Incidence and risk factors of SARS-CoV-2 infection among workers in a public health laboratory in Tunisia.

The aim of this study was to measure the extent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among workers at the Institut Pasteur de Tunis (IPT), a public health laboratory involved in the management of the COVID-19 pandemic in Tunisia, and to identify risk factors for infection in this occupational setting. A cross-sectional survey was conducted on IPT workers not vaccinated against coronavirus disease 2019 (COVID-19). Participants completed a questionnaire that included a history of reverse transcription-polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infection. Immunoglobulin G antibodies against the receptor-binding domain of the spike antigen (anti-S-RBD IgG) and the nucleocapsid protein (anti-N IgG) of the SARS-CoV-2 virus were detected by enzyme-linked immunoassay (ELISA). A multivariate analysis was used to identify factors significantly associated with SARS-CoV-2 infection. A total of 428 workers were enrolled in the study. The prevalence of anti-S-RBD and/or anti-N IgG antibodies was 32.9% [28.7-37.4]. The cumulative incidence of SARS-CoV-2 infection (positive serology and/or previous positive RT-PCR test) was 40.0% [35.5-44.9], while the proportion with asymptomatic infection was 32.9%. One-third of the participants with RT-PCR-confirmed infection tested seronegative more than 90 days postinfection. Participants aged over 40 and laborers were more susceptible to infection (adjusted OR [AOR] = 1.65 [1.08-2.51] and AOR = 2.67 [1.45-4.89], respectively), while tobacco smokers had a lower risk of infection (AOR = 0.54 [0.29-0.97]). The SARS-CoV-2 infection rate among IPT workers was not significantly different from that detected concurrently in the general population. Hence, the professional activities conducted in this public health laboratory did not generate additional risk to that incurred outside the institute in day-to-day activities.

Evaluation of human resources needed and comparison with human resources available to implement emergency vaccination in case of foot and mouth disease outbreaks in Tunisia.

Foot and mouth disease (FMD) is a highly contagious viral disease that affects domestic and wild artiodactyl animals and causes considerable economic losses related to outbreak management, production losses and trade impacts. In Tunisia, the last FMD outbreak took place in 2018-2019. The effectiveness of control measures implemented to control FMD depends, in particular, on the human resources used to implement them. Tunisia has the ultimate objective of obtaining OIE status as 'FMD-free with vaccination'. The aim of this study was to determine and compare the necessary and available human resources to control FMD outbreaks in Tunisia using emergency vaccination and to assess the gaps that would play a role in the implementation of the strategy. We developed a resources-requirement grid of necessary human resources for the management of the emergency vaccination campaign launched after the identification of a FMD-infected premises in Tunisia. Field surveys, conducted in the 24 governorates of Tunisia, allowed quantifying the available human resources for several categories of skills considered in the resources-requirement grid. For each governorate, we then compared available and necessary human resources to implement vaccination according to eight scenarios mixing generalised or cattle-targeted vaccination and different levels of human resources. The resources-requirement grid included 11 tasks in three groups: management of FMD-infected premises, organisational tasks and vaccination implementation. The available human resources for vaccination-related tasks included veterinarians and technicians from the public sector and appointed private veterinarians. The comparison of available and necessary human resources showed vaccination-related tasks to be the most time-consuming in terms of managing a FMD outbreak. Increasing the available human resources using appointed private veterinarians allowed performing the emergency vaccination of animals in the governorate in due time, especially if vaccination was targeted on cattle. The overall approach was validated by comparing the predicted and observed durations of a vaccination campaign conducted under the same conditions as during the 2014 Tunisian outbreak. This study could provide support to the Tunisian Veterinary Services or to other countries to optimise the management of a FMD outbreak.