Dynamics of the seroprevalence of SARS-CoV-2 antibodies among healthcare workers at a COVID-19 referral hospital in Milan, Italy

ObjectivesHealthcare workers (HCWs) are at high risk of developing SARS-CoV-2 infection. The aim of this single-centre prospective study was to evaluate the trend of SARS-CoV-2 seroprevalence in HCWs working at the primary referral centre for infectious diseases and bioemergencies (eg, COVID-19) in Northern Italy and investigate the factors associated with seroconversion.MethodsSix hundred and seventy-nine HCW volunteers were tested for anti-SARS-CoV-2 antibodies three times between 4 March and 27 May 2020 and completed a questionnaire covering COVID-19 exposure, symptoms and personal protective equipment (PPE) training and confidence at each time.ResultsSARS-CoV-2 seroprevalence rose from 3/679 to 26/608 (adjusted prevalence: 0.5%, 95% CI 0.1 to 1.7% and 5.4%, 95% CI 3.6 to 7.9, respectively) between the first two time points and then stabilised, in line with the curve of the COVID-19 epidemic in Milan. From the first time point, 61.6% of the HCWs had received training in the use of PPE and 17 (61.5%) of those who proved to be seropositive reported symptoms compatible with SARS-CoV-2 infection. Contacts with ill relatives or friends and self-reported symptoms were independently associated with an increased likelihood of seroconversion (p<0.0001 for both), whereas there was no significant association with professional exposure.ConclusionThe seroprevalence of SARS-CoV-2 among the HCWs at our COVID-19 referral hospital was low at the time of the peak of the epidemic. The seroconversions were mainly attributable to extrahospital contacts, probably because the hospital readily adopted effective infection control measures. The relatively high number of asymptomatic seropositive HCWs highlights the need to promptly identify and isolate potentially infectious HCWs.

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Knowledge, attitudes and practices regarding tuberculosis amongst healthcare workers in Moyen-Ogooué Province, Gabon

BMC Infectious Diseases ◽

10.1186/s12879-021-06225-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anja Vigenschow ◽

Jean Ronald Edoa ◽

Bayode Romeo Adegbite ◽

Pacome Achimi Agbo ◽

Ayola A. Adegnika ◽

...

Keyword(s):

Infection Control ◽

Healthcare Workers ◽

Control Measures ◽

Tuberculosis Infection ◽

Healthcare Personnel ◽

Factors Associated ◽

Infection Control Measures ◽

High Knowledge ◽

Tuberculosis Infection Control ◽

Knowledge Levels

Abstract Background In countries with a high tuberculosis incidence such as Gabon, healthcare workers are at enhanced risk to become infected with tuberculosis due to their occupational exposure. In addition, transmission can occur between patients and visitors, if a tuberculosis infection is not suspected in time. Knowledge about tuberculosis and correct infection control measures are therefore highly relevant in healthcare settings. Methods We conducted an interviewer-administered knowledge, attitude and practice survey amongst healthcare workers in 20 healthcare facilities at all levels in the Moyen-Ogooué province, Gabon. Correctly answered knowledge questions were scored and then categorised into four knowledge levels. Additionally, factors associated with high knowledge levels were identified. Fisher’s Exact test was used to identify factors associated with high knowledge levels. Results A total of 103 questionnaires were completed by various healthcare personnel. The most-frequently scored category was ‘intermediate knowledge’, which was scored by 40.8% (42/103), followed by ‘good knowledge’ with 28.2% (29/103) and ‘poor knowledge’ with 21.4% (22/103) of participating healthcare workers, respectively. ‘Excellent knowledge’ was achieved by 9.7% (10/103) of the interviewees. Apart from the profession, education level, type of employing healthcare facility, as well as former training on tuberculosis were significantly associated with high knowledge scores. Attitudes were generally positive towards tuberculosis infection control efforts. Of note, healthcare workers reported that infection control measures were not consistently practiced; 72.8% (75/103) of the participants were scared of becoming infected with tuberculosis, and 98.1% saw a need for improvement of local tuberculosis control. Conclusions The survey results lead to the assumption that healthcare workers in the Moyen-Ogooué province are at high risk to become infected with tuberculosis. There is an urgent need for improvement of tuberculosis infection control training for local healthcare personnel, particularly for less trained staff such as assistant nurses. Furthermore, the lack of adequate infection control measures reported by staff could possibly be correlated with a lack of adequate facility structures and protective equipment and requires further investigation.

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Prevalence and Factors Associated With Burnout of Frontline Healthcare Workers in Fighting Against the COVID-19 Pandemic: Evidence From China

Frontiers in Psychology ◽

10.3389/fpsyg.2021.680614 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xin Zhang ◽

Jiahui Wang ◽

Yanhua Hao ◽

Ke Wu ◽

Mingli Jiao ◽

...

Keyword(s):

Infection Control ◽

Healthcare Workers ◽

Final Analysis ◽

Maslach Burnout Inventory ◽

Control Measures ◽

Cluster Sampling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Associated ◽

Infection Control Measures

ObjectivesThe sudden outbreak of the novel coronavirus disease (COVID-19) plunged healthcare workers (HCWs) into warfare. This study aimed to determine the prevalence of burnout and the factors associated with it among frontline HCWs fighting COVID-19.MethodsA cross-sectional survey was conducted among frontline HCWs fighting against the COVID-19 in Wuhan, Harbin, and Shenzhen during the period from February 18 to March 4. Finally, HCWs were recruited using cluster sampling, 1,163 HCWs were included in the final analysis. Burnout was measured using a 22-item Maslach Burnout Inventory scale (MBI scale).ResultsOf the participants, 48.6% suffered from burnout, and 21.8% showed a high degree of burnout. Doctors (b = 3.954, P = 0.011) and nurses (b = 3.067, P = 0.042) showed higher emotional exhaustion (EE) than administrators. Participants who worked continuously for more than 8 h a day (b = 3.392, P = 0.000), those who were unable to eat three regular daily meals (b = 2.225, P = 0.008), whose daily water intake was no more than 800 ml (b = 3.007, P = 0.000), who slept for no more than 6 h (b = 1.609, P = 0.036), and who were infected or had colleagues who were infected with COVID-19 (b = 4.182, P = 0.000) experienced much higher levels of EE, while those who could adhere to infection control procedures (b = −5.992, P = 0.000), who were satisfied with their hospital’s infection control measures(b = −3.709, P = 0.001), and who could receive sufficient psychological crisis intervention (b = −1.588, P = 0.039) reported lower levels of EE.ConclusionThe study reveals that burnout is prevalent among frontline HCWs and that the known factors associated with burnout, such as workload, and the factors directly associated with COVID-19, such as having insufficient protection, can affect burnout symptoms in frontline HCWs. Synergized and comprehensive interventions should be targeted at reducing its occurrence among frontline HCWs fighting COVID-19.

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Preventing SARS-CoV-2 transmission in the emergency department by implementing a separate pathway for patients with respiratory conditions

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2020-0422 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Fulwah Alqahtani ◽

Marzouqah Alanazi ◽

Wajdan Alassaf ◽

Fadilah Sfouq Aleanizy ◽

Muna Aljahany ◽

...

Keyword(s):

Emergency Department ◽

Longitudinal Study ◽

Healthcare Workers ◽

Respiratory Symptoms ◽

Control Measures ◽

University Hospital ◽

Respiratory Pathway ◽

Infection Control Measures ◽

Separate Pathway ◽

Respiratory Conditions

Abstract Objectives This study aimed to describe the development and implementation of a separated pathway to check and treat patients with a suspected/confirmed coronavirus disease 2019 (COVID-19) in the emergency department (ED) at King Abdullah bin Abdulaziz University Hospital in Riyadh. Methods We conducted a retrospective, descriptive longitudinal study from March to July 2020 by analyzing data of all confirmed cases of COVID-19 among ED visitors and healthcare workers in King Abdullah bin Abdulaziz University Hospital. Results During the study period, a total of 1,182 swab samples were collected for testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), of which 285 (24.1%) tested positive. Of the 285 cases of confirmed SARS-CoV-2 infection, 18 were healthcare workers and 267 were patients. As a result of using the respiratory pathway for COVID-19 patients, the hospital managed to limit transmission of SARS-CoV-2 not only between patients but also between patients and healthcare workers, while also containing the pandemic. There were no cases of nosocomial SARS-CoV-2 infection recorded among the patients who visited the ED or the flu clinic. All confirmed cases were community acquired and patients were cared for under constrained measures. Conclusions Implementing infection control measures and restricting those with respiratory symptoms to the ED pathway prevented nosocomial spread of SARS-CoV-2 infection in the ED.

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Healthcare Workers Infection Rate in the Era of Coronavirus Disease 2019 - in Tertiary Teaching Hospital

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6584 ◽

2021 ◽

Vol 9 (A) ◽

pp. 651-658

Author(s):

Mona Mohiedden ◽

Aml M. Said ◽

Ahmed M. Ali ◽

Mohammed M. Abdel Razik ◽

Maha Ali Gad

Keyword(s):

Healthcare Workers ◽

Statistical Significance ◽

Descriptive Analysis ◽

Control Measures ◽

University Hospitals ◽

Cross Sectional ◽

Infection Control Measures ◽

Increased Risk ◽

Tertiary Teaching ◽

Potential Risk Factors

BACKGROUND: Healthcare workers (HCWs) are at the frontline defense against coronavirus disease 2019 (COVID-19) pandemic. AIM: The study aimed to describe the characteristics and appraise potential risk factors of COVID-19 transmission among HCWs who tested positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in one of Cairo University Hospitals. METHOD: Cross-sectional descriptive analysis of confirmed polymerase chain reaction (PCR) positive versus negative cases for COVID-19. RESULTS: Through March–June 2020, (145/846; 17%) suspected HCWs were tested for COVID-19 by PCR; out of them (70/145; 48.3%) were confirmed as positive, these positive cases represented (70/846; 8.3%) of all HCWs of the hospital. About 33% of confirmed COVID-19 positive HCWs acquired the infection from the healthcare while only (13/70; 19%) from community settings, and no clear exposure data were identified in (34/70; 48%) of cases. Most of symptomatic cases showed a positive PCR test for SARS-CoV-2 versus asymptomatic cases, p < 0.001. There was no statistical significance regarding gender, age, presence of comorbidity, workload or the type of acquisition. CONCLUSION: HCWs are at an increased risk of COVID-19 infection at the workplace. Strict implementation of infection control measures is of crucial role in preventing transmission of COVID-19 infection in health-care settings.

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Prevalence of and environmental factors associated with aerosolised Aspergillus spores at a zoological park

Veterinary Record Open ◽

10.1136/vetreco-2018-000281 ◽

2019 ◽

Vol 6 (1) ◽

pp. e000281

Author(s):

Molly Martony ◽

Hendrik Nollens ◽

Melinda Tucker ◽

Linda Henry ◽

Todd Schmitt ◽

...

Keyword(s):

Environmental Factors ◽

Infection Control ◽

High Efficiency ◽

Mitigation Strategies ◽

Control Measures ◽

Surveillance Systems ◽

Factors Associated ◽

Infection Control Measures ◽

Air Sampler ◽

Zoological Park

Aspergillus is a significant pathogen in zoological species, although information on environmental variables influencing fungal prevalence in zoological settings are lacking. The objective of the study was to estimate the prevalence of and to identify environmental factors associated with aerosolised Aspergillus spores at a zoological park to advance the understanding of fungal exposure as a first step towards improved mitigation strategies for susceptible animals. Twenty-one locations were sampled for presence of Aspergillus species using the SAS Super 180 Microbial Air Sampler, while twenty-two environmental factors were evaluated every two weeks at SeaWorld of California during two 12-month periods. In each period, the frequency of investigated environmental factors was compared between samples classified as positive or negative for Aspergillus species using logistic regression. Prevalence of Aspergillus was higher (P<0.05) during the second 12-month period (110/525 or 21 per cent), compared with the first period (62/483 or 13 per cent). In both periods, positive Aspergillus samples were associated with indoor sites without high-efficiency particulate air (HEPA) filtration systems and other infection control measures (adjusted OR=4.33 and 5.19, P<0.01) or outdoor sites (adjusted OR=2.50 and3.79, P≤0.05), compared to indoor sites with HEPA filtration systems and other infection control measures, after controlling for season. Burden of airborne Aspergillus can be higher in indoor sites without HEPA filtration systems than in outdoor sites. The use of HEPA filtration systems and other infection control measures can mitigate the burden of Aspergillus. Risk-based surveillance systems that target indoor areas without HEPA filtration systems can be an efficient approach for early detection of high burden of Aspergillus at zoological parks.

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Tuberculosis in Healthcare Workers and Infection Control Measures at Primary Healthcare Facilities in South Africa

PLoS ONE ◽

10.1371/journal.pone.0076272 ◽

2013 ◽

Vol 8 (10) ◽

pp. e76272 ◽

Cited By ~ 36

Author(s):

Mareli M. Claassens ◽

Cari van Schalkwyk ◽

Elizabeth du Toit ◽

Eline Roest ◽

Carl J. Lombard ◽

...

Keyword(s):

South Africa ◽

Infection Control ◽

Primary Healthcare ◽

Healthcare Workers ◽

Control Measures ◽

Healthcare Facilities ◽

Infection Control Measures

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COVID-19 Critical Care Simulations: An International Cross-sectional Survey

10.21203/rs.3.rs-121001/v1 ◽

2020 ◽

Author(s):

Mohamad-Hani Temsah ◽

Abdulkarim Alrabiaah ◽

Ayman Al-Eyadhy ◽

Fahad Al-Sohime ◽

Abdullah Al Huzaimi ◽

...

Keyword(s):

Infection Control ◽

Healthcare Workers ◽

Primary Outcome ◽

Control Measures ◽

Team Leaders ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Patient Transport ◽

Infection Control Measures ◽

Better Than

Abstract Background: Many healthcare systems initiated rapid training with COVID-19 simulations for their healthcare workers (HCWs) to build surge capacity and optimize infection control measures. This study aimed to describe COVID-19 simulation drills in international healthcare centers. Methods: This is a cross-sectional survey among simulation team leaders and HCWs, based on each center's debriefing reports from simulation centers from 30 countries in all WHO regions where COVID-19 simulation drills were conducted. The primary outcome measures were the COVID-19 simulations' characteristics, outcomes, facilitators, obstacles, and challenges encountered during the simulation sessions. Results: Invitation was sent to 500 simulation team leaders and HCWs, and 343 responded. Those who completed the study comprised 121 participants: 62.8% females; 56.2% physicians; 41.3% from East Mediterranean (EMRO) countries; 25.6% from Southeast Asian countries (SERO); and 12.4% from Europe. The frequency of simulation sessions was monthly (27.1%), weekly (24.8%), twice weekly (19.8%), or daily (21.5%). Among participants, 55.6% reported the team's full engagement in the simulation sessions. The average session length was 30–60 minutes. The most commonly reported debriefing leaders were ICU staff, simulation lab staff, and E.R. facilitators, and the least common were infection control staff. A total of 80% reported "a lot" to "a great improvement" in terms of clinical preparedness after simulation sessions, and 70% were satisfied with the COVID-19 simulation sessions and thought they were better than expected. Most of the perceived issues reported were related to infection control measures, followed by team dynamics, logistics, and patient transport issues. Conclusion: Simulation centers team leaders and HCWs reported positive feedback on COVID-19 simulation sessions. The presence of multiprofessional personnel during drills is warranted. These drills are a valuable tool for rehearsing safe dynamics of HCWs on the frontline of COVID-19.Trial registration: Not applicable.

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COVID-19 Exposure Risk of Healthcare Personnel in Digestive Endoscopy: A Prospective Study

10.21203/rs.3.rs-31812/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Lorenzo Dioscoridi ◽

Chiara Carrisi

Keyword(s):

Healthcare Workers ◽

Large Scale ◽

Control Measures ◽

Healthcare Personnel ◽

Confounding Factors ◽

Digestive Endoscopy ◽

Exposure Risk ◽

Infection Control Measures ◽

A Prospective Study ◽

Large Scale Tests

Abstract Background: Of many descriptive papers about healthcare workers’ (HW) COVID-19 infection, asymptomatic cases have not yet considered. Aims: The present study calculated the numbers of COVID-19 patients afferent to GI endoscopy and the number of positive HW using nasopharyngeal swabs (NS), serological rapid IgM/IgG tests (SRT) and serological quantitative IgG test (SQT).Methods: The study was conducted from 2ndto 30thApril 2020. All the recommended national and international indications on infection control measures were followed. Out of 1227 patients accepted, 1009 were included in the study. 38 HW were tested by NS, SRT and SQT. Descriptive statistical analyses were used to summarize the data.Results: 17 patients were diagnosed COVID-19 positive at NS. 9 patients were known positive at the time of the endoscopy and 8 were diagnosed COVID-19 positive after the procedure. Of the 38 HW, 2 were positive both to NS and SRT with IgM/IgG lines; 7 showed IgG line only at SRT, confirmed by SQT with negative NS. Other 7 HW showed not well-defined line of IgG at SRT, confirmed negative by SQT. The two cases positive to NS and IgM/IgG SRT were asymptomatic. The crude contagion’s rate (R0)was 0.41 and 1.7% of COVID-19 patients caused 19% of positive cases in HW.Conclusions: Not previously diagnosed COVID-19 patients expose HW to additional and incalculable risk of contamination. Association between different tests reduced the variability related to possible confounding factors and increases the accuracy. Since most cases in HW seem to go asymptomatic, large-scale tests using both NS and SRT for both HW and patients should be recommended to minimize the risk of in-hospital infection’s relapses.

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Management of a Hospital-Wide COVID-19 Outbreak Affecting Patients and Healthcare Workers

SN Comprehensive Clinical Medicine ◽

10.1007/s42399-020-00597-2 ◽

2020 ◽

Vol 2 (12) ◽

pp. 2540-2545

Author(s):

Steffen Höring ◽

René Fussen ◽

Johannes Neusser ◽

Michael Kleines ◽

Thea Laurentius ◽

...

Keyword(s):

Infection Control ◽

Healthcare Workers ◽

Spatial Separation ◽

Control Measures ◽

Medical Conditions ◽

Hospital Workers ◽

Infection Control Team ◽

Healthcare Facilities ◽

Infection Control Measures ◽

Control Team

AbstractTo the best of our knowledge, here, we describe the first hospital-wide outbreak of SARS-CoV-2 that occurred in Germany in April 2020. We aim to share our experience in order to facilitate the management of nosocomial COVID-19 outbreaks in healthcare facilities. All patients and hospital workers were screened for SARS-CoV-2 repeatedly. An infection control team on the side was installed. Strict spatial separation of patients and intensified hygiene training of healthcare workers (HCW) were initiated. By the time of reporting, 26 patients and 21 hospital workers were infected with a cluster of cases in the geriatric department. Fourteen patients developed COVID-19 consistent symptoms and five patients with severe pre-existing medical conditions died. The outbreak was successfully contained after intensified infection control measures were implemented and no further cases among patients were detected over a period of 14 days. Strict application of standard infection control measures proved to be successful in the management of nosocomial SARS-CoV-2 outbreaks.

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Latent tuberculosis infection in healthcare workers in low- and middle-income countries: an updated systematic review

European Respiratory Journal ◽

10.1183/13993003.01789-2018 ◽

2019 ◽

Vol 53 (4) ◽

pp. 1801789 ◽

Cited By ~ 15

Author(s):

Lika Apriani ◽

Susan McAllister ◽

Katrina Sharples ◽

Bachti Alisjahbana ◽

Rovina Ruslami ◽

...

Keyword(s):

Systematic Review ◽

Infection Control ◽

Healthcare Workers ◽

Latent Tuberculosis ◽

Annual Incidence ◽

Control Measures ◽

Middle Income ◽

Middle Income Countries ◽

Infection Control Measures ◽

Increased Risk

Healthcare workers (HCWs) are at increased risk of latent tuberculosis (TB) infection (LTBI) and TB disease.We conducted an updated systematic review of the prevalence and incidence of LTBI in HCWs in low- and middle-income countries (LMICs), associated factors, and infection control practices. We searched MEDLINE, Embase and Web of Science (January 1, 2005–June 20, 2017) for studies published in any language. We obtained pooled estimates using random effects methods and investigated heterogeneity using meta-regression.85 studies (32 630 subjects) were included from 26 LMICs. Prevalence of a positive tuberculin skin test (TST) was 14–98% (mean 49%); prevalence of a positive interferon-γ release assay (IGRA) was 9–86% (mean 39%). Countries with TB incidence ≥300 per 100 000 had the highest prevalence (TST: pooled estimate 55%, 95% CI 41–69%; IGRA: pooled estimate 56%, 95% CI 39–73%). Annual incidence estimated from the TST was 1–38% (mean 17%); annual incidence estimated from the IGRA was 10–30% (mean 18%). The prevalence and incidence of a positive test was associated with years of work, work location, TB contact and job category. Only 15 studies reported on infection control measures in healthcare facilities, with limited implementation.HCWs in LMICs in high TB incidence settings remain at increased risk of acquiring LTBI. There is an urgent need for robust implementation of infection control measures.

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