Geographical variation and factors associated with unsafe child stool disposal in Ethiopia: A spatial and multilevel analysis.

BACKGROUND: Unsafe disposal of children's stool makes children susceptible to fecal-oral diseases and children remain vulnerable till the stools of all children are disposed of safely. There is a paucity of data on spatial distribution and factors associated with unsafe child stool disposal in Ethiopia. Previous estimates, however, do not include information regarding individual and community-level factors associated with unsafe child stool disposal. Hence, the current study aimed (i) to explore the spatial distribution and (ii) to identify factors associated with unsafe child stool disposal in Ethiopia. METHODS: A secondary data analysis was conducted using the recent 2016 Ethiopian demographic and health survey data. A total of 4145 children aged 0-23 months with their mother were included in this analysis. The Getis-Ord spatial statistical tool was used to identify high and low hotspots areas of unsafe child stool disposal. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant spatial clusters. A multilevel multivariable logistic regression model was fitted to identify factors associated with unsafe child stool disposal. RESULTS: Unsafe child stool disposal was spatially clustered in Ethiopia (Moran's Index = 0.211, p-value< 0.0001), and significant spatial SaTScan clusters of areas with a high rate of unsafe child stool disposal were detected. The most likely primary SaTScan cluster was detected in Tigray, Amhara, Afar (north), and Benishangul-Gumuz (north) regions (LLR: 41.62, p<0.0001). Unsafe child stool disposal is more prevalent among households that had unimproved toilet facility (AOR = 1.54, 95%CI: 1.17-2.02) and those with high community poorer level (AOR: 1.74, 95%CI: 1.23-2.46). Higher prevalence of unsafe child stool disposal was also found in households with poor wealth quintiles. Children belong to agrarian regions (AOR: 0.62, 95%CI 0.42-0.91), children 6-11 months of age (AOR: 0.65, 95%CI: 0.52-0.83), 12-17 months of age (AOR: 0.68, 95%CI: 0.54-0.86), and 18-23 months of age (AOR: 0.58, 95%CI: 0.45-0.75) had lower odds of unsafe child stool disposal. CONCLUSIONS: Unsafe child stool disposal was spatially clustered. Higher odds of unsafe child stool disposal were found in households with high community poverty level, poor, unimproved toilet facility, and with the youngest children. Hence, the health authorities could tailor effective child stool management programs to mitigate the inequalities identified in this study. It is also better to consider child stool management intervention in existing sanitation activities considering the identified factors.

Correct Use of Facemask Among Health Professionals in the Context of Coronavirus Disease (COVID-19).

PURPOSE: Coronavirus disease (COVID-19) mainly spreads through respiratory droplets and close contacts. Wearing a facemask and other personal protective equipment (PPE) is essential in preventing the spread of COVID-19. However, the use of PPE alone does not provide a sufficient level of protection, and correct use and disposal are required. Hence, this study aimed to assess health professionals' practice regarding proper use of facemask in the perspectives of COVID-19 prevention. METHODS: A web-based online survey was conducted from June 3, 2020, to August 11, 2020, to assess health professionals' practice regarding correct use of facemask. The survey tool was prepared in Google form and distributed to the health professionals through their emails and social media pages. Data were analyzed using STATA version 14. A descriptive result was reported using frequency tables and bar charts. Factors associated with correct use of facemask were assessed using binary logistic regression model. RESULTS: A total of 368 health professionals have participated in this study. All of the participants' work involves direct contact with patients and 98 (26.6%) of them work in direct contact with COVID-19 patients daily. The level of overall correct use of facemask was 10.1% (95% CI: 7.4-13.6). Two hundred fifty-five (69.3%) do not perform hand hygiene before wearing a facemask and 238 (64.7%) do not perform hand hygiene after removing the facemask. Three hundred twenty-three (87.8%) of the study participants reuse disposable facemasks. The odds of practicing correct use of facemask were more than two times higher among health professionals who received training related to personal protective equipment utilization (AOR= 2.2, 95% CI: 1.1-4.5) compared to their counterparts. CONCLUSION: This study revealed that health professionals' practice regarding the correct use of facemask in the context of COVID-19 prevention is very low. Receiving training related to proper utilization of personal protective equipment was found to favor the correct use of facemask. In this regard, health authorities should provide training to enable the rational and correct use of facemask among healthcare workers.

Disinfection of Stethoscope and Non-Infrared Thermometer: Practices of Physicians in Ethiopia in the Era of COVID-19.

BACKGROUND: Stethoscopes and non-infrared thermometers are the customary medical equipment used by the physicians on a daily basis, among various patients. With the rise of potential infections in the healthcare facilities and the transmission nature of the current COVID-19 pandemic, consistent and correct disinfections of these devices after each use should not be pardoned. This study, therefore, aimed to assess the level of stethoscope and non-infrared thermometer disinfection practices among physicians involved in direct patient contact during the COVID-19 pandemic. METHODS: A web-based cross-sectional survey was conducted among physicians working in Ethiopia to assess their practice of stethoscope and non-infrared thermometer disinfection. The online survey was circulated using an anonymous and self-reporting questionnaire via Google form with a consent form appended to it. The developed Google form link was shared with physicians through their email addresses and social media pages. A descriptive summary was computed and presented by tables and figures. Multivariable logistic regression model was used to identify factors associated stethoscope and non-infrared thermometer after every use. RESULTS: The proportion of stethoscope and non-infrared thermometer disinfections after every use was 13.9% (95% CI: 10.9-17.6) and 20.4% (95% CI: 16.7-24.5), respectively. Taking COVID-19 training (AOR: 2.52; 95% CI: 1.29-4.92) and the availability of stethoscope disinfection materials at the workplace (AOR: 3.03; 95% CI: 1.29-7.10) were significantly increased the odds of stethoscope disinfection after every use. The odds of stethoscope disinfection after every use was significantly decreased for those who reported the use of shared stethoscope (AOR: 0.34; 95% CI: 0.12-0.92). CONCLUSION: Only a wee share of the respondents reported that they have disinfected their stethoscopes and non-infrared thermometers after every use - possibly jeopardizing both patients and clinicians safety, particularly during the COVID-19 pandemic.