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Abstract Introduction: The nose and throat are areas of high viral load, which could place otolaryngologists at an even higher risk for COVID-19 than other health-care workers. Objective: To investigate the prevalence of antibodies against SARS-CoV-2 in otorhinolaryngologists in southern Brazil, its relationship to demographic data, professional practice and reported symptoms of COVID-19, and compare it with official data on other health-care workers of the state and the general population in the same period. Methods: In this cross-sectional multicenter study, otolaryngologists actively practicing officially registered in Rio Grande do Sul were screened for IgM and IgG antibodies against SARS-CoV-2 from August 1 to September 15, 2020. A questionnaire was also applied. Results: We screened 358 (80.1%) of 447 actively practicing otolaryngologists (195 [54.5%] male; mean [SD] age, 47.77 [13.57] years; range, 26-84 years). Twenty-three were positive for IgM and/or IgG (6.4%). This result was significantly associated with reports of infected household contacts (19/315 negatives and 8/23 positives; p<0.001). From 23 seropositive participants, 14 were asymptomatic (60.9%; p< 0.001). There were no significant associations between seroconversion and age, sex, number of patient appointments and surgical procedures, workplace (hospital or private practice), patients with or without respiratory symptoms, or level of personal protective equipment used. The rate of COVID-19 in all health-care workers in the state was 7.69% at the end of the same period. Data from state government seroprevalence was 5.26 (risk ratio [RR]; 95% CI 3.27-8.45) and 4.66 (RR; 95% CI 2.93-7.43) times higher in otolaryngologists than in the general population in August and September, respectively. Conclusion: Otolaryngologists had a higher seroconversion rate than the general population. Using personal protective equipment, the level of occupational exposure did not result in higher rates of infection than other health-care workers, but the presence of infected household contacts was associated with higher rates of seroconversion.
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PURPOSE: Specific immunotherapy (SIT) is a suitable but uncommon treatment option for allergic rhinitis (AR) in China. The current understanding and attitude of Chinese ENT (ear, nose, and throat) specialists in regards to SIT is unclear. This study investigates current trends in the awareness and application status of SIT among Chinese ENT specialists. METHODS: We performed a nationwide, cross-sectional survey with a specially designed questionnaire given to 800 ENT specialists in China. A member of the trained research group conducted face-to-face interviews with each respondent. RESULTS: Most of the respondents considered AR (96.0%) and allergic asthma (96.0%) the most suitable indications for SIT. Of all respondents, 77.0% recommended the application of SIT as early as possible; in addition, SIT was considered 'relatively controllable and safe' by most respondents (80.6%). The highest allergen-positive rate in AR was associated with house dust mite (47.7%) and obvious differences existed among geographical regions. Conventional subcutaneous immunotherapy was the most highly recommended treatment option (96.2%). 'The high cost of SIT' (86.6%) and 'lack of patient knowledge of SIT' (85.2%) were probably the main reasons for the lower clinical use of SIT in China. CONCLUSIONS: Most cases showed that the opinions of Chinese ENT specialists appeared to be in agreement with recent SIT progress and international guidelines; however, many areas still need to enhance the standardization and use of SIT in China. Clinical guidelines for SIT require improvement; in addition, Chinese ENT specialists need continuing medical education on SIT.
Subject(s)
Humans , Asian People , Asthma , China , Cross-Sectional Studies , Surveys and Questionnaires , Education, Medical, Continuing , Immunotherapy , Nose , Pyroglyphidae , Rhinitis , Specialization , Surveys and QuestionnairesABSTRACT
Introducción: Constantemente se menciona que existe un déficit de otorrinolaringólogos en Chile. Se desconoce la distribución entre el sector público y privado de salud. Objetivo: Determinar la cantidad y distribución de los otorrinolaringólogos que trabajan en el sector público y privado de salud en Chile. Material y método: Estudio de corte transversal para el que se usaron registros del Ministerio de Salud, Sociedad Chilena de Otorrinolaringología, Superintendencia de Salud y del Departamento de Estadísticas e Información en Salud. Resultados: Se aprecia que hay 152 especialistas que trabajan en el sector público, en contraste con los 405 totales del país, correspondiendo a 37,5% de los profesionales que trabajan en el sectorpúblico. Al evaluar el total de otorrinolaringólogos registrados a nivel nacionaly la población total se obtiene una relación de 1 otorrinolaringólogo/42.589 habitantes, mientras que la relación de otorrinolaringólogos que trabajan en sector público con población beneficiaria de FONASA es de 1 otorrinolaringólogo/85.162 habitantes. Discusión: El principal problema en Chile no es la cantidad de otorrinolaringólogos, sino su distribución, la que es muy asimétrica. Esto es considerando sólo el número de otorrinolaringólogos, no su carga horaria, ya que al evaluar esta relación probablemente la asimetría aumentaría aún más. Es necesario fomentar la permanencia de los especialistas en el sector público.
Introduction: Constantly there are mentions that there is a shortage of otolaryngologists in Chile. It is unknown the reality of the distribution between public and private health sector. Aim: The objective of this study was to determine the amount and distribution of otolaryngologists working in the public and private health sector in Chile. Material and method: A cross sectional study that used the records of the Ministry of Health, Chilean Society of Otolaryngology, Superintendent of Health, and Department of Health Statistics and Information. Results: There are 152 specialists working in the public sector, in contrast to the 405 total in the country, corresponding to 37,5(0)% of total professionals working in the public sector. In assessing the relationship between total otolaryngologists in the country with the total population, and otolaryngologists working in the public sector and the beneficiary population of FONASA, there is a relationship of 1 ORL/42.589 and 1 ORL/85.162 inhabitants, respectively. Discussion: The main problem in Chile is not the amount of otolaryngologists, but its distribution, which is very asymmetric between the private and public sector. It is necessary to promote the retention of specialists in the public sector.