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1.
BMC Infect Dis ; 21(1): 260, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33711939

RESUMEN

BACKGROUND: Hand transmission of harmful microorganisms may lead to infections and poses a major threat to patients and healthcare workers in healthcare settings. The most effective countermeasure against these transmissions is the adherence to spatiotemporal hand hygiene policies, but adherence rates are relatively low and vary over space and time. The spatiotemporal effects on hand transmission and spread of these microorganisms for varying hand hygiene compliance levels are unknown. This study aims to (1) identify a healthcare worker occupancy group of potential super-spreaders and (2) quantify spatiotemporal effects on the hand transmission and spread of harmful microorganisms for varying levels of hand hygiene compliance caused by this group. METHODS: Spatiotemporal data were collected in a hospital ward of an academic hospital using radio frequency identification technology for 7 days. A potential super-spreader healthcare worker occupation group was identified using the frequency identification sensors' contact data. The effects of five probability distributions of hand hygiene compliance and three harmful microorganism transmission rates were simulated using a dynamic agent-based simulation model. The effects of initial simulation assumptions on the simulation results were quantified using five risk outcomes. RESULTS: Nurses, doctors and patients are together responsible for 81.13% of all contacts. Nurses made up 70.68% of all contacts, which is more than five times that of doctors (10.44%). This identifies nurses as the potential super-spreader healthcare worker occupation group. For initial simulation conditions of extreme lack of hand hygiene compliance (5%) and high transmission rates (5% per contact moment), a colonised nurse can transfer microbes to three of the 17 healthcare worker or patients encountered during the 98.4 min of visiting 23 rooms while colonised. The harmful microorganism transmission potential for nurses is higher during weeknights (5 pm - 7 am) and weekends as compared to weekdays (7 am - 5 pm). CONCLUSION: Spatiotemporal behaviour and social mixing patterns of healthcare can change the expected number of hand transmissions and spread of harmful microorganisms by super-spreaders in a closed healthcare setting. These insights can be used to evaluate spatiotemporal safety behaviours and develop infection prevention and control strategies.


Asunto(s)
Simulación por Computador , Infección Hospitalaria/transmisión , Personal de Salud , Análisis Espacio-Temporal , Infección Hospitalaria/prevención & control , Higiene de las Manos , Hospitales , Humanos , Enfermeras y Enfermeros , Dispositivo de Identificación por Radiofrecuencia , Riesgo
2.
Pan Afr Med J ; 38: 27, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33777295

RESUMEN

Introduction: long-distance truck drivers have been identified as a high-risk group for coronavirus disease (COVID-19) infection. Thus, the aim of this scoping review is to map out the existing evidence on the impact of long-distance truck drivers on the spread of COVID-19 and measures that countries can implement to mitigate this route of spread in the African region. Methods: we searched the PubMed database and the website of the World Health Organization (WHO) in March 2020 for eligible studies. Results: the search strategy identified 669 citations, of which six met the inclusion criteria. The most frequently reported interventions were maintaining hand hygiene, social distance, testing truck drivers, regulation of trade and transport e.g. only trucks with the food, medical supplies, fuels, agricultural supplies will be allowed to operate in interstate operations and regulating and controlling trucks carrying essential goods and services e.g. truck drivers are required to declare their final destination and are urged to stop only at designated points. Two studies from the African region reported about border closures and entry and exit screening, two studies from the US reported about the threat for public safety and risks and mitigation plans and 2 guidelines reported about harmonisation and facilitation of cross border in the context of the COVID-19 outbreak. Conclusion: this review highlights the countries response to mitigate the impact of the pandemic by implementing measures to facilitate safe cross-border trade and adopting regional harmonization of trucking regulations.


Asunto(s)
Conducción de Automóvil/estadística & datos numéricos , Exposición Profesional , África/epidemiología , Brotes de Enfermedades , Higiene de las Manos/normas , Humanos , Vehículos a Motor , Salud Laboral , Factores de Riesgo
3.
Artículo en Chino | MEDLINE | ID: mdl-33781034

RESUMEN

Objective: To explore the effect of failure mode and effect analysis (FMEA) in the management of nosocomial infection, and provide reference for the effective prevention and control of nosocomial infection. Methods: Using FMEA to identify, analyze, evaluate and screen out the high-risk events of nosocomial infection in January 2020, from which two hospital level priority improvement projects of hand hygiene compliance and blood-borne occupational exposure were determined. After risk control and intervention measures, the effects before and after improvement were compared. Results: Except for the lack of incentive mechanism and insufficient communication between medical and nursing teams, the differences in hand hygiene compliance and blood-borne occupational exposure risk priority coefficients before and after the implementation of FMEA were statistically significant (P<0.05) . After the implementation of FMEA, the hand hygiene compliance was 74.92% (79375/105953) , which was significantly higher than 68.40% (58361/85328) before the implementation of FMEA, and the difference was statistically significant (χ(2)=996.55, P<0.01) . The incidence of blood-borne occupational exposure after the implementation of FMEA was 3.85% (80/2080) , which was lower than the 6.16% (123/1998) before the implementation of FMEA, and the difference was statistically significant (χ(2)=11.49, P<0.01) . Conclusion: FMEA has a good effect in nosocomial infection management. It can identify and evaluate the risk of nosocomial infection prospectively, so as to control the risk effectively.


Asunto(s)
Infección Hospitalaria , Higiene de las Manos , Análisis de Modo y Efecto de Fallas en la Atención de la Salud , Infección Hospitalaria/prevención & control , Hospitales , Humanos
4.
Artículo en Español | PAHO-IRIS | ID: phr2-53339

RESUMEN

[EDITORIAL] “Andar la salud” es un boletín elaborado en la oficina de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS) en Cuba. Tiene como propósito fundamental compartir lo más relevante de la cooperación técnica de esta Representación con el Ministerio de Salud Pública (MINSAP) y otras instituciones en el país. Al cumplirse un año de comenzada la pandemia en Cuba, el boletín acoge una edición dedicada a sistematizar aspectos relevantes de la respuesta implementada en el territorio nacional a lo largo de estos meses. De manera especial, se incluye una entrevista realizada al Ministro de Salud Pública, Dr. José Ángel Portal Miranda, quien comenta sobre los hitos y el alcance que ha tenido el enfrentamiento al nuevo coronavirus en la isla. También pueden encontrarse artículos relacionados con la situación epidemiológica; el protocolo de tratamiento; el desarrollo de los candidatos vacunales cubanos; el trabajo realizado desde el Programa Materno Infantil y los aportes de los Centros Colaboradores de OPS/OMS en el país, entre otros temas.


Asunto(s)
Coronavirus , Liderazgo , Promoción de la Salud , Vacunación , Cobertura de Vacunación , Higiene de las Manos , Pandemias , Comunicación en Salud , Cooperación Internacional
5.
BMC Public Health ; 21(1): 426, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33648486

RESUMEN

BACKGROUND: During the first wave of the COVID-19 pandemic, social distancing and hand hygiene have been the primary means of reducing transmission in the absence of effective treatments or vaccines, but understanding of their determinants is limited. This study aimed to investigate knowledge and socio-cognitive perceptions, and their associations with such protective behaviours, in UK university students. METHODS: A cross-sectional online survey of 293 students was undertaken on 13 May 2020. Survey questions addressed demographics, knowledge of the disease and effectiveness of the protective measures, risk perception, socio-cognitive perceptions (e.g. attitude, social support, and self-efficacy), habit, time factors and trust, as well as the hand hygiene and social distancing behaviours. Multiple linear regression was used to identify the strongest associations of potential determinants with behaviour. RESULTS: Participants reported high levels of social distancing with 88.9% answering "Mostly" or "Always" for every activity, but only 42.0% reporting the same for all hand hygiene activities. Knowledge of the effectiveness of each activity in preventing transmission was high, with 90.7% and 93.5% respectively identifying at least 7 of 8 hand hygiene or 9 of 10 social distancing activities correctly. Habit (ß = 0.39, p = 0.001) and time factors (ß = 0.28, p = 0.001) were the greatest contributors to unique variance in hand hygiene behaviour, followed by ethnicity (ß = - 0.13, p = 0.014) and risk perception (ß = 0.13, p = 0.016). For social distancing behaviour, the determinants were self-efficacy (ß = 0.25, p < 0.001), perceived advantages (ß = 0.15, p = 0.022), trust in policy (ß = 0.14, p = 0.026) and gender (ß = - 0.14, p = 0.016). Regression models explained 40% hand hygiene and 25% social distancing variance. CONCLUSIONS: This study indicated that communications about effectiveness of hand hygiene and social distancing behaviours had been effective in terms of knowledge acquisition. However, in the light of likely second waves of COVID-19, attention to maintaining social distancing behaviour and improving hand hygiene behaviour may need to address more difficult areas of changing habits, overcoming time factors and building trust, as well as interventions to increase self-efficacy and address risk perception concerns.


Asunto(s)
/prevención & control , Higiene de las Manos/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios , Reino Unido , Universidades
6.
BMC Infect Dis ; 21(1): 234, 2021 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-33639873

RESUMEN

BACKGROUND: The goals of the National Action Plan on Antimicrobial Resistance (AMR) of Japan include "implementing appropriate infection prevention and control" and "appropriate use of antimicrobials," which are relevant to healthcare facilities. Specifically, linking efforts between existing infection control teams and antimicrobial stewardship programs was suggested to be important. Previous studies reported that human resources, such as full-time equivalents of infection control practitioners, were related to improvements in antimicrobial stewardship. METHODS: We posted questionnaires to all teaching hospitals (n = 1017) regarding hospital countermeasures against AMR and infections. To evaluate changes over time, surveys were conducted twice (1st survey: Nov 2016, 2nd survey: Feb 2018). A latent transition analysis (LTA) was performed to identify latent statuses, which refer to underlying subgroups of hospitals, and effects of the number of members in infection control teams per bed on being in the better statuses. RESULTS: The number of valid responses was 678 (response rate, 66.7%) for the 1st survey and 559 (55.0%) for the 2nd survey. More than 99% of participating hospitals had infection control teams, with differences in activity among hospitals. Roughly 70% had their own intervention criteria for antibiotics therapies, whereas only about 60 and 50% had criteria established for the use of anti-methicillin-resistant Staphylococcus aureus antibiotics and broad-spectrum antibiotics, respectively. Only 50 and 40% of hospitals conducted surveillance of catheter-associated urinary tract infections and ventilator-associated pneumonia, respectively. Less than 50% of hospitals used maximal barrier precautions for central line catheter insertion. The LTA identified five latent statuses. The membership probability of the most favorable status in the 2nd study period was slightly increased from the 1st study period (23.6 to 25.3%). However, the increase in the least favorable status was higher (26.3 to 31.8%). Results of the LTA did not support a relationship between increasing the number of infection control practitioners per bed, which is reportedly related to improvements in antimicrobial stewardship, and being in more favorable latent statuses. CONCLUSIONS: Our results suggest the need for more comprehensive antimicrobial stewardship programs and increased surveillance activities for healthcare-associated infections to improve antimicrobial stewardship and infection control in hospitals.


Asunto(s)
Antiinfecciosos/uso terapéutico , Programas de Optimización del Uso de los Antimicrobianos/métodos , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/prevención & control , Farmacorresistencia Bacteriana , Hospitales de Enseñanza , Antibacterianos/uso terapéutico , Programas de Optimización del Uso de los Antimicrobianos/normas , Infecciones Relacionadas con Catéteres/tratamiento farmacológico , Infecciones Relacionadas con Catéteres/epidemiología , Infecciones Relacionadas con Catéteres/prevención & control , Infección Hospitalaria/epidemiología , Higiene de las Manos/normas , Higiene de las Manos/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Hospitales de Enseñanza/normas , Hospitales de Enseñanza/estadística & datos numéricos , Humanos , Control de Infecciones/métodos , Control de Infecciones/normas , Japón/epidemiología , Personal de Hospital/estadística & datos numéricos , Neumonía Asociada al Ventilador/tratamiento farmacológico , Neumonía Asociada al Ventilador/epidemiología , Neumonía Asociada al Ventilador/prevención & control , Pautas de la Práctica en Medicina/normas , Encuestas y Cuestionarios
7.
JAMA Netw Open ; 4(2): e2035331, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33555332

RESUMEN

Importance: Hand hygiene (HH) is essential to prevent hospital-acquired infections. Objective: To determine whether providing real-time feedback on a simplified HH action improves compliance with the World Health Organization's "5 Moments" and the quality of the HH action. Design, Setting, and Participants: This open-label, cluster randomized, stepped-wedge clinical trial was conducted between June 1, 2017, and January 6, 2018 (with a follow-up in March 2018), in a geriatric hospital of the University of Geneva Hospitals, Switzerland. All 12 wards and 97 of 306 eligible health care workers (HCWs) volunteered to wear a novel electronic wearable device that delivered real-time feedback on duration of hand rubbing and application of a hand-sized customized volume of alcohol-based handrub (ABHR). Interventions: This study had 3 sequential periods: baseline (no device), transition (device monitoring without feedback), and intervention (device monitoring and feedback). The start of the transition period was randomly allocated based on a computer-generated block randomization. Main Outcomes and Measures: The primary outcome was HH compliance, according to the direct observation method during intervention as compared with baseline. Secondary outcomes included the volume of ABHR and duration of hand rubbing measured by the device during intervention as compared with transition. Results: All wards and respective HCWs were evenly assigned to group 1 (26 participants), 2 (22 participants), 3 (25 participants), or 4 (24 participants). Twelve HCWs did not fully complete the intervention but were included in the analysis. During 759 observation sessions, 6878 HH opportunities were observed. HH compliance at intervention (62.9%; 95% CI, 61.1%-64.7%) was lower than at baseline (66.6%; 95% CI, 64.8%-68.4%). After adjusting for covariates, HH compliance was not different between periods (odds ratio, 1.03; 95% CI, 0.75-1.42; P = .85). Days since study onset (OR, 0.997; 95% CI, 0.994-0.998; P < .001), older age (OR, 0.97; 95% CI, 0.95-0.99; P = .015), and workload (OR, 0.29; 95% CI, 0.20-0.41; P < .001) were independently associated with reduced HH compliance. The median (interquartile range) volume of ABHR and duration of hand rubbing in transition and intervention increased from 1.12 (0.76-1.68) mL to 1.71 (1.01-2.76) mL and from 6.5 (4.5-10.5) seconds to 8 (4.5-15.5) seconds, respectively. There were no serious adverse events. Conclusions and Relevance: The use of this device did not change HH compliance, but increased the duration of hand rubbing and volume of ABHR used by HCWs. Trial Registration: isrctn.org Identifier: ISRCTN25430066.


Asunto(s)
Infección Hospitalaria/prevención & control , Retroalimentación Formativa , Adhesión a Directriz , Desinfección de las Manos/normas , Desinfectantes para las Manos , Personal de Salud , Dispositivos Electrónicos Vestibles , Adulto , Factores de Edad , Femenino , Higiene de las Manos , Humanos , Masculino , Persona de Mediana Edad , Enfermeras y Enfermeros , Asistentes de Enfermería , Fisioterapeutas , Mejoramiento de la Calidad , Distribución Aleatoria , Carga de Trabajo
8.
JAMA Netw Open ; 4(2): e210361, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33635330

RESUMEN

Importance: Visitor contact precautions (VCPs) are commonly used to reduce the transmission of Clostridioides difficile at health care institutions. Implementing VCPs requires considerable personnel and personal protective equipment resources. However, it is unknown whether VCPs are associated with reduced hospital-onset C difficile infection (HO-CDI) rates. Objective: To estimate the association between VCPs and HO-CDI rates using simulation modeling. Design, Setting, and Participants: This simulation study, conducted between July 27, 2020, and August 11, 2020, used an established agent-based simulation model of C difficile transmission in a 200-bed acute care adult hospital to estimate the association between VCPs and HO-CDI while varying assumptions about factors such as patient susceptibility, behavior, and C difficile transmission. The model simulated hospital activity for 1 year among a homogeneous, simulated adult population. Interventions: No VCP use vs ideal use of VCPs under different hospital configurations. Main Outcomes and Measures: The rate of HO-CDI per 10 000 patient-days according to the Centers for Disease Control and Prevention's definition of HO-CDI. Results: With use of the simulation model, the baseline rate of HO-CDI was 7.94 10 000 patient-days (95% CI, 7.91-7.98 per 10 000 patient-days) with no VCP use compared with 7.97 per 10 000 patient-days (95% CI, 7.93-8.01 per 10 000 patient-days) with ideal VCP use. Visitor contact precautions were not associated with a reduction of more than 1% in HO-CDI rates in any of the tested scenarios and hospital settings. Independently increasing the hand-hygiene compliance of the average health care worker and environmental cleaning compliance by no more than 2% each was associated with greater HO-CDI reduction compared with all other scenarios, including VCPs. Conclusions and Relevance: In this simulation study, the association between VCPs and HO-CDI was minimal, but improvements in health care worker hand hygiene and environmental cleaning were associated with greater reductions in estimated HO-CDI. Hospitals may achieve a higher rate of reduction for HO-CDI by focusing on making small improvements in compliance with interventions other than VCP.


Asunto(s)
Infecciones por Clostridium/prevención & control , Infección Hospitalaria/prevención & control , Control de Infecciones/métodos , Visitas a Pacientes , Infecciones por Clostridium/epidemiología , Infecciones por Clostridium/transmisión , Simulación por Computador , Infección Hospitalaria/epidemiología , Infección Hospitalaria/transmisión , Desinfección , Higiene de las Manos , Humanos , Enfermeras y Enfermeros , Médicos
9.
Medicine (Baltimore) ; 100(3): e23690, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33545936

RESUMEN

ABSTRACT: The coronavirus disease of 2019 (COVID-19) pandemic significantly affected different life aspects, including healthcare communities and academic institutes. We aimed to assess the level of stress and risk factors among medical students and interns during the COVID-19 pandemic in the setting of the middle east respiratory syndrome -CoV endemic area.A questionnaire-based cross-sectional study was conducted on a randomly selected sample of medical students and interns. The questionnaire was anonymously self-administered to indicate perceive hygienic practice change, importance of viral prevention domestic hygiene, perceive adequacy of received information, perceived agreement to facilitators to alleviate covid stress, self-reported stress level, and generalized anxiety disorder score.A total of 322 returned the questionnaire (69.7% response rate). Participants had good knowledge regarding severe acute respiratory syndrome -CoV2 in multiple aspects, with an average score of 13.8 out of 14. Two-thirds (62.4%) of the students experienced mild anxiety, (23.9%) had moderate anxiety, (6.8%) had clinically high anxiety level, and another (6.8%) had a clinically very high anxiety level. The stress level, as reported by the respondents (on a 1-10 scale), showed a correlation with the Generalized Anxiety Disorder scale. We observed an increased level of social avoidance and hygienic practice facilitated by availability of hand sanitizers. Majority of the students receive information regarding COVID-19 from reliable and official resourcesMost students reported mild to moderate levels of anxiety, and was associated with enhancement of their universal precaution measures. The availability of alcohol-based hand sanitizers and the off-campus study were great relievers. The importance of reliable pandemic resources in educating students during pandemics is emphasized. Furthermore, this study indicate the importance of students' support services to address mental health and students' wellbeing in the era of pandemics.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles , Internado y Residencia , Estrés Psicológico/epidemiología , Estudiantes de Medicina/psicología , Adulto , Ansiedad/epidemiología , Estudios Transversales , Enfermedades Endémicas , Femenino , Higiene de las Manos , Humanos , Masculino , Factores de Riesgo , Arabia Saudita/epidemiología , Encuestas y Cuestionarios , Adulto Joven
10.
J Korean Med Sci ; 36(5): e45, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33527787

RESUMEN

Considering the mild degree of coronavirus disease 2019 (COVID-19) in children and the enormous stress caused by isolation in unfamiliar places, policies requiring mandatory isolation at medical facilities should be reevaluated especially given the impact of the pandemic on the availability of hospital beds. In this study, we assessed the usefulness of facility isolation and the transmissibility of severe acute respiratory syndrome coronavirus 2 by infected children to uninfected caregivers in isolation units at a hospital and a residential treatment center in Seoul during August-November 2020. Fifty-three children were included and median age was 4 years (range, 0-18). All were mildly ill or asymptomatic and isolated for a median duration of 12 days. Thirty percent stayed home longer than 2 days before entering isolation units from symptom onset. Among 15 uninfected caregivers, none became infected when they used facemasks and practiced hand hygiene. The results suggest children with mild COVID-19 may be cared safely at home by a caregiver in conditions with adherence to the preventive measures of wearing facemasks and practicing hand hygiene.


Asunto(s)
/prevención & control , Atención Domiciliaria de Salud , Aislamiento de Pacientes/métodos , Adolescente , Cuidadores , Niño , Preescolar , Femenino , Higiene de las Manos , Hospitalización , Humanos , Lactante , Recién Nacido , Masculino , Cooperación del Paciente , Seúl/epidemiología
11.
ABCS health sci ; 46: e021205, 09 fev. 2021. tab
Artículo en Inglés | LILACS | ID: biblio-1152236

RESUMEN

INTRODUCTION: The prevalence of parasitosis in children from Brazilian border cities is unknown. OBJECTIVE: To identify the prevalence of intestinal parasites in children from public pre-school on the Brazilian border and their socioeconomic and health profile. METHODS:: Fecal samples were obtained from 178 children from public early childhood educational center (CMEI) in Brazilian border municipalities in Foz do Iguaçu, Brazil. Samples were processed by Hoffman sedimentation and zinc sulfate centrifugation and flotation methods. A questionnaire was administered to children´s parents or guardians regarding parasitic diseases, socioeconomic status, and sanitary habits. RESULTS: The prevalence of intestinal parasites was 26.9% (n=48). A high prevalence of Giardia duodenalis was found (16.3%), followed by Endolimax nana (8.4%), Enterobius vermiculares (1.7%), Ascaris lumbricoides, and Entamoeba coli (0.5%). Forty-seven children (26.4%) presented monoparasitism. The percentage of parasitosis was significantly higher among male children (33.7% - p<0.036) who exhibited weight loss (50.0%), were from low-income families (35.4% - p=0.05), and had mothers with a low education (54.0% - p=0.0001). The highest percentage of Giardia was in children who exhibited weight loss (42.9% - p<0.05) and had mothers with low education (35.0% - p=0.0001). Multivariate analysis indicated that in the variable gender (male gender), weight loss and low maternal education contributed to the variability of parasitosis in children from the surveyed MCEC. CONCLUSION: The higher prevalence of Giardia was due to child and family variables. The detection of Enterobius vermiculares and Ascaris lumbricoides, despite the low frequency, indicates the need for better basic sanitation policies.


INTRODUÇÃO: A prevalência de parasitoses em crianças de municípios brasileiros de fronteira é desconhecida. OBJETIVO: Identificar a prevalência de parasitos intestinais em crianças de pré-escola pública de fronteira brasileira e seu perfil socioeconômico e sanitário. MÉTODOS: Foram obtidas amostras fecais de 178 crianças de Centro Municipal de Educação Infantil (CMEI) de Foz do Iguaçu, Brasil. As amostras foram processadas pelos métodos de sedimentação de Hoffman e centrifugação e flutuação no sulfato de zinco. Foi aplicado questionário aos pais ou responsáveis, referente a doenças parasitárias, nível socioeconômico e hábitos sanitários. RESULTADOS: A prevalência de parasitos intestinais foi de 26,9% (n=48). Houve maior prevalência de Giardia duodenalis (16,3%), seguido por Endolimax nana (8,4%), Enterobius vermiculares (1,7%), Ascaris lumbricoides e Entamoeba coli (0,5%). 47 (26,4%) crianças apresentaram monoparasitismo. O percentual de parasitose foi significantemente maior nas crianças do sexo masculino (33,7% - p<0,036), perda de peso (50,0%), famílias de baixa renda (35,4% - p=0,05) e mães com baixa escolaridade (54,0% - p=0,0001), enquanto, o maior percentual de Giardia foi em crianças com perda de peso (42,9% - p<0,05) e mães com baixa escolaridade (35,0% - p=0,0001). Análise multivariada indicou que na variável gênero (sexo masculino), perda de peso e baixa escolaridade das mães refletem parte da variabilidade da condição de parasitado das crianças dos CMEI pesquisados. CONCLUSÃO: Presença de maior prevalência de Giardia foi decorrente de variáveis da criança e da família e a detecção de Enterobius vermiculares e Ascaris lumbricoides, apesar da baixa frequência, indica necessidade de melhores políticas de saneamento básico.


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Parásitos , Enfermedades Parasitarias/epidemiología , Áreas Fronterizas , Brasil , Jardines Infantiles , Salud del Niño , Higiene Alimentaria/estadística & datos numéricos , Estudios Transversales , Giardiasis , Salud Fronteriza , Higiene de las Manos/estadística & datos numéricos
12.
Int J Mol Med ; 47(4): 1, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33537803

RESUMEN

Nosocomial infections, also known as hospital-acquired infections, pose a serious challenge to healthcare professionals globally during the Coronavirus disease 2019 (COVID­19) pandemic. Nosocomial infection of COVID­19 directly impacts the quality of life of patients, as well as results in extra expenditure to hospitals. It has been shown that COVID­19 is more likely to transmit via close, unprotected contact with infected patients. Additionally, current preventative and containment measures tend to overlook asymptomatic individuals and superspreading events. Since the mode of transmission and real origin of COVID­19 in hospitals has not been fully elucidated yet, minimizing nosocomial infection in hospitals remains a difficult but urgent task for healthcare professionals. Healthcare professionals globally should form an alliance against nosocomial COVID­19 infections. The fight against COVID­19 may provide valuable lessons for the future prevention and control of nosocomial infections. The present review will discuss some of the key strategies to prevent and control hospital­based nosocomial COVID­19 infections.


Asunto(s)
/epidemiología , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Personal de Salud , Infecciones Asintomáticas , China , Infección Hospitalaria/transmisión , Desinfección , Higiene de las Manos , Hospitales , Humanos , Eliminación de Residuos Sanitarios , Equipo de Protección Personal , Calidad de Vida
13.
BMC Infect Dis ; 21(1): 211, 2021 Feb 25.
Artículo en Inglés | MEDLINE | ID: mdl-33632143

RESUMEN

BACKGROUND: Inconsistent hand hygiene puts people who inject drugs (PWID) at high risk of infectious diseases, in particular skin and soft tissue infections. In healthcare settings, handwashing with alcohol-based hand rubs (ABRH) is recommended before aseptic procedures including intravenous injections. We aimed to evaluate the acceptability, safety and preliminary efficacy of an intervention combining ABHR provision and educational training for PWID. METHODS: A mixed-methods design was used including a pre-post quantitative study and a qualitative study. Participants were active PWID recruited in 4 harm reduction programmes of France and followed up for 6 weeks. After baseline assessment, participants received a face-to-face educational intervention. ABHR was then provided throughout the study period. Quantitative data were collected through questionnaires at baseline, and weeks 2 (W2) and 6 (W6) post-intervention. Qualitative data were collected through focus groups with participants who completed the 6-week study. RESULTS: Among the 59 participants included, 48 (81%) and 43 (73%) attended W2 and W6 visits, respectively. ABHR acceptability was high and adoption rates were 50% (W2) and 61% (W6). Only a minority of participants reported adverse skin reactions (ranging from 2 to 6%). Preliminary efficacy of the intervention was shown through increased hand hygiene frequency (multivariable linear mixed model: coef. W2 = 0.58, p = 0.002; coef. W6 = 0.61, p = 0.002) and fewer self-reported injecting-related infections (multivariable logistic mixed model: AOR W6 = 0.23, p = 0.021). Two focus groups were conducted with 10 participants and showed that young PWID and those living in unstable housing benefited most from the intervention. CONCLUSIONS: ABHR for hand hygiene prior to injection are acceptable to and safe for PWID, particularly those living in unstable housing. The intervention's educational component was crucial to ensure adoption of safe practices. We also provide preliminary evidence of the intervention's efficacy through increased hand hygiene frequency and a reduced risk of infection.


Asunto(s)
Antiinfecciosos Locales/administración & dosificación , Etanol/administración & dosificación , Higiene de las Manos/métodos , Reducción del Daño , Abuso de Sustancias por Vía Intravenosa/prevención & control , Adulto , Femenino , Grupos Focales , Francia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Autoinforme , Infecciones de los Tejidos Blandos/etiología , Infecciones de los Tejidos Blandos/prevención & control , Abuso de Sustancias por Vía Intravenosa/complicaciones , Abuso de Sustancias por Vía Intravenosa/epidemiología , Abuso de Sustancias por Vía Intravenosa/psicología
14.
Nursing ; 51(3): 32-42, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33587415

RESUMEN

ABSTRACT: Protecting nurses in healthcare facilities from SARS-CoV-2 infection is essential for maintaining an adequate nursing force. Foundational guidelines, consistently utilized, protect the nursing staff from infection. This article describes guidelines designed to reduce acute infection and associated morbidity and mortality among nursing staff and improve compliance with infection prevention protocols.


Asunto(s)
/enfermería , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Personal de Enfermería , Guías de Práctica Clínica como Asunto , /transmisión , Higiene de las Manos , Humanos , Control de Infecciones/métodos , Equipo de Protección Personal , Dispositivos de Protección Respiratoria
15.
Int J Qual Health Care ; 33(Supplement_1): 51-55, 2021 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-33432983

RESUMEN

BACKGROUND: In response to the coronavirus disease of 2019 (COVID-19) pandemic, healthcare systems worldwide have stepped up their infection prevention and control efforts in order to reduce the spread of the infection. Behaviours, such as hand hygiene, screening and cohorting of patients, and the appropriate use of antibiotics have long been recommended in surgery, but their implementation has often been patchy. METHODS: The current crisis presents an opportunity to learn about how to improve infection prevention and control and surveillance (IPCS) behaviours. The improvements made were mainly informal, quick and stemming from the frontline rather than originating from formal organizational structures. The adaptations made and the expertise acquired have the potential for triggering deeper learning and to create enduring improvements in the routine identification and management of infections relating to surgery. RESULTS: This paper aims to illustrate how adopting a human factors and ergonomics perspective can provide insights into how clinical work systems have been adapted and reconfigured in order to keep patients and staff safe. CONCLUSION: For achieving sustainable change in IPCS practices in surgery during COVID-19 and beyond we need to enhance organizational learning potentials.


Asunto(s)
Control de Infecciones/métodos , Procedimientos Quirúrgicos Operativos/normas , Antibacterianos/uso terapéutico , Infección Hospitalaria/prevención & control , Monitoreo Epidemiológico , Ergonomía/métodos , Higiene de las Manos , Humanos , Control de Infecciones/normas
16.
BMC Infect Dis ; 21(1): 50, 2021 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-33430792

RESUMEN

BACKGROUND: Hand hygiene (HH) is the cornerstone of infection control, and the promotion of HH is the focus of the world. The study aims to compare the role of two different types of electronic hand hygiene monitoring systems (EHHMSs) in promoting HH of healthcare workers (HCWs) in the intensive care unit (ICU). METHODS: In a 16-bed ICU of a general tertiary hospital in Shenzhen, the research was divided into three stages with interrupted time series (ITS) design. In the first stage, the direct observation method was used to monitor and feed back the HH compliance rate of HCWs monthly. In the second stage, the type1 EHHMS was applied to monitor and feed back the individual number of HH events monthly. In the third stage, the type2 EHHMS with a function of instant reminder and feedback was employed, and the personal HH compliance rates were fed back monthly. Meanwhile, direct observation continued in the last two stages. RESULTS: In the second stage, The HH compliance rate increased. However, there was no significant difference in the trajectory of the rate compared with the first stage. In the first month of the third stage, the HH compliance rate increased by 12.324% immediately and then ascended by 1.242% over time. The number of HH events per bed day and HH products' consumption per bed day were consistent with the change of HH compliance rate observed. CONCLUSION: Monitoring and feedback can improve the HH of HCWs. The EHHMS, with the function of real-time reminders and feedback, has a more noticeable effect on promoting HH.


Asunto(s)
Equipos y Suministros Eléctricos , Higiene de las Manos/métodos , Personal de Salud , Promoción de la Salud/métodos , Control de Infecciones/métodos , Unidades de Cuidados Intensivos , Adulto , China , Infección Hospitalaria/prevención & control , Retroalimentación , Femenino , Conductas Relacionadas con la Salud , Humanos , Análisis de Series de Tiempo Interrumpido , Masculino , Sistemas Recordatorios , Centros de Atención Terciaria
17.
Artículo en Inglés | MEDLINE | ID: mdl-33466858

RESUMEN

This study aimed to assess hand hygiene knowledge, perception, and practices of visitors to the Prophet's Mosque in Al Madinah City, Saudi Arabia. Using a self-administered electronic questionnaire, a cross-sectional survey was conducted among domestic residents, who visited the mosque between 31 July and 3 August 2020. Participants' demographic data, hand hygiene knowledge, perception, and practices were collected. Four hundred participants aged 18-65 (median 36) years completed the survey, of which 215 (53.8%) were female. The visitors' mean knowledge score about hand hygiene was 6.4 (± standard deviation (SD) 1.35) of total 12. Most participants (392, 98%) were aware of the role of hand hygiene in preventing Coronavirus Disease 2019 (COVID-19); nevertheless, 384 (96%) said hand hygiene lowers body immunity and 316 (79%) thought <60% alcohol is sufficient for hand disinfection. Males had a higher knowledge score than females (6.46 (±1.41) vs. 6.14 (±1.27), p = 0.02) and, visitors who had no formal education scored higher than those with post-graduate education (6.88 (±1.45) vs 5.73 (±1.12), p = 0.01). Washing hands with soap and water was the predominant method practiced after a meal (365, 91.7%), after toilet visit (354, 88.5%), after touching a surface (262, 65.7%), after waste disposal (332, 83.2%), and when hands were visibly dirty (357, 89.5%). Al Madinah visitors had moderate knowledge about hand hygiene, but demonstrated some knowledge gaps and negligence in practice that are crucial to curb the spread of COVID-19.


Asunto(s)
/prevención & control , Higiene de las Manos , Conocimientos, Actitudes y Práctica en Salud , Pandemias , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Desinfección de las Manos , Humanos , Masculino , Persona de Mediana Edad , Arabia Saudita , Encuestas y Cuestionarios , Adulto Joven
18.
BMC Public Health ; 21(1): 199, 2021 01 22.
Artículo en Inglés | MEDLINE | ID: mdl-33482790

RESUMEN

BACKGROUND: Novel coronavirus is a global pandemic and killed many individuals, including health care professionals. It caused stress on the health care system of all countries. Presently, studies are emerging regarding the COVID-19 pandemic in different aspects. However, a few have explored barriers that affecting the practice of preventive measures for the COVID-19. As such, the study aimed to fill these research gaps in the study setting. METHODS: A semi-structured interview guide was used to conduct this phenomenological study among 16 key informants. Key informants were recruited by the purposive sampling method. To analyze that data, thematic content analysis was employed by using an inductive approach in NVivo 12 Pro software. RESULTS: In this study, six main themes were identified with the sub-themes. Overview of COVID-19 pandemic (with the six sub-themes), consequences (with the two sub-themes), perceived practice (with four sub-themes), perceived barriers (with four sub-themes), newfangled activities (with three sub-themes), and suggestion for improvement (with seven sub-themes) were the major themes. The participants perceived the influence of shortage of personal protective equipment and solutions for hand hygiene, negligence and ignorance, inadequate infrastructure, lack of training, and lack of attention and recognition for the staff on the practice of preventive measures. CONCLUSIONS: This study showed a gap in preventive measure practices for the COVID-19 in the health care system. Community influences, health care provider related barriers, institutional barriers, and lack of communication and support affect the practice. Hence, attention should give to fulfill the necessary supplies in the health facilities, improve the infrastructures, and equip health professionals by providing capacity-building activities. Besides, health care workers must recognize, and attention is needed.


Asunto(s)
Actitud del Personal de Salud , Personal de Salud/psicología , Pandemias/prevención & control , Administración en Salud Pública , Adulto , Etiopía/epidemiología , Femenino , Higiene de las Manos , Personal de Salud/estadística & datos numéricos , Humanos , Masculino , Equipo de Protección Personal/provisión & distribución , Investigación Cualitativa
19.
Artículo en Inglés | MEDLINE | ID: mdl-33430195

RESUMEN

BACKGROUND: Hand hygiene (HH) is the simplest and most effective way to reduce the incidence of healthcare-associated infections (HCAIs). METHODS: This cross-sectional study aimed to determine factors associated with self-reported HH performance among nurses at Kelantan tertiary care hospitals. A sample of 438 registered nurses was selected through a stratified random sampling method. Self-reported HH performance was assessed using a validated WHO self-administered HH knowledge and perception questionnaire for healthcare workers. RESULTS: A multiple linear regression analysis was performed to identify the predictors. The factors that significantly predicted self-reported HH performance among nurses included perception score (beta coefficient (ß) = 0.260; 95% CI: 0.200, 0.417; p < 0.001), pediatric department (ß = -0.104; 95% CI: -9.335, -2.467; p < 0.001), and orthopedic department (ß = -5.957; 95% CI: -9.539, -0.720; p < 0.023), adjusted R2 = 0.102; p < 0.001. Nurses with a strong perception and belief in HH were more likely to have better HH performance. Compared to pediatric and orthopedic, surgical departments were associated with better self-reported HH performance. CONCLUSIONS: This study showed the importance of factors that could improve the intervention's performance in HH strategy. Lack of perception and HH program intervention in departments engaged in patient care could lead to poor HH practices, thus increasing HCAIs and antimicrobial resistance (AMR).


Asunto(s)
Infección Hospitalaria , Higiene de las Manos , Niño , Estudios Transversales , Adhesión a Directriz , Humanos , Control de Infecciones , Malasia , Autoinforme , Centros de Atención Terciaria
20.
BMC Health Serv Res ; 21(1): 88, 2021 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-33499864

RESUMEN

BACKGROUND: Hand hygiene (HH) among healthcare workers (HCWs) is critical for infection prevention and control (IPC) in healthcare facilities (HCFs). Nonetheless, it remains a challenge in HCFs, largely due to lack of high-impact and efficacious interventions. Environmental cues and mobile phone health messaging (mhealth) have the potential to improve HH compliance among HCWs, however, these remain under-studied. Our study will determine the impact of mhealth hygiene messages and environmental cues on HH practice among HCWs in the Greater Kampala Metropolitan Area (GKMA). METHODS: The study is a cluster-randomized trial, which will be guided by the behaviour centred design model and theory for behaviour change. During the formative phase, we shall conduct 30 key informants' interviews and 30 semi-structured interviews to explore the barriers and facilitators to HCWs' HH practice. Besides, observations of HH facilities in 100 HCFs will be conducted. Findings from the formative phase will guide the intervention design during a stakeholders' insight workshop. The intervention will be implemented for a period of 4 months in 30 HCFs, with a sample of 450 HCWs who work in maternity and children's wards. HCFs in the control arm will receive innovatively designed HH facilities and supplies. HCWs in the intervention arm, in addition to the HH facilities and supplies, will receive environmental cues and mhealth messages. The main outcome will be the proportion of utilized HH opportunities out of the 9000 HH opportunities to be observed. The secondary outcome will be E. coli concentration levels in 100mls of hand rinsates from HCWs, an indicator of recent fecal contamination and HH failure. We shall run multivariable logistic regression under the generalized estimating equations (GEE) framework to account for the dependence of HH on the intervention. DISCUSSION: The study will provide critical findings on barriers and facilitators to HH practice among HCWs, and the impact of environmental cues and mhealth messages on HCWs' HH practice. TRIAL REGISTRATION: ISRCTN Registry with number ISRCTN98148144 . The trial was registered on 23/11/2020.


Asunto(s)
Higiene de las Manos/métodos , Telemedicina , Actitud del Personal de Salud , Señales (Psicología) , Adhesión a Directriz , Personal de Salud , Humanos , Control de Infecciones/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Uganda
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