Aims and Objectives:
This study investigated occupational exposure to blood and body fluids among nurses at the emergency department and intensive care units of public hospitals in Addis Ababa city.
...Methods:
A cross-sectional study was conducted from June 18, 2021 to September 20, 2021. A simple random sampling method and semi-structured, self-administered questionnaires were used to collect the data, which were analyzed using SPSS version 25. A binary logistic regression model was used to identify factors associated with exposure to blood and body fluids on the AOR with a 95% confidence interval at a P-value of <.05.
Patient and Public Involvement:
No patients were involved in this study.
Results:
Of the total study participants (260), 198 (76%) nurses had been exposed to blood and body fluids in their professional live, and 167 (64%) were exposed to blood and body fluids in the last 12 months. Being male (AOR = 2.88, 95% CI: (1.35, 6.12), lacking access to handwashing facilities (AOR = 5.02, 95% CI: (3.73, 14.51)), not consistently wearing all the required types of personal protective equipment (AOR = 6.21, 95% CI: (2.39, 9.55)), and the lack of the required personal protective equipment (AOR = 5.53, 95% CI: (1.87, 10.38)) were all significant factors that were positively associated with exposure to blood and body fluids.
Conclusion:
This study showed that a higher proportion of nurses in the emergency department and intensive care unit were exposed to blood and body fluids in the study setting. Most nurses do not consistently wear all the required types of personal protective equipment, putting them at a higher risk of acquiring blood-borne pathogens. The authors recommended that there is a need to implement and strengthen appropriate and consistent use of all required personal protective equipment during any procedure, and patient care to reduce exposure to blood and body fluids.
Relevance to Clinical Practice:
This study provides baseline information for other action-based studies to assess exposure to blood and body fluids among nurses in emergency and intensive care units.
Strobe Checklist:
This manuscript was prepared based on the strobe checklist guidelines.
Impact Statement:
The study’s findings and recommendations might be used for healthcare providers, non-governmental organizations, and policymakers for appropriate planning and interventions to minimize or safeguard nurses’ exposure to blood and body fluids.
Traumatic brain injury (TBI) is a major public health problem worldwide. Although computed tomography (CT) scans are often used for TBI workup, clinicians in low-income countries are limited by fewer ...radiographic resources. The Canadian CT Head Rule (CCHR) and the New Orleans Criteria (NOC) are widely used screening tools to rule out clinically important brain injury without CT imaging. Although these tools are well validated in studies from upper- and middle-income countries, it is important to study these tools in low-income countries. This study sought to validate the CCHR and NOC in a tertiary teaching hospital population in Addis Ababa, Ethiopia.
This single-center retrospective cohort study included patients older than 13 years presenting from December 2018 to July 2021 with a head injury and a Glasgow Coma Scale score of 13–15. Retrospective chart review collected demographic, clinical, radiographic, and hospital course variables. Proportion tables were constructed to determine the sensitivity and specificity of these tools.
A total of 193 patients were included. Both tools showed 100% sensitivity for identifying patients requiring neurosurgical intervention and abnormal CT scans. The specificity for the CCHR was 41.5% and 26.5% for the NOC. Male gender, falling accidents, and headaches had the strongest association with abnormal CT findings.
The NOC and the CCHR are highly sensitive screening tools that can help rule out clinically important brain injury in mild TBI patients without a head CT in an urban Ethiopian population. Their implementation in this low-resource setting may help spare a significant number of CT scans.
Traumatic brain injury (TBI) is a leading contributor to emergency department (ED) mortalities in Ethiopia. Mild TBI patients comprise half of all TBI patients presenting for care in Ethiopia and ...have a high potential for recovery. As such, context-specific care-improving strategies may be highly impactful for this group of patients.
This study examines the presentation and disposition of mTBI patients who received a computed tomography scan of the head upon arrival at the largest teaching hospital in Ethiopia.
A retrospective cohort study was conducted from 2018 to2021 including patients >13 years old with a head injury and a Glasgow Coma Score of 13–15 who obtained a computed tomography scan of the head. Variables were collected from medical charts and single and multivariable analyses assessed outcomes of clinically important TBI (ciTBI) requiring a neurosurgical procedure or admission.
A total of 193 patients were included. They were predominantly young men with no comorbidities, injured in road traffic accidents or by assault, had stable vital signs and were treated in lower-acuity ED areas. A minority demonstrated focal deficits, and 29.5% of patients had ciTBI. Most patients were discharged from the ED, but 13% were taken for operative neurosurgical procedures and 10.4% were admitted to the neurosurgery ward for observation. ED stays ranged from 8 hours to 10 days, as patients waited for CT availability, neurosurgical decision, or transportation. Female sex was independently protective of ciTBI. Self-referral status was independently protective against operative intervention. Female sex and self-referral status were independently protective of a disposition of admission and/or going to the operating room.
This study characterizes the mTBI subgroup of head injury patients in Ethiopia's busiest ED: predominantly healthy young men with low-acuity presentations and only a fraction with abnormal neurological examinations. Nonetheless, about one-third had ciTBI and a minority were taken for neurosurgical procedures or admission, with female sex and self-referral identified as protective factors. Meanwhile, many patients stayed in the ED for days due to social or other nonmedical reasons. As TBI care in Ethiopia continues to improve, optimizing care for the mTBI subgroup is tantamount given their high recovery potential. This care will benefit from efficiently identifying those who need intervention or hospital level of care, and discharging those who do not.
Data from much of Africa are still scarce on the clinical characteristics, outcomes of treatment, and factors associated with disease severity and mortality of COVID-19. A cross-sectional study was ...conducted at Eka Kotebe General Hospital, Ethiopia's first COVID-19 treatment center. All consecutive symptomatic SARS CoV-2 RT-PCR positive individuals, aged 18 and older, admitted to the hospital between March 13 and September 16, 2020, were included. Of the total 463 cases, 319 (68.9%) were male. The median age was 45 years (interquartile range 32-62). The most common three symptoms were cough (69%), shortness of breath (SOB; 44%), and fatigue (37%). Hypertension was the most prevalent comorbidity, followed by diabetes mellitus. The age groups 40 to 59 and ≥ 60 were more likely to have severe disease compared with those < 40 years of age (adjusted odds ratio aOR = 3.45, 95% confidence interval CI: 1.88-6.31 and aOR = 3.46, 95% CI: 1.91-6.90, respectively). Other factors associated with disease severity included the presence of any malignancy (aOR = 4.64, 95% CI: 1.32-16.33) and SOB (aOR = 3.83, 95% CI: 2.35-6.25). The age group ≥ 60 was significantly associated with greater in-hospital mortality compared with those < 40 years. In addition, the presence of any malignancy, SOB, and vomiting were associated with higher odds of mortality. In Ethiopia, most COVID-19 patients were male and presented with cough, SOB, and fatigue. Older age, any malignancy, and SOB were associated with disease severity; these factors, in addition to vomiting, also predicted mortality.
Effective risk communication is one of the critical strategies in the response to COVID-19. This study examined risk perceptions and attitudinal responses to COVID-19 among the educated section of ...the society in Ethiopia.
An internet-based survey was conducted from April 22 to May 04, 2020, in Ethiopia. A questionnaire addressing the perception of health threat-combination of perceived vulnerability (PV) and perceived seriousness (PS), and perceived efficacy-combinations of perceived response efficacy (PRE), perceived self-efficacy (PSE), and perceived collective efficacy (PCE). The data were analyzed using SPSS 21.0. Descriptive statistics were computed after the standardization of the scores. The scores for overall efficacy and threat were split by median value and response classifications were generated through threat by efficacy interactions. For statistical significance, 95% CI and p-value < 0.05 were used.
A total of 929 respondents submitted their responses. Eight hundred and twenty-eight (89.1%) of the respondents were male and 753 (81.1%) were Christian. The perceived threat to COVID-19 was generally low (median = 58.3). The median score for overall efficacy, PRE, and PSE were 79.8, 87.5, and 80.0, respectively. However, the median value (66.7) for PCE was relatively low. Perceived threat significantly varied by age, education, occupation, and place of residence (p < 0.05). Perceived efficacy significantly differed by gender, residence, and use of some sources of information (p < 0.05). In terms of response to COVID-19, 290 (31.2%), 239 (25.7%), 175 (18.8%) and 225 (24.2%) of the respondents were in the responsive, pro-active, avoidant, and indifferent attitudinal categories, respectively. The avoidant and indifferent groups constituted a fear control response (mal-adaptive motivation towards COVID-19 protective behavior) whereas responsive and pro-active categories formed a danger control response (self-protective motivation). These responses varied significantly by residence, region, religion, and sources of information (p < 0.05).
Understanding people's perceived health threat and efficacy is a critical step toward creating risk communication campaigns. Hence, this study provided an insight that has the potential to inform the COVID-19 risk communication campaigns targeting the educated section of the society, by ensuring a balanced combination of threat appeals and efficacy messages for improved self-protective responses.
Edible oils are imported and produced in Ethiopia, notably in Gondar, and their production has expanded considerably in recent years. The expansion of locally produced edible vegetable oils with ...severe quality control, substandard edible oil production, and quality deterioration may contribute to the contamination of microbes, which may cause public health problems. This study determines the microbiological quality of edible vegetable oils being produced and marketed in Gondar City, Northwest Ethiopia, in 2021. A laboratory-based cross-sectional study design was conducted from May to July 2021 in Gondar City. A simple random sampling technique was used to collect 17 edible vegetable oil samples. Aseptically collected samples were analyzed in the microbiology lab room. The microbiological quality of vegetable oil was assessed using standard microbiological procedures and techniques. The collected data were entered into a Microsoft Excel 2016 spreadsheet and Stata Version 14. A non-parametric Kruskal–Wallis test was used to assess significant variation. Seventeen edible vegetable oil samples were examined and found to contain a varying number of
bacteria
,
yeast
, and
molds
.
Staphylococcus aureus
,
Klebsiella Pneumoniae
, and
Pseudomonas aeruginosa
were the identified bacteria, whereas
Saccharomyces cerevisiae
,
Aspergillus niger
,
Aspergillus flavus
, and
Aspergillus fumigatus
were the identified
fungi. Total coliform
and
fecal coliform
isolates were also identified in the oil samples. A level of microbial contamination that has public health importance was observed in some of the oil samples analyzed, and the isolated microorganisms indicate unhygienic handling, processing, and storage practices in the oil production and market sites. The introduction of strict rules, regulations, and updated manufacturing technologies and processes to ensure food safety and quality is needed.
In this study, the performance of the electrocoagulation (EC) process was evaluated for its capability to remove color, total organic carbon (TOC), chemical oxygen demand (COD) using aluminium ...electrodes. Response surface methodology based on Box-Behnken design was used to optimize different operating conditions of the processes. The interaction effects of four independent variables such as dye concentration, applied current density, electrolysis time, and pH on the percentage of COD, TOC, and color removal were investigated by the EC process. ANOVA analysis was made to examine the significance of input parameters and their interaction effect on responses. At the optimum operating conditions, 89% of color, 47% of TOC, and 76% of COD removal rate were achieved using the EC process. Different research works have been reported on the treatment of textile wastewater by the EC process. However, these researches vary regarding working conditions such as dye type, concentration, current density, pH, electrolysis time, and electrode type. Also, most literature focuses mainly on the performance of the technology. However, it is also important to investigate the economic aspect, removal mechanism, and mineralization study. Thus, economic analyses, mineralization, kinetic, sludge characterization studies of the technology were performed.
Nowadays, food safety is regarded as one of the most critical global public health issues. Edible oil, a key ingredient in food processing, is widely used and consumed in every Ethiopian household. ...However, its safety is often overlooked. Currently, edible oil is produced in Ethiopia from small-scale operations to large industrial levels, as well as imported from other countries.INTRODUCTIONNowadays, food safety is regarded as one of the most critical global public health issues. Edible oil, a key ingredient in food processing, is widely used and consumed in every Ethiopian household. However, its safety is often overlooked. Currently, edible oil is produced in Ethiopia from small-scale operations to large industrial levels, as well as imported from other countries.This study aimed to determine the levels of heavy metals and essential minerals in edible vegetable oils produced and marketed in Gondar City, Northwest Ethiopia.OBJECTIVEThis study aimed to determine the levels of heavy metals and essential minerals in edible vegetable oils produced and marketed in Gondar City, Northwest Ethiopia.A laboratory-based cross-sectional study was conducted from May to July 2021 in Gondar City. Seventeen edible oil samples were collected using simple random sampling techniques. Heavy metal content was determined using an atomic absorption spectrophotometer with the standard procedures and techniques after microwave digestion. The efficiency and validity of the method used were evaluated by determining the limit of detection (LOD), the limit of quantification (LOQ), accuracy, and precision. The collected data were entered into Microsoft Excel and transported to Stata for analysis.METHODSA laboratory-based cross-sectional study was conducted from May to July 2021 in Gondar City. Seventeen edible oil samples were collected using simple random sampling techniques. Heavy metal content was determined using an atomic absorption spectrophotometer with the standard procedures and techniques after microwave digestion. The efficiency and validity of the method used were evaluated by determining the limit of detection (LOD), the limit of quantification (LOQ), accuracy, and precision. The collected data were entered into Microsoft Excel and transported to Stata for analysis.A total of seventeen vegetable oil samples were analyzed. The accuracy of the method was evaluated by recovery studies, which ranged from 81 to 115%, and the relative standard deviations were found to be below 15%. The concentrations of Zn, Cu, Fe, Cd, and Pb were in the range of 0.07 to 0.8 mg/l, 0.002 to 0.06 mg/l, 0.01 to 0.8 mg/l, 0.08 to 0.18 mg/l, and 0.003 to 0.27 mg/l, respectively. In general, the lead and cadmium content was higher than other metals in some of the investigated edible vegetable oils. Most values fell within the permissible quality limits for edibility as prescribed by the World Health Organization (WHO) and the National Agency for Food and Drug Administration and Control (NAFDAC). However, the levels of Pb and Cd exceeded the reference levels in some locally produced vegetable oils.RESULTA total of seventeen vegetable oil samples were analyzed. The accuracy of the method was evaluated by recovery studies, which ranged from 81 to 115%, and the relative standard deviations were found to be below 15%. The concentrations of Zn, Cu, Fe, Cd, and Pb were in the range of 0.07 to 0.8 mg/l, 0.002 to 0.06 mg/l, 0.01 to 0.8 mg/l, 0.08 to 0.18 mg/l, and 0.003 to 0.27 mg/l, respectively. In general, the lead and cadmium content was higher than other metals in some of the investigated edible vegetable oils. Most values fell within the permissible quality limits for edibility as prescribed by the World Health Organization (WHO) and the National Agency for Food and Drug Administration and Control (NAFDAC). However, the levels of Pb and Cd exceeded the reference levels in some locally produced vegetable oils.To address the exceeded levels of heavy metals, it is imperative to implement more careful handling, processing of raw materials, and filtering practices. Producers and marketers should take the necessary precautions to prevent contamination. Strict regulatory control from responsible bodies and stakeholders is recommended to ensure the safety and metal contents of vegetable oils originating from the study area.CONCLUSIONTo address the exceeded levels of heavy metals, it is imperative to implement more careful handling, processing of raw materials, and filtering practices. Producers and marketers should take the necessary precautions to prevent contamination. Strict regulatory control from responsible bodies and stakeholders is recommended to ensure the safety and metal contents of vegetable oils originating from the study area.
The hybrid electrocoagulation-electrooxidation (EC-EO) process was evaluated for its capability to remove color, total organic carbon (TOC), and chemical oxygen demand (COD). Aluminum (Al/Al) and ...iridium dioxide-coated onto titanium (IrO2/Ti) electrodes were selected as anode/cathode for EC and EC-EO experiments, respectively. The box-Behnken statistical experimental design was used to optimize different operating conditions of the processes. The selected EC operating parameters are the concentrated dye concentration, applied current density, electrolysis time, and pH. The three chosen operating conditions for hybrid EC- EO processes are applied current density, pH, and electrolysis time. The results were evaluated based on the interaction effects of operating parameters of the treatment methods on the percentage of COD, TOC, and color removal. The EC process achieved 89% color and 76% COD removal rate at the optimum operating conditions. Likewise, the hybrid EC-EO process obtained 97% COD and color removal efficiency. FT-IR and 1H and 13C NMR spectroscopy combined approach was employed to analyze the dye degradation extent. Both analysis results confirm the complete degradation of the organic contaminants into carbon dioxide and water. Thus, this study discloses that the treatment method using mesh IrO2/Ti electrodes is a promising technology that could reach the discharge limit for industrial effluents. In addition, the optimum operating conditions are tested for real industrial wastewater effluents and show excellent performance in removing pollutants. Furthermore, the treatment method's mineralization study and economic analysis were performed and compared to other studies.
Display omitted
•Hybrid EC and EO were used for textile wastewater treatment.•Interaction effects of operating parameters were studied and optimized using Box-Behnken design under RSM.•Dye degradation extent was studied using a combined approach of FT-IR and 1H and 13C NMR spectroscopy.•Complete degradation of the organic contaminants into carbon dioxide and water was achieved.•Thus, this study discloses that the treatment method using IrO2/Ti electrodes is a promising technology.
Objective. To assess the timing of first antenatal care attendance and associated factors among pregnant women in Arba Minch Town and Arba Minch District, south Ethiopia. Method. Facility based ...cross-sectional study employing both quantitative and qualitative methods was conducted from February to March, 2014, in Arba Minch Town and Arba Minch District. Data were collected from 409 pregnant women attending antenatal care clinics in nine public health facilities using systematic random sampling. Analysis was done using SPSS version 20. Descriptive statistics and binary and multiple logistic regression analysis were done. Results. The mean (SD±) age of the respondents was 26 ± 5.5 years. The mean gestational age at first antenatal care attendance was 5 ± 1.5 months. This study indicated that pregnant women with low monthly income (AOR = 4.9, CI: 1.71, 14.08), women who did not receive advise on when to start ANC (AOR = 3, CI: 1.48, 6.24), women with household food insecurity (AOR = 4.66, CI: 1.007, 21.59) and women with unplanned pregnancy (AOR = 4.49, CI: 2.16, 9.35) had higher odds of late antenatal care attendance compared with their counterparts. Conclusions. The study showed that majority of the pregnant women attended late for first antenatal care. Hence, providing health education on the timing of antenatal care is important.
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