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1.
BMJ ; 374: n2060, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34470747

RESUMO

OBJECTIVE: To determine the risk of hospital admission with covid-19 and severe covid-19 among teachers and their household members, overall and compared with healthcare workers and adults of working age in the general population. DESIGN: Population based nested case-control study. SETTING: Scotland, March 2020 to July 2021, during defined periods of school closures and full openings in response to covid-19. PARTICIPANTS: All cases of covid-19 in adults aged 21 to 65 (n=132 420) and a random sample of controls matched on age, sex, and general practice (n=1 306 566). Adults were identified as actively teaching in a Scottish school by the General Teaching Council for Scotland, and their household members were identified through the unique property reference number. The comparator groups were adults identified as healthcare workers in Scotland, their household members, and the remaining general population of working age. MAIN OUTCOME MEASURES: The primary outcome was hospital admission with covid-19, defined as having a positive test result for SARS-CoV-2 during hospital admission, being admitted to hospital within 28 days of a positive test result, or receiving a diagnosis of covid-19 on discharge from hospital. Severe covid-19 was defined as being admitted to intensive care or dying within 28 days of a positive test result or assigned covid-19 as a cause of death. RESULTS: Most teachers were young (mean age 42), were women (80%), and had no comorbidities (84%). The risk (cumulative incidence) of hospital admission with covid-19 was <1% for all adults of working age in the general population. Over the study period, in conditional logistic regression models adjusted for age, sex, general practice, race/ethnicity, deprivation, number of comorbidities, and number of adults in the household, teachers showed a lower risk of hospital admission with covid-19 (rate ratio 0.77, 95% confidence interval 0.64 to 0.92) and of severe covid-19 (0.56, 0.33 to 0.97) than the general population. In the first period when schools in Scotland reopened, in autumn 2020, the rate ratio for hospital admission in teachers was 1.20 (0.89 to 1.61) and for severe covid-19 was 0.45 (0.13 to 1.55). The corresponding findings for household members of teachers were 0.91 (0.67 to 1.23) and 0.73 (0.37 to 1.44), and for patient facing healthcare workers were 2.08 (1.73 to 2.50) and 2.26 (1.43 to 3.59). Similar risks were seen for teachers in the second period, when schools reopened in summer 2021. These values were higher than those seen in spring/summer 2020, when schools were mostly closed. CONCLUSION: Compared with adults of working age who are otherwise similar, teachers and their household members were not found to be at increased risk of hospital admission with covid-19 and were found to be at lower risk of severe covid-19. These findings should reassure those who are engaged in face-to-face teaching.


Assuntos
COVID-19/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Professores Escolares/estatística & dados numéricos , Adulto , Idoso , Estudos de Casos e Controles , Controle de Doenças Transmissíveis/métodos , Conjuntos de Dados como Assunto , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Medição de Risco , SARS-CoV-2 , Escócia/epidemiologia , Adulto Jovem
2.
Rev Esp Salud Publica ; 952021 Sep 07.
Artigo em Espanhol | MEDLINE | ID: mdl-34489393

RESUMO

In 2014, the first case of secondary Ebola infection outside Africa detected in Spain, caused a sense of global threat. This study assess Risk Perception amongst the health personnel and identify the agents that amplified or reduced it. Through a snowball sampling, 5 in-depth interviews were carried out. Inclusion´s criteria: treating the patient suspected of Ebola and/or of having been actively involved in the management of the crisis. Triangulation and member checking were used to validate findings. Field work was between February and June 2015. In Risk Perception´s construction were involved Formation, Management of Information and Trust. Political and Health Authorities, Media and Unions acted as amplifiers whereas the Expert Committee and Hospital Management as reducers. Peer-to-peer behavior acted as a reducer amongst the medical staff and as an amplifier between the nursing and cleaning staff. This information would be relevant to better manage a health crisis of this characteristics.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Doença pelo Vírus Ebola , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/terapia , Humanos , Medição de Risco , Espanha/epidemiologia
3.
Pan Afr Med J ; 39: 99, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34466201

RESUMO

Introduction: the provision of basic diagnostic imaging services is pivotal to achieving universal health coverage. An estimated two-thirds of the world's population have no access to basic diagnostic imaging. Accurate data on current imaging equipment resources are required to inform health delivery strategy and policy at national level. This is an audit of Zimbabwean public sector diagnostic ultrasound resources and services. Methods: utilising the Ministry of Health and Child Care (MHCC) database, sequential interviews were conducted with provincial health authorities and local facility managers. Ultrasound equipment, personnel and services in all hospitals and clinics, nationally were recorded, collated, and analysed for the whole country, and by province. Results: of the 1798 Zimbabwean public sector healthcare facilities, sixty-six (n=66, 3.67%) have ultrasound equipment. Ninety-nine (n=99) ultrasound units are distributed across the sonar facilities, representing a national average of 8 units per million people. More than half the equipment units (n=53, 54%) are in secondary-level healthcare facilities (district and mission hospitals), and approximately one-fifth (n=22, 22%) in the central hospitals (quaternary level). The best-resourced province has twice the resources of the least resourced. One-hundred and forty-two (n=142) healthcare workers, from six different professional groups, provide the public sector ultrasound service. Most facilities with sonar equipment (n=64/66, 97%) provide obstetrics and gynaecology services, while general abdominal scanning is available at one third (n=22, 33%). Two facilities with ultrasound equipment have no capacity to offer a sonography service. Conclusion: in order to reach the WHO recommendation of 20 sonar units per million people, an estimated 140 additional sonar units are required nationally. The need is greatest in Masvingo, Midlands and Mashonaland East Provinces. Task-shifting plays a key role in the provision of Zimbabwean sonar services. Consideration should be given to formal training and accreditation of all healthcare workers involved in sonar service delivery.


Assuntos
Atenção à Saúde/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde , Ultrassonografia/estatística & dados numéricos , Bases de Dados Factuais , Instalações de Saúde/estatística & dados numéricos , Política de Saúde , Humanos , Setor Público , Cobertura Universal do Seguro de Saúde , Zimbábue
5.
BMJ ; 374: n1868, 2021 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-34407952

RESUMO

OBJECTIVE: To determine associations of BNT162b2 vaccination with SARS-CoV-2 infection and hospital admission and death with covid-19 among nursing home residents, nursing home staff, and healthcare workers. DESIGN: Prospective cohort study. SETTING: Nursing homes and linked electronic medical record, test, and mortality data in Catalonia on 27 December 2020. PARTICIPANTS: 28 456 nursing home residents, 26 170 nursing home staff, and 61 791 healthcare workers. MAIN OUTCOME MEASURES: Participants were followed until the earliest outcome (confirmed SARS-CoV-2 infection, hospital admission or death with covid-19) or 26 May 2021. Vaccination status was introduced as a time varying exposure, with a 14 day run-in after the first dose. Mixed effects Cox models were fitted to estimate hazard ratios with index month as a fixed effect and adjusted for confounders including sociodemographics, comorbidity, and previous medicine use. RESULTS: Among the nursing home residents, SARS-CoV-2 infection was found in 2482, 411 were admitted to hospital with covid-19, and 450 died with covid-19 during the study period. In parallel, 1828 nursing home staff and 2968 healthcare workers were found to have SARS-CoV-2 infection, but fewer than five were admitted or died with covid-19. The adjusted hazard ratio for SARS-CoV-2 infection after two doses of vaccine was 0.09 (95% confidence interval 0.08 to 0.11) for nursing home residents, 0.20 (0.17 to 0.24) for nursing home staff, and 0.13 (0.11 to 0.16) for healthcare workers. Adjusted hazard ratios for hospital admission and mortality after two doses of vaccine were 0.05 (0.04 to 0.07) and 0.03 (0.02 to 0.04), respectively, for nursing home residents. Nursing home staff and healthcare workers recorded insufficient events for mortality analysis. CONCLUSIONS: Vaccination was associated with 80-91% reduction in SARS-CoV-2 infection in all three cohorts and greater reductions in hospital admissions and mortality among nursing home residents for up to five months. More data are needed on longer term effects of covid-19 vaccines.


Assuntos
Vacinas contra COVID-19/uso terapêutico , COVID-19/mortalidade , Pessoal de Saúde/estatística & dados numéricos , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , SARS-CoV-2 , Espanha/epidemiologia , Resultado do Tratamento
6.
Pan Afr Med J ; 39: 53, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34422176

RESUMO

Introduction: health care workers are at greatest risk to being infected with COVID-19 in health care facilities. This study is focused on assessing the level of practice and factors affecting practice towards COVID-19 among health care workers in health care facility of West Guji Zone, Oromia region, Ethiopia. Methods: health facility based cross-sectional study design was carried out from December 1st to 30th 2020 among health care providers in West Guji Zone. The simple random sampling technique was used in study and total sample size for this study was 281. The data enter into Epi Data version 4.4.3.1 and SPSS Version 25 used for analysis. The descriptive statistics and logistic regression are needed. The cut point for statically significance settled at p < 0.05. Results: the response rate in this study was 97.8%. Of all study participants, 50.2%, 8.4%, and 6.5% had traveling history, chronic illnesses, and contact with COVID-19 confirmed cases. Too much working, lack of training, and shortage of protective equipment were reported by 54.5%, 50.9%, and 29.1% respectively. About 36.4% and 38.2% of health care providers had poor level of knowledge and prevention practice towards COVID-19. Working at hospital (AOR= 0.156, 95% CI=0.033-0.741), awareness of the action during suggestive symptoms and signs of COVID-19 developed (AOR= 0.038, 95% CI=0.002-0.817), hand washing (AOR= 0.043, 95% CI=0.008-0.238), not going to crowded place (AOR= 0.001, 95% CI=0.001-0.030), applying physical distance (AOR=0.091,95% CI=0.041-0.579) adherence to triage and isolation protocol (AOR=0.317,95%=0.039-0.577)and knowledge level of COVID-19 (AOR=2.378,95%CI=1.523-6.322) were factors significantly associated with prevention practice of COVID-19. Conclusion: in this study, the knowledge level and prevention practice gap was identified. Type of facility, awareness of the action during suggestive symptoms and signs of COVID-19 developed, hands washing to the standard, not going to crowded place, keeping physical distance, adherence to triage and isolation protocol and having good level of knowledge about COVID-19 were factors associated with good prevention practices. Adequate supply of personal protective materials; provision of continuous on-job training and guideline for prevention of COVID-19 must be given to all health care facilities.


Assuntos
COVID-19/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Adulto , Estudos Transversais , Etiópia , Feminino , Desinfecção das Mãos , Instalações de Saúde , Humanos , Masculino , Equipamento de Proteção Individual/provisão & distribuição , Distanciamento Físico , Inquéritos e Questionários , Adulto Jovem
7.
Pan Afr Med J ; 38: 357, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34367436

RESUMO

Introduction: the knowledge and practices on Lassa fever (LF) infection prevention and control (IPC) remains poor among health workers in Nigeria despite LF endemicity. This study aimed to evaluate the knowledge, attitude, and practices of healthcare workers at the Federal Medical Centre, Owo towards LF. Methods: this was a cross-sectional study among 451 healthcare workers who were enrolled using a simple random sampling technique. Data were collected using a semi-structured interviewer-administered questionnaire and analyzed with SPSS version 23. Adequate knowledge, positive attitude, and good practice of LF infection, prevention, and control were determined by the proportion of respondents who scored >80% in each category. Descriptive statistics were done. Associations were explored using Chi-square tests. Results: the mean age of respondents was 37.95±8.43 years, and 169 (37.5%) were doctors. The mean overall knowledge score was 18.33±2.14, and 236 (52.3%) had appropriate knowledge, 109 (24.2%) had a positive attitude, while 351 (77.8%) demonstrated adequate preventive practices towards LFIPC. Laboratory scientists had five times the odds of appropriate knowledge of LF IPC (OR=4.886; 95%CI: 1.580-15.107). Pharmacists had ten times odds of positive attitude towards LF IPC (OR=10.093; 95%CI= 1.055-95.516). Pharmacists had nine times odds of good LF IPC practices (OR=8.755; 95%CI=1.028-74.531). Conclusion: disparities in knowledge, attitude, and practices of LF IPC exist among healthcare workers. To strengthen IPC, intervention strategies like training to address such gaps are needed.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Febre Lassa/prevenção & controle , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Inquéritos e Questionários
8.
Pan Afr Med J ; 38: 407, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34381551

RESUMO

Introduction: epilepsy is a very common neurological disorder which is associated with high socioeconomic burden. While up to 90% of people with epilepsy (PWE) in developing countries do not get appropriate treatment, there is limited information about care offered to PWE in Tanzania. This study aimed to describe available care offered to PWE in Mwanza. Methods: a cross-sectional study involving health care workers (HCWs) and PWE attending five selected hospitals outpatient clinics of Mwanza region was done. HCWs completed self-administered questionnaires while PWE or caretakers were interviewed using structured questionnaires. Coded data were analyzed using SPSS. Results: a total of 18 HCWs and 218 PWE (or their care takers) participated in this study. Health care workers rarely used investigations to confirm epilepsy diagnosis or explore its causes. 10/18 (55.6%) of HCWs reported that counseling was given to patients but counseling information was largely inadequate regarding the use of anti-epileptic drugs (AEDs). The AEDs prescriptions were dictated by drug availability and affordability to patients. Among 197 PWE, whose AEDs doses were revealed, 136 (69.0%) were under-medicated. No follow-up investigation was done to all PWE who were interviewed. There was discrepancy between hospitals and practitioners regarding withdrawal of AEDs. Conclusion: people with epilepsy in Mwanza received limited care. Patients were not thoroughly investigated, counseled and followed-up, and had limited choice and accessibility to AEDs. Some patients particularly in district hospitals were under-medicated despite of seizure recurrence. We recommend short-course training about epilepsy management to the HCWs who diagnose and treat PWE regularly.


Assuntos
Anticonvulsivantes/administração & dosagem , Epilepsia/terapia , Pessoal de Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde , Adolescente , Adulto , Estudos Transversais , Epilepsia/diagnóstico , Feminino , Humanos , Masculino , Inquéritos e Questionários , Tanzânia , Adulto Jovem
9.
Viruses ; 13(7)2021 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-34372618

RESUMO

Healthcare workers (HCWs) are at high risk for SARS-CoV-2 infection compared to the general population. Here, we aimed to evaluate and characterize the SARS-CoV-2 seropositivity rate in randomly collected samples among HCWs from the largest referral hospitals and quarantine sites during the peak of the COVID-19 epidemic in the city of Jeddah, the second largest city in Saudi Arabia, using a cross-sectional analytic study design. Out of 693 participants recruited from 29 June to 10 August 2020, 223 (32.2%, 95% CI: 28.8-35.8) were found to be confirmed seropositive for SARS-CoV-2 antibodies, and among those 197 (88.3%) had never been diagnosed with COVID-19. Seropositivity was not significantly associated with participants reporting COVID-19 compatible symptoms as most seropositive HCW participants 140 (62.8%) were asymptomatic. The large proportion of asymptomatic SARS-CoV-2 cases detected in our study demands periodic testing as a general hospital policy.


Assuntos
COVID-19/epidemiologia , SARS-CoV-2/imunologia , Adulto , Animais , Anticorpos Neutralizantes , Anticorpos Antivirais/imunologia , Infecções Assintomáticas , COVID-19/imunologia , COVID-19/virologia , Teste Sorológico para COVID-19 , Chlorocebus aethiops , Estudos Transversais , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Controle de Infecções , Masculino , Pessoa de Meia-Idade , Quarentena , Encaminhamento e Consulta , Arábia Saudita/epidemiologia , Estudos Soroepidemiológicos , Células Vero
10.
Mayo Clin Proc ; 96(9): 2312-2322, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34366140

RESUMO

OBJECTIVE: To identify significant factors that help predict whether health care personnel (HCP) will test positive for severe acute respiratory coronavirus 2 (SARS-CoV-2). PATIENTS AND METHODS: We conducted a prospective cohort study among 7015 symptomatic HCP from March 25, 2020, through November 11, 2020. We analyzed the associations between health care role, contact history, symptoms, and a positive nasopharyngeal swab SARS-CoV-2 polymerase chain reaction test results, using univariate and multivariable modelling. RESULTS: Of the symptomatic HCP, 624 (8.9%) were positive over the study period. On multivariable analysis, having a health care role other than physician or advanced practice provider, contact with family or community member with known or suspected coronavirus disease 2019 (COVID-19), and seven individual symptoms (cough, anosmia, ageusia, fever, myalgia, chills, and headache) were significantly associated with higher adjusted odds ratios for testing positive for SARS-CoV-2. For each increase in symptom number, the odds of testing positive nearly doubled (odds ratio, 1.93; 95% CI, 1.82 to 2.07, P<.001). CONCLUSION: Symptomatic HCP have higher adjusted odds of testing positive for SARS-CoV-2 based on three distinct factors: (1) nonphysician/advanced practice provider role, (2) contact with a family or community member with suspected or known COVID-19, and (3) specific symptoms and symptom number. Differences among health care roles, which persisted after controlling for contacts, may reflect the influence of social determinants. Contacts with COVID-19-positive patients and/or HCP were not associated with higher odds of testing positive, supporting current infection control efforts. Targeted symptom and contact questionnaires may streamline symptomatic HCP testing for COVID-19.


Assuntos
Anticorpos Antivirais/análise , Teste para COVID-19/métodos , COVID-19/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Pandemias , SARS-CoV-2/imunologia , Seguimentos , Humanos , Estudos Prospectivos
11.
Front Health Serv Manage ; 38(1): 27-31, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34431816

RESUMO

SUMMARY: Critical access hospitals (CAHs) serve their rural communities as the main access points and communication centers for healthcare, typically with very limited financial, staffing, and support resources. Local residents rely on their CAHs as the only providers for many miles around. When the COVID-19 pandemic hit in early 2020, CAH leaders had to rethink operations and priorities, both internally with staffs and externally with community leaders and organizations. Few critical care beds were available when the need was greatest. Testing was problematic, and cultural barriers complicated care. Now, as virus variants strike where vaccination numbers are low, CAH leaders remain wary of financial hits to elective procedure income, limited resources, and added stress for their staffs. Working with community service organizations and larger regional healthcare centers is a crucial strategy for CAHs as they address care delivery issues and ensure that their caregivers can do their jobs now and in the future.


Assuntos
COVID-19/terapia , Cuidados Críticos/organização & administração , Atenção à Saúde/organização & administração , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Administradores Hospitalares/psicologia , Serviços de Saúde Rural/organização & administração , Adulto , Animais , Atitude do Pessoal de Saúde , Feminino , Administração Hospitalar , Humanos , Illinois , Liderança , Masculino , Pessoa de Meia-Idade , Objetivos Organizacionais , Pandemias , SARS-CoV-2
12.
S Afr Med J ; 111(6): 554-558, 2021 03 26.
Artigo em Inglês | MEDLINE | ID: mdl-34382565

RESUMO

Access to COVID-19 vaccines has raised concerns globally. Despite calls for solidarity and social justice during the pandemic, vaccine nationalism, stockpiling of limited vaccine supplies by high-income countries and profit-driven strategies of global pharmaceutical manufacturers have brought into sharp focus global health inequities and the plight of low- and middle-income countries (LMICs) as they wait in line for restricted tranches of vaccines. Even in high-income countries that received vaccine supplies first, vaccine roll-out globally has been fraught with logistic and ethical challenges. South Africa (SA) is no exception. Flawed global institutional strategies for vaccine distribution and delivery have undermined public procurement platforms, leaving LMICs facing disproportionate shortages necessitating strict criteria for vaccine prioritisation. In anticipation of our first consignment of vaccines, deliberations around phase 1 roll-out were intense and contentious. Although the first phase focuses on healthcare personnel (HCP), the devil is in the detail. Navigating the granularity of prioritising different categories of risk in healthcare sectors in SA is complicated by definitions of risk in personal and occupational contexts. The inequitable public-private divide that characterises the SA health system adds another layer of complexity. Unlike other therapeutic or preventive interventions that are procured independently by the private health sector, COVID-19 vaccine procurement is currently limited to the SA government only, leaving HCP in the private sector dependent on central government allocation. Fair distribution among tertiary, secondary and primary levels of care is another consideration. Taking all these complexities into account, procedural and substantive ethical principles supporting a prioritisation approach are outlined. Within the constraints of suboptimal global health governance, LMICs must optimise progressive distribution of scarce vaccines to HCP at highest risk.


Assuntos
Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Saúde Global , Acesso aos Serviços de Saúde/ética , Vacinas contra COVID-19/provisão & distribuição , Países em Desenvolvimento , Pessoal de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde , Humanos , Setor Privado , Setor Público , Justiça Social , África do Sul
13.
Artigo em Alemão | MEDLINE | ID: mdl-34374799

RESUMO

BACKGROUND: Healthcare workers are among the most exposed and potentially most threatened populations of the ongoing COVID-19 pandemic. Despite some reports on numbers of infections with SARS-CoV­2 in German healthcare workers, the courses of their clinical presentation when affected by COVID-19 are not well described. OBJECTIVE: In this contribution, characteristics and progressions of infected cases among healthcare workers at the University Medical Center Hamburg-Eppendorf during the first wave of the COVID-19 pandemic will be presented. METHODS: Between 1 July and 28 July 2020, 67 healthcare workers, who previously tested positive for SARS-CoV­2 via PCR, were invited via E­mail to participate in an anonymous online questionnaire; 39 persons participated. RESULTS: Participants (58%) were mostly ≤ 39 years old (64%) and female (70%). Most healthcare workers were involved in direct patient management (85%), including contact with SARS-CoV­2 positive patients (62%). All participants reported acute symptoms with a median duration of 19 days. The most frequent symptoms were fatigue (85%), anosmia (67%), cough (64%), headache (62%), and shortness of breath (51%). The disease course was mostly mild with low admission rates (5%). Ongoing symptoms lasting more than four weeks post-symptom-onset, particularly anosmia, fatigue, and shortness of breath, were reported by 38%. This group more frequently had pre-existing conditions (53% vs. 12%, p = 0.010), specifically hypertension (27% vs. 4%, p = 0.062). DISCUSSION: Healthcare workers reported mostly mild courses of COVID-19 despite increased contact with SARS-CoV-2 patients. However, some reported persistent symptoms months after infection.


Assuntos
COVID-19 , Pessoal de Saúde/estatística & dados numéricos , Pandemias , Centros Médicos Acadêmicos , Adulto , COVID-19/epidemiologia , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Universidades
15.
Int J Public Health ; 66: 633917, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34434083

RESUMO

Objectives: Existing evidence suggests that drug-resistant tuberculosis (DR-TB) remains a huge public health threat in high-burden TB countries such as Ethiopia. The purpose of this qualitative study was to explore the challenges of healthcare workers (HCWs) involved in providing DR-TB care in Addis Ababa, Ethiopia. Methods: We conducted in-depth interviews with 18 HCWs purposively selected from 10 healthcare facilities in Addis Ababa, Ethiopia. We then transcribed the audiotaped interviews, and thematically analysed the transcripts using Braun and Clark's reflexive thematic analysis framework. Results: We identified five major themes: 1) inadequate training and provision of information on DR-TB to HCWs assigned to work in DR-TB services, 2) fear of DR-TB infection, 3) risk of contracting DR-TB, 4) a heavy workload, and 5) resource limitations. Conclusion: Our findings highlight major human resource constraints that current DR-TB care policies need to foresee and accommodate. New evidence and best practices on what works in DR-TB care in such resource-limited countries are needed in order to address implementation gaps and to meet global TB strategies.


Assuntos
Pessoal de Saúde , Tuberculose Resistente a Múltiplos Medicamentos , Etiópia/epidemiologia , Feminino , Instalações de Saúde , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Recursos em Saúde/provisão & distribuição , Mão de Obra em Saúde , Humanos , Masculino , Pesquisa Qualitativa , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/terapia
16.
MMWR Morb Mortal Wkly Rep ; 70(34): 1167-1169, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34437521

RESUMO

During December 14, 2020-April 10, 2021, data from the HEROES-RECOVER Cohorts,* a network of prospective cohorts among frontline workers, showed that the Pfizer-BioNTech and Moderna mRNA COVID-19 vaccines were approximately 90% effective in preventing symptomatic and asymptomatic infection with SARS-CoV-2, the virus that causes COVID-19, in real-world conditions (1,2). This report updates vaccine effectiveness (VE) estimates including all COVID-19 vaccines available through August 14, 2021, and examines whether VE differs for adults with increasing time since completion of all recommended vaccine doses. VE before and during SARS-CoV-2 B.1.617.2 (Delta) variant predominance, which coincided with an increase in reported COVID-19 vaccine breakthrough infections, were compared (3,4).


Assuntos
Vacinas contra COVID-19/imunologia , COVID-19/prevenção & controle , Socorristas/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , SARS-CoV-2/isolamento & purificação , COVID-19/epidemiologia , COVID-19/virologia , Vacinas contra COVID-19/administração & dosagem , Estudos de Coortes , Humanos , Fatores de Tempo , Estados Unidos/epidemiologia , Vacinação/estatística & dados numéricos , Vacinas Sintéticas
17.
PLoS One ; 16(8): e0256441, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34449801

RESUMO

ABO blood types could be a biological predisposition for depression. The present cross-sectional analysis was conducted amid the second wave of COVID-19 in Japan during July 2020. We wanted to investigate the association between ABO blood types and depressive symptoms among workers (352 men and 864 women, aged 21-73 years) of a medical institution in Tokyo, Japan, which took a leading role in the response to COVID-19 in the country. A Poisson regression model with a robust variance estimator was used to estimate the prevalence ratio (PR) and 95% confidence interval (CI) for depressive symptoms associated with ABO blood types. Overall, the prevalence of depressive symptoms (using two questions employed from a Two-question case-finding instrument) was 22.0%. The adjusted PRs (95% CI) for depressive symptoms, comparing the carriers of blood type O, A, and AB with those of type B, were 0.88 (0.66, 1.18), 0.81 (0.62, 1.07), and 1.07 (0.74, 1.53), respectively. There was no difference in the prevalence of depressive symptoms between non-B and B carriers. The present study did not support the association of ABO blood types with depressive symptoms.


Assuntos
Sistema ABO de Grupos Sanguíneos , COVID-19/epidemiologia , Transtorno Depressivo/diagnóstico , Pessoal de Saúde/estatística & dados numéricos , Sistema ABO de Grupos Sanguíneos/genética , Adulto , Idoso , COVID-19/virologia , Estudos Transversais , Transtorno Depressivo/epidemiologia , Suscetibilidade a Doenças/sangue , Feminino , Predisposição Genética para Doença , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Pandemias , Prevalência , SARS-CoV-2/isolamento & purificação , Adulto Jovem
19.
PLoS One ; 16(8): e0254821, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34347812

RESUMO

INTRODUCTION: Although most countries and healthcare systems worldwide have been affected by the COVID-19 pandemic, some groups of the population may be more vulnerable to detrimental effects of the pandemic on mental health than others. The aim of this systematic review was to synthesise evidence currently available from systematic reviews on the impact of COVID-19 and other coronavirus outbreaks on mental health for groups of the population thought to be at increased risk of detrimental mental health impacts. MATERIALS AND METHODS: We conducted a systematic review of reviews on adults and children residing in a country affected by a coronavirus outbreak and belonging to a group considered to be at risk of experiencing mental health inequalities. Data were collected on symptoms or diagnoses of any mental health condition, quality of life, suicide or attempted suicide. The protocol for this systematic review was registered in the online PROSPERO database prior to commencing the review (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=194264). RESULTS: We included 25 systematic reviews. Most reviews included primary studies of hospital workers from multiple countries. Reviews reported variable estimates for the burden of symptoms of mental health problems among acute healthcare workers, COVID-19 patients with physical comorbidities, and children and adolescents. No evaluations of interventions were identified. Risk- and protective factors, mostly for healthcare workers, showed the importance of personal factors, the work environment, and social networks for mental health. CONCLUSIONS: This review of reviews based on primary studies conducted in the early months of the COVID-19 pandemic shows a lack of evidence on mental health interventions and mental health impacts on vulnerable groups in the population.


Assuntos
COVID-19/epidemiologia , Infecções por Coronavirus/epidemiologia , Pessoal de Saúde , Saúde Mental/estatística & dados numéricos , Populações Vulneráveis , Adolescente , Adulto , COVID-19/psicologia , Criança , Infecções por Coronavirus/psicologia , Surtos de Doenças , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Pandemias , SARS-CoV-2/fisiologia , Fatores Socioeconômicos , Populações Vulneráveis/psicologia , Populações Vulneráveis/estatística & dados numéricos
20.
PLoS One ; 16(8): e0255680, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34347855

RESUMO

New emerging infectious diseases are identified every year, a subset of which become global pandemics like COVID-19. In the case of COVID-19, many governments have responded to the ongoing pandemic by imposing social policies that restrict contacts outside of the home, resulting in a large fraction of the workforce either working from home or not working. To ensure essential services, however, a substantial number of workers are not subject to these limitations, and maintain many of their pre-intervention contacts. To explore how contacts among such "essential" workers, and between essential workers and the rest of the population, impact disease risk and the effectiveness of pandemic control, we evaluated several mathematical models of essential worker contacts within a standard epidemiology framework. The models were designed to correspond to key characteristics of cashiers, factory employees, and healthcare workers. We find in all three models that essential workers are at substantially elevated risk of infection compared to the rest of the population, as has been documented, and that increasing the numbers of essential workers necessitates the imposition of more stringent controls on contacts among the rest of the population to manage the pandemic. Importantly, however, different archetypes of essential workers differ in both their individual probability of infection and impact on the broader pandemic dynamics, highlighting the need to understand and target intervention for the specific risks faced by different groups of essential workers. These findings, especially in light of the massive human costs of the current COVID-19 pandemic, indicate that contingency plans for future epidemics should account for the impacts of essential workers on disease spread.


Assuntos
COVID-19/transmissão , Controle de Infecções , Distanciamento Físico , Recursos Humanos , COVID-19/epidemiologia , Epidemias/prevenção & controle , Pessoal de Saúde/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Controle de Infecções/estatística & dados numéricos , Modelos Estatísticos , Cidade de Nova Iorque/epidemiologia , Ocupações/estatística & dados numéricos , Pandemias , Quarentena/estatística & dados numéricos , Fatores de Risco , Populações Vulneráveis/estatística & dados numéricos , Recursos Humanos/organização & administração , Recursos Humanos/estatística & dados numéricos
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