scholarly journals 459. Outcomes and Factors Associated with a SARS-CoV-2 Positive Test in Asymptomatic and Symptomatic Healthcare Workers of a Mexican Hospital Converted to Treat COVID-19 Patients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S297-S297
Author(s):  
Sandra Rajme-López ◽  
Patricia E Leal-Morán ◽  
Fernanda Gonzalez-Lara ◽  
Abril T Vargas-Fernández ◽  
Eric Ochoa-Hein ◽  
...  

Abstract Background Starting on 03/16/2020, the hospital was converted to attend only patients with COVID-19. A surveillance program for healthcare workers (HCWs) that included free in-site medical consultation and RT-PCR for detection of SARS-CoV-2 was initiated. On 04/28/2020, screening of HCWs was started to detect asymptomatic carriers. We report the results of such programs updated to 05/21/2020. Methods Sex, worker category, working area, use of personal protective equipment, date of screening, date of onset of symptoms and home address were retrieved from electronic databases. Logistic regression was done to identify factors associated with being a COVID-19 case or carrier, with p< 0.05 being significant. Odds ratios and incidence densities were calculated. Results Of 2566 HCWs in the hospital, 976 (38.0%) underwent screening and 41 (4.2%) were positive for SARS-CoV-2 (7.4 carriers x 10,000 person-days; median follow-up of 55.5 days); none of the latter were diagnosed with COVID-19 after completing a 14-day follow-up. Of HCWs with negative screen results, 6 (0.6%) ultimately developed COVID-19 after a median of 10 days (1.1 cases x 10,000 person-days). Of 232 symptomatic HCWs that did not undergo basal screening, 131 (56.5%) were diagnosed with COVID-19 (8.8 cases x 10,000 person-days). Ten COVID-19 cases (7.6%) were hospitalized and all were discharged without complications after a median hospital stay of 9 days. Factors associated with COVID-19 were working in a non-clinical area (OR=9.3, 95% CI=1.1–78.6) and being a nurse (OR=1.9, 95% CI=1.1–3.4). Factors associated with being a carrier were living in the State of Mexico (OR=3.7, 95% CI=1.8–8.0) and being a hospital cook (OR=3.7, 95% CI=1.7–8.5). Being a physician was associated with not being a carrier (OR=0.07, 95% CI=0.01–0.5). Wearing a face mask at all times tended to be associated with not being a carrier. Hospital epidemic curves closely ressembled those of the community (Mexico City). Hospital Epidemic Curve, 03/16/2020 - 05/21/2020 Conclusion This study suggests that factors present inside and outside of the hospital are associated with COVID-19 and asymptomatic carriage in HCWs. This information is of utmost importance for infection prevention and control policies. Additionally, a lower percentage of severe cases and no deaths were observed in this cohort as compared to others. Disclosures All Authors: No reported disclosures

2019 ◽  
Vol 15 (2) ◽  
Author(s):  
Walelegn Worku Yallew ◽  
Abera Kumie ◽  
Feleke Moges Yehuala

Healthcare workers have good perception towards infection prevention, but there has been a poor practice towards it. Therefore, the aim of this study was to explore barriers to practice of infection prevention and control practice in teaching hospitals in Amhara region. A phenomenological approach used to explore the lived experience of healthcare workers and management staffs towards infection prevention practice and control. The data was collected from ten in-depth interviews and 23 focus group discussion participants, by face to face interview using open ended interview performed in safe and quiet places. Data was managed using OpenCode software version 4.03 and contents were analyzed thematically. Totally ten different barriers were identified, such as availability of facilities, shortage of material supply, lack of maintenance of facilities and equipment, high patient flow, experience, emergency situation, healthcare worker behaviour and healthcare worker’s information about infection prevention, low awareness of patients and visitors and overflow of families and visitors to the hospital. For effective infection prevention practice implementation, barriers should be considered via identifying specific organizational, healthcare worker, patients and visitors as targets.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rapeephan R. Maude ◽  
Monnaphat Jongdeepaisal ◽  
Sumawadee Skuntaniyom ◽  
Thanomvong Muntajit ◽  
Stuart D. Blacksell ◽  
...  

Abstract Background Key infection prevention and control measures to limit transmission of COVID-19 include social distancing, hand hygiene, use of facemasks and personal protective equipment. However, these have limited or no impact if not applied correctly through lack of knowledge, inappropriate attitude or incorrect practice. In order to maximise the impact of infection prevention and control measures on COVID-19 spread, we undertook a study to assess and improve knowledge, attitudes and practice among 119 healthcare workers and 100 general public in Thailand. The study setting was two inpatient hospitals providing COVID-19 testing and treatment. Detailed information on knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations. Results Knowledge of the main transmission routes, commonest symptoms and recommended prevention methods was mostly very high (> 80%) in both groups. There was lower awareness of aerosols, food and drink and pets as sources of transmission; of the correct duration for handwashing; recommended distance for social/physical distancing; and about recommended types of face coverings. Information sources most used and most trusted were the workplace, work colleagues, health workers and television. The results were used to produce a set of targeted educational videos which addressed many of these gaps with subsequent improvements on retesting in a number of areas. This included improvements in handwashing practice with an increase in the number of areas correctly washed in 65.5% of the public, and 57.9% of healthcare workers. The videos were then further optimized with feedback from participants followed by another round of retesting. Conclusions Detailed information on gaps in knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations. This was used to produce targeted educational videos which addressed these gaps with subsequent improvements on retesting. The resulting videos were then disseminated as a resource to aid in efforts to fight COVID-19 in Thailand and worldwide.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Stéphane Marot ◽  
◽  
Isabelle Malet ◽  
Valentin Leducq ◽  
Karen Zafilaza ◽  
...  

AbstractThere are only few data concerning persistence of neutralizing antibodies (NAbs) among SARS-CoV-2-infected healthcare workers (HCW). These individuals are particularly exposed to SARS-CoV-2 infection and at potential risk of reinfection. We followed 26 HCW with mild COVID-19 three weeks (D21), two months (M2) and three months (M3) after the onset of symptoms. All the HCW had anti-receptor binding domain (RBD) IgA at D21, decreasing to 38.5% at M3 (p < 0.0001). Concomitantly a significant decrease in NAb titers was observed between D21 and M2 (p = 0.03) and between D21 and M3 (p < 0.0001). Here, we report that SARS-CoV-2 can elicit a NAb response correlated with anti-RBD antibody levels. However, this neutralizing activity declines, and may even be lost, in association with a decrease in systemic IgA antibody levels, from two months after disease onset. This short-lasting humoral protection supports strong recommendations to maintain infection prevention and control measures in HCW, and suggests that periodic boosts of SARS-CoV-2 vaccination may be required.


2021 ◽  
Author(s):  
Hayat Mushcab ◽  
Jaffar Al-Tawfiq ◽  
Mohammed Ghamdi ◽  
Amani Babgi ◽  
Abdulrazack Amir ◽  
...  

Abstract Background The nature of the healthcare workers' jobs standing at the frontline against the coronavirus disease 2019 (COVID-19) puts them at a higher risk of unknowingly contracting the disease and potentially contributing to the spread. This study aims to assess the overall positive seroconversion prevalence of SARS-CoV-2. Methods This is a longitudinal cohort study of healthcare workers at a tertiary hospital serving patients in several districts in the Eastern Province of Saudi Arabia. Participants were recruited between June - December 2020. Each participant had a serology blood test and completed the World Health Organization's risk factors assessment questionnaire. Results This study included 682 participants working in any capacity at a tertiary hospital, representing 15.7% of our population. Only 87 participants tested positive for SARS-CoV-2 antibodies, a prevalence of 12.7% of all participants. Of the 87 participants, 17 participants never tested positive for COVID-19 rt-PCR before the study, a prevalence of 2.9%. Moreover, the improper technique of using alcohol-based hand rub or soap and water after the risk of body fluid exposure and wearing personal protective equipment when indicated were found to be statistically significant to having positive SARS-CoV-2 IgG assay with P=0.02, P=0.03, and CI: 95% respectively. Conclusion Positive seroconversion rate was considerably low during the first wave of COVID-19 amongst our healthcare workers and similar to other healthcare organizations in Saudi Arabia. Seropositivity correlated significantly with adherence to infection prevention and control recommendations.


Author(s):  
Namaunga Kasumu Chisompola ◽  
Kapambwe Mwape Kamanga ◽  
Pipina Vlahakis Matafwali

Healthcare workers (HCWs) play a critical role in the management and control of nosocomial transmission of tuberculosis (TB). At the same time, working in TB healthcare facilities such as hospital wards, diagnostic and treatment facilities increases the risk of acquiring TB due to occupational exposure in HCWs. The risk is further heightened in high TB prevalence populations, such as Zambia, as HCWs are exposed both occupationally and in the community. This review aims to provide a better understanding of the risk factors associated with occupational transmission of TB in HCWs in Zambia, by synthesising available data on TB in HCWs in Zambia and the surrounding region. A search of peer reviewed original research on the transmission of TB among HCWs in Zambia was conducted in PubMed and Google Scholar. Studies were eligible for inclusion in the analysis if they described TB amongst HCWs in Zambia, risk factors for TB in HCWs, and nosocomial transmission of TB in Zambia and the surrounding region. The prevalence of TB in HCWs has been demonstrated to be higher than that of the general population. Transmission of TB in healthcare facilities is driven by several factors centred on the lack of adherence to TB infection prevention and control (IPC) practices. Nosocomial transmission of TB in HCWs is further driven by the HIV epidemic and the rise in lifestyle diseases such as diabetes mellitus. However, there is very scarce data on the association of diabetes mellitus and TB among HCWs in Zambia. Prolonged contact with TB patients on wards has been demonstrated to play a vital role in occupational transmission of TB amongst nurses in Zambia. To curb the transmission of TB in HCWs several measures will require implementation such as; administrative support, IPC training and annual TB and HIV screening for all HCWs.


2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Peter Collignon ◽  
John J Beggs

Abstract Antimicrobial resistance (AMR) is affected by many factors, but too much of our focus has been on antimicrobial usage. The major factor that drives resistance rates globally is spread. The COVID-19 pandemic should lead to improved infection prevention and control practices, both in healthcare facilities and the community. COVID-19 will also have ongoing and profound effects on local, national and international travel. All these factors should lead to a decrease in the spread of resistant bacteria. So overall, COVID-19 should lead to a fall in resistance rates seen in many countries. For this debate we show why, overall, COVID-19 will not result in increased AMR prevalence. But globally, changes in AMR rates will not be uniform. In wealthier and developed countries, resistance rates will likely decrease, but in many other countries there are already too many factors associated with poor controls on the spread of bacteria and viruses (e.g. poor water and sanitation, poor public health, corrupt government, inadequate housing, etc.). In these countries, if economies and governance deteriorate further, we might see even more transmission of resistant bacteria.


Author(s):  
Ermira Tartari ◽  
Carolina Fankhauser ◽  
Sarah Masson-Roy ◽  
Hilda Márquez-Villarreal ◽  
Inmaculada Fernández Moreno ◽  
...  

Abstract Background Harmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a “Train-the-Trainers” (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries. Methods We developed a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. To evaluate its impact, we have performed a pre-and post-course knowledge questionnaire. The Wilcoxon signed-rank test was used to compare the results before and after training. Results Between June 2016 and January 2018 we conducted seven TTT courses in six countries: Iran, Malaysia, Mexico, South Africa, Spain and Thailand. A total of 305 IPC professionals completed the programme. Participants included nurses (n = 196; 64.2%), physicians (n = 53; 17.3%) and other health professionals (n = 56; 18.3%). In total, participants from more than 20 countries were trained. A significant (p < 0.05) improvement in knowledge between the pre- and post-TTT training phases was observed in all countries. Puebla (Mexico) had the highest improvement (22.3%; p < 0.001), followed by Malaysia (21.2%; p < 0.001), Jalisco (Mexico; 20.2%; p < 0.001), Thailand (18.8%; p < 0.001), South Africa (18.3%; p < 0.001), Iran (17.5%; p < 0.001) and Spain (9.7%; p = 0.047). Spain had the highest overall test scores, while Thailand had the lowest pre- and post-scores. Positive aspects reported included: unique learning environment, sharing experiences, hands-on practices on a secure environment and networking among IPC professionals. Sustainability was assessed through follow-up evaluations conducted in three original TTT course sites in Mexico (Jalisco and Puebla) and in Spain: improvement was sustained in the last follow-up phase when assessed 5 months, 1 year and 2 years after the first TTT course, respectively. Conclusions The TTT in hand hygiene model proved to be effective in enhancing participant’s knowledge, sharing experiences and networking. IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers.


Author(s):  
Kavindhran Velen ◽  
Nguyen Viet Nhung ◽  
Nguyen Thu Anh ◽  
Pham Duc Cuong ◽  
Nguyen Binh Hoa ◽  
...  

Abstract Background Tuberculosis (TB) continues to account for significant morbidity and mortality annually. Household contacts (HHCs) of persons with TB are a key population for targeting prevention and control interventions. We aimed to identify risk factors associated with developing TB among HHCs. Methods We conducted a nested case-control study among HHCs in 8 provinces in Vietnam enrolled in a randomized controlled trial of active case finding for TB. Cases were any HHCs diagnosed and registered with TB within the Vietnam National TB Program during 2 years of follow-up. Controls were selected by simple random sampling from the remaining HHCs. Risk factor data were collected at enrollment and during follow-up. A logistic regression model was developed to determine predictors of TB among HHCs. Results We selected 1254 HHCs for the analysis: 214 cases and 1040 controls. Underlying characteristics varied between both groups; cases were older, more likely to be male, with a higher proportion of reported previous TB and diabetes. Risk factors associated with a TB diagnosis included being male (adjusted odds ratio [aOR], 1.4; 95% confidence interval [CI], 1.03–2.0), residing in an urban setting (aOR, 1.8; 1.3–2.5), prior TB (aOR, 4.6; 2.5–8.7), history of diabetes (aOR, 3.1; 1.7–5.8), current smoking (aOR, 3.1; 2.2–4.4), and prolonged history of coughing in the index case at enrollment (OR , 1.6; 1.1–2.3). Conclusions Household contacts remain an important key population for TB prevention and control. TB programs should ensure effective contact investigations are implemented for household contacts, particularly those with additional risk factors for developing TB.


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