Suchergebnisse

All appendices are available from https://doi.org/10.17037/DATA.00000778. ; Objectives To assess the hand hygiene (HH) compliance before aseptic procedures among birth attendants in the10 highest-volume facilities in Zanzibar. We also examined the extent to which recontamination contributes to poor HH; recording exact recontamination occurrences is not possible using the existing World Health Organisation HH audit tool. Methods In this time-&-motion study, three trained coders used the WOMBATv2 software to record the hand actions of all birth attendants present in the study sites. The percentage compliance and 95% confidence intervals for individual HH behaviours and for behavioural sequences during labour and delivery were calculated.Results We observed 104 birth attendants and 781 HH opportunities before aseptic procedures. Compliance to hand rubbing/washing was 24.6% (CI:21.6-27.8). Only 9.6% (CI:7.6-11.9) also donned gloves and avoided glove recontamination. Half of the time when rubbing/washing or glove donning was performed, hands were recontaminated prior to the aseptic procedure. Conclusions In this study, HH compliance by birth attendants was poor before aseptic procedures. To our knowledge this is the first study in a LMIC to show the large contribution to poor HH compliance from hand and glove recontamination before the procedure. Recontamination is an important driver of infection risk from poor HH and should be understood for the purposes of improvement and therefore included in HH monitoring and interventions. © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. ; Medical Research Council–PHIND scheme, award number MR/N015975/1; The Soapbox Collaborative; CLEAN Study, funded by the United Kingdom Joint Global Health Trials (Wellcome, MRC, DFID, and DOH), award number MR/R019274/1; UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement which is also part of the EDCTP2 programme supported by the European Union. Grant Reference MR/K012126/1.

People who are more avoidant of pathogens are more politically conservative, as are nations with greater parasite stress. In the current research, we test two prominent hypotheses that have been proposed as explanations for these relationships. The first, which is an intragroup account, holds that these relationships between pathogens and politics are based on motivations to adhere to local norms, which are sometimes shaped by cultural evolution to have pathogenneutralizing properties. The second, which is an intergroup account, holds that these same relationships are based on motivations to avoid contact with outgroups, who might pose greater infectious disease threats than ingroup members. Results from a study surveying 11,501 participants across 30 nations are more consistent with the intragroup account than with the intergroup account. National parasite stress relates to traditionalism (an aspect of conservatism especially related to adherence to group norms) but not to social dominance orientation (SDO; an aspect of conservatism especially related to endorsements of intergroup barriers and negativity toward ethnic and racial outgroups). Further, individual differences in pathogen-avoidance motives (i.e., disgust sensitivity) relate more strongly to traditionalism than to SDO within the 30 nations.