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Goldblatt D, Johnson M, Falup-Pecurariu O, Ivaskeviciene I, Spoulou V, Tamm E, Wagner M, Zar HJ, Bleotu L, Ivaskevicius R, Papadatou I, Jõgi P, Lischka J, Franckling-Smith Z, Isarova D, Grandjean L, Zavadska D. Cross-sectional prevalence of SARS-CoV-2 antibodies in healthcare workers in paediatric facilities in eight countries. J Hosp Infect 2021; 110:60-66. [PMID: 33422589 PMCID: PMC7836791 DOI: 10.1016/j.jhin.2020.12.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/24/2020] [Accepted: 12/26/2020] [Indexed: 12/11/2022]
Abstract
Background Healthcare workers (HCWs) have been disproportionately affected by coronavirus disease 2019 (COVID-19), which may be driven, in part, by nosocomial exposure. If HCW exposure is predominantly nosocomial, HCWs in paediatric facilities, where few patients are admitted with COVID-19, may lack antibodies to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and be at increased risk during the current resurgence. Aim To compare the seroprevalence of SARS-CoV-2 amongst HCWs in paediatric facilities in seven European countries and South Africa (N=8). Methods All categories of paediatric HCWs were invited to participate in the study, irrespective of previous symptoms. A single blood sample was taken and data about previous symptoms were documented. Serum was shipped to a central laboratory in London where SARS-CoV-2 immunoglobulin G was measured. Findings In total, 4114 HCWs were recruited between 1st May and mid-July 2020. The range of seroprevalence was 0–16.93%. The highest seroprevalence was found in London (16.93%), followed by Cape Town, South Africa (10.36%). There were no positive HCWs in the Austrian, Estonian and Latvian cohorts; 2/300 [0.66%, 95% confidence interval (CI) 0.18–2.4] HCWs tested positive in Lithuania; 1/124 (0.81%, 95% CI 0.14–4.3) HCWs tested positive in Romania; and 1/76 (1.3%, 95% CI 0.23–7.0) HCWs tested positive in Greece. Conclusion Overall seroprevalence amongst paediatric HCWs is similar to their national populations and linked to the national COVID-19 burden. Staff working in paediatric facilities in low-burden countries have very low seroprevalence rates and thus are likely to be susceptible to COVID-19. Their susceptibility to infection may affect their ability to provide care in the face of increasing cases of COVID-19, and this highlights the need for appropriate preventative strategies in paediatric healthcare settings.
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Affiliation(s)
- D Goldblatt
- Great Ormond Street Institute of Child Health, University College London, London, UK; Great Ormond Street Children's Hospital NHS Foundation Trust, London, UK.
| | - M Johnson
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - O Falup-Pecurariu
- Children's Clinic Hospital, Faculty of Medicine, Transilvania University, Brasov, Romania
| | - I Ivaskeviciene
- Paediatric Centre, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - V Spoulou
- 'Agia Sophia' Children's Hospital of Athens, Athens, Greece
| | - E Tamm
- Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - M Wagner
- Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Department of Paediatrics, Comprehensive Centre for Paediatrics, Medical University of Vienna, Vienna, Austria
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, and SA-MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - L Bleotu
- Children's Clinic Hospital, Faculty of Medicine, Transilvania University, Brasov, Romania
| | - R Ivaskevicius
- Paediatric Centre, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - I Papadatou
- Immunobiology and Vaccinology Research Laboratory, National and Kapodistrian University of Athens, Athens, Greece
| | - P Jõgi
- Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - J Lischka
- Clinical Division of Paediatric Pulmonology, Allergology and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre for Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Z Franckling-Smith
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, and SA-MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - D Isarova
- Children's Clinical University Hospital, Riga, Latvia
| | - L Grandjean
- Great Ormond Street Institute of Child Health, University College London, London, UK; Great Ormond Street Children's Hospital NHS Foundation Trust, London, UK
| | - D Zavadska
- Children's Clinical University Hospital, Riga, Latvia
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Handel A, Martinez L, Sekandi JN, Bellan SE, Zhu L, Chen C, Liu Q, Donkor S, Sutherland J, Hill PC, Gilman RH, Grandjean L, Whalen CC. Evidence for supercoughers in an analysis of six tuberculosis cohorts from China, Peru, The Gambia and Uganda. Int J Tuberc Lung Dis 2020; 23:1286-1292. [PMID: 31931913 DOI: 10.5588/ijtld.18.0819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: It is very difficult to observe tuberculosis (TB) transmission chains and thus, identify superspreaders. We investigate cough duration as a proxy measure of transmission to assess the presence of potential TB superspreaders.DESIGN: We analyzed six studies from China, Peru, The Gambia and Uganda, and determined the distribution of cough duration and compared it with several theoretical distributions. To determine factors associated with cough duration, we used linear regression and boosted regression trees to examine the predictive power of patient, clinical and environmental characteristics.RESULTS: We found within-study heterogeneity in cough duration and strong similarities across studies. Approximately 20% of patients contributed 50% of total cough days, and around 50% of patients contributed 80% of total cough days. The cough duration distribution suggested an initially increasing, and subsequently, decreasing hazard of diagnosis. While some of the exposure variables showed statistically significant associations with cough duration, none of them had a strong effect. Multivariate analyses of different model types did not produce a model that had good predictive power.CONCLUSION: We found consistent evidence for the presence of supercoughers, but no characteristics predictive of such individuals.
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Affiliation(s)
- A Handel
- Department of Epidemiology and Biostatistics, and Health Informatics Institute and Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - L Martinez
- Department of Epidemiology and Biostatistics, and Health Informatics Institute and Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - J N Sekandi
- Department of Epidemiology and Biostatistics, and Health Informatics Institute and Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - S E Bellan
- Department of Epidemiology and Biostatistics, and Health Informatics Institute and Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - L Zhu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, People's Republic of China
| | - C Chen
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, People's Republic of China
| | - Q Liu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, People's Republic of China
| | - S Donkor
- Vaccines and Immunity, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - J Sutherland
- Vaccines and Immunity, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - P C Hill
- Centre for International Health, School of Medicine, University of Otago, Dunedin, New Zealand
| | - R H Gilman
- Universidad Peruana Cayetano Heredia, Lima, Peru, Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, USA
| | - L Grandjean
- Universidad Peruana Cayetano Heredia, Lima, Peru, Wellcome Centre for Clinical Tropical Medicine, Imperial College London, London, Institute of Child Health, University College London, London, UK
| | - C C Whalen
- Department of Epidemiology and Biostatistics, and Health Informatics Institute and Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
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Lamande M, Grandjean L, Gonne E, Van Daele D, Collignon J, Polus M, Loly C, Vanderick J, Coucke P, Martinive P. PO-0801 Esophageal Cancer: One Organ, Two Histologies, One Treatment Strategy: Why? Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31221-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Grandjean L, Lamande M, Gonne E, Van Daele D, Collignon J, Polus M, Loly C, Seydel L, Vanderick J, Coucke P, Martinive P. EP-1450 How smoking status impacts patients undergoing radiochemotherapy for anal canal carcinoma? Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31870-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Grandjean L, Crossa A, Gilman RH, Herrera C, Bonilla C, Jave O, Cabrera JL, Martin L, Escombe AR, Moore DAJ. Tuberculosis in household contacts of multidrug-resistant tuberculosis patients. Int J Tuberc Lung Dis 2012; 15:1164-9, i. [PMID: 21943839 DOI: 10.5588/ijtld.11.0030] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING The burden of tuberculosis (TB) disease among household contacts of multidrug-resistant TB (MDR-TB) patients is poorly understood and might represent a target for transmission-interrupting interventions. DESIGN This retrospective cohort study, conducted in Lima, Peru, from June to September 2008, estimated the incidence of TB disease among household contacts of MDR-TB patients in 358 households. RESULTS Of 2112 household contacts in 80 households (22% of households), 108 (5%) developed TB disease during the study, giving an incidence rate of 2360 per 100 000 contact follow-up years for each of the first 3 years after exposure. Drug susceptibility tests (DST) were available for 50 diseased contacts, of whom 36 (80%) had MDR-TB. Forty-two pairs of index-contact DSTs were available, among which the contact had an identical or less resistant phenotype than the index case in 27 pairs. Multivariate Cox regression demonstrated that male contacts (hazard ratio [HR] 2.8, P < 0.05), with previous TB disease (HR 20.7, P < 0.001) and with associated (non-human immunodeficiency virus) comorbidities (HR 11.2, P < 0.001) were more likely to develop TB. CONCLUSION The high percentage of diseased household contacts highlights an opportunity for household-level interventions to prevent transmission, whether or not these cases were all attributable to the index case.
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Affiliation(s)
- L Grandjean
- The Wellcome Centre for Clinical Tropical Medicine, Imperial College, London, UK.
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