Prevalence and associated factors of needle stick and sharps injuries among healthcare workers in northwestern Ethiopia

Background

Needle stick and sharp injuries (NSSIs) are a common problem among healthcare workers (HCWs). Although the factors related to NSSIs for HCWs are well documented by several studies in Ethiopia, no evidence has been reported about the magnitude of and factors related to NSSIs in hospitals in northwestern Ethiopia.

Methods

An institution-based cross-sectional study was carried out from January to March 2019 among 318 HCWs in three randomly-selected hospitals of the eight hospitals found in South Gondar Zone. Sample sizes were proportionally allocated to professional categories. Study participants were selected by systematic random sampling methods using the monthly salary payroll for each profession as the sampling frame. Data were collected using a self-administered questionnaire. The outcome of this study was the presence (injured) or absence of NSSIs during the 12 months prior to data collection. A binary logistic regression model with 95% confidence interval (CI) was used for data analysis. Variables from the bi-variable analysis with a p-value ≤ 0.25 were retained into the multivariable analysis. From the multivariable analysis, variables with a p-value less than 0.05 was declared as factors significantly associated with NSSIs.

Main findings

The prevalence of NSSIs was 29.5% (95% CI: 24.2–35.5%) during the 12 months prior to the survey. Of these, 46.0% reported that their injuries were moderate, superficial (33.3%) or severe (20.7%). About 41.4% of the injuries were caused by a suture needle. Factors significantly associated with NSSIs were occupation as a nurse (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.18–4.26), disposal of sharp materials in places other than in safety boxes (AOR = 3.93, 95% CI: 2.10–5.35), recapping of needles (AOR = 2.27, 95% CI: 1.13–4.56), and feeling sleepy at work (AOR = 2.24, 95% CI: 1.14–4.41).

Conclusion

This study showed that almost one-third of HCWs had sustained NSSIs, a proportion that is high. Factors significantly associated with NSSIs were occupation as a nurse, habit of needle recapping, disposal of sharp materials in places other than in safety boxes and feeling sleepy at work. Observing proper and regular universal precautions for nurses during daily clinical activities and providing safety boxes for the disposal of sharp materials, practicing mechanical needle recapping and preventing sleepiness by reducing work overload among HCWs may reduce the incidence of NSSIs.

Education can modify the long term impact of early childhood famine exposure on adulthood economic achievement: a historical cohort study among the survivors of the great Ethiopian famine 1983-85

Background

Previous famine studies reported the inverse link between early life nutritional deprivation and adulthood optimal health outcomes. However, there remain sparse data on the impact of early life famine exposure in later life economic achievement. Hence, we set out to examine the association of early life famine exposure on economic achievement among survivors of the 1983–85 great Ethiopian famine.

Method

A historical cohort study design was employed among 968 adult men and women in the Raya Kobo district, Northern Ethiopia. Participants were categorized into in utero exposed, postnatal exposed and unexposed groups based on self-reported age and birthdate. Structured questionnaire was used to collect data on socio-demographic and individual assets. Principal component analysis (PCA) was used to determine wealth index as proxy for economic achievement. Multinomial logistic regression analyses were employed to examine the independent effect of early life famine exposure on the outcome.

Results

In unadjusted model, compared to unexposed cohorts, in utero and postnatal famine exposed cohorts were nearly twice more likely to fall in the lowest wealth category (OR: 1.93, 95% CI: 1.40, 2.64) and (OR: 2.12, 95%CI: 1.45, 3.08), respectively. However, these associations became non-significant when adjusted for biologic and demographic variables (P > 0.05). Instead, educational status appeared to have significant association with wealth; those who can’t read or write among in utero and postnatal exposed group were three times more likely to fall in low wealth index category than those who achieved secondary and above level of education (OR = 3.00 95% CI: 1.74, 5.18) and (OR = 2.92, 95% CI: 1.48, 5.76), respectively. Similarly, those with primary education among in uero and postnatal famine exposed cohorts were twice more likely to fall in the low wealth index than compared to those secondary and above level of education (OR = 2.04 95% CI: (1.18, 3.54) and (OR = 2.17 95% CI: 1.12, 4.22), respectively.

Conclusion

Education appears to be a significant independent factor to determine one’s economic achievement in the studied famine cohort. This may imply, the possible impact of early life famine exposure on economic achievement later in adult life could be modified through better education. Our findings justify the need of expanding education in hunger spots in general and in famine settings in particular.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-021-00564-w.

Consequences of exposure to prenatal famine on estimated glomerular filtration rate and risk of chronic kidney disease among survivors of the great Ethiopian famine (1983-85): a historical cohort study

BACKGROUND

The impact of an adverse prenatal environment such as famine exposure on the development of adulthood non-communicable chronic illnesses, including diabetes and hypertension has been well articulated in the recent past and supported by evidence. However, there exist few longitudinal studies conducted on the long term consequences of prenatal famine exposure on adulthood kidney function. Hence, we set out to examine whether prenatal exposure to the Ethiopian Great Famine (1983-1985) was associated with changes in estimated glomerular filtration rate (eGFR) and the risk of developing chronic kidney disease (CKD) later in adult life.

METHODS

The study was conducted in 219 famine exposed and 222 non exposed cohorts in Raya Kobo district, North Wollo Zone, Northern Ethiopia. Estimated GFR was computed from standardized serum creatinine using the CKD Epidemiology Collaboration (CKD-EPI) equation. The definition of CKD includes those with an eGFR of less than 60 ml/min/1.73 m2 on at least in two occasions of 90 days apart (with or without markers of kidney damage). Linear and logistic regression analyses were employed to examine the independent effect of prenatal famine exposure on eGFR and CKD respectively.

RESULTS

The mean (SD) serum creatinine of exposed and non-exposed groups were 0.78 (0.2) and 0.75 (0.2) respectively. The mean (SD) eGFR of exposed groups was 107.95 (27.49) while the non-exposed 114.48 (24.81) ml/min. In linear regression, the unadjusted model to examine the association between famine exposure and eGFR resulted in a significant negative beta coefficient (β = - 0.124: 95% CI: - 11.43, - 1.64). Adjusting the exposure for outstanding covariates of kidney health, including systolic blood pressure, fasting blood sugar and blood glucose did not alter the inverse relationship (β = -.114 95% CI: - 10.84, - 1.17). In the unadjusted bivariate logistic regression model, famine exposure resulted in nearly 2.7 times higher odds of developing CKD (OR: 2.68, 95% CI: 1.16, 6.2). The odds remained equivalent after adjusting for systolic blood pressure, fasting blood glucose and body mass index (OR = 2.61: 95% CI: 1.120, 6.09).

CONCLUSION

In the study setting, prenatal exposure to the Great Ethiopian Famine was associated with decreased eGFR and higher risk of developing CKD among survivors. These findings may imply that famine in early life may play a significant role in the development of kidney dysfunction in adulthood.

Water, sanitation, and hygiene conditions and prevalence of intestinal parasitosis among primary school children in Dessie City, Ethiopia

BACKGROUND

Intestinal parasitosis is a major public health problem that affects the health of primary school children in low- and middle-income countries where water, sanitation, and hygiene (WASH) conditions are deficient. Since there is a paucity of information on the prevalence and associated factors of this problem among primary school children in Dessie City in Ethiopia, this study was designed to address these gaps.

METHODS

A school-based cross-sectional study was conducted among 407 stratified-sampled primary school children in five primary schools at Dessie City from April to June 2018. Data were collected using a pretested structured questionnaire, an observation checklist and laboratory analysis of stool samples. Stool specimen from each study participant was collected using clean, properly labeled and leak-proof stool cup. A portion of stool from each study participant collected sample was processed using saline wet mount technique and examined by microscope. The remaining specimens were preserved with 10% formalin and transported to Dessie Comprehensive Specialized Hospital laboratory to be processed by using formol-ether concentration technique. Then, slide smears were prepared from each processed stool specimen and finally, it was microscopically examined with 10x as well as 40x objectives for the presence or absence of intestinal parasites. Factors significantly associated with intestinal parasitosis were determined using binary logistic regression model at 95% CI (confidence interval). Thus, bivariate (COR [crude odds ratio]) and multivariable (AOR [adjusted odds ratio]) logistic regression analyses were carried out. From the multivariable analysis, variables having a p-value of less than 0.05 were declared as factors significantly associated with intestinal parasitosis among primary school children.

MAIN FINDINGS

The overall prevalence of intestinal parasitosis was found to be 16.0% (95% CI: 12.5-19.4%), of these, 50.8% were positive for protozoa, 32.2% for helminth infections and 16.9% for double co-infections. Entamoeba histolytica was the most prevalent parasite (29.2%), followed by Giardia lamblia (21.5%), Ascaris lumbricoides (18.5%), Hymenolepis nana (9.2%) and Enterobius vermicularis (4.6%). Prevalence rates were similar among government (16.3%) and private (15.7%) school children. Water consumption was less than 5 liters per capita per day in 4 of the 5 schools. Thirty-eight (9.3%) of primary school students reported that they practiced open defecation. About two-thirds (285, 70.0%) said they always washed their hands after defecation. Mother's education (illiterate) (AOR = 3.3; 95% CI: 1.20-9.37), father's education (illiterate) (AOR = 3.9; 95% CI: 1.40-10.82), fathers who could read and write (AOR = 3.3; 95% CI: 1.25-7.86), handwashing before meal (sometimes) (AOR = 2.2; 95% CI: 1.11-4.17) and poor knowledge of WASH (AOR = 9.3; 95% CI: 2.17-16.70) were statistically associated with presence of intestinal parasitic infections.

CONCLUSION

We concluded that the prevalence of intestinal parasitosis in the study area among Grades 4-8 primary school children had public health significance. Factors significantly associated with intestinal parasitosis among primary school children's were illiterate mothers and fathers, irregular handwashing of children before meals, and poor knowledge of WASH. Health education to improve students' WASH knowledge and mass deworming for parasites are recommended as preventive measures; and improvements to the quality of WASH facilities in primary schools are strongly recommended to support these measures.