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Valjarevic S, Radaljac D, Miladinovic N. Life-Threatening Stridor due to Laryngeal Tuberculosis in the COVID-19 Era: Report of a Case. EAR, NOSE & THROAT JOURNAL 2024; 103:91S-94S. [PMID: 34974770 DOI: 10.1177/01455613211070896] [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] [Indexed: 11/15/2022] Open
Abstract
Laryngeal tuberculosis is the most frequent granulomatous disease of the larynx and it is prone to be diagnosed as cancer. COVID-19 pandemic caused considerable disruption in tuberculosis service provisions both in the primary care and hospital settings. This report describes a rare case of life-threatening stridor in a patient who presented with an ulceroproliferative laryngeal mass later confirmed as laryngeal tuberculosis. Urgent tracheostomy was performed. The patient's sputum and the computed tomography of the chest revealed a pulmonary, as well as laryngeal tuberculosis. The patient was commenced on a 24 week course of anti-tuberculous treatment which was interrupted because of a mild course of hospital-acquired coronavirus infection. 3 months after initial treatment for tuberculosis, his sputum cultures became negative. Flexible laryngoscopy was performed at our department 4 months after commencement of treatment, demonstrating complete regression of the lesion and symmetrical laryngeal mobility, hence the patient was successfully decannulated and discharged to be followed up to his community hospital. In the time of COVID-19 pandemic, we should never underestimate other severe infectious diseases.
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Affiliation(s)
- Svetlana Valjarevic
- Department of Otorhinolaryngology with Maxillofacial Surgery, Clinical Hospital Center "Zemun", Belgrade, Serbia
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Dejan Radaljac
- Department of Otorhinolaryngology with Maxillofacial Surgery, Clinical Hospital Center "Zemun", Belgrade, Serbia
| | - Nenad Miladinovic
- Department of Clinical Pathology, Clinical Hospital Center "Zemun", Belgrade, Serbia
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Chair SY, Ng ST, Chao CYH, Xu JF. Heating, ventilation, and air-conditioning systems in healthcare: a scoping review. J Hosp Infect 2023; 141:33-40. [PMID: 37640266 DOI: 10.1016/j.jhin.2023.08.012] [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: 02/25/2023] [Revised: 08/09/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023]
Abstract
Guidelines for heating, ventilation, and air-conditioning systems have been developed for different settings. However, there is a lack of up-to-date evidence providing concrete recommendations for the heating, ventilation, and air-conditioning systems of an isolation room, which is essential to appropriately guide infection control policies. To highlight the guidelines for heating, ventilation, and air-conditioning systems in isolation rooms to inform relevant stakeholders and policymakers. A systematic search was performed based on Joanna Briggs Methodology using five databases (CINAHL, Embase, Joanna Briggs Institute, Medline, and Web of Science) and websites. Eight articles published by government departments were included in this review. Most studies recommended controlled airflow without recirculation, 12 air changes per hour, high-efficiency particulate air filtrate to exhaust contaminated air from the airborne isolation room, humidity ≤60%, and temperature in the range of 18-30 °C. This review provides further evidence that there is a need for interdisciplinary collaborative research to quantify the optimum range for heating, ventilation, and air conditioning system parameters, considering door types, anterooms, and bed management, to effectively reduce the transmission of infection in isolation rooms.
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Affiliation(s)
- S Y Chair
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China.
| | - S T Ng
- Department of Architecture & Civil Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - C Y H Chao
- Department of Building Environment and Energy Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China; Department of Mechanical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - J F Xu
- Department of Architecture & Civil Engineering, City University of Hong Kong, Hong Kong SAR, China
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Sehat M, Razzaghi R, Ghamsary M, Faghir Ganji M, Sehat M. Changes in the rate of bacillus tuberculosis infection in health workers in the first year of the COVID-19 epidemic in Kashan- Iran. Heliyon 2023; 9:e20560. [PMID: 37829797 PMCID: PMC10565687 DOI: 10.1016/j.heliyon.2023.e20560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 09/15/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
Objective This cohort study aimed to determine the prevalence and risk factors of latent tuberculosis infection among healthcare workers during the COVID-19 pandemic. Methods A one-year cohort study was conducted in a referral hospital in Kashan, involving 176 medical, educational, and cleaning personnel. Initial evaluations and tuberculin skin tests were performed, followed by a one-year follow-up period. Data were analyzed using SPSS version 26 software. Results Among the participants, 26.1% (46 individuals) tested positive for latent tuberculosis infection. Age was a significant risk factor, with a 3.6% increase in latent tuberculosis infection risk with each advancing year. Men had 2.19 times (1.10-4.35) the chance of having a latent infection compared to women. Hospital staff were 3.7 times more at risk of tuberculosis infection than students. Among the hospital job categories, nursing assistants had the highest chance of tuberculosis infection, 6.77 times higher than medical students, followed by cleaning staff and nurses. The ICU, General, and Obstetrics and Gynecology departments had an infection chance of 2.46 (1.11-5.46) compared to other departments. No new positive cases were detected during the follow-up period. Conclusion This study contributes to the understanding of latent tuberculosis infection prevalence and its risk factors among healthcare workers during the COVID-19 pandemic. The findings highlight the importance of infection control measures and targeted interventions to protect healthcare workers from occupational tuberculosis exposure.
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Affiliation(s)
- Mojgan Sehat
- Department of Infectious Diseases, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Reza Razzaghi
- Department of Infectious Diseases, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mark Ghamsary
- Loma Linda University (retired), School of Public Health, Department of Epidemiology and Biostatistics, California, USA
| | - Monireh Faghir Ganji
- Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Sehat
- Trauma Research Center, Department of Community Medicine, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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Fontes B, Scavone D, Bridges W, Landgraf T, Fortgang N. Biorisk Management Features of a Temporary COVID-19 Hospital. APPLIED BIOSAFETY 2023; 28:32-42. [PMID: 36895579 PMCID: PMC9991446 DOI: 10.1089/apb.2022.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Introduction Yale University designed and constructed a temporary field hospital for 100 COVID-19 symptomatic patients. Conservative biocontainment decisions were made in design and operational practices. Objectives of the field hospital included the safe flow of patients, staff, equipment and supplies, and obtaining approval by the Connecticut Department of Public Health (CT DPH) for opening as a field hospital. Methods The CT DPH regulations for mobile hospitals were used as primary guidance for the design, equipment, and protocols. References for BSL-3 and ABSL-3 design from the National Institutes of Health (NIH) and Tuberculosis isolation rooms from the United States Centers for Disease Control and Prevention (CDC) were also utilized. The final design involved an array of experts throughout the university. Results and Conclusion Vendors tested and certified all High Efficiency Particulate Air (HEPA) filters and balanced the airflows inside the field hospital. Yale Facilities designed and constructed positive pressure access and exit tents within the field hospital, established appropriate pressure relationships between zones, and added Minimum Efficiency Reporting Value 16 exhaust filters. The BioQuell ProteQ Hydrogen Peroxide decontamination unit was validated with biological spores in the rear sealed section of the biowaste tent. A ClorDiSys Flashbox UV-C Disinfection Chamber was also validated. Visual indicators were placed the doors of the pressurized tents and spaced throughout the facility to verify airflows. The plans created to design, construct and operate the field hospital provide a blueprint for recreating and reopening a field hospital in the future if ever needed at Yale University.
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Affiliation(s)
- Benjamin Fontes
- Yale Health, Environmental Health and Safety, Yale Center for Clinical Investigation, Yale University, New Haven, Connecticut, USA
| | - Danielle Scavone
- Yale Health, Environmental Health and Safety, Yale Center for Clinical Investigation, Yale University, New Haven, Connecticut, USA
| | - Wesley Bridges
- Yale Health, Environmental Health and Safety, Yale Center for Clinical Investigation, Yale University, New Haven, Connecticut, USA
| | - Tessa Landgraf
- Yale Health, Environmental Health and Safety, Yale Center for Clinical Investigation, Yale University, New Haven, Connecticut, USA
| | - Nanci Fortgang
- Yale Health, Environmental Health and Safety, Yale Center for Clinical Investigation, Yale University, New Haven, Connecticut, USA
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Lee I, Kang S, Chin B, Joh JS, Jeong I, Kim J, Kim J, Lee JY. Predictive Factors and Clinical Impacts of Delayed Isolation of Tuberculosis during Hospital Admission. J Clin Med 2023; 12:jcm12041361. [PMID: 36835896 PMCID: PMC9966369 DOI: 10.3390/jcm12041361] [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: 01/05/2023] [Revised: 02/04/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Delayed isolation of tuberculosis (TB) can cause unexpected exposure of healthcare workers (HCWs). This study identified the predictive factors and clinical impact of delayed isolation. We retrospectively reviewed the electronic medical records of index patients and HCWs who underwent contact investigation after TB exposure during hospitalization at the National Medical Center, between January 2018 and July 2021. Among the 25 index patients, 23 (92.0%) were diagnosed with TB based on the molecular assay, and 18 (72.0%) had a negative acid-fast bacilli smear. Sixteen (64.0%) patients were hospitalized via the emergency room, and 18 (72.0%) were admitted to a non-pulmonology/infectious disease department. According to the patterns of delayed isolation, patients were classified into five categories. Among 157 close-contact events in 125 HCWs, 75 (47.8%) occurred in Category A. Twenty-five (20%) HCWs had multiple TB exposures (n = 57 events), of whom 37 (64.9%) belonged to Category A (missed during emergency situations). After contact tracing, latent TB infection was diagnosed in one (1.2%) HCW in Category A, who was exposed during intubation. Delayed isolation and TB exposure mostly occurred during pre-admission in emergency situations. Effective TB screening and infection control are necessary to protect HCWs, especially those who routinely contact new patients in high-risk departments.
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Affiliation(s)
- Inhan Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul 04564, Republic of Korea
| | - Soyoung Kang
- Department of Infection Control and Prevention, National Medical Center, Seoul 04564, Republic of Korea
| | - Bumsik Chin
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul 04564, Republic of Korea
| | - Joon-Sung Joh
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul 04564, Republic of Korea
| | - Ina Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul 04564, Republic of Korea
| | - Junghyun Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong 18450, Republic of Korea
| | - Joohae Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul 04564, Republic of Korea
| | - Ji Yeon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul 04564, Republic of Korea
- Correspondence:
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Madzinga D, Tshitangano TG, Raliphaswa NS, Razwiedani L. Healthcare Workers' Perception of Measures to Reduce the Risk of New Tuberculosis Infections: A Qualitative Study Report. NURSING REPORTS 2022; 12:873-883. [PMID: 36412803 PMCID: PMC9680215 DOI: 10.3390/nursrep12040084] [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: 10/26/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/18/2022] Open
Abstract
Tuberculosis, which is an infectious airborne disease remained the main leading cause of death in South Africa for three consecutive years from 2016 to 2018. In 2020 alone, the country had an estimated 328,000 people who suffered from TB, with 61,000 dying from it. Collins Chabane Municipality had 129 and 192 new TB cases recorded in 2017 and 2018, respectively, which is far from reaching the END TB STRATEGY targets. WHO scientific evidence demonstrates that TB control measures are effective in reducing the spread and development of new cases. Though scientific evidence revealed negative attitudes towards the recommended TB control measures in public hospitals of the Vhembe district, a deeper understanding of these attitudes is needed to remedy the situation. This study aimed to describe healthcare workers' perceptions of TB control measures at Collins Chabane Municipality in South Africa. A qualitative, exploratory case study design was adopted. Multi-stage sampling technique was used to select both the healthcare facilities and the participants. Only 24 healthcare workers trained on tuberculosis management were voluntarily recruited. However, data were saturated at the twelfth (12) participant purposively selected from six healthcare facilities of Collins Chabane Municipality. Data collected through unstructured in-depth individual interviews were analyzed thematically. The proposal for this study was ethically cleared by the University of Venda Ethics Committee (SHS/20/PDC/35/1111). Results indicate that TB administrative, environmental and respiratory control measures are well understood by health workers even though there are challenges with implementation concerning some, such as closing windows during winter, UVGI lights that are non-functional and taking too long to be fixed, no specimen collection during weekends and holidays thereby delaying TB diagnosis and lack of skills concerning how to use respirators and cough etiquette. The Vhembe district TB control programme should intensify infection control training and continue monitoring giving the needed support.
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Affiliation(s)
- Debra Madzinga
- Department of Public Health, University of Venda, Thohoyandou 0950, South Africa
| | | | | | - Lufuno Razwiedani
- Department of Public Health Medicine, Sefako Mkgatho Health Sciences University, Ga-Rankuwa 0221, South Africa
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Zhang H, Liu M, Fan W, Sun S, Fan X. The impact of Mycobacterium tuberculosis complex in the environment on one health approach. Front Public Health 2022; 10:994745. [PMID: 36159313 PMCID: PMC9489838 DOI: 10.3389/fpubh.2022.994745] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/18/2022] [Indexed: 01/26/2023] Open
Abstract
Tuberculosis caused by the Mycobacterium tuberculosis complex (MTBC) has become one of the leading causes of death in humans and animals. Current research suggests that the transmission of MTBC in the environment indirectly transmit to humans and animals with subsequent impact on their wellbeing. Therefore, it is of great significance to take One Health approach for understanding the role of MTBC in not only the interfaces of humans and animals, but also environment, including soil, water, pasture, air, and dust, etc., in response to the MTBC infection. In this review, we present the evidence of MTBC transmission from environment, as well as detection and control strategies in this interface, seeking to provide academic leads for the global goal of End Tuberculosis Strategy under multidisciplinary and multisectoral collaborations.
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Abugu LI, Iwuagwu TE, Seer-Uke EN, Yohanna W, Obi IR, Eze DN, Onuorah SI. Tuberculosis infection control in health care facilities in Enugu State, Nigeria: a cross-sectional facility-based study. Pan Afr Med J 2022; 41:181. [PMID: 35655688 PMCID: PMC9120735 DOI: 10.11604/pamj.2022.41.181.30114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 02/17/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction overtime, tuberculosis (TB) has remained the most common opportunistic infection among people living with HIV (PLHIV). Proper implementation of TB infection control (TBIC) practices in health care facilities can curb TB menace among PLHIV and the public. We assessed the implementation of TB infection control in health care facilities offering Anti-Retroviral Therapy (ART) in Enugu State, Nigeria. Methods we employed a cross-sectional research design and assessed TB infection control practices in nine State owned public health care facilities offering antiretroviral therapy (ART) services for PLHIV. A 23 item World Health Organization (WHO) checklist for infection control in health care facilities was used to collect data. We assessed the five minimum standards as well as the four sets of TB infection control (TBIC) measures. Frequencies, percentages and chi square statistic were used to analyze data. Results only four (44%) health care facilities that provides ART services studied in Enugu State implemented TBIC practices. Higher proportion of the rural and secondary facilities implemented TBIC although the difference is not statistically significant (p>0.05). Implementation was better with the administrative controls while the personal protective equipment was almost non-existent. Conclusion less than half of the facilities offering ART services in the Enugu State have TB infection control measures. We therefore recommend that in order to reduce TB infection among PLHIV, the issue of proper TBIC in health care facilities need urgent attention. Materials provision, staff training and retraining are issues that must be tackled to achieve the aim of reduction of TB infection among PLHIV, health care workers and the public.
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Affiliation(s)
- Lawreta Ijeoma Abugu
- Department of Human Kinetics and Health Education, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Tochi Emmanuel Iwuagwu
- Department of Human Kinetics and Health Education, University of Nigeria Nsukka, Nsukka, Nigeria
| | | | - Wamanyi Yohanna
- Department of Human Kinetics and Health Education, University of Nigeria Nsukka, Nsukka, Nigeria
- Adamawa State Primary Healthcare Agency, Adamawa, Nigeria
| | - Ifunanya Rosemary Obi
- Department of Human Kinetics and Health Education, University of Nigeria Nsukka, Nsukka, Nigeria
- Federal College of Education (Technical) Umunze, Anambra State, Nigeria
| | - Dorothy Nwakaego Eze
- Department of Human Kinetics and Health Education, University of Nigeria Nsukka, Nsukka, Nigeria
- Nsukka Health Centre, Nsukka, Enugu State, Nigeria
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Raut AW, Meshram PV, Raut RA. Coronavirus disease (COVID-19) transmission through aerosols in restorative and endodontic practice: Strategies for prevention. Ann Afr Med 2022; 21:1-7. [PMID: 35313397 PMCID: PMC9020625 DOI: 10.4103/aam.aam_67_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Rapid spread of coronavirus disease 2019 (COVID-19) in several countries of the world has created a state of public health emergency. COVID-19 is principally a respiratory disease, and the virus is present in respiratory secretions. Oral health-care professionals are susceptible to being infected with the disease since they work in close proximity to patient's face and oral cavity for long period of time. Restorative dentists and endodontists play a significant role in delivering "urgent" or "emergency" dental care to patients. Occupational Safety and Health Administration has categorized dentists performing aerosol-generating treatment procedures at "very high exposure risk" whereas the dentists not performing aerosol-generating procedures at "high exposure risk." Most of the restorative and endodontic treatment procedures involve generation of aerosols. Owing to the possibility of transmission of virus through aerosols, these procedures may transmit the disease to clinician or other patients. A comprehensive search of literature was conducted with the help of PubMed/MEDLINE and Scopus databases using a combination of terms, "COVID-19," "severe acute respiratory syndrome coronavirus 2," "aerosols," "restorative dentistry," and "endodontics." Along with universal precautions, some additional precautions need to be taken to prevent such transmission and cross-infection. This article reviews the research evidence about the role of aerosols in the transmission of COVID-19 and various measures which should be implemented during restorative and endodontic practice for the prevention of such transmission.
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Affiliation(s)
- Ambar W Raut
- Department of Conservative Dentistry and Endodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
| | - Priyatama V Meshram
- Department of Dentistry, Government Medical College and Hospital, Gondia, Maharashtra, India
| | - Radha A Raut
- Department of Oral Medicine and Radiology, Triveni Institute of Dental Sciences, Bilaspur, Chattisgarh, India
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Haque M, Mohd Izham M, A Rahman N. Knowledge, attitude and practices related to tuberculosis among students in a public university in East Coast Malaysia. ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/aihb.aihb_25_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Compliance of Healthcare Worker's toward Tuberculosis Preventive Measures in Workplace: A Systematic Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010864. [PMID: 34682604 PMCID: PMC8536031 DOI: 10.3390/ijerph182010864] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/30/2021] [Accepted: 10/13/2021] [Indexed: 11/17/2022]
Abstract
Despite several guidelines published by the World Health Organization (WHO) and national authorities, there is a general increase in the number of healthcare workers (HCWs) contracting tuberculosis. This review sought to evaluate the compliance of the HCWs toward tuberculosis preventive measures (TPMs) in their workplace. Both electronic databases and manual searches were conducted to retrieve articles regarding the compliance of HCWs in the workplace published from 2010 onwards. Independent reviewers extracted, reviewed, and analyzed the data using the mixed methods appraisal tool (MMAT) 2018, comprising 15 studies, 1572 HCWs, and 249 health facilities. The results showed there was low compliance toward TPMs in the workplace among HCWs and health facilities from mostly high-burden tuberculosis countries. The failure to comply with control measures against tuberculosis was mainly reported at administrative levels, followed by engineering and personnel protective control measures. In addition, low managerial support and negative attitudes of the HCWs influenced the compliance. Further studies are needed to elucidate how to improve the compliance of HCWs toward the preventive measures against tuberculosis in order to reduce the disease burden among HCWs worldwide.
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Occupational Health and Safety Measures in Healthcare Settings during COVID-19: Strategies for Protecting Staff, Patients and Visitors. Disaster Med Public Health Prep 2021; 17:e48. [PMID: 34517932 PMCID: PMC8523969 DOI: 10.1017/dmp.2021.294] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The COVID-19 (SARS-CoV-2) pandemic has profoundly impacted almost every aspect of healthcare systems worldwide, placing the health and safety of frontline healthcare workers at risk, and it still continues to remain an important public health challenge. Several hospitals have put in place strategies to manage space, staff, and supplies in order to continue to deliver optimum care to patients while at the same time protecting the health and safety of staff and patients. However, the emergence of the second and third waves of the virus with the influx of new cases continue to add an additional level of complexity to the already challenging situation of containing the spread and lowering the rate of transmission, thus pushing healthcare systems to the limit. In this narrative review paper, we describe various strategies including administrative controls, environmental controls, and use of personal protective equipment, implemented by occupational health and safety departments for the protection of healthcare workers, patients, and visitors from SARS-CoV-2 virus infection. The protection and safeguard of the health and safety of healthcare workers and patients through the implementation of effective infection control measures, adequate management of possible outbreaks and minimization of the risk of nosocomial transmission is an important and effective strategy of SARS-CoV-2 pandemic management in any healthcare facility. High quality patient care hinges on ensuring that the care providers are well protected and supported so they can provide the best quality of care to their patients.
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Lin BK, Munter B, Pascavis K, Nakaji P, Nicolasora N. Use of Industrial Filters by Health Care Workers During Shortages of N95 Respirators in Pandemic Times. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2021; 29:e278-e281. [PMID: 34539161 PMCID: PMC8436814 DOI: 10.1097/ipc.0000000000001059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to a significant shortage of personal protective equipment in multiple health care facilities around the world, with the highest impact on N95 respirator masks. The N95 respirator is a mask that blocks at least 95% of very small (0.3 μm) particles and is considered a standard for enhanced respiratory precautions. The N95 mask shortage has created a need for other options for nasal and oral respiratory protection with similar filtration efficiency and "medical-grade" clearance, which can be used in health care settings. However, the literature around various filter types, their filtration capabilities, and the organizations certifying their use is dense, confusing, and not easily accessible to the public. Here, we synthesize relevant literature to analyze and disseminate information on (1) alternative viable filter options to N95s, (2) the National Institute for Occupational Safety and Health certification process, (3) the relationship of National Institute for Occupational Safety and Health certification to Food and Drug Administration certification of filtration devices and surgical masks, and (4) how this relationship may affect future filtration usage in the medical community during a pandemic. Analysis of these standards is meant to inform regarding evidence of respirator efficacy but does not imply any official endorsement of these alternatives. With this article, we illuminate viable alternative respirator options during the COVID-19 pandemic to help alleviate the dependency on N95 face masks.
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Affiliation(s)
- Belle K. Lin
- From the University of Arizona College of Medicine—Phoenix, Phoenix
| | - Bryce Munter
- From the University of Arizona College of Medicine—Phoenix, Phoenix
| | - Katie Pascavis
- The Luminosity Lab, Knowledge Enterprise, Arizona State University, Tempe
| | - Peter Nakaji
- Department of Neurosurgery, Banner University Medical Center
| | - Nelson Nicolasora
- Department of Infectious Disease, Banner University Medical Center, Phoenix, AZ
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Davies CG, Reilly K, Altermann E, Hendrickson HL. PLAN-M; Mycobacteriophage Endolysins Fused to Biodegradable Nanobeads Mitigate Mycobacterial Growth in Liquid and on Surfaces. Front Microbiol 2021; 12:562748. [PMID: 33981289 DOI: 10.3389/fmicb.2021.562748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 04/01/2021] [Indexed: 11/13/2022] Open
Abstract
The Mycobacteria are a genus of Actinobacteria that include human pathogens such as Mycobacterium tuberculosis (TB). Active TB disease can spread by airborne transmission to healthcare workers and to their community. The HHMI SEA-PHAGES program has contributed to discovering bacteriophages that are able to infect M. smegmatis MC2 155, a close relative of M. tuberculosis. This collection of diverse Mycobacteriophages is an excellent resource for trialling bacteriophage-sourced enzymes in novel applications. Herein we measured the ability Mycobacteriophage endolysins to lyse their host strain when functionally fused to biodegradable polyhydroxyalkanoate (PHA) nanobeads. PHA nanobeads facilitate both the expression and the application of enzymes to surfaces and have been demonstrated to stabilize a wide array of proteins for practical applications whilst eliminating the challenges of traditional protein purification. We selected two Lysin A and six Lysin B homologs to be functionally fused to the polyhydroxyalkanoate synthase C (PhaC). Expression of these constructs resulted in functional lysins displayed on the surface of PHA nanobeads. The lysins thus directionally displayed on nanobeads lysed up to 79% of the M. smegmatis MC2 155 population using 80 mg/mL of nanobeads in pure culture. In order to determine whether the nanobeads would be effective as a protective layer in PPE we adapted a fabric-based test and observed a maximum of 1 log loss of the cell population after 5 h of exposure on a textile (91% cell lysis). Lysin B enzymes performed better than the Lysin A enzymes as a protective barrier on textiles surface assays. These results suggest that bacterial endolysins are efficient in their action when displayed on PHA nanobeads and can cause significant population mortality in as little as 45 min. Our results provide the proof-of-principle that Mycobacteriophage endolysins can be used on functionalized nanobeads where they can protect surfaces such as personal protective equipment (PPE) that routinely come into contact with aerosolised bacteria.
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Affiliation(s)
- Courtney G Davies
- Massey Phage Whānau, School of Natural and Computational Sciences, Massey University, Auckland, New Zealand
| | | | - Eric Altermann
- AgResearch Ltd., Palmerston North, New Zealand.,Riddet Institute, Massey University, Palmerston North, New Zealand
| | - Heather L Hendrickson
- Massey Phage Whānau, School of Natural and Computational Sciences, Massey University, Auckland, New Zealand.,Infectious Disease Research Centre, Massey University, Palmerston North, New Zealand
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15
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Sirinapakul P, Chaiear N, Krisorn P. Validity and Reliability of Self-Assessment Tool for Risk Prioritization Following Exposure to Tuberculosis in a Hospital Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083981. [PMID: 33918945 PMCID: PMC8070430 DOI: 10.3390/ijerph18083981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/26/2021] [Accepted: 04/06/2021] [Indexed: 11/25/2022]
Abstract
The Modified Self-Assessment (MSA) and Present Self-Assessment (PSA) forms are questionnaires used to prioritize the risk of infection of health workers exposed to tuberculosis (TB) in Srinagarind Hospital in Thailand. As MSA was developed from PSA, the validity and reliability of MSA need to be assessed. The research aim is to examine the content validity of MSA and to assess the respective reliability of MSA and PSA vis-à-vis expert opinion. Seven experts determined the content validity index (CVI) of MSA. MSA and PSA were used to prioritize the TB contact of 108 subjects, and we compared the result with the risk assessed by the experts. The respective Kappa agreements between MSA and PSA and the experts were used to assess reliability. The result of the content validity index revealed that MSA had I-CVI > 0.83 for all questions and an S-CVI/Ave above 0.90 for all factors. The Kappa agreement of contact priority between MSA and the experts was 0.80; it was 0.58 between PSA and the experts. MSA can, thus, be used to prioritize contact with tuberculosis in Srinagarind Hospital. MSA is a valid risk communication tool for aerosol-generating procedures. Further study should be conducted in other hospitals, and the number of participants should be increased in order to come to a concrete result.
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Affiliation(s)
- Piyapong Sirinapakul
- Division of Occupational Medicine, Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (P.S.); (P.K.)
| | - Naesinee Chaiear
- Division of Occupational Medicine, Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (P.S.); (P.K.)
- Occupational Health and Safety Office, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- Correspondence: ; Tel.: +66-4336-3588
| | - Phanumas Krisorn
- Division of Occupational Medicine, Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (P.S.); (P.K.)
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16
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Ul Haq E, Liaqat A, Nadeem M, Ahmad S, Bari MA, Riaz N, Hameed T. Do Dentists Have Awareness of COVID-19 and Are They Ready for Safe Practice? Asia Pac J Public Health 2021; 33:465-466. [PMID: 33736478 DOI: 10.1177/10105395211001703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ehsan Ul Haq
- King Edward Medical University/Mayo Hospital, Lahore, Pakistan
| | | | | | | | - M Ahmad Bari
- Liaqat College of Medicine and Dentistry, Karachi, Pakistan
| | - Nabeela Riaz
- King Edward Medical University/Mayo Hospital, Lahore, Pakistan
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17
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Lee DF, Stewart GR, Chambers MA. Modelling early events in Mycobacterium bovis infection using a co-culture model of the bovine alveolus. Sci Rep 2020; 10:18495. [PMID: 33116165 PMCID: PMC7595104 DOI: 10.1038/s41598-020-75113-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/21/2020] [Indexed: 01/01/2023] Open
Abstract
Bovine tuberculosis (bTB), a zoonosis mainly caused by Mycobacterium bovis has severe socio-economic consequences and impact on animal health. Host-pathogen interactions during M. bovis infection are poorly understood, especially early events which are difficult to follow in vivo. This study describes the utilisation of an in vitro co-culture model, comprising immortalised bovine alveolar type II (BATII) epithelial cells and bovine pulmonary arterial endothelial cells (BPAECs). When cultured at air-liquid interface, it was possible to follow the migration of live M. bovis Bacille Calmette-Guérin (BCG) and to observe interactions with each cell type, alongside cytokine release. Infection with BCG was shown to exert a detrimental effect primarily upon epithelial cells, with corresponding increases in IL8, TNFα, IL22 and IL17a cytokine release, quantified by ELISA. BCG infection increased expression of CD54, MHC Class I and II molecules in endothelial but not epithelial cells, which exhibited constitutive expression. The effect of peripheral blood mononuclear cell conditioned medium from vaccinated cattle upon apical-basolateral migration of BCG was examined by quantifying recovered BCG from the apical, membrane and basolateral fractions over time. The numbers of recovered BCG in each fraction were unaffected by the presence of PBMC conditioned medium, with no observable differences between vaccinated and naïve animals.
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Affiliation(s)
- Diane Frances Lee
- School of Veterinary Medicine, University of Surrey, Guildford, Surrey, UK.
| | | | - Mark Andrew Chambers
- School of Veterinary Medicine, University of Surrey, Guildford, Surrey, UK
- School of Biosciences and Medicine, University of Surrey, Guildford, Surrey, UK
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18
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Al Kawas S, Al-Rawi N, Talaat W, Hamdoon Z, Salman B, Al Bayatti S, Jerjes W, Samsudin ABR. Post COVID-19 lockdown: measures and practices for dental institutes. BMC Oral Health 2020; 20:291. [PMID: 33109185 PMCID: PMC7590562 DOI: 10.1186/s12903-020-01281-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/12/2020] [Indexed: 12/30/2022] Open
Abstract
Resuming regular clinical activities at dental premises after the COVID-19 lockdown period or post COVID-19 is likely to be a challenge for all dental institutes. When returning to the dental practice or training, staff and students alike should abide by the new rules and regulations. In the process of controlling viral spread, clinical dental facilities face a higher risk of disease transmission among patients as well as clinical and non-clinical staff. Aerosols formation and diffusion into the surrounding air can be a real concern of viral transmission, if no protective measures are established. We aim in this review to present the currently implemented measures and propose changes in clinical dental facilities to minimize the risk of transmission. Dental professionals should be prepared to treat every patient as a suspected COVID-19 carrier and be ready to receive and manage an overwhelming number of patients. We suggest that dental practices establish a sensible workforce shift schedule, improve ventilation levels, reduce dental aerosol generating procedures, and develop a comprehensive guidance to Healthcare Workers to reduce the risk of COVID-19 transmission.
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Affiliation(s)
- Sausan Al Kawas
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine and University Dental Hospital Sharjah, University of Sharjah, P.O. Box 27272, Sharjah, UAE. .,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.
| | - Natheer Al-Rawi
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine and University Dental Hospital Sharjah, University of Sharjah, P.O. Box 27272, Sharjah, UAE.,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Wael Talaat
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine and University Dental Hospital Sharjah, University of Sharjah, P.O. Box 27272, Sharjah, UAE.,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.,Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Suez Canal University, Ismaillia, 41522, Egypt
| | - Zaid Hamdoon
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine and University Dental Hospital Sharjah, University of Sharjah, P.O. Box 27272, Sharjah, UAE.,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Basheer Salman
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine and University Dental Hospital Sharjah, University of Sharjah, P.O. Box 27272, Sharjah, UAE.,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Saad Al Bayatti
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine and University Dental Hospital Sharjah, University of Sharjah, P.O. Box 27272, Sharjah, UAE.,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Waseem Jerjes
- North End Medical Centre, Hammersmith and Fulham Partnership, National Health Service, London, W14 9PR, UK
| | - A B Rani Samsudin
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine and University Dental Hospital Sharjah, University of Sharjah, P.O. Box 27272, Sharjah, UAE.,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
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19
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Xie Y, McNeil E, Fan Y, Chongsuvivatwong V, Zhao X, Sriplung H. Quality of Respiratory Infection Disease Prevention in Outpatient and Emergency Departments in Hospitals in Inner Mongolia, China: An Exit Poll Survey. Risk Manag Healthc Policy 2020; 13:501-508. [PMID: 32581612 PMCID: PMC7276319 DOI: 10.2147/rmhp.s248772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/21/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Measures to prevent respiratory infection diseases (RIDs) in hospitals are important to protect both patients and physicians. In 2003, an outbreak of severe acute respiratory syndrome occurred in Inner Mongolia Autonomous Region (IMAR) of China. We aimed to evaluate competency in RID prevention procedures in terms of hospital performance and physician behavior. Patients and Methods We conducted a cross-sectional study in 10 tertiary general public hospitals in 3 cities of IMAR. In each hospital, we chose the respiratory and ear–nose–throat outpatient departments (OPDs) and the emergency department (ED) to invite patients with symptoms of cough to join the study before they consulted a physician. After their consultation, we asked the patients to complete a checklist to score the performance of the departments and the behavior of their physicians in terms of RID prevention practices according to international professional guidelines. Results From 711 respondents, in the domain of hospital performance, display of posters on directive to wash hands after coughing/sneezing had an average score of 0.452 (range 0–1), while other cough etiquette items had scores averaging between 0.33 and 0.39. The average score for air ventilation was 0.66. For physicians’ performance, informing patients the location of handwashing facilities scored the highest (0.62), while low scores were seen for offering a mask to coughing patients (0.14) and encouraging coughing patients to distance themselves from others (0.17). Most RID prevention procedures received low scores in EDs in both hospital performance and physician behavior domains. Conclusion Hospitals in IMAR should improve their performance in RID prevention procedures, especially in giving information to RID patients through the display of posters. The practice of physicians in preventing respiratory infection spread was suboptimum. ED staff and hospital administrators should improve their procedures to prevent the spread of respiratory infections, especially given the increasing occurrences of global pandemics such as COVID-19.
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Affiliation(s)
- Yijing Xie
- Health Management Faculty and Research Institute for Health Policy of Inner Mongolia, Inner Mongolia Medical University, Hohhot, Inner Mongolia, People's Republic of China.,Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Edward McNeil
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Yancun Fan
- Health Management Faculty and Research Institute for Health Policy of Inner Mongolia, Inner Mongolia Medical University, Hohhot, Inner Mongolia, People's Republic of China
| | | | - Xingsheng Zhao
- Inner Mongolia People's Hospital, Hohhot, Inner Mongolia, People's Republic of China
| | - Hutcha Sriplung
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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20
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Saran S, Gurjar M, Baronia A, Sivapurapu V, Ghosh PS, Raju GM, Maurya I. Heating, ventilation and air conditioning (HVAC) in intensive care unit. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2020; 24:194. [PMID: 32375844 PMCID: PMC7201115 DOI: 10.1186/s13054-020-02907-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/17/2020] [Indexed: 02/08/2023]
Abstract
The aim of this review is to describe variation in standards and guidelines on ‘heating, ventilation and air-conditioning (HVAC)’ system maintenance in the intensive care units, across the world, which is required to maintain good ‘indoor air quality’ as an important non-pharmacological strategy in preventing hospital-acquired infections. An online search and review of standards and guidelines published by various societies including American Institute of Architects (AIA), American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), Centers for Disease Control and Prevention (CDC), Department of Health Estates and Facilities Division, Health Technical Memorandum 2025 (HTM) and Healthcare Infection Control Practices Advisory Committee (HICPAC) along with various national expert committee consensus statements, regional and hospital-based protocols available in a public domain were retrieved. Selected publications and textbooks describing HVAC structural aspects were also reviewed, and we described the basic structural details of HVAC system as well as variations in the practised standards of HVAC system in the ICU, worldwide. In summary, there is a need of universal standards for HVAC system with a specific mention on the type of ICU, which should be incorporated into existing infection control practice guidelines.
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Affiliation(s)
- Sai Saran
- Department of Critical Care Medicine, Super Speciality Cancer Institute and Hospital, Lucknow, Uttar Pradesh, 226002, India
| | - Mohan Gurjar
- Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh, 226014, India.
| | - Arvind Baronia
- Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh, 226014, India
| | - Vijayalakshmi Sivapurapu
- Department of Anaesthesiology, Indira Gandhi Medical College and Research Institute, Puducherry, 605 006, India
| | - Pralay S Ghosh
- Department of Critical Care Medicine, Tata Medical Centre, Kolkata, West Bengal, 700156, India
| | - Gautham M Raju
- Department of Critical Care Medicine, Manipal Hospitals, Benguluru, Karnataka, 560017, India
| | - Indubala Maurya
- Department of Anesthesiology, Super Speciality Cancer Institute and Hospital, Lucknow, Uttar Pradesh, 226002, India
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21
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Infection prevention in general medical wards: A call to action. Afr J Thorac Crit Care Med 2019; 25. [PMID: 34286264 PMCID: PMC8278849 DOI: 10.7196/ajtccm.2019.v25i4.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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22
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Rivera-Izquierdo M, Martín-Romero D, Massó-Guijarro P. Tuberculosis respiratoria: repercusión del retraso diagnóstico sobre la salud laboral. Semergen 2019; 45:e45-e46. [DOI: 10.1016/j.semerg.2019.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/12/2019] [Indexed: 10/26/2022]
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23
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Muñoz Sánchez AI, Antolinez Figueroa C. Medidas de protección respiratoria de tuberculosis en personal de salud: revisión integrativa. AVANCES EN ENFERMERÍA 2019. [DOI: 10.15446/av.enferm.v37n3.77318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción: los trabajadores de la salud (TS) son vulnerables a la infección por tuberculosis. Se suma el desconocimiento de los TS de las medidas de protección respiratoria que puede aumentar el riesgo individual de adquirir tuberculosis en instituciones de salud. Objetivo: describir la producción de literatura científica en las bases de datos científicas sobre las medidas de protección respiratoria de la infección tuberculosa durante el periodo 2012-2018. Síntesis de contenido: revisión integrativa a través de: formulación de la pregunta de investigación, recolección de datos, evaluación, análisis e interpretación de datos y presentación de los resultados. 45 artículos cumplieron con los criterios de inclusión. Las características predominantes de los estudios fueron: año 2017 con mayor número de publicaciones, en el continente de África, la metodología de estudio cuantitativo cuasiexperimental. En los estudios se identificaron las características del respirador N95 y la mascarilla quirúrgica, los conocimientos, actitudes y prácticas de las medidas de protección respiratoria y programas educativos. Conclusiones: se evidenció que el respirador N95 es la medida de protección individual más eficiente para el control de la infección tuberculosa en los TS. También se identificó la necesidad del diseño de programas educativos sobre las medidas de protección de la infección tuberculosa.
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24
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Lee S, Ryu JY, Kim DH. Pre-immigration Screening for Tuberculosis in South Korea: A Comparison of Smear- and Culture-Based Protocols. Tuberc Respir Dis (Seoul) 2018; 82:151-157. [PMID: 30302957 PMCID: PMC6435930 DOI: 10.4046/trd.2018.0009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/05/2018] [Accepted: 07/02/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) is the most important disease screened for upon patient history review during preimmigration medical examinations as performed in South Korea in prospective immigrants to certain Western countries. In 2007, the U.S. Centers for Disease Control and Prevention (CDC) changed the TB screening protocol from a smear-based test to the complete Culture and Directly Observed Therapy Tuberculosis Technical Instructions (CDOT TB TI) for reducing the incidence of TB in foreign-born immigrants. METHODS This study evaluated the effect of the revised (as compared with the old) protocol in South Korea. RESULTS Of the 40,558 visa applicants, 365 exhibited chest radiographic results suggestive of active or inactive TB, and 351 underwent sputum tests (acid-fast bacilli smear and Mycobacterium tuberculosis culture). To this end, using the CDOT TB TI, 36 subjects (88.8 per 10⁵ of the population) were found to have TB, compared with only seven using the older U.S. CDC technical instruction (TI) (p<0.001). In addition, there were six drug-resistant cases which were identified (16.7 per 10⁵ of the population), two of whom had multidrug-resistance (5.6 per 10⁵ of the population). CONCLUSION The culture-based 2007 TI identified a great deal of TB cases current to the individuals tested, as compared to older U.S. CDC TI.
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Affiliation(s)
- Sangyoon Lee
- Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Korea
| | - Ji Young Ryu
- Department of Occupational and Environmental Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Dae Hwan Kim
- Department of Occupational and Environmental Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.
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25
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Park JS. The Prevalence and Risk Factors of Latent Tuberculosis Infection among Health Care Workers Working in a Tertiary Hospital in South Korea. Tuberc Respir Dis (Seoul) 2018; 81:274-280. [PMID: 30238715 PMCID: PMC6148103 DOI: 10.4046/trd.2018.0020] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/04/2018] [Accepted: 07/03/2018] [Indexed: 11/24/2022] Open
Abstract
Background The risk of tuberculosis (TB) infection among health care workers (HCWs) is higher than as noted among workers in the general population. The prevalence and risk factors of TB infection among HCWs were assessed in a tertiary hospital in South Korea, resulting in a conclusion of an intermediate TB burden within the country. Methods This cross-sectional study enrolled HCWs who underwent a QuantiFERON-TB Gold In-Tube (QFT-GIT) test to detect the presence of a latent TB infection (LTBI), in patients admitted to a tertiary hospital in South Korea in 2017. The departments of the hospital were divided into TB-related and TB-unrelated departments, which were based on the risk of exposure to TB patients. In this sense, the risk factors for LTBI, including current working in the TB-related departments, were analyzed. Results In this case, a total of 499 HCWs (54 doctors, 365 nurses and 80 paramedical personnel) were enrolled in this study. The median age of the subjects was 31 years (range, 20–67 years), 428 (85.8%) were female, and 208 (41.7%) were working in the TB-related departments. The prevalence of LTBI was 15.8% based on the QFT-GIT. Additionally, the prevalence of experience of exposure to pre-treatment TB patents was higher among HCWs working in the TB-related departments, than among HCWs working in the TB-unrelated departments (78.8% vs. 61.9%, p<0.001). However, there was no significant difference in the prevalence of LTBI between the two groups (17.3% vs. 14.8%, p=0.458). On a review of the multivariate analysis, only the factor of age was independently associated with an increased risk of LTBI (p=0.006). Conclusion Broadly speaking, the factor of age was associated with an increased risk of LTBI among the HCWs in South Korea. However, those workers current working in the TB-related departments was not associated with an increased risk of LTBI.
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Affiliation(s)
- Jae Seuk Park
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
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26
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Bonini S, Riccelli MG, Goldoni M, Selis L, Corradi M. Risk factors for latent tuberculosis infection (LTBI) in health profession's students of the University of Parma. ACTA BIO-MEDICA : ATENEI PARMENSIS 2017; 88:54-60. [PMID: 28327495 PMCID: PMC10548070 DOI: 10.23750/abm.v88i1 -s.6156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 02/23/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Nowadays Tuberculosis (TB) is one of the major Public Health problems for several professional categories. According to Italian law, University students are compared to workers: the main risk for them is represented by biological risk, in particular by blood-transmitted or by air-transmitted agents. As for TB, many scientific studies demonstrated that prevalence of latent tuberculosis infection (LTBI) in Medicine and Surgery students was lower than those in health workers and in general population. The main aim of this study is the evaluation both of reliability and predictive value of a specific anamnestic questionnaire for previous exposure to Mycobacterium tuberculosis, in order to identify individuals at risk for TB. The Mantoux Tuberculin Skin Test (TST) would be executed to compare results of questionnaire. METHODS The study included Health Profession's Degrees who were examinated during health surveillance in the period between June 2014 and March 2016. A questionnaire including 10 closed questions was presented to every student. The questionnaire was considerated positive with at least one positive answer. RESULTS The questionnaire was presented to 580 students, 500 of which completed TST; 466 students were Italian (93.2%). Questionnaire resulted positive in 89 students (17.8%); 15 of them presented positive TST: 14 of them was strangers (93.3%). Sensibility and specificity of questionnaire resulted 100% and 84% respectively. CONCLUSIONS Our data suggested that anamnestic questionnaire could be considerated an efficient mean for identifying candidates for tuberculin screening in a TB- low prevalence population.
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