scholarly journals Impact of COVID-19 Pandemic on Open Fractures: a Retrospective Multi-centre Cohort Study in the Different Risk Periods of China

Author(s):  
Jialei Chen ◽  
Rong Luo ◽  
Gang Zhong ◽  
Ming Liu

Abstract BackgroundThe COVID-19 pandemic has had a significant impact on orthopaedic trauma worldwide, but the extent of this impact regarding the low-risk period is still unclear. This study aims to evaluate the epidemiology of open limbs fractures during the different risk periods and the effect of routine prevention and control measures.MethodsA retrospective multi-centre cohort study was conducted in three different level trauma centres. Three 60-day periods were analyzed: the high-risk period - 2020/1/24-2020/3/24, the low-risk period - 2021/1/24-2021/3/25, and the no-risk period as a control group for comparison - 2019/1/24-2019/3/25. Demographic data, medical history, and surgery and antibiotic therapy data at presentation were collected and evaluated.ResultsA total of 123 patients met the inclusion criteria. We observed a significant "J" shaped change in the total number of patients, with fewer patients in 2020 (n=34, -17%) and more in 2021 (n=48, +17%) compared to 2019 (n=41). However, fewer patients visited the level I centre in the low-risk period (82.9% 2019 vs. 70.6% 2020 vs. 56.3% 2021, P=0.024). Meanwhile, longer antibiotics therapy period (>48 hours) were more prevalent in low-risk period (39% 2019 vs. 58.8% 2020 vs. 68.8% 2021, P=0.018). Regarding definitive closure type, increase in direct closure was observed in high-risk period (51% 2019 vs. 78.9% 2020 vs. 63.5% 2021, P=0.024). ConclusionDuring the high-risk period, the total number of patients was expected to decline, whereas in the low-risk period, the number may increase. They preferred the lower level II and III centre for patients during the pandemic rather than the higher level I centre. For surgeons, they were prone to direct closure and a more extended antibiotic therapy period. Routine prevention and control measures seem not adversely affect the treatment outcomes and process of open fractures.Trial registrationChiCTR, ChiCTR 2100046151. Registered 5 May 2021, http://www.chictr.org.cn/edit.aspx?pid=123490&htm=4.

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042110096
Author(s):  
Yongshun Zheng ◽  
Xingfang Zhang ◽  
Shiyuan Fang ◽  
Yeben Qian ◽  
Fan Zhang

As the coronavirus disease 2019 (COVID-19) spreads globally, hospital departments will need take steps to manage their treatment procedures and wards. The preparations of high-risk departments (infection, respiratory, emergency, and intensive care unit) were relatively well within this pandemic, while low-risk departments may be unprepared. The spine surgery department in The First Affiliated Hospital of Anhui Medical University in Hefei, China, was used as an example in this study. The spine surgery department took measures to manage the patients, medical staff and wards to avoid the cross-infection within hospital. During the outbreak, no patients or healthcare workers were infected, and no treatment was delayed due to these measures. The prevention and control measures effectively reduced the risk of nosocomial transmission between health workers and patients while providing optimum care. It was a feasible management approach that was applicable to most low-risk and even high-risk departments.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ruggero Giuliani ◽  
Sara Mazzilli ◽  
Teresa Sebastiani ◽  
Giorgia Cocca ◽  
Raffaella Bortolotti ◽  
...  

Purpose Early on in the COVID-19 pandemic, the scientific community highlighted a potential risk of epidemics occurring inside prisons. Consequently, specific operational guidelines were promptly released, and containment measures were quickly implemented in prisons. This paper aims to describe the spread of COVID-19 in detention facilities within the Lombardy region of Italy during March to July 2020, and the impact of the prevention and control measures implemented. Design/methodology/approach A descriptive retrospective analysis of case distribution was performed for all COVID-19 cases identified among people in detention (PiD) and prison officers (POs). A comparison of the epidemic burden affecting different populations and a correlation analysis between the number of cases that occurred and prevention measures implemented were also carried out. Findings From this study, it emerged that POs were at a high risk of contracting COVID-19. This study observed a delay in the occurrence of cases among PiD and substantial heterogeneity in the size of outbreaks across different prisons. Correlation between reported cases among PiD and registered sick leave taken by POs suggested the latter contributed to introducing the infection into prison settings. Finally, number of cases among PiD inversely correlated with the capacity of each prison to identify and set up dedicated areas for medical isolation. Originality/value Prevention and control measures when adopted in a timely manner were effective in protecting PiD. According to the findings, POs are a population at high risk for acquiring and transmitting COVID-19 and should be prioritized for testing, active case finding and vaccination. This study highlights the critical importance of including prison settings within emergency preparedness plans.


2011 ◽  
Vol 19 (6) ◽  
pp. 1329-1336 ◽  
Author(s):  
Leandra Terezinha Roncolato da Silva ◽  
Ana Maria Laus ◽  
Silvia Rita Marin da Silva Canini ◽  
Miyeko Hayashida

This study aimed to evaluate the quality of health care delivered in an Intensive Care Unit, concerning the use of pneumonia prevention and control measures in high-risk patients on mechanical ventilation. In this descriptive and exploratory research, 839 observations of patients under invasive ventilation care were carried out, between November 2009 and January 2010, using the Indicator of Evaluation of Adherence to Prevention and Control Measures in High-risk Patients (IRPR). Some isolated measures that compose the mentioned indicator reached rates close to 100%, but the general compliance rate with all prevention and control measures of ventilator-associated pneumonia was 26.94%. It is concluded that, although the evaluated practices are accomplished at the unit, systematic evaluations of the interventions is needed so as to permit the discussion and practice of other educational strategies by the health team.


2020 ◽  
Author(s):  
Wenting Zha ◽  
Nan Zhou ◽  
Guoqun Li ◽  
Weitong Li ◽  
Heng Zhang ◽  
...  

Abstract Background: A new human coronavirus named SARS-CoV-2 emerged during December 2019 in Wuhan, China. Cases have been exported to other Chinese cities and abroad, which may cause the global outbreak. Chang Sha is the nearest provincial capital city to Wuhan, the first case of COVID-19 in Changsha was diagnosed on January 21, 2020. Estimating the transmissibility and forecasting the trend of the outbreak of SARS-CoV-2 under the prevention and control measures in Changsha could inform evidence based decisions to policy makers. Methods: Data were collected from the Health Commission of Changsha and Hunan Center for Disease Control and Prevention. A Susceptible-exposed-infections/ asymptomatic- removed (SEIAR) model was established to simulate the transmission of SARS-CoV-2 in Changsha. Berkeley Madonna 8.3.18 were employed for the model simulation and prediction, while the curve fitting problem was solved by the Runge-Kutta fourth-order method, with a tolerance of 0.001. Results: In this study, we found that Rt was 2.05 from January 21 to 27 and reduced to 0.2 after January 27, 2020 in Changsha. The prediction results showed that when no obvious prevention and control measures were applied, the total number of patients in Changsha would reach the maximum (2.27 million) on the 79th day after the outbreak, and end in about 240 days; When measures have not been fully launched, the total number of patients would reach the maximum (1.60 million) on the 28th day after the outbreak, and end in about 110 days; When measures have been fully launched, the total number of patients would reach the maximum (234) on the 23rd day after the outbreak, and end in about 60 days. Conclusions: Outbreak of SARS-CoV-2 in Changsha is in a controllable stage under current prevention and control measures, it is predicted that the cumulative patients would reach the maximum of 234 on February 12, and the outbreak would be over on 20 March in Changsha. With the fully implementation of prevention and control measures, it could effectively reduce the peak value, short the time to peak and duration of the outbreak.


2020 ◽  
Author(s):  
Richard Makurumidze ◽  
Gombe Notion Tafara ◽  
Magure Tapuwa ◽  
Mufuta Tshimanga

Abstract Background: In Zimbabwe, anthrax continues to be a disease of public health importance with sporadic outbreaks reported in many parts of the country annually. A human anthrax outbreak occurred in Makoni District Ward 22 and 23 between June 2013 and February 2014. The human anthrax outbreak followed cattle deaths in the wards, which were laboratory confirmed to be due to anthrax. We report the clinical characteristics, distribution of anthrax cases (places, person and time), risk factors for contracting the disease, environmental assessment, district preparedness and response and outbreak prevention and control measures. Methods: We conducted an outbreak investigation with the design of a 1:1 case-control study. Cases and controls were frequency matched against sex. Data were collected using a structured interviewer-administered questionnaire. Environmental assessment, district preparedness and response and outbreak prevention and control measures were assessed using a checklist, observations and key informant interviews. Multivariable unconditional logic regression analysis was performed to identify independent risk factors associated with contracting anthrax. Results: Of the 64 cases, 37 cases and 37 controls were interviewed. All the cases had cutaneous anthrax with the commonest site of eschar being the hand (43%). Most of the cases (89%) were managed according to the national guidelines. On multivariable analysis, source of meat from other villagers [vs butchery, OR = 15.21, 95% CI (2.32-99.81)], skinning [OR = 4.32, 95% CI (1.25-14.94)] and belonging to a religion which permits eating meat from cattle slaughtered due to unknown illness or butchered after an unobserved death [OR = 6.12, 95% CI (1.28-29.37)] were associated with contracting anthrax. The district was poorly resourced and delayed to respond to the outbreak. Conclusion: The described anthrax outbreak resulted from contact and consumption of infected cattle meat. The district office response was delayed and was not prepared to control the outbreak. However, the outbreak was eventually controlled through cattle vaccination; health education and awareness campaigns. The district should strengthen its emergency preparedness and response capacity, revive zoonotic committees, conduct awareness campaign during the high-risk period and improve the surveillance of anthrax during high-risk periods.


2020 ◽  
Author(s):  
Richard Makurumidze ◽  
Gombe Notion Tafara ◽  
Magure Tapuwa ◽  
Mufuta Tshimanga

Abstract Background : The first official clinical case of human anthrax case was made at Makoni District Medical Office on the 19 th of December 2013. This followed cattle deaths which were confirmed in the laboratory to be due to anthrax. We report the clinical characteristics, distribution of anthrax cases (place and time), risk factors for contracting the disease, environmental assessment, district preparedness and response and outbreak prevention and control measures. Methods: We conducted an outbreak investigation with the design of a 1:1 unmatched case-control study. Data were collected using a structured questionnaire. Environmental assessment, district preparedness and response and outbreak prevention and control measures were assessed using checklists through observations and key informant interviews. Data were analyzed using Stata-16. Bivariate analysis was performed to identify risk factors for contracting anthrax. Results: Thirty-seven cases (37) and 37 controls were interviewed. All the cases had cutaneous anthrax with commonest site of eschar being the hand (43%). Most of the cases (89%) were managed according to national guidelines. Eating meat from a from a cattle slaughtered due unknown illness or died alone [OR = 7.00 , 95%CI(2.06-23.82], skinning [OR = 5.04, 95%CI(1.77-14.36)], cutting meat [OR = 5.32, 95%CI(1.91-14.77)], cooking meat [OR = 3.42, 95%CI(1.32-8.91.)], source of from other villagers [vs butchery, OR = 14.85, 95%CI(2.79-79.06)], cuts during cutting meat or skinning cattle [OR = 3.50, 95% CI(1.18-10.51)], belonging to a religion which permits eating meat from a from a cattle slaughtered due unknown illness or died alone [OR = 6.29, 95%CI(1.85-21.39)] were associated with contracting anthrax. Having heard of anthrax before was protective against contracting anthrax [OR = 0.35, 95%CI (0.13-0.93)]. The district was ill-equipped and delay to respond to the outbreak. Conclusion: The anthrax outbreak resulted from contact with and consumption of infected cattle meat. The district delayed and was not prepared to control the outbreak. However, the outbreak was controlled through cattle vaccination; health education and awareness campaigns. The district should strengthen its emergence preparedness and response capacity, revive zoonotic committees, conduct awareness campaign during the high-risk period and improve the surveillance of anthrax during high risk periods.


2020 ◽  
Author(s):  
Richard Makurumidze ◽  
Gombe Notion Tafara ◽  
Magure Tapuwa ◽  
Mufuta Tshimanga

Abstract Background: In Zimbabwe, anthrax continues to be a disease of public health importance with sporadic outbreaks reported in many parts of the country annually. A human anthrax outbreak occurred in Makoni District Ward 22 and 23 between June 2013 and February 2014. The human anthrax outbreak followed cattle deaths in the wards, which were laboratory confirmed to be due to anthrax. We report the clinical characteristics, distribution of anthrax cases (places, person and time), risk factors for contracting the disease, environmental assessment, district preparedness and response and outbreak prevention and control measures.Methods: We conducted an outbreak investigation with the design of a 1:1 case-control study. Cases and controls were frequency matched against sex. Data were collected using a structured interviewer-administered questionnaire. Environmental assessment, district preparedness and response and outbreak prevention and control measures were assessed using a checklist, observations and key informant interviews. Multivariable logic regression analysis was performed to identify independent risk factors associated with contracting anthrax. Results: Of the 64 cases, 37 cases and 37 controls were interviewed. All the cases had cutaneous anthrax with the commonest site of eschar being the hand (43%). Most of the cases (89%) were managed according to national guidelines. On multivariable analysis, source of meat from other villagers [vs butchery, OR = 15.21, 95% CI (2.32-99.81)], skinning [OR = 4.32, 95% CI (1.25-14.94)] and belonging to a religion which permits eating meat from cattle slaughtered due to unknown illness or butchered after an unobserved death [OR = 6.12, 95% CI (1.28-29.37)] were associated with contracting anthrax. The district was poorly resourced and delayed to respond to the outbreak.Conclusion: The described anthrax outbreak resulted from contact and consumption of infected cattle meat. The district office response was delayed and was not prepared to control the outbreak. However, the outbreak was eventually controlled through cattle vaccination; health education and awareness campaigns. The district should strengthen its emergency preparedness and response capacity, revive zoonotic committees, conduct awareness campaign during the high-risk period and improve the surveillance of anthrax during high-risk periods.


Author(s):  
Y. Arockia Suganthi ◽  
Chitra K. ◽  
J. Magelin Mary

Dengue fever is a painful mosquito-borne infection caused by different types of virus in various localities of the world. There is no particular medicine or vaccine to treat person suffering from dengue fever. Dengue viruses are transmitted by the bite of female Aedes (Ae) mosquitoes. Dengue fever viruses are mainly transmitted by Aedes which can be active in tropical or subtropical climates. Aedes Aegypti is the key step to avoid infection transmission to save millions of people in all over the world. This paper provides a standard guideline in the planning of dengue prevention and control measures. At the same time gives the priorities including clinical management and hospitalized dengue patients have to address essentially.


2020 ◽  
Author(s):  
Qiangsheng Huang

BACKGROUND As of the end of February 2020, 2019-nCoV is currently well controlled in China. However, the virus is now spreading globally. OBJECTIVE This study aimed to evaluate the effectiveness of outbreak prevention and control measures in a region. METHODS A model is built for find the best fit for two sets of data (the number of daily new diagnosed, and the risk value of incoming immigration population). The parameters (offset and time window) in the model can be used as the evaluation of effectiveness of outbreak prevention and control. RESULTS Through study, it is found that the parameter offset and time window in the model can accurately reflect the prevention effectiveness. Some related data and public news confirm this result. And this method has advantages over the method using R0 in two aspects. CONCLUSIONS If the epidemic situation is well controlled, the virus is not terrible. Now the daily new diagnosed patients in most regions of China is quickly reduced to zero or close to zero. Chinese can do a good job in the face of huge epidemic pressure. Therefore, if other countries can do well in prevention and control, the epidemic in those places can also pass quickly.


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