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1.
MMWR Morb Mortal Wkly Rep ; 69(5): 140-146, 2020 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-32027631

RESUMO

On December 31, 2019, Chinese health officials reported a cluster of cases of acute respiratory illness in persons associated with the Hunan seafood and animal market in the city of Wuhan, Hubei Province, in central China. On January 7, 2020, Chinese health officials confirmed that a novel coronavirus (2019-nCoV) was associated with this initial cluster (1). As of February 4, 2020, a total of 20,471 confirmed cases, including 2,788 (13.6%) with severe illness,* and 425 deaths (2.1%) had been reported by the National Health Commission of China (2). Cases have also been reported in 26 locations outside of mainland China, including documentation of some person-to-person transmission and one death (2). As of February 4, 11 cases had been reported in the United States. On January 30, the World Health Organization (WHO) Director-General declared that the 2019-nCoV outbreak constitutes a Public Health Emergency of International Concern.† On January 31, the U.S. Department of Health and Human Services (HHS) Secretary declared a U.S. public health emergency to respond to 2019-nCoV.§ Also on January 31, the president of the United States signed a "Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus," which limits entry into the United States of persons who traveled to mainland China to U.S. citizens and lawful permanent residents and their families (3). CDC, multiple other federal agencies, state and local health departments, and other partners are implementing aggressive measures to slow transmission of 2019-nCoV in the United States (4,5). These measures require the identification of cases and their contacts in the United States and the appropriate assessment and care of travelers arriving from mainland China to the United States. These measures are being implemented in anticipation of additional 2019-nCoV cases in the United States. Although these measures might not prevent the eventual establishment of ongoing, widespread transmission of the virus in the United States, they are being implemented to 1) slow the spread of illness; 2) provide time to better prepare health care systems and the general public to be ready if widespread transmission with substantial associated illness occurs; and 3) better characterize 2019-nCoV infection to guide public health recommendations and the development of medical countermeasures including diagnostics, therapeutics, and vaccines. Public health authorities are monitoring the situation closely. As more is learned about this novel virus and this outbreak, CDC will rapidly incorporate new knowledge into guidance for action by CDC and state and local health departments.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Surtos de Doenças/prevenção & controle , Adulto , Idoso , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Controle de Infecções , Laboratórios , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Prática de Saúde Pública , Estados Unidos/epidemiologia
2.
Br J Nurs ; 29(1): 8, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31917933

RESUMO

Tracy Doherty, Assistant Director of Infection Prevention & Control, Our Lady of Lourdes Hospital, Drogheda, Co Louth, discusses the maintenance of a clean healthcare environment.


Assuntos
Infecção Hospitalar/etiologia , Ambiente de Instituições de Saúde , Infecção Hospitalar/prevenção & controle , Ambiente de Instituições de Saúde/normas , Serviço Hospitalar de Limpeza/normas , Humanos , Controle de Infecções
4.
Sports Health ; 12(1): 51-57, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31660785

RESUMO

BACKGROUND: Athletic training rooms have a high prevalence of bacteria, including multidrug-resistant organisms, increasing the risk for both local and systematic infections in athletes. There are limited data outlining formal protocols or standardized programs to reduce bacterial and viral burden in training rooms as a means of decreasing infection rate at the collegiate and high school levels. HYPOTHESIS: Adaptation of a hygiene protocol would lead to a reduction in bacterial and viral pathogen counts in athletic training rooms. STUDY DESIGN: Cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: Two high school and 2 collegiate athletic training rooms were studied over the course of the 2017-2018 academic year. A 3-phase protocol, including introduction of disinfectant products followed by student-athlete and athletic trainer education, was implemented at the 4 schools. Multiple surfaces in the athletic training rooms were swabbed at 4 time points throughout the investigation. Bacterial and viral burden from swabs were analyzed for overall bacterial aerobic plate count (APC), bacterial adenosine triphosphate activity, influenza viral load, and multidrug-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE). RESULTS: Overall bacterial load, as measured by APC, was reduced by 94.7% (95% CI, 72.6-99.0; P = 0.003) over the course of the investigation after protocol implementation. MRSA and VRE were found on 24% of surfaces prior to intervention and were reduced to 0% by the end of the study. Influenza was initially detected on 25% of surfaces, with no detection after intervention. No cases of athletic training room-acquired infections were reported during the study period. CONCLUSION: A uniform infection control protocol was effective in reducing bacterial and viral burden, including multidrug-resistant organisms, when implemented in the athletic training rooms of 2 high schools and 2 colleges. CLINICAL RELEVANCE: A standardized infection control protocol can be utilized in athletic training rooms to reduce bacterial and viral burden.


Assuntos
Infecções Comunitárias Adquiridas/prevenção & controle , Reservatórios de Doenças/microbiologia , Controle de Infecções/métodos , Instituições Acadêmicas , Infecções Comunitárias Adquiridas/transmissão , Desinfetantes/administração & dosagem , Infecções por Bactérias Gram-Positivas/prevenção & controle , Infecções por Bactérias Gram-Positivas/transmissão , Desinfecção das Mãos , Educação em Saúde , Humanos , Influenza Humana/prevenção & controle , Influenza Humana/transmissão , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Orthomyxoviridae/isolamento & purificação , Comportamento de Redução do Risco , Infecções Estafilocócicas/prevenção & controle , Infecções Estafilocócicas/transmissão , Enterococos Resistentes à Vancomicina/isolamento & purificação
5.
Curr Opin Ophthalmol ; 31(1): 28-32, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31770164

RESUMO

PURPOSE OF REVIEW: This article reviews the various challenges in infection control in eye clinics and successful measures taken to prevent nosocomial infections. RECENT FINDINGS: The Center for Disease Control recommends hand-washing when hands are visibly soiled, and after direct contact with patients, and inanimate objects such as medical equipment. Published studies have identified poor hygiene in clinical settings as a major cause of nosocomial outbreaks, particularly in cases of epidemic keratoconjunctivitis (EKC). Some studies of EKC outbreaks are able to support direct observation of hygiene lapses with molecular analysis that can match viral strains on particular instruments to those found in infected patients. Although most studies are about adenoviral infection and tonometer use, researchers have found viral and bacterial loads on other common surfaces, indicating a need for further research. SUMMARY: Proper hygiene in eye clinics requires special attention because of the potential to examine many patients at a time and because multiple instruments are often used during a single exam. Studies reinforce the link between hygiene and outbreak prevention, and more research can be done to determine the specific links between certain instruments and nosocomial infections.


Assuntos
Infecção Hospitalar/prevenção & controle , Desinfecção/métodos , Higiene das Mãos , Controle de Infecções/métodos , Oftalmologia/instrumentação , Esterilização/métodos , Instituições de Assistência Ambulatorial/normas , Humanos , Oftalmologia/normas
8.
Presse Med ; 48(12): 1536-1550, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31784255

RESUMO

Africa along side with south-east Asia are the epicentres of emerging and epidemic prone-infectious diseases and megacity biosecurity threat scenarios. Massive mobility and reluctance in the populations exposed to epidemic and emerging prone-infectious diseases coupled by a weak health system made disease alert and control measures difficult to implement. The investigation of virus detection and persistence in semen across a range of emerging viruses is useful for clinical and public health reasons, in particular for viruses that lead to high mortality or morbidity rates or to epidemics. Innovating built facility to safely treat patients with highly pathogenic infectious diseases is urgently need, not only to prevent the spread of infection from patients to healthcare workers but also to offer provision of relatively invasive organ support, whenever considered appropriate, without posing additional risk to staff. Despite multiple challenges, the need to conduct research during epidemics is inevitable, and candidate products must continue undergoing rigorous trials. Preparedness including management of complex humanitarian crises with community distrust is a cornerstone in response to high consequence emerging infectious disease outbreaks and imposes strengthening of the public health response infrastructure and emergency outbreak systems in high-risk regions.


Assuntos
Doenças Transmissíveis Emergentes/epidemiologia , Epidemias , Controle de Infecções , Doenças Transmissíveis Emergentes/prevenção & controle , Surtos de Doenças/prevenção & controle , Epidemias/prevenção & controle , Epidemias/estatística & dados numéricos , Saúde Global/normas , Saúde Global/tendências , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/tendências , Saúde Pública/normas , Saúde Pública/tendências , Administração em Saúde Pública/métodos , Administração em Saúde Pública/tendências
9.
Rev. Esc. Enferm. USP ; 53: e03508, Jan.-Dez. 2019. tab, graf
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1020384

RESUMO

RESUMO Objetivo Avaliar a estrutura e a adesão às medidas de precauções-padrão e específicas dos profissionais de saúde em Unidade de Terapia Intensiva de hospital de ensino, no Distrito Federal. Método Estudo descritivo, transversal e prospectivo. Utilizou-se de questionário estruturado mediante observações que registraram as práticas dos profissionais com Equipamentos de Proteção Individual e indicações de precauções. Foi aplicado o teste Qui-quadrado, e calculado o p-valor . Resultados Participaram do estudo 52 profissionais, e foram observados 445 procedimentos assistenciais em 36 sessões de auditoria. A média da taxa de adesão ao uso de equipamentos foi de 72,72%, sendo 94,91% às luvas, 91,43% ao avental, 80% à máscara e 24,56% aos óculos de proteção. Quando não havia indicação e não foi utilizado o Equipamento de Proteção Individual, a média da taxa foi de 68,01%, sendo 30,77% em relação às luvas, 87,58% ao avental, 57,58% à máscara, e 96,13% aos óculos. As precauções de contato foram indicadas desnecessariamente em 35% dos pacientes. Conclusão Verificou-se boa adesão ao uso de luvas, avental e máscara, baixa adesão ao uso de óculos de proteção e uso desnecessário de máscaras e precauções de contato admissionais.


RESUMEN Objetivo Evaluar la estructura y la adhesión a las medidas de precauciones estándar y específicas de los profesionales sanitarios en Unidad de Cuidados Intensivos de hospital de enseñanza, en el Distrito Federal. Método Estudio descriptivo, transversal y prospectivo. Se utilizó un cuestionario estructurado mediante observaciones que registraron las prácticas de los profesionales con Equipos de Protección Individual e indicaciones de precauciones. Se aplicó la prueba de Chi cuadrado y se calculó el p-valor. Resultados Participaron en el estudio 52 profesionales y se observaron 445 procedimientos asistenciales en 36 sesiones de auditoría. El promedio de la tasa de adhesión al uso de equipos fue del 72,72%, siendo el 94,91% a los guantes, el 91,43% al delantal, el 80% a la mascarilla y el 24,56% a los anteojos de protección. Cuando no había indicación y no fue utilizado el Equipo de Protección Individual, el promedio de la tasa fue del 68,01%, siendo el 30,77% con relación a los guantes, el 87,58% al delantal, el 57,58% a la mascarilla y el 96,13% a los anteojos. Las precauciones de contacto fueron indicadas innecesariamente al 35% de los pacientes. Conclusión Se verificó buena adhesión al uso de guantes, delantal y mascarilla, baja adhesión al uso de anteojos de protección y uso innecesario de mascarillas y precauciones de contacto de ingreso.


ABSTRACT Objective To evaluate the structure and adherence to the standardized and specific precautionary measures of health professionals in the Intensive Care Unit of a teaching hospital in the Federal District of Brazil. Method A descriptive, cross-sectional and prospective study. A structured questionnaire was used via observations which recorded the practices of professionals with Individual Protection Equipment and indications of precautions. The chi-square test was applied, and the p-value was calculated. Results A total of 52 professionals participated in the study, and 445 care procedures were observed in 36 audit sessions. The average adhesion rate for equipment use was 72.72%, with 94.91% for gloves, 91.43% for aprons, 80% for masks and 24.56% for safety glasses. When there was no indication and no personal protective equipment was used, the average rate was 68.01%, with 30.77% for gloves, 87.58% for aprons, 57.58% for masks, and 96.13% for safety glasses. Contact precautions were unnecessarily indicated for 35% of patients. Conclusion Good adherence to using gloves, aprons and masks were observed, but there was poor adherence to using safety glasses and unnecessary use of masks and admission contact precautions.


Assuntos
Humanos , Prática Profissional , Precauções Universais , Controle de Infecções , Pessoal de Saúde , Unidades de Terapia Intensiva , Estudos Transversais , Estudos Prospectivos , Segurança do Paciente , Hospitais de Ensino
10.
Presse Med ; 48(12): 1528-1535, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31767249

RESUMO

The emergence of a viral disease most often results from an imbalance in the interaction between the infectious agent, the host and the environment. After the introduction phase of a viral disease in a territory or a given population and once the first chains of transmission occur, the spread of the disease or its sustainability are possible if the control measures are not implemented or are not sufficiently effective. If it is difficult to anticipate the occurrence and introduction of an emerging viral disease, the following three key elements must be strengthened to limit its impact: (1) anticipation and preparation; (2) research and (3) monitoring and surveillance. Finally, to guarantee that the measures taken are relevant and acceptable to the population, a multidisciplinary approach must be systematically relied upon and re-evaluated on a prospective basis.


Assuntos
Doenças Transmissíveis Emergentes/epidemiologia , Surtos de Doenças , Previsões , Viroses/epidemiologia , Doenças Transmissíveis Emergentes/prevenção & controle , Surtos de Doenças/prevenção & controle , Meio Ambiente , Projetos de Pesquisa Epidemiológica , Monitoramento Epidemiológico , Previsões/métodos , Humanos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Controle de Infecções/tendências , Prevenção Primária/métodos , Prevenção Primária/organização & administração , Viroses/prevenção & controle
11.
Harefuah ; 158(11): 748-751, 2019 Nov.
Artigo em Hebraico | MEDLINE | ID: mdl-31721520

RESUMO

INTRODUCTION: The use of ultrasound is a keystone in current obstetrics and gynecology. In several studies, the presence of various biological infecting agents (bacteria, viruses and fungi) has been demonstrated on various parts of the transducers. These findings led to other studies in which different methods of cleaning, disinfection and sterilization have been evaluated for their efficacy in the elimination of these infections. These studies are inconclusive in terms of the preferred method for the total cleaning of these agents from the transducers. The coupling gel, which is used during sonographic examinations, has also been found to harbor all kinds of polluting biological agents. Despite these findings and due to the lack of scientific evidence for transference of infection to the patients, between patients or the staff, the question for the need of those cleaning procedures has been raised in the current relevant literature.


Assuntos
Desinfecção , Controle de Infecções , Ultrassonografia , Humanos , Ultrassonografia/instrumentação
13.
Nature ; 575(7781): 130-136, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31695207

RESUMO

With rapidly changing ecology, urbanization, climate change, increased travel and fragile public health systems, epidemics will become more frequent, more complex and harder to prevent and contain. Here we argue that our concept of epidemics must evolve from crisis response during discrete outbreaks to an integrated cycle of preparation, response and recovery. This is an opportunity to combine knowledge and skills from all over the world-especially at-risk and affected communities. Many disciplines need to be integrated, including not only epidemiology but also social sciences, research and development, diplomacy, logistics and crisis management. This requires a new approach to training tomorrow's leaders in epidemic prevention and response.


Assuntos
/epidemiologia , Saúde Pública/tendências , Ciência/tendências , Métodos Epidemiológicos , História do Século XIX , História do Século XX , História do Século XXI , Controle de Infecções , /microbiologia , Saúde Pública/história , Ciência/história
15.
MMWR Morb Mortal Wkly Rep ; 68(39): 851-854, 2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31581162

RESUMO

Infection prevention and control (IPC) in health care facilities is essential to protecting patients, visitors, and health care personnel from the spread of infectious diseases, including Ebola virus disease (Ebola). Patients with suspected Ebola are typically referred to specialized Ebola treatment units (ETUs), which have strict isolation and IPC protocols, for testing and treatment (1,2). However, in settings where contact tracing is inadequate, Ebola patients might first seek care at general health care facilities, which often have insufficient IPC capacity (3-6). Before 2014-2016, most Ebola outbreaks occurred in rural or nonurban communities, and the role of health care facilities as amplification points, while recognized, was limited (7,8). In contrast to these earlier outbreaks, the 2014-2016 West Africa Ebola outbreak occurred in densely populated urban areas where access to health care facilities was better, but contact tracing was generally inadequate (8). Patients with unrecognized Ebola who sought care at health care facilities with inadequate IPC initiated multiple chains of transmission, which amplified the epidemic to an extent not seen in previous Ebola outbreaks (3-5,7). Implementation of robust IPC practices in general health care facilities was critical to ending health care-associated transmission (8). In August 2018, when an Ebola outbreak was recognized in the Democratic Republic of the Congo (DRC), neighboring countries began preparing for possible introduction of Ebola, with a focus on IPC. Baseline IPC assessments conducted in frontline health care facilities in high-risk districts in Uganda found IPC gaps in screening, isolation, and notification. Based on findings, additional funds were provided for IPC, a training curriculum was developed, and other corrective actions were taken. Ebola preparedness efforts should include activities to ensure that frontline health care facilities have the IPC capacity to rapidly identify suspected Ebola cases and refer such patients for treatment to protect patients, staff members, and visitors.


Assuntos
Infecção Hospitalar/prevenção & controle , Surtos de Doenças/prevenção & controle , Administração de Instituições de Saúde , Doença pelo Vírus Ebola/prevenção & controle , Controle de Infecções/organização & administração , República Democrática do Congo/epidemiologia , Pesquisa sobre Serviços de Saúde , Doença pelo Vírus Ebola/epidemiologia , Humanos , Medição de Risco , Uganda
16.
BMC Health Serv Res ; 19(1): 689, 2019 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-31606053

RESUMO

BACKGROUND: Antimicrobial resistance is an increasing problem in hospitals world-wide. Following other countries, English hospitals experienced outbreaks of carbapenemase-producing Enterobacteriaceae (CPE), a bacterial infection commonly resistant to last resort antibiotics. One way to improve CPE prevention, management and control is the production of guidelines, such as the CPE toolkit published by Public Health England in December 2013. The aim of this research was to investigate the implementation of the CPE toolkit and to identify barriers and facilitators to inform future policies. METHODS: Acute hospital trusts (N = 12) were purposively sampled based on their self-assessed CPE colonisation rates and time point of introducing local CPE action plans. Following maximum variation sampling, 44 interviews with hospital staff were conducted between April and August 2017 using a semi-structured topic guide based on the Capability, Opportunity, Motivation and Behaviour Model and the Theoretical Domains Framework, covering areas of influences on behaviour. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. RESULTS: The national CPE toolkit was widely disseminated within infection prevention and control teams (IPCT), but awareness was rare among other hospital staff. Local plans, developed by IPCTs referring to the CPE toolkit while considering local circumstances, were in place in all hospitals. Implementation barriers included: shortage of isolation facilities for CPE patients, time pressures, and competing demands. Facilitators were within hospital and across-hospital collaborations and knowledge sharing, availability of dedicated IPCTs, leadership support and prioritisation of CPE as an important concern. Participants using the CPE toolkit had mixed views, appreciating its readability and clarity about patient management, but voicing concerns about the lack of transparency on the level of evidence and the practicality of implementation. They recommended regular updates, additional clarifications, tailored information and implementation guidance. CONCLUSIONS: There were problems with the awareness and implementation of the CPE toolkit and frontline staff saw room for improvement, identifying implementation barriers and facilitators. An updated CPE toolkit version should provide comprehensive and instructive guidance on evidence-based CPE prevention, management and control procedures and their implementation in a modular format with sections tailored to hospitals' CPE status and to different staff groups.


Assuntos
Enterobacteriáceas Resistentes a Carbapenêmicos , Infecção Hospitalar/prevenção & controle , Surtos de Doenças/prevenção & controle , Infecções por Enterobacteriaceae/prevenção & controle , Controle de Infecções/métodos , Adulto , Idoso , Antibacterianos/uso terapêutico , Inglaterra , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Adulto Jovem
17.
Orv Hetil ; 160(38): 1487-1494, 2019 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-31537095

RESUMO

Immune status was investigated in 186 patients with chronic lymphoid leukaemia between January 2012 and March 2015. Incidences of infections and mortality were analysed in patients who did not receive prophylactic immunoglobulin therapy. Immunoglobulin G (IgG) levels were normal (7-17.8 g/L) or decreased in 62.37% and 35.48% of patients, respectively. We measured high immunoglobulin levels only in a few cases (2.15%). Immunoglobulin levels became increasingly lower in more advanced disease stages (Rai stages). The number of infections was inversely proportional to that. Hypogammaglobulinaemia proved to be more important than disease progression in terms of the development of infections. The most common infections were upper respiratory tract (33.07%) and sepsis (18.90%). Two months after chemotherapy, initially normal immunoglobulin levels decreased by an average of 21%, and at the same time the incidence of infections increased. The most common cause of death was sepsis: 30% occurred at low immunoglobulin levels, while 20% at normal immunoglobulin levels. According to literature, prophylactic immunoglobulin treatment is indicated in patients with chronic lymphoid leukaemia and immunodeficiency for decreasing both morbidity and mortality. According to recommendations in literature, replacement treatment must be administered in severe or moderately severe recurrent bacterial infections. Immunoglobulin prophylaxis may be provided as low dose (10 g), fix dose (18 g) or individually customized higher dose (300-400 mg/kg body weight) treatment. According to recommendations, higher dose immunoglobulin prophylaxis, administered every three weeks on six occasions, is more efficient when customized. With this dose, infection-free condition may be achieved in 50% of patients. Orv Hetil. 2019; 160(38): 1487-1494.


Assuntos
Agamaglobulinemia/tratamento farmacológico , Agamaglobulinemia/mortalidade , Imunoglobulinas Intravenosas/uso terapêutico , Imunoglobulinas/administração & dosagem , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Sepse/mortalidade , Agamaglobulinemia/complicações , Relação Dose-Resposta a Droga , Feminino , Humanos , Hungria/epidemiologia , Imunoglobulina G/sangue , Imunoglobulinas Intravenosas/administração & dosagem , Controle de Infecções , Leucemia Linfocítica Crônica de Células B/complicações , Leucemia Linfocítica Crônica de Células B/mortalidade , Masculino , Sepse/diagnóstico , Resultado do Tratamento
18.
Parasit Vectors ; 12(1): 458, 2019 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-31547850

RESUMO

BACKGROUND: Schistosomiasis primarily affects poor and neglected communities due to their lack of safe water and sanitation facilities. In an effort to improve intervention strategies, the present study investigated the association of socio-demographic characteristics of women with their existing knowledge, perceptions and practices (KPP) in five urogenital schistosomiasis endemic rural communities in Zimbabwe. METHODS: In February 2016, a cross sectional study was conducted in which 426 women in rural Madziwa area, Shamva District were interviewed using a pretested structured questionnaire seeking their KPP and socio-demographic characteristics. Logistic regression analysis was performed to identify socio-demographic factors associated with the KPP variables. RESULTS: Among the 426 participants, 93.7% knew about schistosomiasis, while 97.7 and 87.5% understood the disease transmission and methods for prevention, respectively. A significantly higher percentage of women aged ≥ 30 years compared to those < 30 years indicated that infertility is a complication of untreated chronic schistosomiasis (OR: 1.7, 95% CI: 0.9-3.0). Compared to women who had no history of infection, those who had been infected before were more likely to think that they were currently infected (OR: 3.7, 95% CI: 2.4-6.0). Bathing in unsafe water sources was more common in non-apostolic compared to apostolic followers (OR: 2.1, 95% CI: 1.2-3.7). Sole use of unsafe water for domestic purposes was significantly higher in uneducated women compared to the educated (OR: 1.8, 95% CI: 1.0-3.1). Compared to women of the Chakondora community, those in Chihuri, Nduna and Kaziro were more likely to know that dysuria is a symptom of schistosomiasis while those in Chihuri were also likely to allow young children to perform water contact activities (OR: 2.9, 95% CI: 1.5-5.5). CONCLUSIONS: Despite the high level of schistosomiasis awareness, some women had inadequate knowledge about the mode of transmission and preventive measures for schistosomiasis. Socio-demographic characteristics were associated with the KPP of women. Thus, disease control efforts should consider socio-demographic factors, which may influence the knowledge, perceptions and practices of occupants in a given setting.


Assuntos
Transmissão de Doença Infecciosa/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Controle de Infecções/métodos , Mães , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Adolescente , Adulto , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , População Rural , Inquéritos e Questionários , Adulto Jovem , Zimbábue/epidemiologia
19.
JAMA ; 322(9): 824-833, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31479137

RESUMO

Importance: Clinical studies have been inconclusive about the effectiveness of N95 respirators and medical masks in preventing health care personnel (HCP) from acquiring workplace viral respiratory infections. Objective: To compare the effect of N95 respirators vs medical masks for prevention of influenza and other viral respiratory infections among HCP. Design, Setting, and Participants: A cluster randomized pragmatic effectiveness study conducted at 137 outpatient study sites at 7 US medical centers between September 2011 and May 2015, with final follow-up in June 2016. Each year for 4 years, during the 12-week period of peak viral respiratory illness, pairs of outpatient sites (clusters) within each center were matched and randomly assigned to the N95 respirator or medical mask groups. Interventions: Overall, 1993 participants in 189 clusters were randomly assigned to wear N95 respirators (2512 HCP-seasons of observation) and 2058 in 191 clusters were randomly assigned to wear medical masks (2668 HCP-seasons) when near patients with respiratory illness. Main Outcomes and Measures: The primary outcome was the incidence of laboratory-confirmed influenza. Secondary outcomes included incidence of acute respiratory illness, laboratory-detected respiratory infections, laboratory-confirmed respiratory illness, and influenzalike illness. Adherence to interventions was assessed. Results: Among 2862 randomized participants (mean [SD] age, 43 [11.5] years; 2369 [82.8%]) women), 2371 completed the study and accounted for 5180 HCP-seasons. There were 207 laboratory-confirmed influenza infection events (8.2% of HCP-seasons) in the N95 respirator group and 193 (7.2% of HCP-seasons) in the medical mask group (difference, 1.0%, [95% CI, -0.5% to 2.5%]; P = .18) (adjusted odds ratio [OR], 1.18 [95% CI, 0.95-1.45]). There were 1556 acute respiratory illness events in the respirator group vs 1711 in the mask group (difference, -21.9 per 1000 HCP-seasons [95% CI, -48.2 to 4.4]; P = .10); 679 laboratory-detected respiratory infections in the respirator group vs 745 in the mask group (difference, -8.9 per 1000 HCP-seasons, [95% CI, -33.3 to 15.4]; P = .47); 371 laboratory-confirmed respiratory illness events in the respirator group vs 417 in the mask group (difference, -8.6 per 1000 HCP-seasons [95% CI, -28.2 to 10.9]; P = .39); and 128 influenzalike illness events in the respirator group vs 166 in the mask group (difference, -11.3 per 1000 HCP-seasons [95% CI, -23.8 to 1.3]; P = .08). In the respirator group, 89.4% of participants reported "always" or "sometimes" wearing their assigned devices vs 90.2% in the mask group. Conclusions and Relevance: Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza. Trial Registration: ClinicalTrials.gov Identifier: NCT01249625.


Assuntos
Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Influenza Humana/prevenção & controle , Influenza Humana/transmissão , Máscaras , Dispositivos de Proteção Respiratória , Adulto , Assistência Ambulatorial , Feminino , Humanos , Incidência , Controle de Infecções/métodos , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/transmissão
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 880-882, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484247

RESUMO

The recent developed diarrhea and acute respiratory infections surveillance systems were a breakthrough of the infectious disease surveillance and monitoring in Shanghai. This series "Infectious Disease Surveillance in Shanghai" briefly introduced current experiences of the updated surveillance systems, in order to provide evidences for promotion in other disease surveillance and to enhance the connection between different surveillance systems.


Assuntos
Diarreia/epidemiologia , Controle de Infecções/métodos , Vigilância da População/métodos , Vigilância em Saúde Pública/métodos , Doença Aguda , China/epidemiologia , Doenças Transmissíveis/epidemiologia , Surtos de Doenças , Humanos , Infecções Respiratórias/epidemiologia , Vigilância de Evento Sentinela
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