The Journal of the Egyptian Public Health Association最新文献

Background: The COVID-19 pandemic has impacted medical professionals' job satisfaction and was a call to adopt telemedicine. Finding out how far medical professionals are satisfied and ready to use telemedicine would be important to improve medical practice.

Methods: Data was collected from 959 medical professionals from both the governmental and private health sectors in Egypt in 2021 using a specifically designed online questionnaire, to evaluate job satisfaction, perception of telemedicine, and propose solutions to improve medical practice.

Results: The study revealed low to moderate job satisfaction at governmental (27.2%) and private (58.7%) sectors. Underpayment was the most reported challenge at both sectors (37.8% and 28.3%, respectively). Dissatisfaction with government salary was independently predicted by working at the Ministry of Health and Population (OR = 5.54, 95%CI = 2.39,12.8; p < 0.001). Wage increase (46.10%), medical training of professionals (18.1%), and management of non-human resources (14.4%) were the most proposed solutions to improve medical practice in Egypt. During the COVID-19 pandemic, 90.7% of medical professionals had practiced telemedicine with moderate level of perception of its benefits (56%).

Conclusions: During the COVID-19 pandemic, medical professionals reported low to moderate job satisfaction and a moderate level of perception of telemedicine. It is recommended to analyze the healthcare financing system and provide continuous training of medical professionals to improve medical practice in Egypt.

Coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) is responsible for a high mortality rate due to its unique and severe host-pathogen interactions. Critically ill or immunocompromised COVID-19 patients are more prone to suffer from aggressive mycoses. Probable victims include those with uncontrolled diabetes mellitus (DM), metabolic acidosis, prolonged neutropenia, increased ferritin levels, hypoxia, and prolonged hospitalization with/without mechanical ventilators and corticosteroids administration. The current review aims to outline the journey of patients with CAM as well as the advantages and disadvantages of the currently available diagnostic techniques. It also discussed the current status of treatment options and caveats in the management of mucormycosis. Multidisciplinary team, early diagnosis, controlling the predisposing condition(s), complete surgical debridement, effective antifungal therapies (e.g., amphotericin B, isavuconazole, and posaconazole), and implementing antifungal stewardship programs are imperative in CAM cases.

Background: Kitchen work is associated with exposure to heavy workload which has been linked to work-related musculoskeletal disorders (WRMSDs) and many other occupational hazards. This study aimed to measure the frequency of WRMSDs related to working in kitchens of two major Egyptian students' hostels, to determine the associated risk factors, and determine the distribution of musculoskeletal problems in various joints in different job categories.

Methods: A cross-sectional analytical study was carried out among 128 kitchen workers of two major students' hostels in Cairo, Egypt. A structured interview questionnaire was used to collect information on personal and occupational data and the prevalence of musculoskeletal pain in the past 12 months based on the valid Nordic musculoskeletal disorders questionnaire (NMQ).

Results: The study revealed that the majority of kitchen workers (90.6%) at the students' hostel reported WRMSDs within the past 12 months. The lower back (64.8%), knee (46.9%), foot (46.1%), neck (29.7%), and shoulders (23.4%) were the most affected sites. Age, educational status, job category, job duration, and body mass index (BMI) were significantly associated with WRMSDs among kitchen workers.

Conclusion: kitchen workers are at a high risk of musculoskeletal disorders (MSDs) due to the poor work environment, the massive workload, and great time pressure to perform their duties. Interventions such as hiring more workers of younger age, providing rest breaks, and health education about occupational hazards to reduce the risk of musculoskeletal problems should be reinforced.

Background: Even though informal caregivers have always been a major element within any society, their contribution to the healthcare system has only recently been recognized. Accordingly, the sustainability of their informal social role is becoming a major concern to policymakers. In Saudi Arabia, recognition of informal caregiving is still limited. This study was carried out to investigate the experience of caregiving in informal settings through identifying the needs of the caregivers along with their expectations of the formal system.

Methods: A cross-sectional study was conducted to measure the experience of Saudi informal caregivers who were caring for at least one individual with a dependency resulting from either disability, aging, or both. A self-administered questionnaire was designed specifically for this study with 88% reliability. A convenient sample of 300 caregivers was invited electronically through 14 websites supporting families with dependent individuals.

Results: Of the eligible participants (n = 271), about two-thirds were caring for one elderly person or more, while one-third were caring for individual(s) with disabilities. The two groups did not differ in their needs; their greatest perceived needs were necessary equipment for care recipients, free time to socialize, alternative care setting, and proper income. Overall, the needs on the system level were the highest, followed by the needs on the financial level, then on the social level. On the other hand, the caregivers of individuals with disabilities had greater expectations of formal support than caregivers of the elderly. The greatest expectation among the participants was facilitating care recipients' mobility within their communities. Overall, the expectations of information support were the highest followed by the expectations of financial support and then material support.

Conclusion: The participants expressed great expectations of formal support along with some unmet needs. Further research is recommended to emphasize the role of primary caregivers along with the nature of the assistance received throughout the caregiving process. The needs of individuals with dependencies along with those of the caregivers must be considered in the planning process of healthcare services. Finally, the expectations of informal caregivers should lead the priorities of the development decisions of long-term care services.

Background: Research shows that trust in government is associated with the acceptance of COVID-19 vaccination. However, there is no empirical evidence suggesting the pathway by which this association is formed. This study examines how dimensional attitudes towards vaccination explain the relationship between mistrust in government and COVID-19 vaccination acceptance.

Methods: The study was an online cross-sectional survey involving 1026 adults (of which 58.9% are female) resident in Nigeria with a mean age of 26.09 (±8.46) years. Data were collected using structured questionnaires assessing the level of mistrust in government, dimensional attitudes towards vaccination, and acceptance to be vaccinated for COVID-19. Structural equation modeling was used to analyze data.

Results: Results show that 56.8% of participants mistrust the government, while COVID-19 vaccination acceptance rate was 28.2%. Mistrust in government was significantly associated with low acceptance of COVID-19 vaccination. Furthermore, mistrust in the government was predictive of negative attitudes towards COVID-19 vaccination which include worries about unforeseen future effects of vaccines, mistrust of vaccine benefits (MVB), concerns about commercial profiteering (CCP), and preference for natural immunity. The outcomes of indirect effect analyses indicated that mistrust in government was associated with high mistrust in vaccine benefits (MVB) and increased concerns about commercial profiteering (CCP), which in turn lead to low acceptance of COVID-19 vaccination.

Conclusions: Mistrust in the government was high and was coupled with low vaccination acceptance. It is important to initiate culturally relevant awareness programs aiming at combating false notions about COVID-19 vaccination such as MVB and CCP arising from mistrust in government.

Background: Unsafe injection necessitates some preventive steps including promoting and assuring the execution of safe injection administration and waste disposal methods. The present study aimed to assess the awareness and practices of safe injection among health care providers working at all primary health care (PHC) facilities in Fayoum governorate, Egypt. Also, it assessed the awareness, readiness, and response related to needle stick injuries (NSIs).

Methods: A cross-sectional observational study conducted from September to December 2019 at all working PHC facilities in Fayoum Governorate, Egypt, resulted in enrolling 685 health care providers, and observation of 520 injection processes. Data were collected by a combination of staff interviews and structured observation of different injection processes using the WHO revised C tool.

Results: Safe injection and post-exposure NSI policies and procedures was implemented in 96.5% of the PHC facilities. Compliance to hand wash before preparing a procedure was 56.7%. Immediate disposal of used needles was 76.2% in observed injections. Hepatitis B vaccination rate among participants was 87.2%. Most participants 87.6% admitted the existence of a NSI reporting system but only 38.8% of those who had experienced NSI event reported. The rate of NSI was 14%.

Conclusions: Fayoum PHC facilities have good awareness level among providers and broadly accepted compliance with injection practices as per the WHO tool. Most injection-safety aspects were satisfactory, and implemented measures to face NSI were in place. Appropriate timely actions are required to maintain the fair awareness and improve injections practices in the PHC facilities.

Background: Catheter-associated urinary tract infections (CAUTIs) are the most common infections found in healthcare facilities. Urinary catheters predispose the development of CAUTIs by destroying natural barriers and providing a source for infection and biofilm formation (BF). This study aimed to evaluate probiotic lactic acid bacteria (LAB) as a means of preventing in vitro urinary catheter colonization and BF.

Methods: Cross-sectional screening, followed by an experimental study, was conducted on 120 catheterized patients admitted to the urology department in a tertiary care hospital for 7 months. The isolated and identified uropathogens were tested for their antimicrobial susceptibility patterns by the disk diffusion method according to Clinical and Laboratory Standards Institute recommendations and examined for their ability to produce biofilms using a microtiter plate (MtP) assay. Five LAB (Lactobacillus acidophilus (L. acidophilus), Bifidobacterium bifidum (B. bifidum), L. paracasei, L. pentosus, and L. plantarum) were identified and examined for preventing in vitro colonization and BF of some isolated uropathogens on Foley urinary catheter surfaces.

Results: Of the 120 samples collected, 32.5% were found to be associated with CAUTIs. Of isolated organisms, 74.4% were gram-negative bacilli, while gram-positive cocci represented 14%, and only 11.6% were of the Candida species. About two-thirds of isolated uropathogens were biofilm formers. All five probiotic strains had inhibitory effects on the growth of all the uropathogens tested but with varying intensities according to the duration of application after 2, 4, and 6 days.

Conclusions: The prevalence of CAUTIs was high, and the predominant bacterial isolates were gram-negative bacilli. Many of the studied uropathogens were biofilm formers. The bacterial isolates had a higher prevalence of resistance to commonly prescribed antimicrobial agents. Probiotics have the potential to prevent in vitro urinary catheter colonization and inhibit BF. Pre-coating urinary catheters with probiotics is recommended after ensuring the safety of probiotics' use in vivo by carrying out further large-scale studies.

Background: Coronavirus disease 2019 vaccine acceptance among healthcare workers (HCWs) plays a fundamental role in combating the COVID-19 pandemic. Vaccination acceptance depends on perceptions of competence and motives of the providers, producers, health professionals, and policymakers. This study aimed to identify the frequency and determinants of COVID-19 vaccine uptake acceptance, hesitancy, and barriers among HCWs.

Methods: A total of 500 HCWs from 3 different hospital affiliations in Ismailia Governorate, Egypt, were included in this mixed methods study. The study was conducted between March and April 2021 through two phases. Phase 1 included a cross-sectional study using a self-administered questionnaire with inquiries about different determinants of vaccine acceptance, hesitancy, and barriers, which was completed either electronically in a Google form or a hard printed copy. Phase 2 included four focus group discussions to explore the determinants in depth.

Results: The mean age of participants was 33.9 ± 7.9 years, 70% were females, 51.2% were nurses, and 28.6% were physicians. Of the 500 HCWs, only 27.8% accepted taking the vaccine immediately, 49.2% refused, and 23% were hesitant. Vaccine safety was the highest associated factor with vaccine acceptance (odds ratio (OR) = 6.3, 95% confidence interval (CI) 3.132-12.619), followed by previous uptake of influenza vaccine (OR = 3.3, 95% CI 2.048-5.217) and vaccine effectiveness (OR = 2.6, 95% CI 1.282-5.262). The main barriers to vaccine acceptance were mistrust in governmental policies during the pandemic or in the healthcare facility they work in. Hesitancy was common among females and nurses and was attributed to three prominent factors, including safety concerns, negative stories, and personal knowledge.

Conclusions: The vaccine acceptance frequency among HCWs was considered low, as the majority either refused or was hesitant about taking the vaccine. Concerns about vaccine safety and effectiveness were significant determinants of vaccine acceptance. Factors related to trust were the main barriers to vaccine uptake. The health authority should establish a surveillance system for side effects of the COVID-19 vaccine and communicate this information between HCWs to decrease their worries about safety and increase vaccine uptake.

Background: In Yemen, dengue fever (DF) is a widespread, locally endemic infectious disease, with high morbidity and mortality which mainly affects impoverished regions. Thus, this study aims to evaluate the knowledge, attitudes, and behaviors of the Shabwah community in Yemen regarding DF characteristics and prevention.

Methods: The present study is a cross-sectional community-based study conducted in Shabwah Governorate, Yemen, between June 2021 and November 2021. Simple random sampling was used to select the sample (n = 370), and a validated closed-ended questionnaire was used to collect data.

Results: In total, 370 individuals participated in this study; most respondents were female (N = 247, 66.8%), and more than half (N = 214, 57.8%) were younger than age 30. More than 50% of the population had completed a primary or secondary school, while approximately 33.03% of them were illiterate. Furthermore, more than half (53.5%) of the population had good knowledge of DF, while most of those educated at a university level (64.1%) had good attitude toward DF. Most of the population (68.4%) had good practice toward DF. Moreover, participants with a university level education, followed by those who completed secondary school, had significantly higher knowledge and practice scores than primary school and illiteracy (P = 0.05).

Conclusion: The results of the study indicate that the residents of Yemen's Shabwah Governorate are well-informed about the symptoms and signs of DF, have a positive attitude toward the disease, and employ appropriate preventive measures. Health education via various media should be mandated to increase community awareness and dispel misconceptions about DF.