SARS-CoV-2 Infection in Healthcare Professionals and General Population During “First Wave” of COVID-19 Pandemic: A Cross-Sectional Study Conducted in Sicily, Italy

On December 31, 2019, an outbreak of lower respiratory infections was documented in Wuhan caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the beginning, SARS-CoV-2 has caused many infections among healthcare workers (HCWs) worldwide. Aims of this study were: a. to compare the distribution among the HCWs and the general population of SARS-CoV-2 infections in Western Sicily and Italy; b. to describe the characteristics of HCWs infected with SARS-CoV-2 in the western Sicilian healthcare context during the first wave of the epidemic diffusion in Italy. Incidence and mean age of HCWs infected with SARS-CoV-2 were comparable in Western Sicily and in the whole Italian country. The 97.6% of infections occurred in HCWs operating in non-coronavirus disease 2019 (COVID-19) working environments, while an equal distribution of cases between hospital and primary care services context was documented. Nurses and healthcare assistants, followed by physicians, were the categories more frequently infected by SARS-CoV-2. The present study suggests that healthcare workers are easily infected compared to the general population but that often infection could equally occur in hospital and non-hospital settings. Safety of HCWs in counteracting the COVID-19 pandemic must be strengthened in hospital [adequate provision of personal protective equipment (PPE), optimization of human resources, implementation of closed and independent groups of HCWs, creation of traffic control building and dedicated areas in every healthcare context] and non-hospital settings (influenza vaccination, adequate psychophysical support, including refreshments during working shifts, adequate rest, and family support).

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COVID-19 infections among Healthcare Workers and Transmission within Households

10.1101/2020.06.12.20129619 ◽

2020 ◽

Cited By ~ 3

Author(s):

Kevin L. Schwartz ◽

Camille Achonu ◽

Sarah A. Buchan ◽

Kevin A. Brown ◽

Brenda Lee ◽

...

Keyword(s):

General Population ◽

Personal Protective Equipment ◽

Healthcare Workers ◽

Population Based ◽

Cross Sectional Study ◽

Nosocomial Transmission ◽

Protective Equipment ◽

Sectional Study ◽

Cross Sectional ◽

Testing Bias

AbstractImportanceProtecting healthcare workers (HCWs) from COVID-19 is a priority to maintain a safe and functioning healthcare system. The risk of transmitting COVID-19 to family members is a source of stress for many.ObjectiveTo describe and compare HCW and non-HCW COVID-19 cases in Ontario, Canada, as well as the frequency of COVID-19 among HCWs’ household members.Design, Setting, and ParticipantsUsing reportable disease data at Public Health Ontario which captures all COVID-19 cases in Ontario, Canada, we conducted a population-based cross-sectional study comparing demographic, exposure, and clinical variables between HCWs and non-HCWs with COVID-19 as of 14 May 2020. We calculated rates of infections over time and determined the frequency of within household transmissions using natural language processing based on residential address.Exposures and OutcomesWe contrasted age, gender, comorbidities, clinical presentation (including asymptomatic and presymptomatic), exposure histories including nosocomial transmission, and clinical outcomes between HCWs and non-HCWs with confirmed COVID-19.ResultsThere were 4,230 (17.5%) HCW COVID-19 cases in Ontario, of whom 20.2% were nurses, 2.3% were physicians, and the remaining 77.4% other specialties. HCWs were more likely to be between 30-60 years of age and female. HCWs were more likely to present asymptomatically (8.1% versus 7.0%, p=0.010) or with atypical symptoms (17.8% versus 10.5%, p<0.001). The mortality among HCWs was 0.2% compared to 10.5% of non-HCWs. HCWs commonly had exposures to a confirmed case or outbreak (74.1%), however only 3.1% were confirmed to be nosocomial. The rate of new infections was 5.5 times higher in HCWs than non-HCWs, but mirrored the epidemic curve. We identified 391 (9.8%) probable secondary household transmissions and 143 (3.6%) acquisitions. Children < 19 years comprised 14.6% of secondary cases compared to only 4.2% of the primary cases.Conclusions and RelevanceHCWs represent a disproportionate number of COVID-19 cases in Ontario but with low confirmed numbers of nosocomial transmission. The data support substantial testing bias and under-ascertainment of general population cases. Protecting HCWs through appropriate personal protective equipment and physical distancing from colleagues is paramount.Key PointsQuestionWhat are the differences between healthcare workers and non-healthcare workers with COVID-19?FindingsIn this population-based cross-sectional study there were 4,230 healthcare workers comprising 17.5% of COVID-19 cases. Healthcare workers were diagnosed with COVID-19 at a rate 5.5 times higher than the general population with 0.8% of all healthcare workers, compared to 0.1% of non-healthcare workers.MeaningHigh healthcare worker COVID-19 burden highlights the importance of physical distancing from colleagues, appropriate personal protective equipment, as well as likely substantial testing bias and under-ascertainment of COVID-19 in the general population.

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Primary care services provided to adolescents in detention: a cross-sectional study using ICPC-2

Acta Paediatrica ◽

10.1111/j.1651-2227.2010.01716.x ◽

2010 ◽

Vol 99 (7) ◽

pp. 1060-1064 ◽

Cited By ~ 5

Author(s):

DM Haller ◽

P Sebo ◽

B Cerutti ◽

D Bertrand ◽

A Eytan ◽

...

Keyword(s):

Primary Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Care Services ◽

Primary Care Services

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Experiences of adult patients using primary care services in Poland – a cross-sectional study in QUALICOPC study framework

BMC Family Practice ◽

10.1186/s12875-017-0665-6 ◽

2017 ◽

Vol 18 (1) ◽

Cited By ~ 2

Author(s):

Marek Oleszczyk ◽

Anna Krztoń-Królewiecka ◽

Willemijn L. A. Schäfer ◽

Wienke G. W. Boerma ◽

Adam Windak

Keyword(s):

Primary Care ◽

Cross Sectional Study ◽

Adult Patients ◽

Sectional Study ◽

Cross Sectional ◽

Care Services ◽

Primary Care Services

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Understanding COVID-19 vaccine hesitancy in Pakistan: The paradigm of Confidence, Convenience and Complacency; A Cross-sectional study.

10.1101/2021.07.12.21260409 ◽

2021 ◽

Author(s):

Naveen Siddique Sheikh ◽

Mumtaz Touseef ◽

Riddah Sultan ◽

Kanwal Hassan Cheema ◽

Sidra Shafiq Cheema ◽

...

Keyword(s):

General Population ◽

Healthcare Workers ◽

Herd Immunity ◽

Population Data ◽

Cross Sectional Study ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Sectional Study ◽

Cross Sectional ◽

Vaccination Programs

Background and objectives: Vaccine hesitancy is a big obstacle for vaccination programs, as is anticipated for the COVID-19 vaccination program, resulting in low uptake of vaccines thereby hindering the process of reaching herd immunity. Bearing this in mind the current study was aimed to explore the determinants of vaccine hesitancy amongst the Pakistani population. Methodology: A cross-sectional study was carried out from the 23rd-31st January 2021. The conceptual framework of the study was based on the 3Cs (Confidence, Convenience, Complacency) model. Google-forms-based questionnaire was disseminated amongst the general population. Data collected were entered into SPSS version 26 and analyzed. Results: Of the 421 participants, 68.4% were females. Non-healthcare workers were 55.8% of respondents. Vaccine hesitant individuals, 26.13% reported they were very unlikely to get vaccinated. Vaccine was not safe as it came out too fast was agreed upon by 12.6% individuals, 50.6% were worried about experiencing side-effects, 18% believed vaccine will not offer protection and 5.9% believed vaccine would cause death. Low Practice of SOP in non-Healthcare workers was the strongest contributor to vaccine hesitancy (OR: 5.338, p=0.040, 95% CI: 1.082-26.330) followed by High complacency (p=0.026) and Moderate Complacency (OR: 0.212, p=0.007, 95% CI: 0.069-0.654) towards COVID-19 vaccination. In Healthcare workers the strongest contributor to vaccine hesitancy was having a Moderate Confidence (OR: 0.323, p=0.042, 95% CI: 0.109-0.958) in the vaccine followed by Moderate Convenience (OR: 0.304, p=0.049, 95% CI: 0.093-0.993) for vaccination Conclusion: Campaigning and communication strategies to reaffirm confidence in the COVID-19 vaccine and educating the general population about the vaccine could lead to increased perception of vaccine safety and effectiveness thereby restoring confidence in vaccine and decreasing vaccine hesitancy. Likewise, working to increase vaccine convenience and decreasing complacency towards the COVID-19 vaccine would translate into high vaccine uptake.

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Continuity of care and delivery of diabetes and hypertensive care among regular users of primary care services in Chile: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-027830 ◽

2019 ◽

Vol 9 (10) ◽

pp. e027830

Author(s):

Javiera Leniz ◽

Martin C Gulliford

Keyword(s):

Primary Care ◽

Continuity Of Care ◽

Cross Sectional Study ◽

Self Report ◽

Secondary Outcome ◽

Diabetic Patients ◽

Sectional Study ◽

Cross Sectional ◽

Care Services ◽

Primary Care Services

ObjectivesExplore factors related to continuity of care and its association with diabetes and hypertensive care, and disease control.DesignCross-sectional study.SettingData from the Chilean Health National Survey 2009–2010.ParticipantsRegular users of primary care services aged 15 or older.Primary and secondary outcome measuresProportion of hypertensive and diabetic patients with a blood pressure <140/90 mm Hg and HbA1c<7.0% respectively, self-report of diagnosis, treatment and recent foot and ophthalmological exams. Associations between continuity of care, sociodemographic characteristics, and primary and secondary outcomes were explored using logistic regression.Results3887 primary care service users were included. 14.7% recognised a usual GP, 82.3% of them knew their name. Continuity of care was positively associated with age >65 years (OR 4.81, 95% CI 3.16 to 7.32), being female (OR 1.66, 95% CI 1.34 to 2.05), retired (OR 2.22, 95% CI 1.75 to 2.83), obese (OR 1.66, 95% CI 1.29 to 2.14), high cardiovascular risk (OR 2.98, 95% CI 2.13 to 4.17) and widowed (OR 1.50, 95% CI 1.13 to 1.99), and negatively associated with educational level (8–12 vs <8 years OR 0.79, 95% CI 0.64 to 0.97), smoking (OR 0.65, 95% CI 0.52 to 0.82) and physical activity (OR 0.76, 95% CI 0.61 to 0.95). Continuity of care was associated with diagnosis awareness (OR 2.83, 95% CI 1.21 to 6.63), pharmacological treatment (OR 2.04, 95% CI 1.15 to 3.63) and a recent foot (OR 3.17, 95% CI 1.84 to 5.45) and ophthalmological exam (OR 3.20, 95% CI 1.66 to 6.18) in diabetic but not in hypertensive patients.ConclusionsContinuity of care was associated with higher odds of having a recent foot and ophthalmological exam in patients with diabetes, but not with better diseases control. Findings suggest patients with chronic conditions have better continuity of care access.

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Analysis of vaccine loss due to temperature change

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2019-0762 ◽

2021 ◽

Vol 74 (1) ◽

Author(s):

Flávia dos Santos Patine ◽

Luciano Garcia Lourenção ◽

Anneliese Domingues Wysocki ◽

Maria de Lourdes Sperli Geraldes Santos ◽

Isabela Cristina Rodrigues ◽

...

Keyword(s):

Temperature Change ◽

Secondary Data ◽

Cross Sectional Study ◽

Epidemiological Surveillance ◽

Cross Sectional ◽

Significance Level ◽

Temperature Changes ◽

Care Services ◽

Primary Care Services ◽

Change Notification

ABSTRACT Objectives: to analyze vaccine losses in a Health Region in the Northwest of São Paulo. Methods: retrospective cross-sectional study with secondary data obtained from Temperature Change Notification Forms used by the Epidemiological Surveillance Group XXIX of São José do Rio Preto between 2010 and 2017. Descriptive and inferential analysis were performed using multiple linear regression and significance level of 95%. Results: in total, 341 notifications of temperature changes were analyzed, of which 70.1% were caused by structural reasons, 57.8% in industrial refrigerators and 91.2% in primary care services. Of the doses that suffered a change in temperature, 41.4% were lost and 58.6% were administered to the population. The highest percentage of lost doses compared to those applied occurred in smaller municipalities, although they reported less. Conclusions: nursing workers who work in vaccination rooms should make efforts to prevent temperature changes and avoid losses and higher public expenses.

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Performance evaluation of primary care services for the treatment of tuberculosis

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-623420140000700012 ◽

2014 ◽

Vol 48 (6) ◽

pp. 1044-1053 ◽

Cited By ~ 9

Author(s):

Daiane Medeiros da Silva ◽

Jordana de Almeida Nogueira ◽

Lenilde Duarte de Sá ◽

Anneliese Domingues Wysocki ◽

Lucia Marina Scatena ◽

...

Keyword(s):

Primary Care ◽

Professional Training ◽

Cross Sectional Study ◽

Cross Sectional ◽

Professional Qualification ◽

Process Indicators ◽

Care Services ◽

Primary Care Services ◽

Directly Observed Treatment ◽

Structural Indicators

Objective Evaluating the performance of primary care services for the treatment of tuberculosis according to the assessment referential of health services (structure/process) in Cabedelo, a port city in the state of Paraíba. Method An evaluation quantitative, cross-sectional study, in which were carried out 117 interviews with health professionals using a structured instrument. The analysis was based on the construction of indicators using a standardized value for the reduced variable (z=1). Results The structural indicators showed regular performance for the following variables: professional training, access to record instruments and coordination with other services. The process indicators related to external actions and information about the disease had unsatisfactory performance. The directly observed treatment and the flows of reference/counter-reference had regular performance. Conclusion The focused professional qualification, the fragmentation of practices and the unsystematic home care constitute obstacles for carrying out actions aimed at providing expanded, continuous and resolute care.  

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Seroprevalence of IgG antibodies against SARS-CoV-2 among the general population and healthcare workers in India, June–July 2021: A population-based cross-sectional study

PLoS Medicine ◽

10.1371/journal.pmed.1003877 ◽

2021 ◽

Vol 18 (12) ◽

pp. e1003877

Author(s):

Manoj V. Murhekar ◽

Tarun Bhatnagar ◽

Jeromie Wesley Vivian Thangaraj ◽

V. Saravanakumar ◽

Muthusamy Santhosh Kumar ◽

...

Keyword(s):

General Population ◽

Rural Areas ◽

Urban Areas ◽

Nucleocapsid Protein ◽

Healthcare Workers ◽

National Level ◽

Cross Sectional Study ◽

Igg Antibodies ◽

Cross Sectional ◽

June July

Background India began COVID-19 vaccination in January 2021, initially targeting healthcare and frontline workers. The vaccination strategy was expanded in a phased manner and currently covers all individuals aged 18 years and above. India experienced a severe second wave of COVID-19 during March–June 2021. We conducted a fourth nationwide serosurvey to estimate prevalence of SARS-CoV-2 antibodies in the general population aged ≥6 years and healthcare workers (HCWs). Methods and findings We did a cross-sectional study between 14 June and 6 July 2021 in the same 70 districts across 20 states and 1 union territory where 3 previous rounds of serosurveys were conducted. From each district, 10 clusters (villages in rural areas and wards in urban areas) were selected by the probability proportional to population size method. From each district, a minimum of 400 individuals aged ≥6 years from the general population (40 individuals from each cluster) and 100 HCWs from the district public health facilities were included. The serum samples were tested for the presence of IgG antibodies against S1-RBD and nucleocapsid protein of SARS-CoV-2 using chemiluminescence immunoassay. We estimated the weighted and test-adjusted seroprevalence of IgG antibodies against SARS-CoV-2, along with 95% CIs, based on the presence of antibodies to S1-RBD and/or nucleocapsid protein. Of the 28,975 individuals who participated in the survey, 2,892 (10%) were aged 6–9 years, 5,798 (20%) were aged 10–17 years, and 20,285 (70%) were aged ≥18 years; 15,160 (52.3%) participants were female, and 21,794 (75.2%) resided in rural areas. The weighted and test-adjusted prevalence of IgG antibodies against S1-RBD and/or nucleocapsid protein among the general population aged ≥6 years was 67.6% (95% CI 66.4% to 68.7%). Seroprevalence increased with age (p < 0.001) and was not different in rural and urban areas (p = 0.822). Compared to unvaccinated adults (62.3%, 95% CI 60.9% to 63.7%), seroprevalence was significantly higher among individuals who had received 1 vaccine dose (81.0%, 95% CI 79.6% to 82.3%, p < 0.001) and 2 vaccine doses (89.8%, 95% CI 88.4% to 91.1%, p < 0.001). The seroprevalence of IgG antibodies among 7,252 HCWs was 85.2% (95% CI 83.5% to 86.7%). Important limitations of the study include the survey design, which was aimed to estimate seroprevalence at the national level and not at a sub-national level, and the non-participation of 19% of eligible individuals in the survey. Conclusions Nearly two-thirds of individuals aged ≥6 years from the general population and 85% of HCWs had antibodies against SARS-CoV-2 by June–July 2021 in India. As one-third of the population is still seronegative, it is necessary to accelerate the coverage of COVID-19 vaccination among adults and continue adherence to non-pharmaceutical interventions.

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Funding and Service Delivery in Rural and Urban Local US Health Departments in 2010 and 2016

American Journal of Public Health ◽

10.2105/ajph.2020.305757 ◽

2020 ◽

Vol 110 (9) ◽

pp. 1293-1299 ◽

Cited By ~ 1

Author(s):

Kate Beatty ◽

Megan Heffernan ◽

Nathan Hale ◽

Michael Meit

Keyword(s):

Service Delivery ◽

The United States ◽

Cross Sectional Study ◽

Local Health ◽

Clinical Services ◽

Health Departments ◽

Cross Sectional ◽

Care Services ◽

Primary Care Services ◽

Rural And Urban

Objectives. To investigate differences in funding and service delivery between rural and urban local health departments (LHDs) in the United States. Methods. In this repeated cross-sectional study, we examined rural–urban differences in funding and service provision among LHDs over time using 2010 and 2016 National Association of County and City Health Officials data. Results. Local revenue among urban LHDs (41.2%) was higher than that in large rural (31.3%) and small rural LHDs (31.2%; P < .05). Small (20.9%) and large rural LHDs (19.8%) reported greater reliance on revenue from Center for Medicare and Medicaid Services than urban LHDs (11.5%; P < .05). All experienced decreases in clinical revenue between 2010 and 2016. Urban LHDs provided less primary care services in 2016; rural LHDs provided more mental health and substance abuse services (P < .05). Conclusions. Urban LHDs generated more revenues from local sources, and rural LHDs generated more from the Center for Medicare and Medicaid Services and clinical services. Rural LHDs tended to provide more clinical services. Given rural LHDs’ reliance on clinical revenue, decreases in clinical services could have disproportionate effects on them. Public Health Implications. Differences in financing and service delivery by rurality have an impact on the communities. Rural LHDs rely more heavily on state and federal dollars, which are vulnerable to changes in state and national health policy.

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Knowledge about the intrauterine device and interest in using it among women users of primary care services

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.3140.3232 ◽

2020 ◽

Vol 28 ◽

Author(s):

Ana Luiza Vilela Borges ◽

Karina Simão Araújo ◽

Osmara Alves dos Santos ◽

Renata Ferreira Sena Gonçalves ◽

Elizabeth Fujimori ◽

...

Keyword(s):

Intrauterine Device ◽

Cross Sectional Study ◽

Health Care Facilities ◽

Reproductive Age ◽

Chi Square ◽

Cross Sectional ◽

Younger Women ◽

Care Services ◽

Primary Care Services ◽

Level Of Knowledge

Objective: to analyze the level of knowledge about the intrauterine device, the interest in using it and the relationship between these events among women in reproductive age. Method: cross-sectional study conducted with 1858 women between 18 and 49 years old, attending Primary Health Care Facilities. Data were obtained in face-to-face interviews. The level of knowledge was evaluated by items with answers options “agree”, “disagree” and “I don’t know”. Knowledge was categorized as below/equal and above the median. Chi-square and multiple logistic regression were used in Stata 14.2 (95% confidence level). Results: intrauterine device current use was not frequent (1.7%; n=32) and the level of knowledge was higher among women between 25 and 34 years old, white, living in Aracaju (Sergipe), who were more educated, and who were currently using or had already used the intrauterine device. Interest in using the intrauterine device (38.0%; n=634) was higher among younger women, single, more educated, had health insurance, no children and with higher level of knowledge about the intrauterine device. Conclusion: the level of knowledge about the intrauterine device was associated with the interest in using it.

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