivariate analysis was used to identify associated factors for delayed TB diagnosis.ResultsOut of 170 tuberculosis patients included, 162 patients were studied with a response rate of 95.3%. The proportion of tuberculosis patients who had delayed diagnosis was 59.9%. The mean time of health-seeking after developing the symptom of tuberculosis was 7.6 weeks. Tuberculosis patients with extra pulmonary site involvements were about four times more likely to be delayed in seeking health services (OR: 4.00, 95% CI: 1.77-9.03) as compared to patients with pulmonary TB. New patients were about three times more likely to come lately for TB diagnosis (OR: 2.94, 95% CI: 1.26-6.84) as compared to patients who had previous-history of treatment. Patients who had no information about TB before they started TB treatment were also around three times to be delayed (OR: 3.37, 95% CI: 1.43-8.00) as compared to those who had the information.ConclusionsMore than 50% of TB patients reported in health-seeking relatively a longer time. Strengthening the health education activities for the community about tuberculosis and capacity building of the health care provider to increase suspicion of identifying tuberculosis and early diagnosis is crucial.

Project description:BackgroundThe burden to fight with Corona Virus Disease-19 (COVID-19) pandemic has lied to frontline health care workers that are putting themselves at a higher risk in the battle against the disease. This study aimed to assess the exposure health risks of COVID-19 among frontline healthcare workers in the Amhara region, Ethiopia.MethodA web-based cross-sectional study was conducted on public health workers from May to August 2020. Data were collected using a structured questionnaire via email and telegram services. Both descriptive statistics and bivariate followed by multivariable logistic regression analyses were conducted to identify distribution patterns and factors associated with exposure risks to COVID-19. Odds ratio with 95% Confidence Interval (CI), and a P-value of <0.05 was used to determine statistical significance.ResultA total of 418 health care workers participated in the study with a response rate of 99.1%. The majority of the study participants 310(74.2%), were males, and 163(39%) were nurses/ midwives respectively. More than half of the respondents 237(56.7%), had reported that they didn`t have face-to-face contact with a confirmed COVID-19 patient. Among the respondents, 173(41.4%), 147(35.2%), 63(15.1%), and 65(15.6%) of the health professionals had always used gloves, medical masks, face shield, or goggles/protective glasses, and disposable gown, respectively. In this study, age between 25-34 years (AOR = 0.20), age between 35-44 years (AOR = 0.13), family size of >6 (AOR = 3.77), work experience of 21-30 years (AOR = 0.01), and good handwashing habit (AOR = 0.44) were the protective factors against COVID-19. On the other hand, perception of non-exposure to COVD 19 (AOR = 9.56), and poor habit of decontamination of high touch areas (AOR = 2.52) were the risk factors associated with confirmed COVID 19 cases among health care workers.ConclusionPoor adherence to personal protective equipment use and aseptic practices during and after health care interactions with patients were identified. Strategies should be implemented to institute effective and sustainable infection control measures that protect the health care workers from COVID-19 infection.

Project description:BACKGROUND:The emergence of pre-extensively and extensively drug-resistant tuberculosis (Pre-XDR/XDR-TB) is the major hurdle for TB prevention and care programs especially in developing countries like Ethiopia. The less emphasis on universal access to laboratory techniques for the rapid diagnosis of TB and drug susceptibility testing (DST) makes the management of MDR-TB a challenge. Early detection of second line anti-TB drugs resistance is essential to reduce transmission of Pre-XDR/XDR-TB strains and adjusting the treatment regimen in MDR-TB. OBJECTIVE:To determine the prevalence and resistance pattern of Pre-XDR- and XDR-TB among MDR-TB patients in the Amhara region, Ethiopia. METHODS:A cross sectional study was carried out in nine MDR-TB treatment centers in the Amhara region. Sputum samples were collected from all pulmonary rifampicin resistant (RR) or MDR-TB patients prior to anti-TB treatment. L?wenstein-Jensen (LJ) culture, Ziehl Neelsen (ZN) smear, MTBDRplus and MTBDRsl assays were performed according to the standard procedures. Data were analyzed using SPSS 20 software. Chi-square and/or Fishers exact test was employed. RESULTS:Overall, 6.3% of MDR-TB isolates were resistant to at least one second line drugs. Pre-XDR-TB and XDR-TB isolates accounted 5.7% and 0.6% respectively. Moreover, 3.4% were resistant to FQs and 3.4% were resistant to second line injectable drugs. All isolates were susceptible for low level kanamycin. Almost all pre-XDR-TB strains (90%) were previously treated with anti-TB drugs. Drug resistant Mycobacterium tuberculosis isolates were disproportionately distributed in districts of the Amhara region and the majorities were concentrated in urban areas. CONCLUSIONS:The high proportion of MDR-TB patients resistant to at least one second line drug is alarming. Strengthening the laboratory facilities to monitor pre-XDR and XDR-TB patients is crucial. The TB programs need to give emphasis on the effective and rational use of second line drugs for newly diagnosed MDR-TB patients to prevent the emergence of pre-XDR/XDR-TB strains.

Project description:BackgroundTrachoma recrudescence after elimination as a public health problem has been reached is a concern for control programs globally. Programs typically conduct district-level trachoma surveillance surveys (TSS) ≥ 2 years after the elimination threshold is achieved to determine whether the prevalence of trachomatous inflammation-follicular (TF) among children ages 1 to 9 years remains <5%. Many TSS are resulting in a TF prevalence ≥5%. Once a district returns to TF ≥5%, a program typically restarts costly mass drug administration (MDA) campaigns and surveys at least twice, for impact and another TSS. In Amhara, Ethiopia, most TSS which result in a TF ≥5% have a prevalence close to 5%, making it difficult to determine whether the result is due to true recrudescence or to statistical variability. This study's aim was to monitor recrudescence within Amhara by waiting to restart MDA within 2 districts with a TF prevalence ≥5% at TSS, Metema = 5.2% and Woreta Town = 5.1%. The districts were resurveyed 1 year later using traditional and alternative indicators, such as measures of infection and serology, a "wait and watch" approach.Methods/principal findingsThese post-surveillance surveys, conducted in 2021, were multi-stage cluster surveys whereby certified graders assessed trachoma signs. Children ages 1 to 9 years provided a dried blood spot and children ages 1 to 5 years provided a conjunctival swab. TF prevalence in Metema and Woreta Town were 3.6% (95% Confidence Interval [CI]:1.4-6.4) and 2.5% (95% CI:0.8-4.5) respectively. Infection prevalence was 1.2% in Woreta Town and 0% in Metema. Seroconversion rates to Pgp3 in Metema and Woreta Town were 0.4 (95% CI:0.2-0.7) seroconversions per 100 child-years and 0.9 (95% CI:0.6-1.5) respectively.Conclusions/significanceBoth study districts had a TF prevalence <5% with low levels of Chlamydia trachomatis infection and transmission, and thus MDA interventions are no longer warranted. The wait and watch approach represents a surveillance strategy which could lead to fewer MDA campaigns and surveys and thus cost savings with reduced antibiotic usage.