Postexposure Detection ofMycobacterium tuberculosisInfection in Health Care Workers in Resource‐Limited Settings

Abstract Background The scale of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care workers (HCWs), particularly in resource-limited settings, remains unclear. To address this concern, universal (non-symptom-based) screening of HCWs was piloted to determine the proportion of SARS-CoV-2 infection and the associated epidemiological and clinical risk factors at a large public health care facility in Egypt. Methods Baseline voluntary screening of 4040 HCWs took place between 22 April and 14 May 2020 at 12 hospitals and medical centres in Cairo. Epidemiological and clinical data were collected using an online survey. All participants were tested for SARS-CoV-2 using reverse transcription polymerase chain reaction (RT-PCR) and rapid IgM and IgG serological tests. Results Of the 4040 HCWs screened, 170 [4.2%; 95% confidence interval (CI): 3.6-4.9] tested positive for SARS-CoV-2 by either of the three tests (i.e. infected); 125/170 (73.5%) tested PCR-positive. Most infected HCWs were nurses (97/170, 57.5%). Median age of infected HCWs was 31.5 [interquartile range (IQR): 27.0–41.3] years. Of infected HCWs, 78 (45.9%) reported contact with a suspected case and 47 (27.6%) reported face-to-face contact within 2 m with a confirmed case. The proportion of infection among symptomatic HCWs (n = 54/616) was 8.8% (95% CI: 6.7-11.3); 6/54 (11.1%) had fever ≥38°C and 7/54 (13.0%) reported severe symptoms. Most infected HCWs were asymptomatic (116/170, 68.2%). The proportion of infection among asymptomatic HCWs (n = 116/3424) was 3.4% (95% CI: 2.8-4.0). Conclusions The high rate of asymptomatic infections among HCWs reinforces the need for expanding universal regular testing. The infection rate among symptomatic HCWs in this study is comparable with the national rate detected through symptom-based testing. This suggests that infections among HCWs may reflect community rather than nosocomial transmission during the early phase of the COVID-19 epidemic in Egypt.

Download Full-text

COVID-19 and Face Masks – To Use or Not to Use!

Indian Journal of Community Health ◽

10.47203/ijch.2020.v32i02supp.012 ◽

2020 ◽

Vol 32 (2 (Supp)) ◽

pp. 240-243 ◽

Cited By ~ 1

Author(s):

Devraj Ramakrishnan

Keyword(s):

Health Care ◽

Health Care Workers ◽

Preventive Measures ◽

Community Setting ◽

Community Settings ◽

Resource Limited ◽

Care Workers ◽

Surgical Masks ◽

Time And Being ◽

Limited Setting

COVID-19 has evolved into a pandemic in quick time and being a droplet infection, it was quickly understood that prevention is the key. People started to use all types of masks and there was a panic as stocks started running out. Health care workers must use a triple layered surgical mask and those exposed to aerosol generating procedures must use an N 95 mask and these should be kept reserved for them, especially in a resource limited setting. Though initial advice from experts to the general public was not to use a mask in community settings unless they are sick or taking care of someone sick, the advice had to be later modified. Though CDC Atlanta currently advices everyone with no symptoms to wear cloth masks in the community, WHO opines there is no clear evidence to advise for or against mask use in the community. However, WHO encourages countries advising community mask use as it can generate useful evidence. Along with mask use, practicing all other preventive measures such as handwashing, cough etiquette, social distancing, quarantine and isolation are of utmost importance, without which, using surgical masks or even N95 masks, will not be much effective in the community setting.

Download Full-text