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Bhagavathula AS, Aldhaleei WA, Rahmani J, Mahabadi MA, Bandari DK. Knowledge and Perceptions of COVID-19 Among Health Care Workers: Cross-Sectional Study. JMIR Public Health Surveill 2020; 6:e19160. [PMID: 32320381 PMCID: PMC7193987 DOI: 10.2196/19160] [Citation(s) in RCA: 243] [Impact Index Per Article: 60.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/18/2020] [Accepted: 04/19/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND During the first week of March, the coronavirus disease 2019 (COVID-19) outbreak reached more than 100 countries with over 100,000 cases. Health care authorities have already initiated awareness and preparedness activities worldwide. A poor understanding of the disease among health care workers (HCWs) may result in delayed treatment and result in the rapid spread of the infection. OBJECTIVE This study aimed to investigate the knowledge and perceptions of HCWs about COVID-19. METHODS A cross-sectional, web-based study was conducted among HCWs about COVID-19 during the first week of March 2020. A 23-item survey instrument was developed and distributed randomly to HCWs using social media; it required 5 minutes to complete. A chi-square test was used to investigate the level of association among variables, with significance set to P<.05. RESULTS Of 529 participants, a total of 453 HCWs completed the survey (response rate: 85.6%); 51.6% (n=234) were male, 32.1% (n=147) were aged 25-34 years, and most were doctors (n=137, 30.2%) and medical students (n=134, 29.6%). Most participants (n=276, 61.0%) used social media to obtain information on COVID-19. A significant proportion of HCWs had poor knowledge of its transmission (n=276, 61.0%) and symptom onset (n=288, 63.6%) and showed positive perceptions of COVID-19. Factors such as age and profession were associated with inadequate knowledge and a poor perception of COVID-19. CONCLUSIONS As the global threat of COVID-19 continues to emerge, it is critical to improve the knowledge and perceptions of HCWs. Educational interventions are urgently needed to reach HCWs worldwide, and further studies are warranted.
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Affiliation(s)
- Akshaya Srikanth Bhagavathula
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Wafa Ali Aldhaleei
- Department of Gastroenterology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Jamal Rahmani
- Student Research Committee, National Nutrition and Food Technology Research Institute, Department of Community Nutrition, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Deepak Kumar Bandari
- Department of Clinical Pharmacy, Vaagdevi Institute of Pharmaceutical Sciences, Warangal, Telangana, India
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COVID-19: The daunting experience of healthcare workers in Sardinia, Italy. Infect Control Hosp Epidemiol 2020; 41:1118-1119. [PMID: 32307028 PMCID: PMC7198454 DOI: 10.1017/ice.2020.149] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Prin M, Bartels K. Social distancing: implications for the operating room in the face of COVID-19. Can J Anaesth 2020; 67:789-797. [PMID: 32291632 PMCID: PMC7155950 DOI: 10.1007/s12630-020-01651-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 12/27/2022] Open
Affiliation(s)
- Meghan Prin
- Department of Anesthesiology, University of Colorado, School of Medicine, Aurora, CO, USA
| | - Karsten Bartels
- Department of Anesthesiology, University of Colorado, School of Medicine, Aurora, CO, USA. .,Department of Surgery, University of Colorado, School of Medicine, University of Colorado Anschutz Medical Campus, 12401 E. 17th Ave., Leprino Office Building, 7th Floor, MS B-113, Aurora, CO, 80045, USA.
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Ayebare RR, Mayanja F. Benchmarking infection control training and practice in Africa: A long-term strategy needed now. Am J Infect Control 2020; 48:465-466. [PMID: 31493937 DOI: 10.1016/j.ajic.2019.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 10/26/2022]
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Rugarabamu S, Mboera L, Rweyemamu M, Mwanyika G, Lutwama J, Paweska J, Misinzo G. Forty-two years of responding to Ebola virus outbreaks in Sub-Saharan Africa: a review. BMJ Glob Health 2020; 5:e001955. [PMID: 32201623 PMCID: PMC7061886 DOI: 10.1136/bmjgh-2019-001955] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 01/16/2020] [Accepted: 01/27/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction Ebola virus disease (EVD) is one of the deadliest haemorrhagic fevers affecting humans and non-human primates. Thirty-four outbreaks have been reported in Africa since it was first recognised in 1976. This review analysed 42 years of EVD outbreaks and identified various challenges and opportunities for its control and prevention in Sub-Saharan Africa. Methods A literature search of relevant articles on EVD was done in PubMed, Web of Science and Google Scholar electronic databases. Articles published from 1976 to 2019 were reviewed to document reports of EVD outbreaks in Sub-Saharan Africa. Data extraction focused on the year of outbreak, geographical spread, virus strain involved, number of cases and deaths, case fatality, and outbreak management. Analyses of trends in case fatality were performed by calculating ORs between times. Results In the past four decades, a total of 34 EVD outbreaks affecting 34 356 cases and causing 14 823 deaths were reported in 11 countries in Sub-Saharan Africa. The overall case fatality rate (95% CI) was 66% (62 to 71) and did not change substantially over time (OR in 2019 vs 1976=1.6 (95% CI 1.5 to 1.8), p<0.001). The results of this review indicate that challenges to control EVD outbreaks are related to epidemiological, sociocultural and health system factors. Conclusions Sub-Saharan Africa continues to face considerable challenges in EVD control, whereby there are no significant changes in case fatality rates observed during the past four decades. Socioeconomic and cultural processes need to be critically considered to shape the community behaviours that lead to exposure to EVD outbreaks. Areas that need to be addressed to prevent future EVD outbreaks include a broad-based, one-health approach, effective communication, social mobilisation, and strengthening of the health systems.
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Affiliation(s)
- Sima Rugarabamu
- SACIDS Foundation for One Health – Africa Centre of Excellence for Infectious Diseases of Human and Animals, Sokoine University of Agriculture, Chuo Kikuu, Tanzania
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Leonard Mboera
- SACIDS Foundation for One Health – Africa Centre of Excellence for Infectious Diseases of Human and Animals, Sokoine University of Agriculture, Chuo Kikuu, Tanzania
| | - Mark Rweyemamu
- SACIDS Foundation for One Health – Africa Centre of Excellence for Infectious Diseases of Human and Animals, Sokoine University of Agriculture, Chuo Kikuu, Tanzania
| | - Gaspary Mwanyika
- SACIDS Foundation for One Health – Africa Centre of Excellence for Infectious Diseases of Human and Animals, Sokoine University of Agriculture, Chuo Kikuu, Tanzania
- Department of Health Science and Technology, Mbeya University of Science and Technology, Mbeya, Tanzania
| | - Julius Lutwama
- Department of Arbovirology, Emerging and Re-emerging Infectious Diseases, Uganda Virus research Institute, Entebbe, Uganda
| | - Janusz Paweska
- National Institute of Communicable Diseases, National Laboratory Services, Johannesburg, South Africa
| | - Gerald Misinzo
- SACIDS Foundation for One Health – Africa Centre of Excellence for Infectious Diseases of Human and Animals, Sokoine University of Agriculture, Chuo Kikuu, Tanzania
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Raab M, Pfadenhauer LM, Millimouno TJ, Hoelscher M, Froeschl G. Knowledge, attitudes and practices towards viral haemorrhagic fevers amongst healthcare workers in urban and rural public healthcare facilities in the N'zérékoré prefecture, Guinea: a cross-sectional study. BMC Public Health 2020; 20:296. [PMID: 32138720 PMCID: PMC7059383 DOI: 10.1186/s12889-020-8433-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/28/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The 2013-2016 Ebola epidemic in West Africa began in Guinea's Forest region, a region now considered to be at high risk for future epidemics of viral haemorrhagic fevers (VHF). Good knowledge, attitudes and practices towards VHF amongst healthcare workers in such regions are a central pillar of infection prevention and control (IPC). To inform future training in IPC, this study assesses the knowledge, attitudes and practices (KAP) towards VHF amongst healthcare workers in public healthcare facilities in the most populated prefecture in Forest Guinea, and compares results from urban and rural areas. METHODS In June and July 2019, we interviewed 102 healthcare workers in the main urban and rural public healthcare facilities in the N'zérékoré prefecture in Forest Guinea. We used an interviewer-administered questionnaire adapted from validated KAP surveys. RESULTS The great majority of respondents demonstrated good knowledge and favourable attitudes towards VHF. However, respondents reported some gaps in preventive practices such as VHF suspect case detection. They also reported a shortage of protective medical equipment used in everyday clinical work in both urban and rural healthcare facilities and a lack of training in IPC, especially in rural healthcare facilities. However, whether or not healthcare workers had been trained in IPC did not seem to influence their level of KAP towards VHF. CONCLUSIONS Three years after the end of the Ebola epidemic, our findings suggest that public healthcare facilities in the N'zérékoré prefecture in Forest Guinea still lack essential protective equipment and some practical training in VHF suspect case detection. To minimize the risk of future VHF epidemics and improve management of outbreaks of infectious diseases in the region, current efforts to strengthen the public healthcare system in Guinea should encompass questions of supply and IPC training.
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Affiliation(s)
- Manuel Raab
- Division of Infectious Diseases and Tropical Medicine, University Hospital (LMU), Leopoldstr. 5, 80802 Munich, Germany
| | - Lisa M. Pfadenhauer
- Institute of Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig Maximilian University Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Tamba Jacques Millimouno
- Department of Disease Surveillance, Agence Nationale de Sécurité Sanitaire (ANSS), Conakry, Guinea
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital (LMU), Leopoldstr. 5, 80802 Munich, Germany
| | - Guenter Froeschl
- Division of Infectious Diseases and Tropical Medicine, University Hospital (LMU), Leopoldstr. 5, 80802 Munich, Germany
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Inungu J, Iheduru-Anderson K, Odio OJ. Recurrent Ebolavirus disease in the Democratic Republic of Congo: update and challenges. AIMS Public Health 2019; 6:502-513. [PMID: 31909070 PMCID: PMC6940573 DOI: 10.3934/publichealth.2019.4.502] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/18/2019] [Indexed: 12/31/2022] Open
Abstract
The current Ebolavirus disease (EVD) outbreak in the provinces of North Kivu and Ituri is the tenth outbreak affecting the Democratic Republic of Congo (DRC); the first outbreak occurring in a war context, and the second most deadly Ebolavirus outbreak on record following the 2014 outbreak in West Africa. The DRC government's response consisted of applying a package of interventions including detection and rapid isolation of cases, contact tracing, population mapping, and identification of high-risk areas to inform a coordinated effort. The coordinated effort was to screen, ring vaccinate, and conduct laboratory diagnoses using GeneXpert (Cepheid) polymerase chain reaction. The effort also included ensuring safe and dignified burials and promoting risk communication, community engagement, and social mobilization. Following the adoption of the “Monitored Emergency Use of Unregistered Products Protocol,” a randomized controlled trial of four investigational treatments (mAb114, ZMapp, and REGN-EB3 and Remdesivir) was carried out with all consenting patients with laboratory-confirmed EVD. REGN-EB3 and mAb114 showed promise as treatments for EVD. In addition, one investigational vaccine (rVSV-ZEBOV-GP) was used first, followed by a second prophylactic vaccine (Ad26.ZEBOV/MVA-BN-Filo) to reinforce the prevention. Although the provision of clinical supportive care remains the cornerstone of EVD outbreak management, the DRC response faced daunting challenges including general insecurity, violence and community resistance, appalling poverty, and entrenched distrust of authority. Ebolavirus remains a public health threat. A fully curative treatment is unlikely to be a game-changer given the settings of transmission, zoonotic nature, limits of effectiveness of any therapeutic intervention, and timing of presentation.
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Affiliation(s)
- Joseph Inungu
- Master of Public Health Program, College of Health Professions, Central Michigan University, Michigan, United States
| | | | - Ossam J Odio
- Department of Internal Medicine, Medical School Hospital, University of Kinshasa, Kinshasa, Congo
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Maehira Y, Spencer RC. Harmonization of Biosafety and Biosecurity Standards for High-Containment Facilities in Low- and Middle-Income Countries: An Approach From the Perspective of Occupational Safety and Health. Front Public Health 2019; 7:249. [PMID: 31572701 PMCID: PMC6751378 DOI: 10.3389/fpubh.2019.00249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 08/19/2019] [Indexed: 01/10/2023] Open
Abstract
Following the global-level Ebola virus disease (EVD) outbreak during 2014–2016, international collaboration with multiorganizational participation has rapidly increased. Given the greater priorities for research and development (R&D) outcomes despite the quantitative and qualitative lack of high-containment laboratory facilities in low- and middle-income countries (LMICs), where biological targets for investigation are located near their natural habitats, occupational readiness for health workers' safety has not been well-addressed, where limited global expert human resources are being deployed to high-containment laboratories including biosafety level 4 (BSL-4) facilities for case management and medical investigations. Pursuing scientific and managerial success to make laboratories efficient and productive, most laboratory safety policies have focused on the functionality of technical skills or performance, procedural methodologies, and supervision over the employees to collaborate in LMICs. The experts dispatched from advanced countries bring a long list of scientific tasks with high-tech devices, supplies, and training programs to introduce their collaboration with local partners in LMICs. However, the dispatched experts would subsequently realize their list becomes endless to establish their basic functions required in high-containment laboratories to ensure qualified scientific outcomes in LMICs. Under such circumstances where dual or multiple policies and standards accommodated pose dilemmas for operational procedures to ensure biosafety and biosecurity, all the frontline experts from both LMICs and advanced countries may be exposed to significant risks of life-threating infection of highly pathogenic agents like EVD, without any pragmatic measures or road maps to establish valued international collaboration, pursuing its sustainability. Given the fact mentioned above, we conducted a quick review of the key biosafety and biosecurity management documents, relevant policy analyses, and research to understand the current status and, if any, measures to dissolve critical dilemmas mentioned above. As a result, we found that occupational safety and health (OSH) aspects had not been sufficiently addressed, particularly in the context of international BSL-4 collaboration in LMICs. Moreover, consideration of OSH can be one of the key drivers to make such collaborative interventions more pragmatic, safer to reorient, harness disease-based vertical approaches, and harmonize policies of biosafety and biosecurity, particularly for collaborations organized in resource-limited settings.
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Affiliation(s)
- Yuki Maehira
- Department of Emerging Infectious Diseases, Nagasaki University Institute of Tropical Medicine, Nagasaki, Japan
| | - Robert C Spencer
- Index Microbiology Ltd., School of Veterinary Science, University of Bristol, Bristol, United Kingdom
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Weber DJ, Sickbert-Bennett EE, Kanamori H, Rutala WA. New and emerging infectious diseases (Ebola, Middle Eastern respiratory syndrome coronavirus, carbapenem-resistant Enterobacteriaceae, Candida auris): Focus on environmental survival and germicide susceptibility. Am J Infect Control 2019; 47S:A29-A38. [PMID: 31146847 PMCID: PMC7132701 DOI: 10.1016/j.ajic.2019.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Viral Haemorrhagic Fever (VHF) and Other Serious Viral Infections. PREVENTION AND CONTROL OF INFECTIONS IN HOSPITALS 2019. [PMCID: PMC7120164 DOI: 10.1007/978-3-319-99921-0_88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Viral haemorrhagic fever—VHF—virus and a number of other special viruses are considered to cause the world’s most dangerous infections with very high mortality, lack of therapeutic possibilities and often absence of effective vaccines. Such viruses are identified as “biohazard-level 4” agents and are treated at the highest level of infection protection with strict isolation measures. At least 14 patients with Ebola disease were transported to Europe and the United States (11 patients) for hospital treatment during the African epidemic in 2014. There were no secondary spread of VHF import cases in Europe and the United States from 1999 until the Ebola outbreak in 2014. Then there were three cases of nosocomial spread to personnel in hospitals, two in the United States and one in Spain, despite alleged use of strict containment routines. This indicates a high risk of spread of infection through intensive treatment and handling of very sick persons with VHF like Ebola. In most cases vaccines are not available or specific antiviral drugs. Therefore, infection control must be based on a proper infection protection. This chapter is focused on practical means to handle and treat patients with suspect VHF or other dangerous agents to avoid spread to personnel and environment
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