COVID-19 knowledge, attitude and frequent hand hygiene practices among taxi drivers and associated factors in urban areas of Ethiopia

Hand contamination and hand hygiene knowledge and practices among commercial transport users after the SARS-CoV-2 virus (COVID-19) scare, Enugu State, Nigeria

Contaminated hands are one of the most common modes of microorganism transmission that are responsible for many associated infections in healthcare, food industries, and public places such as transportation parks. Public health approaches during COVID-19 pandemic have shown that hand hygiene practices and associated knowledge are critical measure to control the spread of infectious agent. Hence, assessment of commercial transport users' knowledge, belief and practices on hand hygiene, and potential contamination with infectious agents which is the aim of the study, aligns with general health concern of quantifying contamination risk levels to predict disease outbreaks. This study utilized a randomized sampling approach to select 10 frequently used commercial parks within two districts in the State: Enugu and Nsukka. The parameters analysed include a cross-sectional questionnaire survey, hand swab and hand washed samples collected from dominant hand of participants. A total of 600 participants responded to the questionnaire survey, while 100 participants' hand swabs were examined for microbial contamination. This study recorded a high prevalence of fungal (90.0%) and bacterial (87.0%) species; 20 species of fungus were identified with prevalence range of 1% to 14%; 21 bacterial species were isolated with prevalence range of 1% to 16%. These species were identified as either opportunistic, non-invasive, or pathogenic, which may constitute a health concern amongst immunocompromised individuals within the population. Aspergillus spp. (14%), was the most common fungal species that was exclusively found amongst Nsukka commercial users, while E. coli was the most prevalent isolated bacterial species amongst Nsukka (12%) and Enugu (20%) commercial park users. Prevalence of fungal contamination in Nsukka (94.0%; 47/50) and Enugu (86.0%; 43/50) were both high. Prevalence of bacterial contamination was higher in Enugu than Nsukka but not significantly (47[94.0%] vs. 40[80.0%], p = 0.583). A greater number of participants (99.3%) were aware of the importance of hand hygiene, however with low compliance rate aside "after using the toilet" (80%) and "before eating" (90%), other relevant hand washing and sanitizing practices were considered less important. With these observations, we can emphatically say that despite the COVID-19 scare, commercial park users within the sampled population do not efficiently practice quality hand wash and hygiene measures, hence, risking the widespread of infectious agents in situation of disease outbreak or among immunocompromised individuals.

Knowledge, attitudes and practices towards COVID-19: Community survey in southern Ethiopia

BACKGROUND

Being well informed about the pandemic and how the virus spreads help to prevent and control the pandemic. Health authorities should monitor community practice to prevent the pandemic to identify gaps and minimize risks. This study was, therefore, designed to assess community knowledge, attitude and practices (KAP) related to COVID-19 prevention and its associated factors in urban settings.

METHODS

Community based cross-sectional study was conducted in southern Ethiopia. Twelve towns with high population density and mobility and 1162 participants were included in the study using multi-stage sampling. Semi-structured questionnaire was used to collect data. Mask use was assessed by observation while social distancing and handwashing were assessed by interview. Good practice was defined as wearing face mask, keeping social distance and handwashing. Data was collected by health professionals who have BSc and above (in nursing and public health) and analyzed using SPSS version 25. Descriptive statistics and binary logistic regression at 95% confidence level were performed.

RESULTS

From 1162 respondents, about three fifths, 714 (61.4%), were females and 829 (64.2%) were married. The mean knowledge score was 69.7 (SD±17.87) while mean score for attitude was 80.6 (SD±6.29). Only about one third, 380 (32.7%), had good practice. Occupation, age and overall knowledge about COVID-19 and its prevention were associated with good COVID-19 prevention measures.

CONCLUSION

Knowledge and attitude related to COVID-19 prevention and control were moderate while practice was low. The risk communication strategy should be strengthened using precautionary advocacy.

Knowledge and practice of personal protective measures against COVID-19 in Africa: a systematic review

BACKGROUND

The Coronavirus disease 2019 (COVID-19) pandemic being a newly evolving disease, its response measures largely depend on the practice of and compliance with personal protective measures (PPMs).

OBJECTIVE

This systematic review aimed to examine the knowledge and practice of COVID-19 PPMs in African countries, as documented in the published literature.

METHODS

A systematic search was conducted on Scopus, PubMed, and Web of Science databases using appropriate keywords and predefined eligibility criteria for the selection of relevant studies. Only population-based original research studies (including qualitative, quantitative, and mixed-method studies) done in Africa, and published in the English language were included. The screening process and data extraction were performed according to a pre-registered protocol in PROSPERO (CRD42022355101) and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The quality of included studies was assessed using the Mixed-Method Appraisal Tool. Thematic analysis was used to systematically summarise the studies into four predefined domains: i) knowledge and perception about PPMs, ii) mask use, iii) social/physical distancing, and iv) hand washing/hygiene, including their respective levels and associated factors.

RESULTS

A total of 58 studies across 12 African countries were included, and these were published between 2019 and 2022. African communities, including various population groups, had varying levels of knowledge and practice of COVID-19 PPMs, with lack of personal protective equipment (PPE) (mainly face masks), and side effects (among health care workers) being the major reasons for poor compliance. Lower rates of handwashing/ hygiene were particularly noted in several African countries, especially among the urban poor and slum-dwellers, with the main barrier being the lack of safe and clean water. Various cognitive (knowledge and perception), socio-demographic and economic factors were associated with the practice of COVID-19 PPMs. Moreover, there were evident research inequalities on the regional level, where East Africa contributed 36.2%, West Africa 20.7%, North Africa 17.2%, Southern Africa 6.9%, and no single-country study from Central Africa. Nonetheless, the overall quality of the included studies was generally good, as they satisfied most of the quality assessment criteria.

CONCLUSIONS

There is a need to enhance local capacity to produce and supply PPE. Consideration of various cognitive, demographic and socioeconomic differences, with extra focus on the most vulnerable, is crucial for inclusive and more effective strategies against the pandemic. Moreover, more focus and involvement in community behavioral research are needed to fully understand and address the dynamics of the current pandemic in Africa.

CLINICALTRIAL

The study protocol was registered in PROSPERO (CRD42022355101).

A Systematic Review of Water, Sanitation, and Hygiene for Urban Poor in Low- and Middle-Income Countries during the COVID-19 Pandemic through a Gendered Lens

Inadequate water, sanitation, and hygiene (WASH) among urban poor women is a major urban policy concern in low- and middle-income countries (LMICs). There was a paucity of systematic information on WASH among the urban poor during the pandemic. We reviewed the opportunities and challenges faced by the urban poor in LMICs during the COVID-19 pandemic. We used the PRISMA guidelines to conduct a comprehensive search of 11 databases, including MEDLINE, Embase, Web of Science, and CINAHL, between November 2019 and August 2021. We used thematic analysis to synthesize the qualitative data and meta-analyses to estimate the pooled prevalence. We screened 5008 records, conducted a full-text review of 153 studies, and included 38 studies. The pooled prevalence of shared water points was 0.71 (95% CI 0.37-0.97), non-adherence to hygiene practices was 0.15 (95% CI 0.08-0.24), non-adherence to face masks was 0.27 (95% CI 0.0-0.81), and access to shared community toilets was 0.59 (95% CI 0.11-1.00). Insufficient facilities caused crowding and long waiting times at shared facilities, making physical distancing challenging. Women reported difficulty in maintaining privacy for sanitation, as men were present due to the stay-at-home rule. Due to unaffordability, women reported using cloth instead of sanitary pads and scarves instead of masks.

Hand hygiene practices during the COVID-19 pandemic and associated factors among barbers and beauty salon workers in Ethiopia

Coronavirus disease-2019 (COVID-19) is still causing morbidity and mortality all over the world. Preventive measures such as wearing a facemask, social distancing and hand hygiene continue to be the only options available in countries such as Ethiopia where vaccines are not yet widely available. Hand hygiene is one of the easiest and cheapest preventive measures, and one that is especially important for barbers and beauty salon workers who are widely exposed to the virus due to their contact with many customers. Therefore, measuring the proportion of good hand hygiene practices and associated factors among barbers and beauty salon workers may provide essential guidance in the development of effective interventions to improve COVID-19 prevention measures. A facility-based cross-sectional study was conducted among 410 barbers and beauty salon workers in Dessie City and Kombolcha Town from January 5 to February 10, 2021. The study participants were selected using a simple random sampling technique. A structured questionnaire and an observational checklist were used to collect the data. The collected data were entered into EpiData version 4.6 and analysed using Statistical Package for Social Sciences (SPSS) version 25.0. Logistic regression analysis using bivariate and multivariable logistic regression models was employed. From the bivariate analysis, variables with p <0.25 were retained into multivariable logistic regression analysis. Finally, from the multivariable analysis, variables that had a p-value < 0.05 were declared as factors significantly associated with good hand hygiene practices. Of the total 410 barbers and beauty salon workers, 52.9% [95% CI: 48.3–57.6] had good hand hygiene practices whereas 47.1% [95% CI: 42.4–51.7] had poor hand hygiene practices. From the total respondents, more than half 250 (61%) were male and 160 (39%) were female, with a mean age of 27.42 ±7.37 years. Out of 410 barbers and beauty salon workers, 73.7% had good knowledge about COVID-19 and 59.5% had a positive attitude towards taking precautions against COVID-19. Female sex (AOR = 2.17, 95% CI:1.29–3.65), educational level of college or above (AOR = 5.53, 95% CI:2.85–10.71), positive attitude towards taking precautions against COVID-19 (AOR = 2.4, 95% CI:1.46–4.17), belief in the effectiveness of hand hygiene practices (AOR = 3.78, 95% CI:2.18–6.55) and presence of a hand-washing facility with soap and water (AOR = 5.55, 95% CI:3.28–9.40) were factors significantly associated with good hand hygiene practices among barbers and beauty salon workers. The proportion of good hand hygiene practice was not sufficient to combat the virus. Good hand hygiene practice was higher among those with higher educational level, positive attitude towards taking precautions against COVID-19, belief in the effectiveness of hand hygiene practices, presence of a hand-washing facility with soap and water and those of female sex. Thus, improving hand hygiene practices through continued training, especially for those with a lower educational level and for male workers, is recommended. Moreover, government and non-government organizations should work together to provide alcohol-based hand sanitizer at a low cost to those barbershops and beauty salons if there is no access to water and soap.

The effect of compliance to Hand hygiene during COVID-19 on intestinal parasitic infection and intensity of soil transmitted helminthes, among patients attending general hospital, southern Ethiopia: Observational study

Background

Intestinal parasitic infection (IPIs) is one of the major health problems in Sub -Saharan Africa where water, sanitation and hygiene practices are inadequate. Taking into account the national level implementation of intensive hand hygiene against COVID-19 pandemic and general protective effect this study assessed its effect on intestinal parasite.

Objective

This study aim to investigate the effect of compliance to hand hygiene practice on the prevalence of intestinal parasitic infection (IPIs) and intensity of Soil transmitted helminthes (STH) among patients attending tertiary care hospital in southern Ethiopia.

Methods

Observational study was conducted from June to September 2021. Data on socio demographic, hand hygiene practice and intestinal parasite (prevalence and intensity of helminthic infection) was collected from randomly selected and consented patients. Compliance to hand hygiene practice was assessed using pre-tested questionnaire. Fresh stool sample from each participant was examined by direct wet mount, concentration and Ziehl-Neelson (ZN) staining technique to detect intestinal parasite. Intensity of STH measurements was done through direct egg-count per gram using Kato Katz methods. Data analysis was done using SPSS version 25. Odds ratio with 95% confidence interval was used to measure association and p-value <0.05 was considered as statistically significant.

Results

The study population (N = 264) consisted of 139(52.65%) male and 125 (47.34%) female with the mean ages of 36 ±16.12(±SD). The proportion of good compliance to hand hygiene during COVID-19 to was 43.93% (95%CI: 37% to 47) and prevalence of intestinal parasite was 26.14% (95%CI:21.2% to 31.75) comprising 23.48% intestinal protozoa and 6.43% of soil transmitted helminthic infection. Gardia lamblia, Entamoeba histolytica/dispar, Ascaris lumbricoides were the common parasite in the study area with prevalence of 15.53%, 6.44%, and 1.52% respectively. Prevalence of intestinal parasite among participants with good compliance to hand hygiene group and poor compliance to hand hygiene were (14.65% vs. 35.13%)(AOR: 0.48,95%CI:0.13 to 0.68) (p = 0.002) implying that good compliance to hand hygiene can reduce the risk of IPIs by 52%. Moreover significantly lower odds of intestinal protozoa among good compliance to hand hygiene group than the control (OR:0.38; (95%CI: 0.20 to 0.71);P = 0.001. However, no significant difference in the odds of intensity of STH infection in good compliance hand hygiene and poor compliance group. The result of this study also confirmed the association between intestinal parasitic infections and younger /adolescent age, education status, habit of eating raw vegetable and figure nail status.

Conclusion

Good hand hygiene compliance during COVID-19 significantly associated with reduction of intestinal parasitic infection. This finding highlights the secondary protective effect of improved hand hygiene against IPIs and suggest it can used in augmenting the existing parasitic control strategies in the study setting.