Suchergebnisse

BACKGROUND: South Africa has unique and diverse social and economic factors that have an impact on the provision of basic water, sanitation, hygiene and waste management infrastructure and practices at health care facilities in ensuring patient safety and prevent the spread of diseases. METHODS: The aim of this study was to evaluate water, sanitation and hygiene access and standards at 50 government owned public health care clinics in the rural region of the Vhembe district of South Africa during 2016/2017, using self-observation, an observation checklist, record reviews and interviews with clinic managers. Water quality from all available water sources on the clinic compound was analysed for Total coliform and E. coli counts using the Colilert Quanti-tray/2000 system. The prevalence of pathogenic diarrhea causing E. coli strains was established using multiplex-Polymerase Chain Reaction. RESULTS: The health care clinics in the Vhembe District generally complied with the basic WASH services guidelines according to the World Health Organisation. Although 80% of the clinics used borehole water which is classified as an improved water source, microbiological assessment showed that 38% inside taps and 64% outside taps from the clinic compounds had TC counts higher than guideline limits for safe drinking. Similarly, EC counts above the guideline limit for safe drinking water were detected in 17% inside taps and 32% outside taps from the clinic compounds. Pathogenic EAEC, EPEC, ETEC and EHEC strains were isolated in the collected water samples. Although improved sanitation infrastructures were present in most of the clinics, the sanitary conditions of these toilets were not up to standard. Waste systems were not adequately managed. A total of 90% of the clinics had hand washing basins, while only 61% of the clinics had soap present and only 64% of the clinics had adequate signs and posters reminding the staff, care givers and patients to wash their hands. CONCLUSIONS: Various WASH aspects within the primary health care ...

BACKGROUND : Advances in intra-abdominal pressure (IAP) measurement have enabled better monitoring and physiological manipulation of patients with intra-abdominal hypertension or abdominal compartment syndrome. This study aimed to determine the correlation between transvesical (TV), transgastric (TG) and direct transperitoneal (TP) IAP monitoring at different IAPs in porcine models. OBJECTIVES : To assess the statistical agreement between TV, TG and TP pressure monitoring in a pneumoperitoneum and an intestinal obstruction intra-abdominal hypertension model at different IAPs. METHODS : Fifty-nine pigs were divided into six groups: a control group (Cr; n=5), three pneumoperitoneum groups at pressures of 20 mmHg, 30 mmHg, and 40 mmHg (Pn20, Pn30, Pn40; n=40), and two intestinal-occlusion groups at pressures of 20 mmHg and 30 mmHg (Oc20, Oc30; n=14). IAP was simultaneously measured in each pig using the three methods at different times. The control group did not have any intervention to increase the IAP. Intra-class correlation was used to assess agreement between the methods. RESULTS : At pressures >20 mmHg, all three methods showed good correlation with each other (Pn20=0.87; Pn30=0.96; Pn40=0.88; Oc20=0.69; Oc30=0.86). Correlation between TP and TG (Cr=0.0; Pn20=0.85; Pn30=0.94; Pn40=0.90; Oc20=0.78; Oc30=0.78); TP and TV (Cr=0.0; Pn20=0.83; Pn30=0.95; Pn40=0.86; Oc20=0.59; Oc30=0.88); and importantly between TV and TG (Cr=0.0; Pn20=0.95; Pn30=0.98; Pn40=0.88; Oc20=0.69; Oc30=0.91) was good. CONCLUSION : All three measurement methods showed good correlation at pressures >20 mmHg and were unaffected by the type of IAP model. These results suggest that either transvesical or transgastric pressure measurements can be used for IAP measurement when TP pressures are >20 mmHg. ; Grant from Extremadura Regional Government through the Plan Regional de Investigación de Extremadura (PRI09A161 to Minimally Invasive Surgery Center Jesús Usón). ; http://www.sajcc.org.za ; am2018 ; Statistics