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Aung AH, Li AL, Kyaw WM, Khanna R, Lim WY, Ang H, Chow ALP. Harnessing a real-time location system for contact tracing in a busy emergency department. J Hosp Infect 2023; 141:63-70. [PMID: 37660888 DOI: 10.1016/j.jhin.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/31/2023] [Accepted: 08/12/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND With the persistent threat of emerging infectious diseases (EIDs), digital contact tracing (CT) tools can augment conventional CT for the prevention of healthcare-associated infectious disease transmission. However, their performance has yet to be evaluated comprehensively in the fast-paced emergency department (ED) setting. OBJECTIVE This study compared the CT performance of a radiofrequency identification (RFID)-based real-time location system (RTLS) with conventional electronic medical record (EMR) review against continuous direct observation of close contacts ('gold standard') in a busy ED during the coronavirus disease 2019 pandemic period. METHODS This cross-sectional study was conducted at the ED of a large tertiary care hospital in Singapore from December 2020 to April 2021. CT performance [sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and kappa] of the RTLS, EMR review and a combination of the two approaches (hybrid CT) was compared with direct observation. Finally, the mean absolute error (MAE) in the duration of each contact episode found via the RTLS and direct observation was calculated. RESULTS In comparison with EMR review, both the RTLS and the hybrid CT approach had higher sensitivity (0.955 vs 0.455 for EMR review) and a higher NPV (0.997 vs 0.968 for EMR review). The RTLS had the highest PPV (0.777 vs 0.714 for EMR review vs 0.712 for hybrid CT). The RTLS had the strongest agreement with direct observation (kappa=0.848). The MAE between contact durations of 80 direct observations and their respective RTLS contact times was 1.81 min. CONCLUSION The RTLS was validated to be a high-performing CT tool, with significantly higher sensitivity than conventional CT via EMR review. The RTLS can be used with confidence in time-strapped EDs for time-sensitive CT for the prevention of healthcare-associated transmission of EIDs.
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Affiliation(s)
- A H Aung
- Department of Preventive and Population Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
| | - A L Li
- Department of Preventive and Population Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - W M Kyaw
- Department of Preventive and Population Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - R Khanna
- Department of Preventive and Population Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - W-Y Lim
- Department of Preventive and Population Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - H Ang
- Department of Emergency Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - A L P Chow
- Department of Preventive and Population Medicine, Tan Tock Seng Hospital, Singapore, Singapore; Lee Kong Chian School of Medicine, Singapore, Singapore; Infectious Disease Research and Training Office, National Centre for Infectious Disease, Singapore, Singapore; Saw Swee Hock School of Public Health, Singapore, Singapore
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Mercogliano M, Fiorilla C, Esposito F, Sorrentino M, Mirizzi PD, Parisi A, Tajani A, Buonocore G, Triassi M, Palladino R. Knowledge and attitude factors associated with the prevalence of Tdap (tetanus, diphtheria, and acellular pertussis) booster vaccination in healthcare workers in a large academic hospital in Southern Italy in 2022: a cross-sectional study. Front Public Health 2023; 11:1173482. [PMID: 37522000 PMCID: PMC10374026 DOI: 10.3389/fpubh.2023.1173482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/13/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction In Europe, there is still suboptimal tetanus, diphtheria, and acellular pertussis (Tdap) booster coverage. This study aimed to assess coverage status, knowledge, and attitude on Tdap vaccination in healthcare workers (HcWs) of the University Hospital "Federico II" in Naples, Southern Italy, in 2022, to improve current vaccination strategies. Methods A cross-sectional study was conducted using a validated anonymous questionnaire. Knowledge and attitude were measured as scores. Multivariable logistic and linear regression models were employed to identify correlates of Tdap booster and knowledge and attitude toward the vaccination, as appropriate. Models were controlled for age, sex, profession, department, and job seniority. Results A total of 206 questionnaires were administered among HcWs, and 143 (69.4%) were medical doctors. In total, 71 (34.47%) HcWs received the Tdap booster. Those who have worked 5-9 years at the hospital had a 78% lower likelihood of being vaccinated with the Tdap booster (5-9 years-OR: 0.22, CI: 0.06 | 0.85) as compared with newly hired HcWs. No differences in the average knowledge score were found. Other healthcare workers had a lower attitude as compared to medical doctors (Other-Coef. -2.15; CI: -4.14 | -0.15) and, as compared with those who worked in a clinical department, those who worked in a diagnostic-therapeutic department or medical management had 3.1 and 2.0 lower attitude scores, on average, respectively (diagnostic-therapeutic-Coef. -3.12, CI: -5.13 | -1.12; public health-Coef. -1.98, CI: -3.41 | -0.56). Discussion The study findings support the necessity to implement public health strategies and improve knowledge and attitude toward vaccinations and specifically highlight the importance of Tdap booster every 10 years as a prevention tool to protect high-risk populations.
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Affiliation(s)
| | - Claudio Fiorilla
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Federica Esposito
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | | | - Antonio Parisi
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Andrea Tajani
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Gaetano Buonocore
- Clinical Directorate, University Hospital “Federico II” of Naples, Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy
- Department of Primary Care and Public Health, School of Public Health, Imperial College, London, United Kingdom
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Li M, Luo Y, Watson R, Zheng Y, Ren J, Tang J, Chen Y. Healthcare workers' (HCWs) attitudes and related factors towards COVID-19 vaccination: a rapid systematic review. Postgrad Med J 2023; 99:520-528. [PMID: 37319159 DOI: 10.1136/postgradmedj-2021-140195] [Citation(s) in RCA: 122] [Impact Index Per Article: 122.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/29/2021] [Indexed: 01/24/2023]
Abstract
Herd immunity through vaccination is a key measure to control COVID-19 pandemic. However, vaccine hesitancy remains a public health threat, which is still common among healthcare workers (HCWs). This systematic review aimed to synthesise evidence on HCWs' attitudes towards COVID-19 vaccination and analyse associated factors to provide information for vaccine policy development and practice. We searched PubMed, Embase, ScienceDirect, Web of Science and three Chinese databases for literature published on 12 February 2021. Two researchers screened the literature independently, and 13 studies were included in the systematic review. Vaccine acceptance varied widely and ranged from 27.7% to 77.3%. HCWs had positive attitudes towards future COVID-19 vaccines, while vaccine hesitancy was still common. Demographic variables such as men, older age and physicians were positive predictive factors. Women and nurses had more vaccine hesitancy. Previous influenza vaccination and self-perceived risk were facilitators. Concerns for safety, efficacy and effectiveness and distrust of the government were barriers. Influences of direct (COVID-19) patient care towards vaccination intention were less conclusive. Tailored communication strategies were needed to increase the uptake rate of COVID-19 vaccines among HCWs. More importantly, more data and information on the safety and efficacy of vaccines should be provided with transparency.
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Affiliation(s)
- Mei Li
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Yue Luo
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Roger Watson
- Health and Social Care Faculty, University of Hull, Hull, UK
| | - Yu Zheng
- Department of Rheumatism and Immunology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Jianlan Ren
- Department of Anesthesiology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jian Tang
- Department of Central Sterile Supply, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yanhua Chen
- Department of Nursing, the Affiliated Hospital of Southwest Medical University, Luzhou, China
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Luo D, Eicher M, White K. Resilience in adults with colorectal cancer: Refining a conceptual model using a descriptive qualitative approach. J Adv Nurs 2023; 79:254-268. [PMID: 36239211 PMCID: PMC10092807 DOI: 10.1111/jan.15464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 08/20/2022] [Accepted: 09/21/2022] [Indexed: 12/15/2022]
Abstract
AIMS To examine and refine a conceptual model of resilience in adult cancer care based on the perspectives and experiences of resilience in adults with colorectal cancer. DESIGN A descriptive qualitative study was performed. METHODS Twelve participants diagnosed with colorectal cancer that had completed cancer treatment with curative intent were recruited from a tertiary hospital in Australia from July to December 2019. The meaning of individual resilience was explored using in-depth individual interviews. Data were analysed using inductive thematic analysis. Following data analysis, the elements of the conceptual model of resilience were mapped against the themes and subthemes to refine the model. RESULTS Five themes were identified as key elements of individual resilience in adults with colorectal cancer: (1) seeking motivations to move forward; (2) striving for normality; (3) adapting and managing self; (4) drawing on external supports; (5) redefining self. A refined conceptual model of individual resilience in adults with colorectal cancer was developed based on the integration of the themes and the elements of the conceptual model of individual resilience. CONCLUSIONS Our refined conceptual model of individual resilience in adults with colorectal cancer could facilitate nurses' and other health professionals' understanding of the process of how resilient individuals with colorectal cancer overcome their illness-related adversity. This refined model may be used to further develop and test cancer-specific resilience measures and develop interventions to facilitate resilience in people living with colorectal cancer. IMPACT This research identified five features of resilience in adults with colorectal cancer and refined a conceptual model of resilience in adults with colorectal cancer. The findings could help nurses and other health professionals with identifying individuals who are at risk of adaptation difficulties and contribute to an early referral to psychosocial support services.
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Affiliation(s)
- Dan Luo
- Cancer Care Research Unit, Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, New South Wales, Australia.,The Daffodil Centre, Sydney, New South Wales, Australia
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland.,Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Kate White
- Cancer Care Research Unit, Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, New South Wales, Australia.,The Daffodil Centre, Sydney, New South Wales, Australia
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PIYARAJ P, KITTIKRAISAK W, BUATHONG S, SINTHUWATTANAWIBOOL C, NIVESVIVAT T, YOOCHAROEN P, NUCHTEAN T, KLUNGTHONG C, LYMAN M, MOTT JA, CHOTTANAPUND S. Encounter patterns and worker absenteeism/presenteeism among healthcare providers in Thailand. CURRENT RESEARCH IN BEHAVIORAL SCIENCES 2022. [DOI: 10.1016/j.crbeha.2022.100067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Noverón NR, Peralta LP, Compte DV, Montalvo LAH, Pineda SRG, Gómez AAG, Vega OAR, Gutiérrez RC, Miranda AH, Vargas AM, Martínez DDLR, Juárez PC, García AAM. SARS-CoV-2 positivity rates in asymptomatic workers at a cancer referral center in Mexico City: A prospective observational study in the context of adapting hospitals back to regular practice. Am J Infect Control 2021; 49:1469-1473. [PMID: 34551335 PMCID: PMC8452087 DOI: 10.1016/j.ajic.2021.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 10/30/2022]
Abstract
BACKGROUND Healthcare workers are at increased risk of SARS-CoV-2 infection. The positivity rates in hospitals that do not receive patients with COVID-19, such as the National Cancer Institute (INCan) in Mexico, and the associated factors are unknown. OBJECTIVE To assess the incidence and factors associated with SARS-CoV-2 infection in health workers at INCan. METHODS A cohort study of 531 workers who were followed for 6 months. RT-PCR analysis of saliva and nasopharyngeal swab samples were used in the baseline and to confirm cases during follow-up The incidence rate ratio was calculated according to the measured characteristics and the associated factors were calculated using logistic regression models. RESULTS Out of 531 workers, 9.6% tested positive for SARS-CoV-2, Being male (RR: 2.07, 95% CI: 1.1-3.8, P = .02), performing administrative tasks (RR: 1.99, 95% CI: 1.0-3.9, P = .04), and having relatives also working at INCan (RR: 3.7, 95% CI: 1.4-9.5, P < .01) were associated with higher positivity rates. DISCUSSION Incidence of positive cases in health workers were similar to that reported in non-COVID hospitals from other countries. CONCLUSIONS Even though active surveillance helped to detect a significant number of asymptomatic infections, it is still necessary to reinforce preventive measures in non-medical staff to prevent nosocomial transmission.
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Affiliation(s)
| | - Liliana Pérez Peralta
- Instituto de Oftalmología Fundación Conde de Valenciana (CONVAL), Mexico City, Mexico; Centro de Atención Integral del Paciente con Diabetes del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City, Mexico
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Sahoo DP, Singh AK, Sahu DP, Pradhan SK, Patro BK, Batmanabane G, Mishra B, Behera B, Das A, Dora GS, Anand L, Azhar SM, Nair J, Panigrahi S, Akshaya R, Sahoo BK, Sahu S, Sahoo S. Hospital-Based Contact Tracing of Patients With COVID-19 and Health Care Workers During the COVID-19 Pandemic in Eastern India: Cross-sectional Study. JMIR Form Res 2021; 5:e28519. [PMID: 34596569 PMCID: PMC8534486 DOI: 10.2196/28519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/15/2021] [Accepted: 09/18/2021] [Indexed: 02/06/2023] Open
Abstract
Background The contact tracing and subsequent quarantining of health care workers (HCWs) are essential to minimizing the further transmission of SARS-CoV-2 infection and mitigating the shortage of HCWs during the COVID-19 pandemic situation. Objective This study aimed to assess the yield of contact tracing for COVID-19 cases and the risk stratification of HCWs who are exposed to these cases. Methods This was an analysis of routine data that were collected for the contact tracing of COVID-19 cases at the All India Institute of Medical Sciences, Bhubaneswar, in Odisha, India. Data from March 19 to August 31, 2020, were considered for this study. COVID-19 cases were admitted patients, outpatients, or HCWs in the hospital. HCWs who were exposed to COVID-19 cases were categorized, per the risk stratification guidelines, as high-risk contacts or low-risk contacts Results During contact tracing, 3411 HCWs were identified as those who were exposed to 360 COVID-19 cases. Of these 360 cases, 269 (74.7%) were either admitted patients or outpatients, and 91 (25.3%) were HCWs. After the risk stratification of the 3411 HCWs, 890 (26.1%) were categorized as high-risk contacts, and 2521 (73.9%) were categorized as low-risk contacts. The COVID-19 test positivity rates of high-risk contacts and low-risk contacts were 3.8% (34/890) and 1.9% (48/2521), respectively. The average number of high-risk contacts was significantly higher when the COVID-19 case was an admitted patient (number of contacts: mean 6.6) rather than when the COVID-19 case was an HCW (number of contacts: mean 4.0) or outpatient (number of contacts: mean 0.2; P=.009). Similarly, the average number of high-risk contacts was higher when the COVID-19 case was admitted in a non–COVID-19 area (number of contacts: mean 15.8) rather than when such cases were admitted in a COVID-19 area (number of contacts: mean 0.27; P<.001). There was a significant decline in the mean number of high-risk contacts over the study period (P=.003). Conclusions Contact tracing and risk stratification were effective and helped to reduce the number of HCWs requiring quarantine. There was also a decline in the number of high-risk contacts during the study period. This indicates the role of the implementation of hospital-based, COVID-19–related infection control strategies. The contact tracing and risk stratification approaches that were designed in this study can also be implemented in other health care settings.
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Affiliation(s)
- Durgesh Prasad Sahoo
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Arvind Kumar Singh
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Dinesh Prasad Sahu
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Somen Kumar Pradhan
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Binod Kumar Patro
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | | | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Bijayini Behera
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ambarish Das
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - G Susmita Dora
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - L Anand
- College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - S M Azhar
- College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Jyolsna Nair
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sasmita Panigrahi
- College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - R Akshaya
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Bimal Kumar Sahoo
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Subhakanta Sahu
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suchismita Sahoo
- College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Angelo AT, Alemayehu DS, Dachew AM. Health care workers intention to accept COVID-19 vaccine and associated factors in southwestern Ethiopia, 2021. PLoS One 2021; 16:e0257109. [PMID: 34478470 PMCID: PMC8415602 DOI: 10.1371/journal.pone.0257109] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/23/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Health care workers are the most affected part of the world population due to the COVID-19 pandemic. Countries prioritize vaccinating health workers against COVID-19 because of their susceptibility to the virus. However, the acceptability of the vaccine varies across populations. Thus, this study aimed to determine the health care worker's intentions to accept the COVID-19 vaccine and its associated factors in southwestern Ethiopia, 2021. METHODS A facility-based cross-sectional study was conducted among health care workers in public hospitals in southwestern Ethiopia from March 15 to 28, 2021. A simple random sampling method was used to select 405 participants from each hospital. Data were collected using self-administered questionnaires. Descriptive statistics, such as frequency and percentage, were calculated. Multivariable logistic regression was also performed to identify factors associated with health care worker's intention to accept the COVID-19 vaccine. Statistically significant variables were selected based on p-values (<0.05) and the adjusted odds ratio was used to describe the strength of association with 95% confidence intervals. RESULT Among the respondents, 48.4% [95% CI: 38.6, 58.2] of health care workers intended to accept COVID-19. Intention to accept COVID-19 vaccination was significantly associated with physicians (AOR = 9.27, 95% CI: 1.27-27.32), professionals with a history of chronic illness (AOR = 4.07, 95% CI: 2.02-8.21), perceived degree of risk of COVID-19 infection (AOR = 4.63, 95% CI: 1.26-16.98), positive attitude toward COVID-19 prevention (AOR = 6.08, 95% CI: 3.39-10.91) and good preventive practices (AOR = 2.83, 95% CI: 1.58-5.08). CONCLUSION In this study, the intention of health care workers to accept the COVID-19 vaccine was low. Professional types, history of chronic illness, perceived degree of risk to COVID-19 infection, attitude toward COVID-19 and preventive practices were found to be factors for intention to accept COVID-19 vaccine in professionals. It is important to consider professional types, history of chronic illness, perceived degree of risk to COVID-19, attitude of professionals and preventive behaviors to improve the intention of professionals' vaccine acceptance.
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Procter SR, Abbas K, Flasche S, Griffiths U, Hagedorn B, O'Reilly KM, Jit M. SARS-CoV-2 infection risk during delivery of childhood vaccination campaigns: a modelling study. BMC Med 2021; 19:198. [PMID: 34384441 PMCID: PMC8359640 DOI: 10.1186/s12916-021-02072-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has disrupted the delivery of immunisation services globally. Many countries have postponed vaccination campaigns out of concern about infection risks to the staff delivering vaccination, the children being vaccinated, and their families. The World Health Organization recommends considering both the benefit of preventive campaigns and the risk of SARS-CoV-2 transmission when making decisions about campaigns during COVID-19 outbreaks, but there has been little quantification of the risks. METHODS We modelled excess SARS-CoV-2 infection risk to vaccinators, vaccinees, and their caregivers resulting from vaccination campaigns delivered during a COVID-19 epidemic. Our model used population age structure and contact patterns from three exemplar countries (Burkina Faso, Ethiopia, and Brazil). It combined an existing compartmental transmission model of an underlying COVID-19 epidemic with a Reed-Frost model of SARS-CoV-2 infection risk to vaccinators and vaccinees. We explored how excess risk depends on key parameters governing SARS-CoV-2 transmissibility, and aspects of campaign delivery such as campaign duration, number of vaccinations, and effectiveness of personal protective equipment (PPE) and symptomatic screening. RESULTS Infection risks differ considerably depending on the circumstances in which vaccination campaigns are conducted. A campaign conducted at the peak of a SARS-CoV-2 epidemic with high prevalence and without special infection mitigation measures could increase absolute infection risk by 32 to 45% for vaccinators and 0.3 to 0.5% for vaccinees and caregivers. However, these risks could be reduced to 3.6 to 5.3% and 0.1 to 0.2% respectively by use of PPE that reduces transmission by 90% (as might be achieved with N95 respirators or high-quality surgical masks) and symptomatic screening. CONCLUSIONS SARS-CoV-2 infection risks to vaccinators, vaccinees, and caregivers during vaccination campaigns can be greatly reduced by adequate PPE, symptomatic screening, and appropriate campaign timing. Our results support the use of adequate risk mitigation measures for vaccination campaigns held during SARS-CoV-2 epidemics, rather than cancelling them entirely.
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Affiliation(s)
- Simon R Procter
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK.
| | - Kaja Abbas
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK
| | - Stefan Flasche
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK
| | | | | | - Kathleen M O'Reilly
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK
| | - Mark Jit
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK
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Procter SR, Abbas K, Flasche S, Griffiths U, Hagedorn B, O'Reilly KM, Jit M. SARS-CoV-2 infection risk during delivery of childhood vaccination campaigns: a modelling study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.05.14.21257215. [PMID: 34031666 PMCID: PMC8142667 DOI: 10.1101/2021.05.14.21257215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The COVID-19 pandemic has disrupted delivery of immunisation services globally. Many countries have postponed vaccination campaigns out of concern about infection risks to staff delivering vaccination, the children being vaccinated and their families. The World Health Organization recommends considering both the benefit of preventive campaigns and the risk of SARS-CoV-2 transmission when making decisions about campaigns during COVID-19 outbreaks, but there has been little quantification of the risks. METHODS We modelled excess SARS-CoV-2 infection risk to vaccinators, vaccinees and their caregivers resulting from vaccination campaigns delivered during a COVID-19 epidemic. Our model used population age-structure and contact patterns from three exemplar countries (Burkina Faso, Ethiopia, and Brazil). It combined an existing compartmental transmission model of an underlying COVID-19 epidemic with a Reed-Frost model of SARS-CoV-2 infection risk to vaccinators and vaccinees. We explored how excess risk depends on key parameters governing SARS-CoV-2 transmissibility, and aspects of campaign delivery such as campaign duration, number of vaccinations, and effectiveness of personal protective equipment (PPE) and symptomatic screening. RESULTS Infection risks differ considerably depending on the circumstances in which vaccination campaigns are conducted. A campaign conducted at the peak of a SARS-CoV-2 epidemic with high prevalence and without special infection mitigation measures could increase absolute infection risk by 32% to 45% for vaccinators, and 0.3% to 0.5% for vaccinees and caregivers. However, these risks could be reduced to 3.6% to 5.3% and 0.1% to 0.2% respectively by use of PPE that reduces transmission by 90% (as might be achieved with N95 respirators or high-quality surgical masks) and symptomatic screening. CONCLUSIONS SARS-CoV-2 infection risks to vaccinators, vaccinees and caregivers during vaccination campaigns can be greatly reduced by adequate PPE, symptomatic screening, and appropriate campaign timing. Our results support the use of adequate risk mitigation measures for vaccination campaigns held during SARS-CoV-2 epidemics, rather than cancelling them entirely.
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Affiliation(s)
- Simon R Procter
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom
| | - Kaja Abbas
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom
| | - Stefan Flasche
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom
| | | | | | - Kathleen M O'Reilly
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom
| | - Mark Jit
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom
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Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Intention of healthcare workers to accept COVID-19 vaccination and related factors: A systematic review and meta-analysis. ASIAN PAC J TROP MED 2021. [DOI: 10.4103/1995-7645.332808] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Gagneux-Brunon A, Detoc M, Bruel S, Tardy B, Rozaire O, Frappe P, Botelho-Nevers E. Intention to get vaccinations against COVID-19 in French healthcare workers during the first pandemic wave: a cross-sectional survey. J Hosp Infect 2020; 108:168-173. [PMID: 33259883 PMCID: PMC7699157 DOI: 10.1016/j.jhin.2020.11.020] [Citation(s) in RCA: 358] [Impact Index Per Article: 89.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 01/07/2023]
Abstract
Background Healthcare workers (HCWs) are at the frontline of the COVID-19 pandemic and identified as a priority target group for COVID-19 vaccines. We aimed to determine COVID-19 vaccine acceptance rate in HCWs in France. Methods We conducted an anonymous survey from 26th March to 2nd July 2020. The primary endpoint was the intention to get vaccinated against COVID-19 if a vaccine was available. Results Two-thousand and forty-seven HCWs answered the survey; women accounted for 74% of respondents. Among respondents, 1.554 (76.9%, 95% confidence interval 75.1–78.9) would accept a COVID-19 vaccine. Older age, male gender, fear about COVID-19, individual perceived risk and flu vaccination during previous season were associated with hypothetical COVID-19 vaccine acceptance. Nurses and assistant nurses were less prone to accept vaccination against COVID-19 than physicians. Vaccine hesitancy was associated with a decrease in COVID-19 vaccine acceptance. Flu vaccine rate was 57.3% during the previous season, and 54.6% of the respondents had the intention to get a flu vaccine during the next season. Conclusions Intention to get vaccinated against COVID-19 reached 75% in HCWs with discrepancies between occupational categories. COVID-19 pandemic had no positive effect on flu vaccine acceptance rate.
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Affiliation(s)
- A Gagneux-Brunon
- Department of Infectious and Tropical Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France; Centre d'investigation Clinique 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France; Groupe Immunité des Muqueuses et Agents Pathogènes EA3064, University Jean Monnet, Université de Lyon, Saint-Etienne, France; Institut PRESAGE, Chaire Prevention Vaccination et Contrôle de L'Infection, University Jean Monnet, Université de Lyon, Saint-Etienne, France.
| | - M Detoc
- Department of Infectious and Tropical Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France; Centre d'investigation Clinique 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - S Bruel
- Department of General Medicine, Faculté de Médecine Jacques Lisfranc, University Jean Monnet, Université de Lyon, Saint-Etienne, France
| | - B Tardy
- Centre d'investigation Clinique 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - O Rozaire
- Union Régionale des Professionnels de Santé Pharmaciens, Auvergne Rhône Alpes, France
| | - P Frappe
- Centre d'investigation Clinique 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France; Department of General Medicine, Faculté de Médecine Jacques Lisfranc, University Jean Monnet, Université de Lyon, Saint-Etienne, France
| | - E Botelho-Nevers
- Department of Infectious and Tropical Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France; Centre d'investigation Clinique 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France; Groupe Immunité des Muqueuses et Agents Pathogènes EA3064, University Jean Monnet, Université de Lyon, Saint-Etienne, France; Institut PRESAGE, Chaire Prevention Vaccination et Contrôle de L'Infection, University Jean Monnet, Université de Lyon, Saint-Etienne, France
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Wee LE, Sim XYJ, Conceicao EP, Aung MK, Goh JQ, Yeo DWT, Gan WH, Chua YY, Wijaya L, Tan TT, Tan BH, Ling ML, Venkatachalam I. Containment of COVID-19 cases among healthcare workers: The role of surveillance, early detection, and outbreak management. Infect Control Hosp Epidemiol 2020; 41:765-771. [PMID: 32391746 PMCID: PMC7248595 DOI: 10.1017/ice.2020.219] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/22/2020] [Accepted: 04/26/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Staff surveillance is crucial during the containment phase of a pandemic to help reduce potential healthcare-associated transmission and sustain good staff morale. During an outbreak of SARS-COV-2 with community transmission, our institution used an integrated strategy for early detection and containment of COVID-19 cases among healthcare workers (HCWs). METHODS Our strategy comprised 3 key components: (1) enforcing reporting of HCWs with acute respiratory illness (ARI) to our institution's staff clinic for monitoring; (2) conducting ongoing syndromic surveillance to obtain early warning of potential clusters of COVID-19; and (3) outbreak investigation and management. RESULTS Over a 16-week surveillance period, we detected 14 cases of COVID-19 among HCWs with ARI symptoms. Two of the cases were linked epidemiologically and thus constituted a COVID-19 cluster with intrahospital HCW-HCW transmission; we also detected 1 family cluster and 2 clusters among HCWs who shared accommodation. No transmission to HCWs or patients was detected after containment measures were instituted. Early detection minimized the number of HCWs requiring quarantine, hence preserving continuity of service during an ongoing pandemic. CONCLUSIONS An integrated surveillance strategy, outbreak management, and encouraging individual responsibility were successful in early detection of clusters of COVID-19 among HCWs. With ongoing local transmission, vigilance must be maintained for intrahospital spread in nonclinical areas where social mingling of HCWs occurs. Because most individuals with COVID-19 have mild symptoms, addressing presenteeism is crucial to minimize potential staff and patient exposure.
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Affiliation(s)
- Liang En Wee
- Singhealth Infectious Diseases Residency, Singapore
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Xiang Ying Jean Sim
- Department of Infectious Diseases, Singapore General Hospital, Singapore
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Edwin Philip Conceicao
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - May Kyawt Aung
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Jia Qing Goh
- Department of Clinical Quality and Performance Management, Singapore General Hospital, Singapore
| | - Dennis Wu Ting Yeo
- Department of Clinical Quality and Performance Management, Singapore General Hospital, Singapore
| | - Wee Hoe Gan
- Department of Occupational and Environmental Medicine, Singapore General Hospital, Singapore
| | - Ying Ying Chua
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Limin Wijaya
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Thuan Tong Tan
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Ban Hock Tan
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Moi Lin Ling
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Indumathi Venkatachalam
- Department of Infectious Diseases, Singapore General Hospital, Singapore
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
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14
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Ho HJ, Zhang ZX, Huang Z, Aung AH, Lim WY, Chow A. Use of a Real-Time Locating System for Contact Tracing of Health Care Workers During the COVID-19 Pandemic at an Infectious Disease Center in Singapore: Validation Study. J Med Internet Res 2020; 22:e19437. [PMID: 32412416 PMCID: PMC7252199 DOI: 10.2196/19437] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In early 2020, coronavirus disease (COVID-19) emerged and spread by community and nosocomial transmission. Effective contact tracing of potentially exposed health care workers is crucial for the prevention and control of infectious disease outbreaks in the health care setting. OBJECTIVE This study aimed to evaluate the comparative effectiveness of contact tracing during the COVID-19 pandemic through the real-time locating system (RTLS) and review of the electronic medical record (EMR) at the designated hospital for COVID-19 response in Singapore. METHODS Over a 2-day study period, all admitted patients with COVID-19, their ward locations, and the health care workers rostered to each ward were identified to determine the total number of potential contacts between patients with COVID-19 and health care workers. The numbers of staff-patient contacts determined by EMR reviews, RTLS-based contact tracing, and a combination of both methods were evaluated. The use of EMR-based and RTLS-based contact tracing methods was further validated by comparing their sensitivity and specificity against self-reported staff-patient contacts by health care workers. RESULTS Of 796 potential staff-patient contacts (between 17 patients and 162 staff members), 104 (13.1%) were identified by both the RTLS and EMR, 54 (6.8%) by the RTLS alone, and 99 (12.4%) by the EMR alone; 539 (67.7%) were not identified through either method. Compared to self-reported contacts, EMR reviews had a sensitivity of 47.2% and a specificity of 77.9%, while the RTLS had a sensitivity of 72.2% and a specificity of 87.7%. The highest sensitivity was obtained by including all contacts identified by either the RTLS or the EMR (sensitivity 77.8%, specificity 73.4%). CONCLUSIONS RTLS-based contact tracing showed higher sensitivity and specificity than EMR review. Integration of both methods provided the best performance for rapid contact tracing, although technical adjustments to the RTLS and increasing user compliance with wearing of RTLS tags remain necessary.
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Affiliation(s)
- Hanley J Ho
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore
| | - Zoe Xiaozhu Zhang
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore
| | - Zhilian Huang
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore
| | - Aung Hein Aung
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore
| | - Wei-Yen Lim
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore
| | - Angela Chow
- Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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15
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Vilches TN, Bonesso MF, Guerra HM, Fortaleza CMCB, Park AW, Ferreira CP. The role of intra and inter-hospital patient transfer in the dissemination of heathcare-associated multidrug-resistant pathogens. Epidemics 2018; 26:104-115. [PMID: 30583920 DOI: 10.1016/j.epidem.2018.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 11/26/2018] [Accepted: 11/29/2018] [Indexed: 11/28/2022] Open
Abstract
Healthcare-associated infections cause significant patient morbidity and mortality, and contribute to growing healthcare costs, whose effects may be felt most strongly in developing countries. Active surveillance systems, hospital staff compliance, including hand hygiene, and a rational use of antimicrobials are among the important measures to mitigate the spread of healthcare-associated infection within and between hospitals. Klebsiella pneumoniae is an important human pathogen that can spread in hospital settings, with some forms exhibiting drug resistance, including resistance to the carbapenem class of antibiotics, the drugs of last resort for such infections. Focusing on the role of patient movement within and between hospitals on the transmission and incidence of enterobacteria producing the K. pneumoniae Carbapenemase (KPC, an enzyme that inactivates several antimicrobials), we developed a metapopulation model where the connections among hospitals are made using a theoretical hospital network based on Brazilian hospital sizes and locations. The pathogen reproductive number, R0 that measures the average number of new infections caused by a single infectious individual, was calculated in different scenarios defined by both the links between hospital environments (regular wards and intensive care units) and between different hospitals (patient transfer). Numerical simulation was used to illustrate the infection dynamics in this set of scenarios. The sensitivity of R0 to model input parameters, such as hospital connectivity and patient-hospital staff contact rates was also established, highlighting the differential importance of factors amenable to change on pathogen transmission and control.
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Affiliation(s)
- T N Vilches
- São Paulo State University (UNESP), Institute of Biosciences, Department of Biostatistics, 18618-689 Botucatu, Brazil
| | - M F Bonesso
- Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, Brazil
| | - H M Guerra
- Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, Brazil
| | - C M C B Fortaleza
- Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, Brazil
| | - A W Park
- Odum School of Ecology & Department of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - C P Ferreira
- São Paulo State University (UNESP), Institute of Biosciences, Department of Biostatistics, 18618-689 Botucatu, Brazil.
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Jiang L, Ng IHL, Hou Y, Li D, Tan LWL, Ho HJA, Chen MIC. Infectious disease transmission: survey of contacts between hospital-based healthcare workers and working adults from the general population. J Hosp Infect 2017; 98:404-411. [PMID: 29097147 PMCID: PMC7114670 DOI: 10.1016/j.jhin.2017.10.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 10/25/2017] [Indexed: 10/29/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) may be the inadvertent interface between the healthcare setting and the community for infectious diseases transmission. AIM To investigate HCWs' contacts during a work day and compare these against working adults from the general population. METHODS Prospective survey of contacts through 24 h self-reported diary in three public sector tertiary care hospitals and community-based working adults in Singapore. Participants were HCWs and working adults from the community. FINDINGS In all, 211 HCWs and 1028 working adults reported a total of 4066 and 9206 contacts. HCWs reported more work-related contacts than community-based working adults (median of 13 versus 4), and more contacts that were neither household nor work-related (1 versus 0) but fewer household contacts (2 versus 3). HCWs reported more work-related contacts involving physical contacts, and more new contacts particularly with short duration (≤15 min) compared to community-based working adults. Among different HCW types, doctors reported the highest whereas ward-based nurses reported the lowest total work-related contacts. Around half of ward-based and clinic-based nurses' contacts involved physical touch. Work-related contacts reported by clinic-based nurses, doctors, and assorted HCWs were shorter than in ward-based nurses, with a substantial number effectively occurring with new contacts. Institutional effects significant on univariate analyses were much reduced and non-significant after adjusting for confounding by HCW type. CONCLUSION HCWs' contacts differ substantially from those of community-based working adults. HCWs may thus be at higher risk of acquiring and spreading contact-transmissible and respiratory infections due to the nature of their work. Whereas total number of contacts was fairly similar between HCW types, the characteristics of their contacts differed substantively.
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Affiliation(s)
- Lili Jiang
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | | | - Yan'an Hou
- Infectious Diseases - Epidemiology Unit, National University Hospital, Singapore, Singapore
| | - Dunli Li
- Department of Infection Control, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Linda Wei Lin Tan
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Hanley Jian An Ho
- Department of Clinical Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Mark I-Cheng Chen
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore; Department of Clinical Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore.
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