Factors related to quality of life of people living with HIV in Alicante, Spain. / Factores relacionados con la calidad de vida en personas que viven con el VIH en Alicante, España.

PURPOSE: To analyze the determinants that influence the health-related quality of life of people living with HIV in Alicante (Spain). METHODS: A cross-sectional study was conducted, which recruited 214 Spanish-speaking participants over 18 years of age living with HIV from an outpatient consulting office of the infectious diseases in a hospital in Alicante between 2013 and 2014. A self-administration sociodemographic survey and the Short Form Health Survey (SF-36v2) was used to assess health-related quality of life. This questionnaire measures health on 8domains. RESULTS: 70% of the participants were male, 50% had CD4 cell count between 200-499 cells/mm3 and 20% were infected by the hepatitis C virus (HCV). For the 8SF-36v2 scales, the average scores were higher than 45. Men presented better scores than women; there were statistically significant differences in all the scales except for general health. Being co-infected with HCV and being unemployed or other situations other than having a job were significantly associated with a lower physical component summary, while being married or having a partner were significantly associated with a higher score in the mental component summary. CONCLUSION: The socioeconomic level and the presence of clinical factors such as HCV influence the scales of quality of life of physical health among adults living with HIV.

Conocimientos y aptitudes del personal sanitario frente a sospecha de caso de enfermedad por el virus del Ébola / Knowledge and attitudes of healthcare workers towards a suspect case of Ebola virus disease

Introducción. El último brote de la enfermedad por el virus del Ébola, constituyó un precedente a la hora de evidenciar la necesaria formación del personal sanitario para posibles eventualidades de casos sospechosos de enfermedades contagiosas. Se precisa estudiar el nivel de cualificación del personal sanitario ante dichas situaciones. Material y métodos. Estudio descriptivo mediante encuesta post-taller al personal sanitario de un departamento de salud de la Comunidad Valenciana sobre los conocimientos y aptitudes adquiridos tras la formación. Resultados y conclusiones. El personal sanitario obtuvo una calificación global de aprobado en la encuesta post-taller, pero con diferencias en cuanto a categorías profesionales y distintos bloques de la formación, cuyas calificaciones podrían ser consideradas como deficientes en algunos casos. Se debería revisar la formación del personal sanitario periódicamente y calibrar dicha formación a los recursos de los que se dispone para una correcta actuación (AU)

Introduction. The last outbreak of the Ebola virus disease, was a precedent to demonstrate the necessary training of healthcare personnel for possible eventualities of suspected cases of infectious diseases. It is required to study the level of qualification of healthcare workers in such situations. Methods. Descriptive study using post-workshop survey of healthcare workers in a Valencian Community health department on acquired knowledge and skills after training. Results and conclusions. Healthcare personnel received an overall passing score on the post-workshop survey, but with differences in occupational categories and different blocks of training. The ratings could be considered deficient in some cases. It should be reviewed periodically training health personnel and calibrate such training to the resources available for proper operation (AU)

[Knowledge and attitudes of healthcare workers towards a suspect case of Ebola virus disease]. / Conocimientos y aptitudes del personal sanitario frente a sospecha de caso de enfermedad por el virus del Ébola.

OBJECTIVE: The last outbreak of the Ebola virus disease, was a precedent to demonstrate the necessary training of healthcare personnel for possible eventualities of suspected cases of infectious diseases. It is required to study the level of qualification of healthcare workers in such situations. METHODS: Descriptive study using post-workshop survey of healthcare workers in a Valencian Community health department on acquired knowledge and skills after training. CONCLUSIONS: Healthcare personnel received an overall passing score on the post-workshop survey, but with differences in occupational categories and different blocks of training. The ratings could be considered deficient in some cases. It should be reviewed periodically training health personnel and calibrate such training to the resources available for proper operation.

Oportunidades perdidas de vacunación antineumocócica. ¿Se puede hacer algo más en prevención? / Missed Opportunities in Antipneumococcal Vaccination. Can Something More be Done for Prevention?

Introducción: La vacunación es la medida más efectiva para la prevención de la enfermedad neumocócica invasiva (ENI). Los pacientes con enfermedades predisponentes se podrían beneficiar de esta vacuna si se recomienda durante las visitas médicas. Objetivos: Describir los casos de ENI. Valorar los serotipos más frecuentes y evaluar oportunidades perdidas de vacunación. Métodos: Estudio descriptivo retrospectivo de la incidencia de ENI en Elche durante 5 años. Se ha revisado el estado vacunal y las visitas a atención especializada previas a la enfermedad. También se ha calculado la efectividad vacunal con vacuna antineumocócica 23 valente en nuestra población. Resultados: Desde 2007 a 2011 se han notificado 181 casos de ENI. Las formas clínica más frecuentes son neumonía y sepsis, con una tasa de mortalidad del 12%. El 80% de los serotipos causales son serotipos vacunales. Más de la mitad tenían alguno de los factores de riesgo que indican vacunación. Este porcentaje disminuye hasta el 6,2% en los menores de 65 años con algún factor de riesgo. Conclusiones: Tras 10 años de introducción de la vacuna en el calendario vacunal del adulto sigue siendo baja la cobertura vacunal de pacientes con factores de riesgo. En nuestro estudio, el 75% de los casos no están vacunados. Teniendo en cuenta la efectividad de la vacuna para la prevención de ENI, entre los pacientes que han sido atendidos en el hospital por el especialista previo a su ENI, se podrían haber prevenido en el mejor de los supuestos (85% de efectividad vacunal) 60 casos de ENI

Introduction: Vaccination is the most effective measure in the prevention of invasive pneumococcal disease (IPD). High-risk patients immunized during medical visits would benefit from the vaccine. Objectives: To describe the IPD cases. To assess the most prevalent causative serotypes and to evaluate the missed opportunities for vaccination. Methods: This is a descriptive retrospective study of the incidence of IPD cases in Elche during 5 years. It was reviewed the vaccination status and the visits to specialized care prior to disease. It was also calculated the vaccine effectiveness with the 23-valent pneumococcal vaccine in our population. Results: Between 2007 and 2011 were notified 181 of IPD, the most frequent medical conditions were pneumonia and sepsis, with a mortality rate of 12%. 80% of the causative serotypes are included in the vaccine. More than the half of the cases had at least one of the risk factor for indicating the vaccination. This percentage decreases by 6.2% in cases below 65 years of age with any risk factor. Conclusions: After 10 years of introducing the vaccine into the adult immunization schedule the coverage it is still low among the patients with risk factors. In our study, 75% of the cases were not vaccinated. Taking in count the vaccine effectiveness for preventing IPD, among the patients attended at the hospital by the specialist prior their IPD, it could have been prevented in the best assumption (85% vaccine effectiveness) 60 IPD cases

Missed opportunities in antipneumococcal vaccination. Can something more be done for prevention?

INTRODUCTION: Vaccination is the most effective measure in the prevention of invasive pneumococcal disease (IPD). High-risk patients immunized during medical visits would benefit from the vaccine. OBJECTIVES: To describe the IPD cases. To assess the most prevalent causative serotypes and to evaluate the missed opportunities for vaccination. METHODS: This is a descriptive retrospective study of the incidence of IPD cases in Elche during 5 years. It was reviewed the vaccination status and the visits to specialized care prior to disease. It was also calculated the vaccine effectiveness with the 23-valent pneumococcal vaccine in our population. RESULTS: Between 2007 and 2011 were notified 181 of IPD, the most frequent medical conditions were pneumonia and sepsis, with a mortality rate of 12%. 80% of the causative serotypes are included in the vaccine. More than the half of the cases had at least one of the risk factor for indicating the vaccination. This percentage decreases by 6.2% in cases below 65 years of age with any risk factor. CONCLUSIONS: After 10 years of introducing the vaccine into the adult immunization schedule the coverage it is still low among the patients with risk factors. In our study, 75% of the cases were not vaccinated. Taking in count the vaccine effectiveness for preventing IPD, among the patients attended at the hospital by the specialist prior their IPD, it could have been prevented in the best assumption (85% vaccine effectiveness) 60 IPD cases.

Exposición cutáneo-mucosa a sangre o material biológico en trabajadores sanitarios / Skin or mucous exposure to blood or biological materials in healthcare workers

Objetivo: analizar las exposiciones cutáneo-mucosas a sangre y material biológico en trabajadores sanitarios de la Comunidad Valenciana recogidas en un período de catorce años (1997-2010).Material y método: estudio descriptivo con componente transversal y longitudinal (1997-2010), en el ámbito que corresponde al Hospital General Universitario de Elche (Comunidad Valenciana). Se utilizó la información generada por el sistema de vigilancia epidemiológica EPINETAC, que recoge las exposiciones accidentales a sangre o material biológico y su seguimiento. También se recogieron variables de identificación, laborales, uso de dispositivos de protección, actuación tras exposición, situación vacunal frente al VHB del expuesto y estado serológico de la fuente. Los datos fueron recogidos mediante entrevista personal, revisión de expediente laboral e historia clínica de la fuente. Resultados: las declaraciones de exposiciones cutáneo-mucosa han ido aumentando con el paso de los años. Las enfermeras declararon el 44%,los médicos de plantilla un 17% y los auxiliares de Enfermería un 14%.El lugar de la exposición más habitual fue la habitación del paciente(34%). La sangre fue el fluido más frecuentemente implicado 76%.Conclusiones: la exposición cutáneo-mucosa en los sanitarios depende de muchas variables: características del paciente y trabajo a realizar, los protocolos y material de seguridad utilizado, la dotación y estructuras que se posean en el lugar de trabajo, pero también son muy importantes factores ligados al comportamiento humano y la organización en el trabajo. Estas exposiciones cutáneo-mucosas, aunque menos numerosas que las percutáneas, deben ser tenidas en cuenta a la hora de la prevención y gestión del riesgo (AU)

Objective: to analyze mucocutaneous exposures to blood and biological material in healthcare workers in the Valencian Community collected over a period of fourteen years (1997-2010).Material and methods: descriptive cross-sectional study with longitudinal component (1997-2010), in the catchment area corresponding to the Hospital General Universitario de Elche (Comunidad Valenciana).The information generated by the surveillance system EPINETAC was used, which includes accidental exposures to blood or biological material, and monitoring. Variables were also collected for identification, employment, use of protective devices, actions taken after exposure, vaccination status of the person exposed against HBV and serological status of the source. Data were collected through personal interview, review of employment records and medical history of the source. Results: confirmations of mucocutaneous exposures have been increasing over the years. Nursing reported 44%, staff physicians 17% and nursing assistants 14%. The place of exposure was most frequently the patient's room (34%). Blood was the most frequently involved fluid 76%.Conclusions: mucocutaneous exposure in health workers depends on many variables: patient characteristics and work to be done, protocols and safety gear used, the equipment and structures in the workplace, but also of outmost importance are factors associated to human behavior and organization at work. These mucocutaneous exposures, though less numerous than the percutaneous, must be taken into account in prevention and risk management planning (AU)