Background: An emerging respiratory disease was abbreviated as COVID 19, after it has been first reported in December 2019 in Wuhan city of China. The virus is zoonotic which has a tendency to be transmitted between animal to human and human to human. The major route of transmission of COVID-19 is droplet and close contact. Ethiopian ministry of health has initiated training for health care workers at a different level. WHO and CDC also initiated a multidisciplinary approach to tackle COVID-19 of which awareness creation is the main. Thus, the main objective of this study is to assess knowledge, attitude, and practices of health workers in Ethiopia towards COVID-19 and its prevention techniques.Method: an institutional-based multicenter cross-sectional study was conducted in each of eight teaching and referral hospitals. A total of 422 Ethiopian healthcare workers were selected for the assessment of knowledge, attitude, and practice towards COVID-19. Socio-demographic characteristics and data related to the KAP of the participants were collected using a structured questionnaire Logistic regression model was used to identify factors associated with the attitude and knowledge of healthcare workers towards COVID-19 at a significance level of p<0.05.Result: Three hundred ninety-seven healthcare workers participated in the study with a response rate of 94%. Among these, 88.2% and 94.7% of respondents had good knowledge and positive attitude respectively. A respondent with history of chronic medical illness (OR: 0.193, 95% CI: 0.063-0.593), social media, telecommunication, and television/radio as a source of information were significantly associated with knowledge (OR: 3.4, 95% CI: 1.5-7.4, OR: 4.3, 95% CI: 1.3-14.3 and OR: 3.2, 95% CI: 1.4-7.2). Additionally respondent with history of chronic medical illness was significantly associated with negative attitude towards COVID-19.Conclusion: The overall level of knowledge and attitude was good. However, the practice was relatively low. Source of information like social media, telecommunication, and television/radio were positively associated with healthcare workers' knowledge about COVID-19. Strategies for enhancing the capacity of healthcare workers to develop practice are needed.Keyword: COVID-19, Knowledge, Attitude, Practice, Healthcare worker, Ethiopia
BackgroundSpinal anesthesia is a form of regional anesthesia frequently used in various lower abdominal, orthopedic, obstetric operations such as a cesarean delivery. The most common local anesthetic used for spinal anesthesia in obstetric and non-obstetric surgery is bupivacaine which can be utilized as an isobaric or hyperbaric solution, producing differences in maternal hemodynamic changes. Against this backdrop, the study aims to compare the effects of isobaric and hyperbaric bupivacaine on maternal hemodynamic alterations after administering spinal anesthesia for elective cesarean delivery at Gandhi Memorial Hospital, Addis Ababa, Ethiopia.MethodsA hospital-based prospective cohort study design was employed for the period December 1, 2017 to January 30, 2018. A total of 100 parturient were involved, with one group exposed to isobaric bupivacaine and the other to hyperbaric bupivacaine to observe their effects on maternal hemodynamic changes post spinal anesthesia. The participants were selected through systematic random sampling. Data analysis was performed using SPSS (version 20) through descriptive statistic, independent sample t-test, Mann-Whitney U-test, Fisher’s exact test, and Chi-square test were used. P values of <0.05 was assumed as statistically significant for all tests.ResultsThe incidence of hypotension was found to be greater in isobaric than hyperbaric groups (82% vs. 60% respectively; p = 0.015). No statistical significant differences were found in mean arterial pressure value at baseline, but, statistically significant changes were observed among the groups (p <0.05) at all study timing after spinal anesthesia, except at 30thmin. No statistically significant differences were seen in the mean heart rate variability after spinal anesthesia at all periods, except the 15th minute (p = 0.033). A greater rate of vasopressor was used in the isobaric group as compared to the hyperbaric group (36% vs. 14% respectively; p = 0.011).ConclusionBaricity is a significant factor in maternal hemodynamic changes in the parturient for elective cesarean section. Isobaric bupivacaine produces greater change in blood pressure and incidence of hypotension and entails a greater vasopressor requirement than hyperbaric bupivacaine after spinal anesthesia for elective cesarean section.
Background Postoperative nausea and vomiting is among the most common postoperative complications, despite modern anesthetics and surgical techniques. It can occur during the operation and persisting in the postoperative period cause reduces patient comfort, delayed discharge from the hospital and an increase in costs. The risk factors that affect the incidence of post-operative nausea and vomiting are multifactorial in origin and occur in 20 to 30% of all patients and can extend up to 60–70% in high-risk patients. The objective of this study was to determine the incidence and associated risk factors of postoperative nausea and vomiting. Methods An institution-based, cross-sectional study was conducted from March to August 2019 in Wolaita Sodo University teaching referral hospital (WSUTRH). A total of 371 adult elective patients who operated during this period were included in the study. Data were collected by interviewing patients and reviewing their cards then entered and analyzed using SPSS version 25. Variables with P value less than < 0.2 in the bivariate analysis were fitted into the multivariable logistic regression analysis to identify factors associated with postoperative nausea and vomiting and a P value of < 0.05 was considered statistically significant. Results The incidence of postoperative nausea and vomiting 24hour after surgery was 29.1%. In multivariable analysis, previous history of PONV (AOR = 5.1, 95%CI = 4.00-6.58), use of opioids (AOR = 4.91, 95%CI = 3.08–10.37), use of inhalational anesthetic agent (AOR = 2.38, 95%CI = 1.45–5.30), and long duration of surgery AOR = 6.65, 95%CI = 5.52–8.30) were significantly associated with the incidence of postoperative nausea and vomiting. Conclusions The incidence of postoperative nausea and vomiting was high compared to other studies done in different settings. Previous history of PONV, use of opioids, use of inhalational anesthetic agents and long duration of surgery are predictors of postoperative nausea and vomiting. We recommend routine preoperative PONV risk evaluation and give antiemetic premedication for those high-risk patients.
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