Analysing the implementation of infection prevention and control measures in health care facilities during the COVID-19 pandemic in the African Region.

BACKGROUND: The declaration of SARS-CoV-2 as a public health emergency of international concern in January 2020 prompted the need to strengthen infection prevention and control (IPC) capacities within health care facilities (HCF). IPC guidelines, with standard and transmission-based precautions to be put in place to prevent the spread of SARS-CoV-2 at these HCFs were developed. Based on these IPC guidelines, a rapid assessment scorecard tool, with 14 components, to enhance assessment and improvement of IPC measures at HCFs was developed. This study assessed the level of implementation of the IPC measures in HCFs across the African Region during the COVID-19 pandemic. METHOD: An observational study was conducted from April 2020 to November 2022 in 17 countries in the African Region to monitor the progress made in implementing IPC standard and transmission-based precautions in primary-, secondary- and tertiary-level HCFs. A total of 5168 primary, secondary and tertiary HCFs were assessed. The HCFs were assessed and scored each component of the tool. Statistical analyses were done using R (version 4.2.0). RESULTS: A total of 11 564 assessments were conducted in 5153 HCFs, giving an average of 2.2 assessments per HCF. The baseline median score for the facility assessments was 60.2%. Tertiary HCFs and those dedicated to COVID-19 patients had the highest IPC scores. Tertiary-level HCFs had a median score of 70%, secondary-level HCFs 62.3% and primary-level HCFs 56.8%. HCFs dedicated to COVID-19 patients had the highest scores, with a median of 68.2%, followed by the mixed facilities that attended to both COVID-19 and non-COVID-19 patients, with 64.84%. On the components, there was a strong correlation between high IPC assessment scores and the presence of IPC focal points in HCFs, the availability of IPC guidelines in HCFs and HCFs that had all their health workers trained in basic IPC. CONCLUSION: In conclusion, a functional IPC programme with a dedicated focal person is a prerequisite for implementing improved IPC measures at the HCF level. In the absence of an epidemic, the general IPC standards in HCFs are low, as evidenced by the low scores in the non-COVID-19 treatment centres.

Evaluation of physicochemical and hydromechanical properties of MSWI bottom ash for road construction.

Municipal Solid Waste Incinerator (MSWI) Bottom Ash has been used as a substitute for traditional aggregates in road construction; however, this material is little understood. The work presented in this paper pursues the study on the mechanical performance of bottom ash, proven by Le et al. (2017). Using a coupling technique for the first time, the physicochemical aspects and hydromechanical resistance of bottom ash were evaluated and analyzed. Physicochemical tests were first carried out, followed by oedometer tests under a wetting path. This coupled evaluation underlined the role of principal mineralogical components of the studied bottom ash as well as the link with its hydromechanical properties. Tests results showed that the principal constituent of bottom ash is SiO2, which thus affects the characteristics of bottom ash. Given the physical stability of SiO2 which generated a compacted material being less sensitive to water and chemical reactions, and bottom ash's other characteristics, this demonstrates why bottom ash could be a viable material in roadworks.

Long term chemo-hydro-mechanical behavior of compacted soil bentonite polymer complex submitted to synthetic leachate.

An experimental program is carried out to investigate the long term hydro-mechanical behavior correlated with chemical one of compacted soils with low concentration of Ca-bentonite and Ca-bentonite polymer mixture. The effect of prehydration on the hydraulic performance is compared to the polymer adding effect. All specimens are submitted to synthetic leachate (LS) under different permeation conditions. Several issues are studied: mechanical stability, hydraulic performance, chemical exchange of cations validated with microstructure observations. Scanning Electron Microscope (SEM) observations demonstrate two distinct behaviors: dispersive for Bentonite (B) and B with Polymer P1 (BP1) and flocculated for B with Polymer P2 (BP2). Direct shear tests show that bentonite adding increases the Soil (S) cohesion and decreases the friction angle. Polymer adding behaves similarly by maintaining the soil cohesion and increasing the friction angle. Hydraulic conductivity of prehydrated soil bentonite (SB) and direct permeation of polymer added soil bentonite are studied (SBP1 and SBP2). Hydraulic test duration are in range of 45days to 556days long. Prehydration allows to delay the aggressive effect of the LS in short term but seems to increase its negative effect on the hydraulic conductivity value in long term exposure. SB and SBP1 behave similarly and seem to act in the long term as a granular filler effect. SBP2 presents positive results comparing to the other mixtures: it maintains the hydraulic conductivity and the chemical resistance. Chemical analysis confirms that all specimens are subjected to Na(+) dissolution and Ca(2+) retention which are more pronounced for prehydrated specimen. The short term effect of prehydration and the positive effect of SBP2 are also confirmed.