scholarly journals European Recommendations for the Management of Healthcare Workers Occupationally Exposed to Hepatitis

2020 ◽  
Vol 3 (2) ◽  
pp. 67
Author(s):  
Enis Uruci
Keyword(s):  
Occupational Exposure ◽  
Hepatitis B ◽  
Healthcare Workers ◽  
World Health ◽  
Bloodborne Pathogens ◽  
Mediterranean Countries ◽  
Hbv Prevalence ◽  
The World ◽  
Health Organization

Exposure prevention is the primary strategy to reduce the risk of occupational bloodborne pathogen infections in healthcare workers (HCW). HCWs should be made aware of the medicolegal and clinical relevance of reporting an exposure, and have ready access to expert consultants to receive appropriate counselling, treatment and follow-up. Vaccination against hepatitis B virus (HBV), and demonstration of immunisation before employment are strongly recommended. HCWs with postvaccinal anti-HBs levels, 1-2 months after vaccine completion, -or=10 mIU/mL are considered as responders. Responders are protected against HBV infection: booster doses of vaccine or periodic antibody concentration testing are not recommended. Alternative strategies to overcome non-response should be adopted. Isolated anti-HBc positive HCWs should be tested for anti-HBcIgM and HBV-DNA: if negative, anti-HBs response to vaccination can distinguish between infection (anti-HBs -or=50 mIU/ml 30 days after 1st vaccination: anamnestic response) and false positive results(anti-HBs -or=10 mUI/ml 30 days after 3rd vaccination: primary response); true positive subjects have resistance to re-infection. and do not need vaccination The management of an occupational exposure to HBV differs according to the susceptibility of the exposed HCW and the serostatus of the source. When indicated, post-exposure prophylaxis with HBV vaccine, hepatitis B immunoglobulin or both must be started as soon as possible (within 1-7 days). In the absence of prophylaxis against hepatitis C virus (HCV) infection, follow-up management of HCV exposures depends on whether antiviral treatment during the acute phase is chosen. Test the HCW for HCV-Ab at baseline and after 6 months; up to 12 for HIV-HCV co-infected sources. If treatment is recommended, perform ALT (amino alanine transferase) activity at baseline and monthly for 4 months after exposure, and qualitative HCV-RNA when an increase is detected. Introduction Bloodborne pathogens such as hepatitis B (HBV) and C virus (HCV) represent an important hazard for healthcare workers (HCWs) [1]. In the general population, HCV prevalence varies geographically from about 0.5 percent in northern countries to 2 percent in Mediterranean countries, with some 5 million chronic carriers estimated in Europe; while HBV prevalence ranges from 0.3 percent to 3 percent. The World Health Organization (WHO) estimates that each year in Europe 304 000 HCWs are exposed to at least one percutaneous injury with a sharp object contaminated with HBV, 149 000 are exposed to HCV and 22 000 to HIV. The probability of acquiring a bloodborne infection following an occupational exposure has been estimated to be on average. Bloodborne pathogens such as hepatitis B (HBV) and C virus (HCV) represent an important hazard for healthcare workers (HCWs) [1]. In the general population, HCV prevalence varies geographically from about 0.5 percent in northern countries to 2 percent in Mediterranean countries, with some 5 million chronic carriers estimated in Europe; while HBV prevalence ranges from 0.3 percent to 3 percent. The World Health Organization (WHO) estimates that each year in Europe 304 000 HCWs are exposed to at least one percutaneous injury with a sharp object contaminated with HBV, 149 000 are exposed to HCV and 22 000 to HIV.We present here recommendations for the general management of occupational risk of bloodborne infections, HBV vaccination and management of HBV and HCV exposures. A description of the project and recommendations for HIV post-exposure management, including antiretroviral prophylaxis, has been previously published [2], and so issues related to occupational risk and prevention of HIV infection following an occupational exposure will not be discussed further.

European Recommendations for the Management of Healthcare Workers Occupationally Exposed to Hepatitis

2018 ◽  
Vol 2 (1) ◽  
pp. 49
Author(s):  
Enis Uruci
Keyword(s):  
Occupational Exposure ◽  
Hepatitis B ◽  
Healthcare Workers ◽  
Antiviral Treatment ◽  
World Health ◽  
Antibody Concentration ◽  
Post Exposure Prophylaxis ◽  
Transferase Activity ◽  
Mediterranean Countries

Exposure prevention is the primary strategy to reduce the risk of occupational bloodborne pathogen infections in healthcare workers (HCW). HCWs should be made aware of the medicolegal and clinical relevance of reporting an exposure, and have ready access to expert consultants to receive appropriate counselling, treatment and follow-up. Vaccination against hepatitis B virus (HBV), and demonstration of immunisation before employment are strongly recommended. HCWs with postvaccinal anti-HBs levels, 1-2 months after vaccine completion, .or=10 mIU/mL are considered as responders. Responders are protected against HBV infection: booster doses of vaccine or periodic antibody concentration testing are not recommended. Alternative strategies to overcome non-response should be adopted. Isolated anti-HBc positive HCWs should be tested for anti-HBcIgM and HBV-DNA: if negative, anti-HBs response to vaccination can distinguish between infection (anti-HBs .or=50 mIU/ml 30 days after 1st vaccination: anamnestic response) and false positive results(anti-HBs .or=10 mUI/ml 30 days after 3rd vaccination: primary response); true positive subjects have resistance to re-infection. and do not need vaccination The management of an occupational exposure to HBV differs according to the susceptibility of the exposed HCW and the serostatus of the source. When indicated, post-exposure prophylaxis with HBV vaccine, hepatitis B immunoglobulin or both must be started as soon as possible (within 1-7 days). In the absence of prophylaxis against hepatitis C virus (HCV) infection, follow-up management of HCV exposures depends on whether antiviral treatment during the acute phase is chosen. Test the HCW for HCV-Ab at baseline and after 6 months; up to 12 for HIV-HCV co-infected sources. If treatment is recommended, perform ALT (amino alanine transferase) activity at baseline and monthly for 4 months after exposure, and qualitative HCV-RNA when an increase is detected. Introduction Bloodborne pathogens such as hepatitis B (HBV) and C virus (HCV) represent an important hazard for healthcare workers (HCWs) (1). In the general population, HCV prevalence varies geographically from about 0.5% in northern countries to 2% in Mediterranean countries, with some 5 million chronic carriers estimated in Europe; while HBV prevalence ranges from 0.3% to 3%. The World Health Organization (WHO) estimates that each year in Europe 304 000 HCWs are exposed to at least one percutaneous injury with a sharp object contaminated with HBV, 149 000 are exposed to HCV and 22 000 to HIV. The probability of acquiring a bloodborne infection following an occupational exposure has been estimated to be on average.

Successful Implementation of the World Health Organization Hand Hygiene Improvement Strategy in a Referral Hospital in Mali, Africa

2010 ◽  
Vol 31 (2) ◽  
pp. 133-141 ◽  
Author(s):  
Benedetta Allegranzi ◽  
Hugo Sax ◽  
Loséni Bengaly ◽  
Hervé Riebet ◽  
Daouda K. Minta ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
World Health Organization ◽  
Low Income ◽  
Healthcare Workers ◽  
World Health ◽  
Improvement Strategy ◽  
Hand Hygiene Improvement ◽  
The World ◽  
Health Organization

Objective.To assess the feasibility and effectiveness of the World Health Organization hand hygiene improvement strategy in a low-income African country.Design.A before-and-after study from December 2006 through June 2008, with a 6-month baseline evaluation period and a follow-up period of 8 months from the beginning of the intervention.Setting.University Hospital, Bamako, Mali.Participants.TWO hundred twenty-four healthcare workers.Methods.The intervention consisted of introducing a locally produced, alcohol-based handrub; monitoring hand hygiene compliance; providing performance feedback; educating staff; posting reminders in the workplace; and promoting an institutional safety climate according to the World Health Organization multimodal hand hygiene improvement strategy. Hand hygiene infrastructure, compliance, healthcare workers' knowledge and perceptions, and handrub consumption were evaluated at baseline and at follow-up.Results.Severe deficiencies in the infrastructure for hand hygiene were identified before the intervention. Local handrub production and quality control proved to be feasible, affordable, and satisfactory. At follow-up, handrubbing was the quasi-exclusive hand hygiene technique (93.3%). Compliance increased from 8.0% at baseline to 21.8% at follow-up (P< .001). Improvement was observed across all professional categories and medical specialities and was independently associated with the intervention (odds ratio, 2.50; 95% confidence interval, 1.8-3.5). Knowledge enhanced significantly (P< .05), and perception surveys showed a high appreciation of each strategy component by staff.Conclusions.Multimodal hand hygiene promotion is feasible and effective in a low-income country. Access to handrub was critical for its success. These findings motivated the government of Mali to expand the intervention nationwide. This experience represents a significant advancement for patient safety in developing countries.

viewpoint TIME TO RESTART: PROTOCOL OF RESUMPTION OF ACTIVITIES OF A DERMATOLOGICAL CLINIC OF A LEVEL II HOSPITAL IN THE COVID-19 ERA. (Preprint)

2020 ◽  
Author(s):  
Federico Diotallevi ◽  
Anna Campanati ◽  
Giulia Radi ◽  
Oriana Simonetti ◽  
Emanuela Martina ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
World Health ◽  
New Wave ◽  
Staff Members ◽  
Level Ii ◽  
The World ◽  
Health Organization ◽  
Spread Of Infection ◽  
Hospital Wards ◽  
Medical And Healthcare

UNSTRUCTURED Two months have passed since the World Health Organization (WHO) declared the pandemic of the Coronavirus Disease 19 (COVID-19), caused by the SARS CoV-2 virus, on March 11, 2020. Medical and healthcare workers have continued to be on the frontline to defeat this disease, however, continual changes are being made to their working habits which are proving to be difficult. Since the beginning of the pandemic, a major reorganisation of all hospital wards, including dermatological wards, has been carried out in order to make medical and nursing staff available in COVID wards and to prevent the spread of infection. These strategies, which were also adopted in our clinic, proved to be effective, as no staff members or patients were infected by the virus. Now, thanks to the global decrease in SARS-CovV2 infections, it is necessary to make dermatological wards accessible to patients again, but it is also essential to adopt specific protocols to avoid a new wave of infections.

scholarly journals COVID-19 Vaccination Perception and Attitude among Healthcare Workers in Egypt

2021 ◽  
Vol 12 ◽  
pp. 215013272110133
Author(s):  
Samar Fares ◽  
Merihan M. Elmnyer ◽  
Shimaa Sabry Mohamed ◽  
Radwa Elsayed
Keyword(s):  
Healthcare Workers ◽  
Study Groups ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Accurate Information ◽  
P Value ◽  
Major Barrier ◽  
Vaccination Programs ◽  
The World ◽  
Health Organization

Introduction COVID-19 pandemic has affected the whole world, especially the frontline worriers. To get shielded through this war, the world is racing to reach and manufacture COVID-19 vaccines. Vaccination hesitancy is one of the significant obstacles to global health. Objectives This study aimed to assess the perception and attitude of healthcare workers in Egypt toward COVID-19 vaccines, acknowledge the determinants of their attitude, and the factors that could increase the acceptance of the vaccine. Methods an observational web-based anonymous survey was conducted on 385 Egyptian healthcare workers in different governorates. The questionnaire-based on Vaccine Hesitancy Survey Questions of the World Health Organization was available in Arabic and English languages and was tested for reliability. Results Regarding vaccination decision, 51% of the participants were undecided, 28% refused, and 21% accepted vaccination. Reasons for vaccine acceptance mainly were risks of COVID-19 (93%), safety (57.5%), and effectiveness (56.25%) of the vaccine. Simultaneously, the reasons for vaccine hesitancy were the absence of enough clinical trials (92.4%) and fear of side effects of the vaccine (91.4%). The leading factor that could increase vaccination acceptance among the participants was to get sufficient and accurate information about the available vaccines. The participants revealed a high mean level of concern for COVID-19 vaccines’ safety (3.8 of 5) that differs significantly among the different study groups ( P-value .002). Conclusion Despite the COVID-19 pandemic, only approximately 21% of Egyptian healthcare workers in our study accepted the COVID-19 vaccination. Vaccine hesitancy represents a major barrier to implementing vaccination programs.

scholarly journals Testing brief intervention and phone contact among subjects with suicidal behavior: a randomized controlled trial in French Polynesia in the frames of the World Health Organization/Suicide Trends in At-Risk Territories study

2015 ◽  
Vol 7 (2) ◽  
Author(s):  
Stéphane Amadéo ◽  
Moerani Rereao ◽  
Aurelia Malogne ◽  
Patrick Favro ◽  
Ngoc Lam Nguyen ◽  
...  
Keyword(s):  
At Risk ◽  
World Health Organization ◽  
Brief Intervention ◽  
Suicidal Behavior ◽  
French Polynesia ◽  
World Health ◽  
Suicidal Behaviors ◽  
The World ◽  
Health Organization

The World Health Organization <em>Suicide trends in at-risk territories</em> study is a multi-site regional research program operating first in French Polynesia and countries of the Western Pacific, then extended to the world. The aims of the study were to establish a monitoring system for suicidal behaviors and to conduct a randomised control trial intervention for non-fatal suicidal behaviors. The latter part is the purpose of the present article. Over the period 2008-2010, 515 patients were admitted at the Emergency Department of the Centre Hospitalier de Polynésie Française for suicidal behavior. Those then hospitalized in the Psychiatry Emergency Unit were asked to be involved in the study and randomly allocated to either Treatment As Usual (TAU) or TAU plus Brief Intervention and Contact (BIC), which provides a psycho-education session and a follow-up of 9 phone contacts over an 18-months period. One hundred persons were assigned to TAU, while 100 participants were allocated to the BIC group. At the end of the follow-up there were no significant differences between the two groups in terms of number of presentations to the hospital for repeated suicidal behaviors. Although the study could not demonstrate the superiority of a treatment over the other, nevertheless – given its importance – the investigation captured public attention and was able to contribute to the awareness of the need of suicide prevention in French Polynesia. The BIC model of intervention seemed to particularly suit the geographical and health care context of the country.

scholarly journals Disability in people clinically at high risk of psychosis

2010 ◽  
Vol 197 (4) ◽  
pp. 278-284 ◽  
Author(s):  
Eva Velthorst ◽  
Dorien H. Nieman ◽  
Don Linszen ◽  
Hiske Becker ◽  
Lieuwe de Haan ◽  
...  
Keyword(s):  
High Risk ◽  
Help Seeking ◽  
Cox Regression ◽  
World Health ◽  
Disability Assessment ◽  
Community Activities ◽  
Transition Group ◽  
The World ◽  
Health Organization

BackgroundDecline in social functioning occurs in individuals who later develop psychosis.AimsTo investigate whether baseline differences in disability are present in those who do and those who do not make a transition to psychosis in a group clinically at high risk and whether disability is a risk factor for transition.MethodProspective multicentre, naturalistic field study with an 18-month follow-up period on 245 help-seeking individuals clinically at high risk. Disability was assessed with the Disability Assessment Schedule of the World Health Organization (WHODAS–II).ResultsAt baseline, the transition group displayed significantly greater difficulties in making new friends (z =−3.40, P = 0.001), maintaining a friendship (z =−3.00, P = 0.003), dealing with people they do not know (z =−2.28, P = 0.023) and joining community activities (z =−2.0, P = 0.05) compared with the non-transition group. In Cox regression, difficulties in getting along with people significantly contributed to the prediction of transition to psychosis in our sample (β = 0.569, s.e. = 0.184, Wald = 9.548, P = 0.002, hazard ratio (HR) = 1.767, 95% CI 1.238–2.550).ConclusionsCertain domains of social disability might contribute to the prediction of psychosis in a sample clinically at high risk.

scholarly journals Pharmacotherapeutic management of chronic viral hepatitis

2021 ◽  
Vol 2 (4) ◽  
pp. 1-8
Author(s):  
Gabriela Mitea ◽  
Marius Daniel Radu ◽  
Ana Maria Ionescu ◽  
Nicoleta Blebea
Keyword(s):  
Hepatitis B ◽  
Viral Hepatitis ◽  
World Health Organization ◽  
Geographical Area ◽  
Chronic Viral Hepatitis ◽  
World Health ◽  
Effective Vaccine ◽  
Special Importance ◽  
The World ◽  
Health Organization

In infectious diseases, viral hepatitis has an increased incidence, being an important cause of morbidity and mortality, being a "sentinel" indicator of the socio-economic and hygienic-cultural standard of a geographical area. The World Health Organization (WHO) admits the following types of hepatitis viruses: A, B, B + D, C, E, F and G. Among the viral entities recognized by the WHO, a special importance in terms of incidence, evolution over time with the risk of chronicity and the therapeutic options are presented by hepatitis B and C. There is currently an effective vaccine as well as treatment for hepatitis B. There is no vaccine for hepatitis C, but in recent years considerable progress has been made in treating this disease. Also, the introduction of drugs known as direct-acting antivirals makes it possible to cure over 90% of patients within 2-3 months. But in many countries, current drug policies, regulations and prices keep treatment out of the reach of most people with hepatitis. Eradication of viral hepatitis is possible if greater emphasis is placed on prevention, diagnosis and treatment. Vaccination is very important, as it is possible for types A and B of hepatitis. Early diagnosis is also extremely important, given that there are currently very effective drugs that can prevent the development of liver cancer. The WHO also noted that about two million people worldwide become ill each year due to the reuse of syringes and stressed the importance of checking blood donors to see if they are not carriers of hepatitis B or C viruses. Therefore, the purpose of this article is to highlight the pharmacological treatment and the main therapeutic and prevention schemes currently used for patients with these liver diseases. The paper was based on the most popular methods of identification of the latest international information about the treatment of hepatitis (by electronic search using Pubmed, SciFinder, Scirus, GoogleScholar and Web of Science). We also consulted the global literature cited in the hepatitis database of the World Health Organization (WHO) updated frequent from the current literature on this topic.

scholarly journals Spinal surgery complications: an unsolved problem—Is the World Health Organization Safety Surgical Checklist an useful tool to reduce them?

2019 ◽  
Vol 29 (5) ◽  
pp. 927-936
Author(s):  
Giovanni Barbanti-Brodano ◽  
Cristiana Griffoni ◽  
Jarkko Halme ◽  
Giuseppe Tedesco ◽  
Silvia Terzi ◽  
...  
Keyword(s):  
World Health Organization ◽  
Spinal Surgery ◽  
World Health ◽  
The World ◽  
Oncological Diseases ◽  
Supplementary Material ◽  
The Mean ◽  
Health Organization ◽  
Surgical Checklist

Abstract Purpose To investigate whether the World Health Organization Safety Surgical Checklist (SSC) is an effective tool to reduce complications in spinal surgery. Methods We retrospectively evaluated the clinical and radiological charts prospectively collected from patients who underwent a spinal surgery procedure from January 2010 to December 2012. The aim of this study was to compare the incidence of complications between two periods, from January to December 2010 (without checklist) and from January 2011 and December 2012 (with checklist), in order to assess the checklist’s effectiveness. Results The sample size was 917 patients with an average of 30-month follow-up. The mean age was 52.88 years. The majority of procedures were performed for oncological diseases (54.4%) and degenerative diseases (39.8%). In total, 159 complications were detected (17.3%). The overall incidence of complications for trauma, infectious pathology, oncology, and degenerative disease was 22.2%, 19.2%, 18.4%, and 15.3%, respectively. No correlation was observed between the type of pathology and the complication incidence. We observed a reduction in the overall incidence of complications following the introduction of the SSC: In 2010 without checklist, the incidence of complications was 24.2%, while in 2011 and 2012, following the checklist introduction, the incidence of complications was 16.7% and 11.7%, respectively (mean 14.2%). Conclusions The SSC seems to be an effective tool to reduce complications in spinal surgery. We propose to extend the use of checklist system also to the preoperative and postoperative phases in order to further reduce the incidence of complications. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.

scholarly journals Protecting healthcare workers from SARS-CoV-2 infection: practical indications

2020 ◽  
Vol 29 (155) ◽  
pp. 200068 ◽  
Author(s):  
Martina Ferioli ◽  
Cecilia Cisternino ◽  
Valentina Leo ◽  
Lara Pisani ◽  
Paolo Palange ◽  
...  
Keyword(s):  
High Risk ◽  
Severe Acute Respiratory Syndrome ◽  
World Health Organization ◽  
Noninvasive Ventilation ◽  
Healthcare Workers ◽  
World Health ◽  
Evidence Based ◽  
The World ◽  
Health Organization ◽  
Respiratory Devices

The World Health Organization has recently defined the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection a pandemic. The infection, that may cause a potentially very severe respiratory disease, now called coronavirus disease 2019 (COVID-19), has airborne transmission via droplets. The rate of transmission is quite high, higher than common influenza. Healthcare workers are at high risk of contracting the infection particularly when applying respiratory devices such as oxygen cannulas or noninvasive ventilation. The aim of this article is to provide evidence-based recommendations for the correct use of “respiratory devices” in the COVID-19 emergency and protect healthcare workers from contracting the SARS-CoV-2 infection.

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