Browsing by Author "Kesande, Maureen"

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    Bacterial Contamination of Healthcare Worker’s Mobile Phones: A Case Study at Two Referral Hospitals in Uganda
    (Global Security: Health, Science and Policy, 2022) Tusabe, Fred; Kesande, Maureen; Amir, Afreenish; Iannone, Olivia; Ayebare, Rodgers Rodriguez; Nanyondo, Judith
    Hospital and community-acquired infections are escalating and pose significant public health unhealthiness worldwide. The advancements of telemedicine and automation of healthcare records are supported by cellphones, laptops and wearable devices. This study focused on the incidence of healthcare workers’ mobile phones becoming contaminated with pathogenic bacteria and their possible roles as vehicles of transmission of antimicrobial-resistant bacteria. A case study at two referral hospitals in Uganda between May and October 2020. Self-administered questionnaires were administered to participants after informed consent. Mobile phones of the participants in different departments of the hospitals were swabbed and samples were collected and transported to the microbiology laboratory for bacterial culture and antimicrobial susceptibility tests. The point prevalence of Healthcare workers’ mobile phone bacterial contamination with one or more species was 93%. Organisms isolated were E. coli 5.6% (1), Micrococcus spp 11.1% (2), Coagulase-negative staphylococci, CoNS, 61.1% (11) and Bacillus spp 22.2% (4). About 45% of the organisms were multidrug-resistant. Resistance was major to penicillin, cotrimoxazole, ciprofloxacin and Gentamicin, respectively. The isolated E. coli was resistant to all antibiotics used in the study. Only 15% (2) of the participants disinfected their phones at least once a week and 8% cleaned their hands after using a mobile phone. Healthcare Workers’ mobile phones can act as fomites for the transmission of multidrug-resistant microorganisms. This study provides strong evidence for developing and strengthening disinfection protocols for mobile phones and does not underscore the importance of hand hygiene in the middle of a patient encounter especially when the HCW grabs a phone but doesn’t re-clean their hands before patient contact.
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    Bacterial contamination of healthcare worker’s mobile phones: a case study at two referral hospitals in Uganda
    (Global Security: Health, Science and Policy, 2022-01-24) Tusabe, Fred; Kesande, Maureen; Iannone, Olivia; Ayebare, Rodgers Rodriguez; Nanyondo, Judith
    Hospital and community-acquired infections are escalating and pose significant public health unhealthiness worldwide. The advancements of telemedicine and automation of healthcare records are supported by cellphones, laptops and wearable devices. This study focused on the incidence of healthcare workers’ mobile phones becoming contaminated with pathogenic bacteria and their possible roles as vehicles of transmission of antimicrobial-resistant bacteria. A case study at two referral hospitals in Uganda between May and October 2020. Self-administered questionnaires were administered to participants after informed consent. Mobile phones of the participants in different departments of the hospitals were swabbed and samples were collected and transported to the microbiology laboratory for bacterial culture and antimicrobial susceptibility tests. The point prevalence of Healthcare workers’ mobile phone bacterial contamination with one or more species was 93%. Organisms isolated were E. coli 5.6% (1), Micrococcus spp 11.1% (2), Coagulase-negative staphylococci, CoNS, 61.1% (11) and Bacillus spp 22.2% (4). About 45% of the organisms were multidrug-resistant. Resistance was major to penicillin, cotrimoxazole, ciprofloxacin and Gentamicin, respectively. The isolated E. coli was resistant to all antibiotics used in the study. Only 15% (2) of the participants disinfected their phones at least once a week and 8% cleaned their hands after using a mobile phone. Healthcare Workers’ mobile phones can act as fomites for the transmission of multidrug-resistant microorganisms. This study provides strong evidence for developing and strengthening disinfection protocols for mobile phones and does not underscore the importance of hand hygiene in the middle of a patient encounter especially when the HCW grabs a phone but doesn’t re-clean their hands before patient contact.
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    Changes in Access to Alcohol-Based Hand Rub and Hand Hygiene Adherence among Healthcare Workers after a Hand Rub Production and Distribution Program in Rural Uganda before and during the COVID-19 Pandemic
    (The American Journal of Tropical Medicine and Hygiene, 2024-09-18) Ishida, Kanako; Kesande, Maureen; Tusabe, Fred; Ocitti, Francis; Nanyondo, Judith; Isabirye, Herbert; Lamorde, Mohammed; Berendes, David
    During the COVID-19 pandemic, the use of alcohol-based hand rubs (ABHRs) was critical for improving hand hygiene (HH) among healthcare workers (HCWs). Before and during the pandemic, we supported district-led production and district-wide distribution of ABHRs and one-time provision of portable handwashing stations to select healthcare facilities (HCFs) in five rural districts in Uganda. Comparison between baseline and follow-up assessments showed an overall increase in access to HH materials and HH adherence (HHA; handwashing with soap and water or use of ABHR) among HCWs. However, large differences in the changes in HH material coverage and HHA across districts may have been heavily influenced by the COVID-19 disease burden and its risk perception when the assessments were conducted. Using data collected at multiple time points before and during the pandemic across districts and estimating and controlling for pandemic effects in an exploratory multivariate analysis, the adjusted odds ratio of HHA in district HCFs was 4.6 (95% CI: 1.8–11.8) after (versus before) the ABHR intervention. This increase appeared to be primarily in larger HCFs, where the perceived need for ABHRs may have been greater. Additional strategies are needed to further increase HHA, especially in the smallest HCFs, among laboratory technicians and nurses and before patient contact. However, district-scale ABHR interventions seemed successful in ensuring the continued availability of HH materials.
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    Establishment of district-led production of WHO-recommended Alcohol-Based Hand Rub (ABHR) during the COVID-19 pandemic: a model for improving access to ABHR during health emergencies
    (Journal of Water, Sanitation and Hygiene for Development, 2023-09-19) Tusabe, Fred; Kesande, Maureen; Yapswale, Sauda; Ociti, Francis; Kasule, Juliet N.; Pratt, Caroline; Berendes, David
    In response to the COVID-19 pandemic, we established and sustained local production of Alcohol-Based Hand Rub (ABHR) at a district scale for healthcare facilities and community, public locations in four districts in Uganda. District officials provided space and staff for production units. The project renovated space for production, trained staff on ABHR production, and transported ABHR to key locations. The production officer conducted internal ABHR quality assessments while trained district health inspectors conducted external quality assessments prior to distribution. Information, education, and communication materials accompanied ABHR distribution. Onsite ABHR consumption was monitored by site staff using stock cards. On average, it took 11 days (range: 8–14) and 5,760 USD (range: 4,400–7,710) to setup a production unit. From March to December 2021, 21,600 L of quality-controlled ABHR were produced for 111 healthcare facilities and community locations at an average cost of 4.30 USD/L (range: 3.50–5.76). All ABHR passed both internal and external quality control (average ethanol concentration of 80%, range: 78–81%). This case study demonstrated that establishing centralized, local production of quality-controlled, affordable ABHR at a district-wide scale is feasible and strengthens the ability of healthcare workers and community locations to access and use ABHR during infectious disease outbreaks in low-resource countries.
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    Impacts and Lessons Learnt From Local Production of WHO Recommended Alcohol Based Hand Rub During Covid-19 Pandemic in Uganda
    (Research Square, 2020) Tusabe, Fred; Otita, Morgan; Kesande, Maureen; Twinomugisha, Fred
    The Government of Uganda through the Ministry of Health and other partners have promoted hand washing and hand rubbing using ABHS as one of the key preventive measures against person-to-person spread of the Covid-19 virus. The people of Uganda have greatly heeded to these messages and as a result, the demand for ABHS has increased because of high consumption rates. A district multi modal design was established in 2019 in Kabarole and Kasese districts in Western Uganda Part of the strategy was to set up an ABHS production units. The prevailing COVID-19 outbreak has instigated set up at centrally located Kasangati HCIV. We analysed the demand and production of ABHS produced before and during the COVID-19 outbreak.
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    Improving Water, Sanitation, and Hygiene (WASH), with a Focus on Hand Hygiene, Globally for Community Mitigation of COVID-19
    (PLOS Water, 2022) Medley, Alexandra; Osborne, Taylor; Kesande, Maureen; Tusabe, Fred; Mwaki, Alex
    Continuity of key water, sanitation, and hygiene (WASH) infrastructure and WASH practices—for example, hand hygiene—are among several critical community preventive and mitigation measures to reduce transmission of infectious diseases, including COVID-19 and other respiratory diseases. WASH guidance for COVID-19 prevention may combine existing WASH standards and new COVID-19 guidance. Many existing WASH tools can also be modified for targeted WASH assessments during the COVID-19 pandemic. We partnered with local organizations to develop and deploy tools to assess WASH conditions and practices and subsequently implement, monitor, and evaluate WASH interventions to mitigate COVID-19 in low- and middle-income countries in Latin America and the Caribbean and Africa, focusing on healthcare, community institution, and household settings and hand hygiene specifically. Employing mixed-methods assessments, we observed gaps in access to hand hygiene materials specifically despite most of those settings having access to improved, often onsite, water supplies. Across countries, adherence to hand hygiene among healthcare providers was about twice as high after patient contact compared to before patient contact. Poor or non-existent management of handwashing stations and alcohol-based hand rub (ABHR) was common, especially in community institutions. Markets and points of entry (internal or external border crossings) represent congregation spaces, critical for COVID-19 mitigation, where globally-recognized WASH standards are needed. Development, evaluation, deployment, and refinement of new and existing standards can help ensure WASH aspects of community mitigation efforts that remain accessible and functional to enable inclusive preventive behaviors.