[High prevalence of burnout in the Tunisian units that support terminally ill patients]

Polymyxin sensitivity/resistance cosmopolitan status, epidemiology and prevalence among O1/O139 and non-O1/non-O139 Vibrio cholerae: A meta-analysis

Resistance/sensitivity to polymyxin-B (PB) antibiotic has been employed as one among other epidemiologically relevant biotyping-scheme for Vibrio cholerae into Classical/El Tor biotypes. However, recent studies have revealed some pitfalls bordering on PB-sensitivity/resistance (PBR/S) necessitating study. Current study assesses the PBR/S cosmopolitan prevalence, epidemiology/distribution among O1/O139 and nonO1/nonO139 V. cholerae strains. Relevant databases (Web of Science, Scopus and PubMed) were searched to retrieve data from environmental and clinical samples employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Random-effect-model (REM) and common-effect-model (CEM) of meta-analysis was performed to determine prevalence of PBR/S V. cholerae strains, describe the cosmopolitan epidemiological potentials and biotype relevance. Heterogeneity was determined by meta-regression and subgroup analyses. The pooled analyzed isolates from articles (7290), with sensitive and resistance are 2219 (30.44%) and 5028 (69.56%). Among these PB-sensitive strains, more than 1944 (26.67%) were O1 strains, 132 (1.81%) were nonO1 strains while mis-reported Classical biotype were 2080 (28.53) respectively indicating potential spread of variant/dual biotype. A significant PB-resistance was observed in the models (CEM = 0.66, 95% CI [0.65; 0.68], p-value = 0.001; REM = 0.83 [0.74; 0.90], p = 0.001) as both models had a high level of heterogeneity (I2 = 98.0%; d f = 33 2 = 1755.09 , Q p = 2.4932 ). Egger test (z = 5.4017, p < 0.0001) reveal publication bias by funnel plot asymmetry. The subgroup analysis for continents (Asia, Africa) and sources (acute diarrhea) revealed (98% CI (0.73; 0.93); 55% CI (0.20; 0.86)), and 92% CI (0.67; 0.98). The Epidemiological prevalence for El tor/variant/dual biotype showed 88% CI (0.78; 0.94) with O1 strains at 88% CI (0.78; 0.94). Such global prevalence, distribution/spread of phenotypes/genotypes necessitates updating the decades-long biotype classification scheme. An antibiotic stewardship in the post antibiotic era is suggestive/recommended. Also, there is need for holistic monitoring/evaluation of clinical/epidemiological relevance of the disseminating strains in endemic localities.

Burn-out of the Medical Oncology Health Care Professionals and Associated Factors in Tunisia

Introduction: Burn-out is defined as a syndrome of emotional exhaustion, depersonalization and diminished self-achievement that affects individuals exposed to chronic occupational stress. Physicians and caregivers faced with the death of their patients, such as oncology, are particularly vulnerable to this syndrome.

Objectives: To evaluate the burn-out of medical professionals in medical oncology, to research the predisposing factors and to analyze the functional complaints and the behavior of the staff associated with this syndrome.

Methods: A descriptive and analytical cross-sectional study among medical oncology professionals practicing in public hospitals in the Tunisian territory who exercise more than two years in oncology; with the Maslach Burnout Inventory (MBI).

Results: Our study population was predominantly female (81%). 53% are doctors and 47% are paramedical health care professionals. A high degree of emotional exhaustion, depersonalization and personal achievement were found in 63%, 53% and 59% in our population, respectively. With 21% global high burn-out. The female sex was associated with high emotional exhaustion and low personal accomplishment as well as global burn-out. This burn-out was attributed to factors associated with working conditions and professional climate, mainly: overwork, poor organization of service, lack of resources and time, lack of recognition, lack of communication, lack of respect, conflicts with colleagues, report unsatisfactory salary effort and aggressions by patients and their families. Functional complaints and health care professional’s behavior associated with burn-out were: feelings of sadness, blockage, and irritability, sleep disorders, unexplained pain, epigastralgia, addictive behaviors, psychotropic consumption, suicidal thoughts, decreased performance and desire for a job transfer.

Conclusions: By its impact on professionals, burn-out in medical oncology represents a major threat to the quality of health care. Its etiologies, although complex and intricate, are well known. Its prevention and its support are possible, but involve mobilization at all levels.

Epidemiology of burnout syndrome in four occupational sectors in Cameroon-impact of the practice of physical activities and sport

BACKGROUND

The purpose of this study was to determine the prevalence of Burnout syndrome (BOS), risk factors and the effect of physical activity in six professions in Cameroon.

METHODS

2012 participants completed questionnaires related to socio-demographic conditions and work perception. Appropriate Maslach Burnout Inventory (MBI) psychometers were used for specific professions. Level of physical activity and sports practice was determined using the Ricci and Gagnon scale.

RESULTS

The overall prevalence of burnout was 67.9%; with 5.3% high; 34.3% moderate; and 60.4% low degree. 42.2% of victims of BOS were in high loss of personal achievement, 39.9% in high depersonalization of and 38.2% in high emotional exhaustion. Higher prevalence of BOS was found in Army (85.3%) and educational sectors (78.5% in secondary school teachers (SET) and 68% in university teaching staff (UTS)). BOS was significantly associated (p < 0.05) with distance from home to workplace, number of children per participant, number of hospitals attended, number of guards per month, labour hours per day, conflicts with the hierarchy, conflicts with colleagues, poor working conditions, unsatisfactory salary, part time teaching in private university institutions, job seniority, sedentariness. Apart from UTS, no association was observed between the level of physical activity and occurrence of BOS.

CONCLUSION

Burnout is a reality in occupational environments in Cameroon.

[Burnout among caregivers in the Yaounde Central Hospital, Cameroon]

Introduction

Le burnout ou syndrome d'épuisement professionnel des soignants est un problème de santé publique au Cameroun. Il se manifeste par un épuisement émotionnel, une dépersonnalisation et une diminution de l'accomplissement personnel du sujet. Il touche la plupart des personnels soignants et les conséquences sont nombreuses. Au Cameroun en général et à l'Hôpital Central de Yaoundé (HCY) en particulier, toutes ces dernières années, les soignants n'ont cessés d'exprimer leur mécontentement face à leurs conditions de travail à travers des grèves et menaces de divers ordres. La prise en charge des patients se fait de façon impersonnelle et on assiste à des conséquences dramatiques et des problèmes déontologiques.

Méthodes

Notre étude transversale analytique avait pour objectif de déterminer les facteurs qui sont associés au burnout dans cette population des soignants de l'HCY. Pour ce faire, pendant un mois, nous avons administré auprès de ces soignants notre questionnaire conçu selon les modèles théoriques de Maslach et Siegrist. Nous avons pu obtenir des informations recherchées auprès de 104 personnels soignants; la saisie et l'analyse des données se sont faites avec SPSS 20.

Résultats

Les résultats montrent auprès des soignants de quatre unités de soins de l'HCY des manifestations similaires à celles trouvées dans la littérature et une prévalence du Burnout (BO) de 63% parmi ces soignants. Sept facteurs y ont été associés de façon statistiquement significative: il s'agit du pavillon d'exercice (OR= 3.93; 1.16-13.24; p-value=0.027); le statut matrimonial (OR: 2.56; 1.22 - 5.39; p-value=0,049); le ratio effort/récompenses déséquilibré (OR: 2.31; 1.10 - 4.84; p-value=0.026 ); avoir été menacé physiquement ou verbalement (OR: 3,75; 1,49 - 9,41; 0,005); le maintien de l'équilibre entre vie privée et vie professionnelle (OR: 3,41; 1,19- 10,7; p-value=0,038); la fréquence des oublis (OR: 4,25 -1,33; 7,91; p-value=0,002) l'attribution des erreurs aux conditions de travail (OR: 2,05;1,52 - 24,0; p-value=0,011).

Conclusion

Le burnout est présent au sein des populations soignantes de l'HCY et risque de s'accroitre si rien n'est fait. Des stratégies de prévention et de promotion de la santé au travail sont vivement nécessaires dans les aspects de l'amélioration des conditions de travail; les prises de bonnes décisions politique et managériales; l'amélioration des relations entre soignants et soignant-hiérarchie et la recherche constante, le suivi et contrôle des facteurs de risque.