A twenty-four-hour observational study of hand hygiene compliance among health-care workers in Debre Berhan referral hospital, Ethiopia.

BACKGROUND: Hand hygiene (HH) is recognized as the single most effective strategy for preventing health care-associated infections. In developing countries, data on hand hygiene compliance is available only for few health-care facilities. This study aimed to assess hand hygiene compliance among health-care workers in Debre Berhan referral hospital, Ethiopia. METHODS: This study employed the WHO hand hygiene observation method. Direct observation of the health care workers (HCWs) was conducted using an observation record form in five different wards. Trained and validated observers watched HCWs while they had direct contact with patients or their surroundings, and the observers then recorded all possible hand hygiene opportunities and hand hygiene actions. Observation was conducted over a 24 h period to minimize selection bias. More than 200 opportunities per ward were observed according to WHO recommendation, except in neonatal intensive care unit. HH compliance was calculated by dividing the number of times hand hygiene was performed by the total number of opportunities for hand hygiene. A 95% confidence interval (CI) was computed for compliance with the exact binomial method. RESULTS: A total of 917 hand hygiene opportunities were observed during the study. Overall HH compliance was 22.0% (95% CI: 19.4-24.9). HH compliance was similar across all professional categories and did not vary by shift. Levels of compliance were lower before patient contact (2.4%; 95% CI: 0.9-5.3), before an aseptic procedure (3.6%; 95% CI: 1.6-7.6) and after contact with patient surroundings (3.3%; 95% CI: 1.2-7.9), whereas better levels of compliance were found after body fluid exposure (75.8%; 95% CI: 68.0-82.3) and after patient contact (42.8%; 95% CI: 35.2-50.7). CONCLUSION: HH compliance of HCWs was found to be low in Debre Berhan referral hospital. Compliance with indications that protect patients from infection was lower than that protect the HCWs. The findings of this study indicate that HH compliance needs further improvement.

Health Care Seeking Behavior for Common Childhood Illnesses in Jeldu District, Oromia Regional State, Ethiopia.

BACKGROUND: Even though health care seeking interventions potentially reduce child mortality from easily treatable diseases, significant numbers of children die without ever reaching a health facility or due to delays in seeking care in Ethiopia. This study aimed to assess health care seeking behavior for common childhood illnesses and associated factors. METHODS: A community-based cross-sectional study was conducted in Jeldu District from January to February 2011. A systematic sampling method was used for sample selection. Data were collected from 422 caregivers with under-five children who experienced diseases within six weeks before the survey. Interviewer administered structured and pre-tested questionnaire which were used to collect data. Data entry and cleaning were carried out using Epi Info version 3.5.1 and analyzed using SPSS version 16. Descriptive analysis was done to determine the magnitude of health care seeking behavior. Multivariate logistic regression analyses were performed to identify associated factors. RESULTS: A total of 422 caregivers of under-five children were participated in the study giving an overall response rate of 97.5%. Three hundred fifteen (74.6%) children sought care from health facilities for all conditions. However, only 55.4% of them were taken to health facilities as first source treatment during their illness and prompt care was also very low (13.7%). Marital status of the caregivers (AOR = 2.84; 95%CI: 1.62-4.98), number of symptoms experienced by the child (AOR = 2.04; 95%CI: 1.24-3.36) and perceived severity of the illness (AOR = 3.20; 95%CI: 1.96-5.22) were predictors of health care seeking behavior. CONCLUSION: Health care seeking behavior for childhood illnesses was delayed and decision to seek care from health facilities was influenced by worsening of the illnesses. Thus, community level promotion of prompt health care seeking is essential to enhance the health care seeking behavior for child hood illnesses in the locality.

Peer communication on sex and sexual health among youths: a case of Debre Berhan university, Ethiopia.

INTRODUCTION: Friends are considered an important source of advice and information about sex. Conversations about sex among young people tend to generate norms that influence positive or negative pressure on individuals to conform to group standards. The aim of the study was to explore peer communication on sex and sexual health. METHODS: Grounded theory qualitative study design was employed using focus group discussions and participant observation. Participants were selected using criterion purposive sampling. Semi-structured guides and checklists were used as data collection tools. Information was audio-recorded and transcribed verbatim and uploaded to ATLAS.ti 7 software for coding. Data collection and analysis were undertaken simultaneously using constant comparative analysis. RESULTS: Students talked with peers and sexual partners about sex more than sexual health issues. Common places of talk included dormitory, begtera (near dorm where students meet), and space (reading rooms). Whereas, time of talk, either in a group or with just their close friends or sex partners, included during training, evening and weekend time, during walking together, and break time. Students used verbal and non-verbal and formal and informal communication styles. CONCLUSION: The content, place, and time for discussions about sex were influenced by gender, social-cultural norms (e.g. religion), rural vs urban living, and the occurrence of sexual health issues (e.g, sexually-transmitted infections or unwanted pregnancies). Priority should be given to designing audience-specific strategies and messages to promote discussions about sex and to encourage safe sexual practices. Primary target groups should include female and rural students, who are predisposed to risky sexual behavior.

Seroprevalence of human immunodeficiency virus among voluntary counseling and testing clients at the University of Gondar Teaching Hospital, Northwest Ethiopia.

BACKGROUND: The epidemiology of human immunodeficiency virus (HIV) infection in Ethiopia varies with regions, study population, and time. Thus, timely information on HIV epidemiology is critical for the combat of the epidemic. In this study, we aim to update HIV prevalence and risk factors among voluntary counseling and testing (VCT) clients at the University of Gondar Teaching Hospital, Northwest Ethiopia. METHODS: A total of 2,120 VCT clients' records from September 2007 to August 2010 were analyzed retrospectively. Bivariate logistic regression analysis was used to identify significant predictors. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated. Statistical significance was set at P-value <0.05. RESULTS: Of 2,120 VCT clients, 363 (17.1%) were seropositive for HIV. A higher rate of HIV positivity was observed among female clients (20.4%) than that in male clients (14.0%) (OR 1.58, 95% CI 1.26-1.98, P=0.00). Widowed (95% CI 10.42-34.92, P=0.00), married (95% CI 3.42-5.94, P=0.00), divorced (95% CI 2.79-5.32, P=0.00), and illiterate (95% CI 2.33-5.47, P=0.00) clients were associated with HIV infection with the odds ratios of 19.07, 4.51, 3.85, and 3.57, respectively. Clients within the age category of 35-49 years (OR 5.03, 95% CI 3.56-7.12, P=0.00) and above the age of 50 years (OR 4.99, 95% CI 2.67-9.34, P=0.00) were more likely to be infected with HIV. CONCLUSION: HIV is still the major concern of public health in the Gondar area as evidenced by our data. Being female, widowed, married, illiterate, and older age were the identified risk factors for HIV infection. Thus, consideration of these factors in future intervention and clinical practice is recommended.