Compliance with Postexposure Screening and Treatment of Latent Tuberculosis Infection among Healthcare Workers in a Tertiary Care Hospital in Saudi Arabia

2014 ◽  
Vol 35 (2) ◽  
pp. 176-181 ◽  
Author(s):  
Hanan H. Balkhy ◽  
Thaddeus L. Miller ◽  
Saira Ali ◽  
Jennifer B. Nuzzo ◽  
Karine Kentenyants ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Latent Tuberculosis ◽  
Care Hospital ◽  
Respiratory Therapists ◽  
Occupationally Exposed ◽  
Medical City ◽  
Latent Tb Infection ◽  
Clinical Records

Background.Controlling tuberculosis (TB) infection among occupationally exposed healthcare workers (HCWs) may be challenging.Methods.We retrospectively reviewed clinical records of HCWs who were exposed to patients diagnosed with infectious TB at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between 2008 and 2010. The collected data included baseline tuberculin skin test (TST) status, potential predictors of TST positivity, postexposure diagnosis of latent TB infection (LTBI), and postexposure compliance with LTBI therapy.Results.Thirteen patients were diagnosed with infectious pulmonary TB during the study period. A total of 298 HCWs met our definition for exposure. Exposed HCWs tended to be female (62.9%), non-Saudi (83.9%), nurses (68.6%), or respiratory therapists (24.0%) working in critical care locations (72.8%). Baseline (preemployment) TST documentation existed for 41.3% (123/298). Among those with documented baseline TSTs, 51.2% (63/123) were positive, representing 21.1% (63/298) of all HCWs. Only 48.9% (115/235) of exposed HCWs who had negative or unknown preexposure TST status had their TST tested after exposure. Approximately 46.1% (53/115) of them were diagnosed with postexposure LTBI, and 92.5% (49/53) of them were prescribed LTBI therapy. Among those, 93.9% (46/49) started LTBI therapy; however, 82.6% (38/46) failed to complete the recommended course.Conclusions.We found low rates of baseline TST documentation and postexposure screening among exposed HCWs. Compliance with initiating postexposure isoniazid prophylaxis among HCWs was fair, but only a small fraction of those who started prophylaxis completed the recommended course of therapy. These findings suggest substantial opportunities to implement administrative measures to enhance LTBI management among HCWs.

Local experience for managing oncology services during COVID-19 pandemic in a tertiary care hospital in Saudi Arabia

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Nagwa Ibrahim ◽  
Mohamed Almeziny ◽  
Abdulaziz Alhamad ◽  
Ashraf Farrag
Keyword(s):  
Saudi Arabia ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Active Treatment ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Risk Of Infection ◽  
Local Experience ◽  
Medical City

The COVID-19 pandemic led to several critical challenges that impacted the healthcare system worldwide. Many guidelines have been developed internationally and nationally aiming to minimize the risk of infection and its sequential complications. Cancer patients on active treatment are at higher risk to get infected either due to the disease itself or the cancer treatment and other comorbid diseases. In this manuscript we share our local experience while delivering oncology services during the COVID-19 pandemic at Prince Sultan Military Medical City in Riyadh, Saudi Arabia.

scholarly journals Identifying factors affecting latent tuberculosis treatment acceptance among healthcare workers: a retrospective analysis in a tertiary care centre

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047444
Author(s):  
Maskit Bar-Meir ◽  
Gali Pariente ◽  
Ayal Romem ◽  
Yonit Wiener-Well
Keyword(s):  
Healthcare Workers ◽  
Tertiary Care ◽  
Latent Tuberculosis ◽  
Acceptance Rate ◽  
Tertiary Care Centre ◽  
Academic Medical Centre ◽  
Ltbi Treatment ◽  
Factors Affecting ◽  
Latent Tb Infection ◽  
Treatment Acceptance

ObjectiveOfficial guidelines recommend tuberculosis (TB) screening programmes for all healthcare workers (HCWs), along with offering treatment when latent TB infection (LTBI) is diagnosed. However, adherence to treatment among HCWs is lower compared with non-HCWs. The aim of the present study was to examine the rate of LTBI treatment acceptance among HCWs and to characterise the factors associated with non-acceptance.Design and settingThis was a retrospective cohort study. All HCWs diagnosed with LTBI, who had tuberculin skin test (TST) conversion during their work, between 2000 and 2015, in a single tertiary academic medical centre, and who consented to answer a questionnaire, were enrolled.ResultsOverall, 147 of 219 (67%) with TST conversion agreed to participate. Acceptance rate for LTBI treatment was only 16%. The overall completion rate among those who accepted treatment was 87%. HCWs’ recall of discussing the importance of LTBI treatment with their caregiver had the strongest association with LTBI treatment acceptance: 23 of 52 HCWs (44%) who recalled this discussion accepted treatment (adjusted OR=10.2, 95% CI: 2.2 to 47.6, p=0.003). Knowing the risk of developing TB was associated with 3.7 increased odds to accept treatment (95% CI: 1.2 to 11.8, p=0.02).ConclusionsLTBI acceptance rate was very low among our HCWs. Focusing on educating HCWs is potentially the key step towards an increased rate of LTBI treatment acceptance.

Epidemiology of H1N1 (2009) Influenza among Healthcare Workers in a Tertiary Care Center in Saudi Arabia: A 6-Month Surveillance Study

2010 ◽  
Vol 31 (10) ◽  
pp. 1004-1010 ◽  
Author(s):  
Hanan H. Balkhy ◽  
Aiman El-Saed ◽  
Mahmoud Sallah
Keyword(s):  
Saudi Arabia ◽  
Healthcare Workers ◽  
Care Center ◽  
Tertiary Care ◽  
H1n1 Influenza ◽  
Surveillance Study ◽  
Emerging Infections ◽  
Medical City ◽  
Few Data ◽  
Second Wave

Background.Certain emerging infections, such as severe acute respiratory syndrome and avian influenza, represent a great risk to healthcare workers (HCWs). There are few data about the epidemiology of H1N1 influenza among HCWs.Methods.We conducted a prospective surveillance study for all HCWs at King Abdulaziz Medical City (Riyadh, Saudi Arabia) who were confirmed positive for H1N1 influenza by polymerase chain reaction (PCR) from June 1 through November 30, 2009.Results.During 6 months of surveillance, 526 HCWs were confirmed positive for H1N1 influenza. The distribution of these cases showed 2 clear outbreaks: an initial outbreak (peak at early August) and a shorter second wave (peak at end of October). Among all PCR-confirmed cases, the attack rate was significantly higher in clinical HCWs than in nonclinical HCWs (6.0% vs 4.3%; P < .001 ) and in HCWs in emergency departments than in HCWs in other hospital locations (17.4% vs 5.0%, P < .001). The percentage of HCWs who received regular influenza vaccination was greater for clinical HCWs than for nonclinical HCWs (46.2% vs 24.6%; P < .001). The majority of HCWs with confirmed H1N1 influenza were young (mean age ± standard deviation, 34.5 ± 9.5 years), not Saudi (58.4%), female (55.1%), and nurses (36.1%). Approximately 4% of women who were less than 50 years old were pregnant. Reported exposures included contact with a case (41.0%), contact with a sick household member (23.8%), and recent travel history (13.3%). Respiratory symptoms (98.0%), including cough (90.1%), were the most frequently reported symptoms, followed by muscle aches (66.2%), fever (62.5%), headache (57.9%), diarrhea (16.5%), and vomiting (9.8%). None of these HCWs died, and all recovered fully without hospital admission.Conclusions.The results confirm the vulnerability of HCWs, whether clinical or nonclinical, to emerging H1N1 influenza.

scholarly journals Description of a Hospital Outbreak of Middle East Respiratory Syndrome in a Large Tertiary Care Hospital in Saudi Arabia

2016 ◽  
Vol 37 (10) ◽  
pp. 1147-1155 ◽  
Author(s):  
Hanan H. Balkhy ◽  
Thamer H. Alenazi ◽  
Majid M. Alshamrani ◽  
Henry Baffoe-Bonnie ◽  
Yaseen Arabi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Saudi Arabia ◽  
Infection Control ◽  
Healthcare Workers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Control Measures ◽  
Care Hospital ◽  
Infection Control Measures ◽  
Large Tertiary Care

BACKGROUNDSince the first isolation of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia in 2012, sporadic cases, clusters, and sometimes large outbreaks have been reported.OBJECTIVETo describe the recent (2015) MERS-CoV outbreak at a large tertiary care hospital in Riyadh, Saudi Arabia.METHODSWe conducted an epidemiologic outbreak investigation, including case finding and contact tracing and screening. MERS-CoV cases were categorized as suspected, probable, and confirmed. A confirmed case was defined as positive reverse transcription polymerase chain reaction test for MERS-CoV.RESULTSOf the 130 suspected cases, 81 (62%) were confirmed and 49 (38%) were probable. These included 87 patients (67%) and 43 healthcare workers (33%). Older age (mean [SD], 64.4 [18.3] vs 40.1 [11.3] years, P<.001), symptoms (97% vs 58%, P<.001), and comorbidity (99% vs 42%, P<.001) were more common in patients than healthcare workers. Almost all patients (97%) were hospitalized whereas most healthcare workers (72%) were home isolated. Among 96 hospitalized cases, 63 (66%) required intensive care unit management and 60 (63%) required mechanical ventilation. Among all 130 cases, 51 (39%) died; all were patients (51 [59%]) with no deaths among healthcare workers. More than half (54%) of infections were believed to be caught at the emergency department. Strict infection control measures, including isolation and closure of the emergency department, were implemented to interrupt the chain of transmission and end the outbreak.CONCLUSIONMERS-CoV remains a major healthcare threat. Early recognition of cases and rapid implementation of infection control measures are necessary.Infect Control Hosp Epidemiol 2016;1–9

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