RESUMEN
Background: Dengue which is an arboviral disease transmitted by Aedes aegypti mosquito, drastically affected communities worldwide. It has been showing consistently a rising trend in developing country like India. Study Objectives: To assess the knowledge, attitude and practices (KAPs) related to the prevention and control of dengue fever (DF) among frontline staff members at a medical teaching institution in Rishikesh, Uttarakhand. Materials and Methods: A community-based cross-sectional study was conducted at a medical teaching institution in Rishikesh, Uttarakhand. Out of 830 frontline workers only 208 workers were recruited in a study by the simple random selection method. A semi-structured interview questionnaire was applied to assess the KAPs of participants. Attitude was assessed by four-point Likert scaling. Statistical analysis was done using SPSS version 23 for Windows. Results: A total of 208 participants were interviewed. Majority were male (70.2%) with the age group of 31 to 45 years (71.2%). Majority (50.5%) of participants were educated up to higher secondary and working as a security guard (78.8%). Most (72.6%) of the respondents said the rainy season was the most common outbreak season for dengue. Most (63.6%) of the participants were aware that dengue is transmitted by mosquitoes. The majority (49%) of participants strongly agreed that dengue is a fatal disease. Conclusion: There is an urgent need to prevent and control the epidemics of dengue by adoption of seven plus one model which contributes in reducing the overall burden in healthcare delivery system.
RESUMEN
Infection prevention and control (IPC) program is obligatory for delivering quality services in any healthcare setup. Lack of administrative support and resource-constraints (under-staffing, inadequate funds) were primary barriers to successful implementation of IPC practices in majority of the hospitals in the developing countries. The Coronavirus Disease 2019 (COVID-19) brought a unique opportunity to improve the IPC program in these hospitals. A PDSA (Plan-Do-Study- Act) model was adopted for this study in a tertiary care hospital which was converted into a dedicated COVID-19 treatment facility in Varanasi, India. The initial focus was to identify the deficiencies in existing IPC practices and perceive the opportunities for improvement. Repeated IPC training (induction and reinforce) was conducted for the healthcare personnel (HCP) and practices were monitored by direct observation and closed-circuit television. Cleaning audits were performed by visual inspection, review of the checklists and qualitative assessment of the viewpoints of the HCP was carried out by the feedbacks received at the end of the training sessions. A total of 2552 HCP and 548 medical students were trained in IPC through multiple offline/onsite sessions over a period of 15 months during the ongoing pandemic. Although the overall compliance to surface disinfection and cleaning increased from 50% to >80% with repeated training, compliance decreased whenever newly recruited HCP were posted. Fear psychosis in the pandemic was the greatest facilitator for adopting the IPC practices. Continuous wearing of personal protective equipment for long duration, dissatisfaction with the duty rosters as well as continuous posting in high-risk areas were the major obstacles to the implementation of IPC norms. Recognising the role of an infection control team, repeated training, monitoring and improvisation of the existing resources are keys for successful implementation of IPC practices in hospitals during the COVID-19 pandemic.