scholarly journals Risk of SARS-CoV-2 exposure among hospital healthcare workers in relation to patient contact and type of care

2021 ◽  
pp. 140349482110224
Author(s):  
Susanna Klevebro ◽  
Fuad Bahram ◽  
K. Miriam Elfström ◽  
Ulrika Hellberg ◽  
Sophia Hober ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Odds Ratio ◽  
Healthcare Workers ◽  
Adjusted Odds Ratio ◽  
Care Hospital ◽  
Patient Contact ◽  
Questionnaire Data ◽  
Igg Antibodies ◽  
Serum Samples ◽  
Factors Associated

Aim: We aimed to assess prevalence of IgG antibodies to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and factors associated with seropositivity in a large cohort of healthcare workers (HCWs). Methods: From 11 May until 11 June 2020, 3981 HCWs at a large Swedish emergency care hospital provided serum samples and questionnaire data. Presence of IgG antibodies to SARS-CoV-2 was measured as an indicator of SARS-CoV-2 exposure. Results: The total seroprevalence was 18% and increased during the study period. Among the seropositive HCWs, 11% had been entirely asymptomatic. Participants who worked with COVID-19 patients had higher odds for seropositivity: adjusted odds ratio 1.96 (95% confidence intervals 1.59–2.42). HCWs from three of the departments managing COVID-19 patients had significantly higher seroprevalences, whereas the prevalence among HCWs from the intensive care unit (also managing COVID-19 patients) was significantly lower. Conclusions: HCWs in contact with SARS-CoV-2 infected patients had a variable, but on average higher, likelihood for SARS-CoV-2 infections.

scholarly journals Risk of SARS-CoV-2 exposure among hospital healthcare workers in relation to patient contact and type of care

2021 ◽  
Author(s):  
Susanna Klevebro ◽  
Fuad Bahram ◽  
K. Miriam Elfström ◽  
Ulrika Hellberg ◽  
Sophia Hober ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Emergency Care ◽  
Healthcare Workers ◽  
Care Hospital ◽  
Patient Contact ◽  
Questionnaire Data ◽  
Igg Antibodies ◽  
Serum Samples

AbstractAimWe aimed to assess the risk for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in a large cohort of healthcare workers (HCWs).MethodsFrom May 11 until June 11, 2020, 3,981 HCWs at a large Swedish Emergency Care hospital provided serum samples and questionnaire data. Exposure was measured by assaying IgG antibodies to SARS-CoV-2.ResultsThe total seroprevalence was 17.7% and increased during the study period. Among the seropositive HCWs, 10.5% had been entirely asymptomatic. Participants who worked with COVID-19 patients had higher odds for seropositivity: ORadj 1.96 (95% CI 1.59 – 2.42). HCWs from three of the departments managing COVID-19 patients had significantly higher seroprevalences, whereas the prevalence among HCWs from the Intensive Care Unit (also managing COVID-19 patients) was significantly lower.ConclusionHCWs in contact with SARS-CoV-2 infected patients had a variable, but on average higher, likelihood for SARS-CoV-2 infections.

scholarly journals SARS-CoV-2 exposure, symptoms and seroprevalence in healthcare workers in Sweden

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Ann-Sofie Rudberg ◽  
Sebastian Havervall ◽  
Anna Månberg ◽  
August Jernbom Falk ◽  
Katherina Aguilera ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Occupational Health ◽  
Acute Care ◽  
Odds Ratio ◽  
Healthcare Workers ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Patient Contact ◽  
Igg Antibodies ◽  
Time Period

Abstract SARS-CoV-2 may pose an occupational health risk to healthcare workers. Here, we report the seroprevalence of SARS-CoV-2 antibodies, self-reported symptoms and occupational exposure to SARS-CoV-2 among healthcare workers at a large acute care hospital in Sweden. The seroprevalence of IgG antibodies against SARS-CoV-2 was 19.1% among the 2149 healthcare workers recruited between April 14th and May 8th 2020, which was higher than the reported regional seroprevalence during the same time period. Symptoms associated with seroprevalence were anosmia (odds ratio (OR) 28.4, 95% CI 20.6–39.5) and ageusia (OR 19.2, 95% CI 14.3–26.1). Seroprevalence was also associated with patient contact (OR 2.9, 95% CI 1.9–4.5) and covid-19 patient contact (OR 3.3, 95% CI 2.2–5.3). These findings imply an occupational risk for SARS-CoV-2 infection among healthcare workers. Continued measures are warranted to assure healthcare workers safety and reduce transmission from healthcare workers to patients and to the community.

scholarly journals Oseltamivir Use Among Children and Adults Hospitalized With Community-Acquired Pneumonia

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Ikwo K. Oboho ◽  
Anna Bramley ◽  
Lyn Finelli ◽  
Alicia Fry ◽  
Krow Ampofo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Differential Diagnosis ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Influenza Season ◽  
Community Acquired Pneumonia ◽  
Severe Illness ◽  
Factors Associated ◽  
Icu Admission ◽  
Clinician Education

Abstract Background Data on oseltamivir treatment among hospitalized community-acquired pneumonia (CAP) patients are limited. Methods Patients hospitalized with CAP at 6 hospitals during the 2010−2012 influenza seasons were included. We assessed factors associated with oseltamivir treatment using logistic regression. Results Oseltamivir treatment was provided to 89 of 1627 (5%) children (<18 years) and 143 of 1051 (14%) adults. Among those with positive clinician-ordered influenza tests, 39 of 61 (64%) children and 37 of 48 (77%) adults received oseltamivir. Among children, oseltamivir treatment was associated with hospital A (adjusted odds ratio [aOR], 2.76; 95% confidence interval [CI], 1.36−4.88), clinician-ordered testing performed (aOR, 2.44; 95% CI, 1.47−5.19), intensive care unit (ICU) admission (aOR, 2.09; 95% CI, 1.27−3.45), and age ≥2 years (aOR, 1.43; 95% CI, 1.16−1.76). Among adults, oseltamivir treatment was associated with clinician-ordered testing performed (aOR, 8.38; 95% CI, 4.64−15.12), hospitals D and E (aOR, 3.46−5.11; 95% CI, 1.75−11.01), Hispanic ethnicity (aOR, 2.06; 95% CI, 1.18−3.59), and ICU admission (aOR, 2.05; 95% CI, 1.34−3.13). Conclusions Among patients hospitalized with CAP during influenza season, oseltamivir treatment was moderate overall and associated with clinician-ordered testing, severe illness, and specific hospitals. Increased clinician education is needed to include influenza in the differential diagnosis for hospitalized CAP patients and to test and treat patients empirically if influenza is suspected.

scholarly journals High anti-SARS-CoV-2 antibody seroprevalence in healthcare workers in an Irish university teaching hospital

2021 ◽  
Author(s):  
Ann Leonard ◽  
Anna Rose Prior ◽  
Phyllis Reilly ◽  
Caroline Murray ◽  
Meghan O’ Brien ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Tertiary Care ◽  
Antibody Test ◽  
University Teaching ◽  
Transmission Risk ◽  
Molecular Testing ◽  
Care Hospital ◽  
Patient Contact ◽  
Serum Samples ◽  
Joint Research

Abstract Introduction Healthcare workers are at very high risk for SARS-CoV-2 exposure and infection. This study evaluated anti-SARS-CoV-2 seroprevalence in healthcare workers in a tertiary care hospital and then correlated seroprevalence with confirmed or suspected SARS-CoV-2 infection in this population since the onset of the COVID-19 pandemic. Method The study was approved by our institution’s Joint Research Ethics Committee in June 2020. All volunteers were provided with a consent form, an information leaflet and a questionnaire on the day before phlebotomy. Serum samples were collected from 1176 participants over a 3-month period and analysed using the Elecsys Anti-SARS-CoV-2 assay (Roche Diagnostics GmbH, Mannheim, Germany) which detects total antibodies against the nucleocapsid protein of SARs-COV-2. Results Overall anti-SARS-CoV-2 seroprevalence among participating healthcare workers was 17.9%. The rate of confirmed infection by real-time polymerase chain reaction molecular testing prior to participation was 12.2%. Of 211 participants who had a reactive antibody test result, 37% did not have COVID-19 infection confirmed at any point prior to participation in this study, either having had a swab which did not detect SARS-CoV-2 RNA or having never been tested. Seropositivity was the highest (30%) in the youngest quintile of age (20–29 years old). Staff with more patient contact had a higher seroprevalence of 19.5% compared to 13.4% in staff with less patient contact. Conclusion This study demonstrates that a substantial proportion of SARS-CoV-2 infections in healthcare workers may be asymptomatic or subclinical and thus potentially represent a significant transmission risk to colleagues and patients.

Factors associated with prolonged psychiatric intensive care unit admission at Somdet Chaophraya Institute of Psychiatry, Thailand

2020 ◽  
Vol 16 (1) ◽  
pp. 9-14
Author(s):  
Poom Chompoosri ◽  
Thatsani Kunchanaphongphan
Keyword(s):  
Intensive Care Unit ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Multiple Logistic Regression Analysis ◽  
Compulsory Admission ◽  
Multiple Logistic Regression ◽  
Factors Associated

Aim: Our objective is to determine factors associated with prolonged psychiatric intensive care unit (PICU) admission at Somdet Chaophraya Institute of Psychiatry (SCIP).<br/> Method: We reviewed the medical records of patients admitted to the PICU between 1 July 2016 and 31 December 2016 meeting PICU admission criteria. We defined prolonged admission as PICU clinical stay of longer than five days. We then performed univariate binary logistic regression analysis to analyse the association between factors and prolonged PICU admission. Factors with p-value <0.25 were then included in backward stepwise multiple logistic regression analysis.<br/> Results: We included 293 cases then excluded 42 of them using our exclusion criteria (30 were discharged by other means and 12 cases were due to inability to obtain essential information). Of 251 studied cases, 112 cases (44.6%) had prolonged PICU admission. Univariate logistic regression analysis found that a history of prior PICU admission, compulsory admission, treatment with electroconvulsive therapy (ECT), and primary diagnosis were associated with prolonged PICU admission with p-value <0.25. Using multiple logistic regression analysis, factors associated with prolonged PICU admission were: compulsory admission (adjusted odds ratio 2.45, 95% CI 1.06–5.69 when adjusted with treatment with ECT) and treatment with ECT during PICU admission (adjusted odds ratio 9.01, 95% CI 2.57–31.59 when adjusted with compulsory admission).<br/> Conclusions: Factors associated with prolonged PICU admission at SCIP were compulsory admission and treatment with ECT during PICU admission. We propose that further study of these two groups should provide clues on how to improve treatment in PICU.

scholarly journals Factors associated with the development of ocular candidiasis and ocular prognosis with echinocandin therapy for candidemia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Daiki Sakai ◽  
Wataru Matsumiya ◽  
Sentaro Kusuhara ◽  
Makoto Nakamura
Keyword(s):  
Candida Albicans ◽  
Medical Records ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Patient Characteristics ◽  
Antifungal Drugs ◽  
Factors Associated ◽  
Logistic Analysis ◽  
Multivariate Logistic Analysis ◽  
Systemic Antifungal Therapy

Abstract Purpose To evaluate the factors associated with the development of ocular candidiasis (OC) and ocular prognosis with echinocandin therapy for candidemia. Methods The medical records of 56 consecutive patients with a positive blood culture for Candida species between November 2016 and October 2019 were retrospectively reviewed. Information on patient characteristics, isolated Candida species, treatment details for candidemia, and ocular findings were extracted to identify factors associated with OC development. Results The leading pathogen of candidemia was Candida albicans (C.albicans) (41.1%). Of 56 patients, 18 (32.1%) were diagnosed with chorioretinitis, categorized as either probable (8 patients) or possible OC (10 patients). There was no case of endophthalmitis with vitritis. The incidence of probable OC was not significantly different between the groups treated with echinocandins and other antifungal drugs (15.2% vs. 11.1%, p = 1.00). In all probable OC cases, systemic antifungal therapy was switched from echinocandins to azoles, and no case progressed to endophthalmitis. A multivariate logistic analysis revealed that female sex (adjusted odds ratio [aOR], 8.93; 95% confidence interval [CI], 1.09–72.9) and C. albicans (aOR, 23.6; 95% CI, 1.8–281) were independent factors associated with the development of probable OC. Conclusion One-seventh of patients with candidemia developed probable OC. Given the evidence of female and C. albicans as the factors associated with OC development, careful ophthalmologic management is required with these factors, especially in candidemia. Although echinocandins had no correlation with OC development and did not lead to the deterioration of ocular prognosis, further investigation is required.

Māori health outcomes in an intensive care unit in Aotearoa New Zealand

2021 ◽  
pp. 0310057X2198971
Author(s):  
M Atif Mohd Slim ◽  
Hamish M Lala ◽  
Nicholas Barnes ◽  
Robert A Martynoga
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
New Zealand ◽  
Renal Replacement Therapy ◽  
Confidence Interval ◽  
Health Outcomes ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
One Year ◽  
Maori Health

Māori are the indigenous people of New Zealand, and suffer disparate health outcomes compared to non-Māori. Waikato District Health Board provides level III intensive care unit services to New Zealand’s Midland region. In 2016, our institution formalised a corporate strategy to eliminate health inequities for Māori. Our study aimed to describe Māori health outcomes in our intensive care unit and identify inequities. We performed a retrospective audit of prospectively entered data in the Australian and New Zealand Intensive Care Society database for all general intensive care unit admissions over 15 years of age to Waikato Hospital from 2014 to 2018 ( n = 3009). Primary outcomes were in–intensive care unit and in-hospital mortality. The secondary outcome was one-year mortality. In our study, Māori were over-represented relative to the general population. Compared to non-Māori, Māori patients were younger (51 versus 61 years, P < 0.001), and were more likely to reside outside of the Waikato region (37.2% versus 28.0%, P < 0.001) and in areas of higher deprivation ( P < 0.001). Māori had higher admission rates for trauma and sepsis ( P < 0.001 overall) and required more renal replacement therapy ( P < 0.001). There was no difference in crude and adjusted mortality in–intensive care unit (16.8% versus 16.5%, P = 0.853; adjusted odds ratio 0.98 (95% confidence interval 0.68 to 1.40)) or in-hospital (23.7% versus 25.7%, P = 0.269; adjusted odds ratio 0.84 (95% confidence interval 0.60 to 1.18)). One-year mortality was similar (26.1% versus 27.1%, P=0.6823). Our study found significant ethnic inequity in the intensive care unit for Māori, who require more renal replacement therapy and are over-represented in admissions, especially for trauma and sepsis. These findings suggest upstream factors increasing Māori risk for critical illness. There was no difference in mortality outcomes.

scholarly journals Factors associated with parental traditional medicine use for children in Fagita Lekoma Woreda Northwest Ethiopia: A cross-sectional study

2020 ◽  
Vol 8 ◽  
pp. 205031212097800
Author(s):  
Damtew Asrat ◽  
Atsede Alle ◽  
Bekalu Kebede ◽  
Bekalu Dessie
Keyword(s):  
Confidence Interval ◽  
Traditional Medicine ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Cross Sectional Study ◽  
Medicine Use ◽  
Community Based ◽  
Cross Sectional ◽  
Traditional Medicines ◽  
Factors Associated

Background: Over the last 100 years, the development and mass production of chemically synthesized drugs have revolutionized health care in most parts of the world. However, large sections of the population in developing countries still depend on traditional medicines for their primary health care needs. More than 88% of Ethiopian parents use different forms of traditional medicine for their children. Therefore, this study aimed to determine factors associated with parental traditional medicine use for children in Fagita Lekoma Woreda. Method: Community-based cross-sectional study was conducted from 1 to 30 March 2019 in Fagita Lekoma Woreda. Data collection tool was a structured interviewer-administered questionnaire. Both descriptive and inferential statistics were used to present the data. Odds ratio and binary and multiple logistic regression analysis were used to measure the relationship between dependent and independent variables. Results: Among 858 participants, 71% of parents had used traditional medicine for their children within the last 12 months. Parents who cannot read and write (adjusted odds ratio = 6.42, 95% confidence interval = 2.1–19.7), parents with low monthly income (adjusted odds ratio = 4.38, 95% confidence interval = 1.58–12.1), and those who had accesses to traditional medicine (adjusted odds ratio = 2.21, 95% confidence interval = 1.23–3.98) were more likely to use traditional medicine for their children. Urban residents (adjusted odds ratio = 0.20, 95% confidence interval = 0.11–0.38) and members of community-based health insurance (adjusted odds ratio = 0.421, 95% confidence interval = 0.211–0.84) were less likely to use traditional medicine for their children. Conclusions: Our study revealed that the prevalence of traditional medicine remains high. Educational status, monthly income, residence, accessibility to traditional medicine, and being a member of community-based health insurance were predictors of potential traditional medicine use. Therefore, the integration of traditional medicine with modern medicine should be strengthened. Community education and further study on efficacy and safety of traditional medicines should be also given great attention.

scholarly journals Analysis models for variables associated with breastfeeding duration

2013 ◽  
Vol 31 (3) ◽  
pp. 306-314 ◽  
Author(s):  
Edson Theodoro dos S. Neto ◽  
Eliana Zandonade ◽  
Adauto Oliveira Emmerich
Keyword(s):  
Logistic Regression ◽  
Protective Factors ◽  
Regression Model ◽  
Odds Ratio ◽  
Regression Models ◽  
Adjusted Odds Ratio ◽  
Cox Regression ◽  
Bottle Feeding ◽  
Breastfeeding Duration ◽  
Factors Associated

OBJECTIVE To analyze the factors associated with breastfeeding duration by two statistical models. METHODS A population-based cohort study was conducted with 86 mothers and newborns from two areas primary covered by the National Health System, with high rates of infant mortality in Vitória, Espírito Santo, Brazil. During 30 months, 67 (78%) children and mothers were visited seven times at home by trained interviewers, who filled out survey forms. Data on food and sucking habits, socioeconomic and maternal characteristics were collected. Variables were analyzed by Cox regression models, considering duration of breastfeeding as the dependent variable, and logistic regression (dependent variables, was the presence of a breastfeeding child in different post-natal ages). RESULTS In the logistic regression model, the pacifier sucking (adjusted Odds Ratio: 3.4; 95%CI 1.2-9.55) and bottle feeding (adjusted Odds Ratio: 4.4; 95%CI 1.6-12.1) increased the chance of weaning a child before one year of age. Variables associated to breastfeeding duration in the Cox regression model were: pacifier sucking (adjusted Hazard Ratio 2.0; 95%CI 1.2-3.3) and bottle feeding (adjusted Hazard Ratio 2.0; 95%CI 1.2-3.5). However, protective factors (maternal age and family income) differed between both models. CONCLUSIONS Risk and protective factors associated with cessation of breastfeeding may be analyzed by different models of statistical regression. Cox Regression Models are adequate to analyze such factors in longitudinal studies.

scholarly journals Hand hygiene compliance in the intensive care unit of the Onderstepoort Veterinary Academic Hospital.

2019 ◽  
Author(s):  
Dikeledi Carol Sebola ◽  
Charlie Boucher ◽  
Caroline Maslo ◽  
Daniel Nenene Qekwana
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Infection Prevention And Control ◽  
Patient Contact ◽  
Academic Hospital ◽  
Hand Wash ◽  
Hygiene Compliance

Abstract Hand hygiene compliance remains the cornerstone of infection prevention and control (IPC) in healthcare facilities. However, there is a paucity of information on the level of IPC in veterinary health care facilities in South Africa. Therefore, this study evaluated hand hygiene compliance of healthcare workers and visitors in the intensive care unit (ICU) at the Onderstepoort Veterinary Academic Hospital (OVAH). Method: A cross-sectional study was conducted among healthcare workers (HCWs) and visitors in the ICU using the infection control assessment tool (ICAT) as stipulated by the South African National Department of Health. Direct observations using the “five hand hygiene moments” criteria as set out by the World helath Organisation were also recorded. The level of compliance and a 95% confidence interval were calculated for all variables. Results: Individual bottles of alcohol-based hand-rub solution and hand-wash basins with running water, soap dispensers, and paper towels were easily accessible and available at all times in the ICU. In total, 296 observations consisting of 734 hand hygiene opportunities were recorded. Hand hygiene compliance was also evaluated during invasive (51.4%) and non-invasive (48.6%) procedures. The overall hand hygiene compliance was 24.3% (178/734). In between patients, most HCWs did not sanitize stethoscopes, leashes, and cellular phones used. Additionally, the majority of HCWs wore jewellery below the elbows. The most common method of hand hygiene was hand-rub (58.4%), followed by hand-wash (41.6%). Nurses had a higher (44%) level of compliance compared to students (22%) and clinicians (15%). Compliance was also higher after body fluid exposure (42%) compared to after patient contact (32%), before patient contact (19%), after contact with patient surroundings (16%), and before an aseptic procedure (15%). Conclusion: Hand hygiene compliance in this study was low, raising concerns of potential transmission of hospital-acquired infections and zoonoses in the ICU. Therefore, it is essential that educational programs be developed to address the low level of hand hygiene in this study.

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