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ObjectiveTo investigate the latent tuberculosis infection （LTBI） of close contacts in schools of Xuhui District， and to explore the tuberculin skin test （TST）- interferon-γ release assay （IGRA） two-step method in order to discover the screening strategy of tuberculosis in Xuhui District. MethodsClose contacts of tuberculosis in schools of Xuhui District from 2020 to 2022 were selected as research subjects. Screening was conducted using symptom questionnaire， TST， chest X-rays， IGRA， and the information including the etiological results and grade of the index cases， as well as gender， age， and relationship with the index cases of the research subjects were collected. ResultsTotally 615 close contacts of 32 tuberculosis cases occurred in the schools were finally included. Of the 609 close contacts who completed tuberculosis infection screening and underwent TST testing， 153 TST（+） individuals underwent IGRA testing. The final LTBI rate was 4.6%， and the pulmonary tuberculosis detection rate was 163 per 100 000. The relationship with the index cases was an influencing factor for LTBI. The IGRA positivity rate was higher among close contacts with TST ≥15 mm than among those with 10 mm≤ TST <15 mm （χ2=14.41， P<0.05）. ConclusionThe latent tuberculosis infection among close contacts of school tuberculosis cases in Xuhui District remains serious. TST-IGRA two-step method can assist in the accurate diagnosis of LTBI and pulmonary tuberculosis cases.
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Resumen Introducción: La información sobre COVID en médicos es limitada. Su conocimiento permitiría implementar acciones para reducir su impacto. El objetivo general fue determinar la incidencia de infección por SARS-CoV-2 en médicos de instituciones de salud de Argentina, sus características y factores aso ciados. Materiales y Métodos: Se realizó un estudio multicéntrico de cohorte prospectiva/retrospectiva con estudio de casos-controles anidado. Se incluyeron médicos activos al inicio de la pandemia no exceptuados por riesgo. Se estimó incidencia de casos confirmados. Se compararon factores asociados en casos y controles y se creó un modelo de regresión logística con las variables significativas del análisis bivariado. Resultados: Se incluyeron 343 médicos con COVID de 8 centros. La incidencia de la enfermedad fue de 12.1% y la de ausentismo global relacionado a COVID, de 34.1%. El 70% de los contactos estrechos fueron laborales. En el análisis multivariado de casos y controles, la residencia en la Ciudad Autónoma de Buenos Aires (OR 0.19, p = 0.01), el trabajo en áreas de alto riesgo (OR 0.22, p = 0.01) y vehículo individual (OR 0.34, p = 0.03) redujeron el riesgo de COVID. El odds de enfermar aumentó 4.6 veces (p = 0.02) por cada aislamiento por contacto estrecho. Discusión: El riesgo de enfermar aumentó considerablemente con cada aislamiento por contacto estrecho. La residencia en Ciudad Autónoma, el traslado en vehículo individual y el trabajo en áreas de alto riesgo lo redujeron. Dada la alta frecuencia de contactos estrechos en el ámbito laboral recomendamos reforzar las medidas de prevención en áreas de descanso y no COVID.
Abstract Background: Information about COVID infection in physicians is limited. This knowledge would allow the implementation of actions to reduce its impact. The objective was determining the incidence of SARS-CoV-2 infection in physicians from health institutions in Argentina, its characteristics, and associated factors. Methods: We conducted a multicenter prospective / retrospective cohort study with nested case-control study. Physicians active at the beginning of the pandemic were included, those on leave due to risk factors were excluded. The incidence of confirmed cases was estimated. We conducted bivariate analyses with various factors and used those significant in a logistic regression. Results: Three hundred and forty three physicians with COVID-infection from 8 centers were included. The incidence of disease was 12.1% and that of global absenteeism related to COVID, 34.1%. Almost 70% of close contacts were work-related. In the multivariate analysis living in Autonomous City of Buenos Aires (CABA) (OR 0.19, p = 0.01), working in high-risk areas (OR 0.22, p = 0.01) and individual transportation (OR 0, 34, p = 0.03) reduced the risk of COVID. The odds of infection increased 5.6 times (p = 0.02) for each close contact isolation. Discussion: The number of close contact isolation increased considerably the risk of infection. Living in Buenos Aires City, individual transpor tation and working in high-risk areas reduced it. Given the high frequency of close contact in the workplace, we strongly recommend the reinforcement of prevention measures in rest areas and non-COVID-wards.
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El personal de salud por su ámbito laboral sanitario es de alto riesgo para la adquisición y transmisión de la infección por Covid-19. Los contactos cercanos del personal de salud fuera del ambiente hospitalario son frecuentes y variados. El objeto de la investigación es determinar la frecuencia de contactos cercanos para infecciones Covid-19 del personal de salud en su ambiente sanitario,social y familiar previo y durante la pandemia marzo y abril 2020. Métodos: Estudio de corte transversal por cuestionario auto administrado por vía digital dirigido al personal de salud. La población objeto son profesionales activos adscritos a Sociedades Científicas y la UCV. Variables demográficas: edad, sexo,año académico, cohabitante y los contactos cercanos durante traslados, actividades académicas, hospitalarias y sociales.Medidas de tendencia central y dispersión, distribuciones de frecuencia y figuras. Chi cuadrado e intervalos de confianza al 95%, medidas de correlación, comparación con t con error al fade 0,05. Resultados: 194 trabajadores de la salud completaron la encuesta, Sexo femenino 124 (63,9%), edad promedio 49,6 y mediana 53 años. La gran mayoría médicos 88,6%. Se dedican a actividades asistenciales 81%. El promedio de contactos diarios del personal de salud es 38. Los contactos intrahospitalario promedio diario son la mayoría 71%, (27,1 contactos/día). De estos con colegas 5,6, con enfermeras y paraclínicos 3,7; otro personal 4,7; pacientes y sus familiares 7,5 y 5,4. Conclusión:El personal de salud tiene un alto número de contactos cercanos diarios para la transmisión de infecciones respiratorias agudas,lo que representa un alto riesgo para adquirir y son potenciales dispersores de las infecciones a familiares y sociales(AU)
Introduction: Health workers are at high risk for the acquisition and transmission of Covid-19 infection. Close contacts of health workers outside the hospital environment are frequent and varied. The objective of the investigation is to determine the frequency of close contacts for COVID-19 infections of health workers in their previous health, social and family environment and during the pandemic. Methodology: Cross-sectional study by self-administered digital questionnaire to health workers. The target were active professionals of Scientific Societies and professionals of UCV. Demographic variables: age, gender, academic year, cohabitant and close contacts during transfers, academics, hospitals and social. Analysis of central trend and dispersion measures, presentationof data in frequency distributions and bar charts, and segment diagrams. Chi squared, confidence intervals to 95%, correlation measures, comparison with t with alpha error of 0.05 was calculated. Results: 194 health workers participants, most female 124 (63.9%), average age 49.6 and median 53 years.The majority were doctors 88.6%. 81% are dedicated to welfare activities. The average daily contact of health workers is 38people. The average daily hospital contacts are the majority 71%, average of 27.1. Average daily contacts with colleagues 5.6,with nurses and paraclinical 3.7; other personnel 4.7; patientsand their families 7.5 and 5.4. Conclusion: Health workers are highly exposed to infectious respiratory diseases due to their high frequency of close contacts in their daily routine. Therefore, Health workers are potential dispersants of infections to family members, friends and others(AU)
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Humans , Male , Female , Adult , Middle Aged , Quarantine , Health Personnel , Physical Distancing , COVID-19 , Cross-Sectional Studies , Surveys and Questionnaires , Occupational GroupsABSTRACT
Objective To explore the epidemic characteristics of close contacts of corona virus disease 2019(COVID-19) in Xi'an so as to provide reference for further prevention and control of the epidemic. Methods Data of the close contacts of COVID-19 in Xi'an was collected. We analyzed the distribution of close contacts in the population and isolation measures of close contacts and confirmed cases among different exposure conditions. Results By 0: 00 February 28, the cumulative number of confirmed cases and close contacts in Xi'an had been 120 and 5 241, respectively.Medical workers accounted for 7.92% of the close contacts. Across different age groups, the proportion of the youth group was the highest (56%). Indifferent areas of Xi'an, Yanta District had the largest number of close contacts(913) while Huyi District had the lowest number (29). The main contact route was contact within the family (1 875). The majority of the confirmed cases were infected within the family (35), followed by shopping places (26). Conclusion By 0: 00 February 28, close contacts of COVID-19 in Xi'an had mostly been found in Yanta District. The young constituted the main group, and close contacts within the family had a high risk of infection. In view of the above characteristics, it is necessary to improve the screening of people having close contact with COVID-19 in key areas and populations.
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Objective To screen college students contacts of tuberculosis index cases among colleges located in Haidian District,Beijing,so as to provide evidence for the modification of screening strategies for college students.Method The purified protein derivative test (PPD) and chest X-ray examination were carried out in colleges,located in Haidian District from March 2015 to March 2016.The basic demographic characteristics,tuberculosis infection and detection of patients,etc were analyzed.Results A total of 88 cases of tuberculosis index cases were diagnosed,and 3 604 college students contacts were detected 16 pulmonary tuberculosis cases were detected among close contacts,and all patients were negative,the detection rate was 443.95/100 000.Among the 3 604 close contacts,the positive rate of PPD was 8.32％.With the increase of the diameter of the PPD reaction,the detection rate of tuberculosis patients increased significantly (xtrend =8.06,P ＜0.001).During the period of outbreak,the PPD positive rate and the detection rate of patients were significantly higher than that of non-outbreak period,and the difference was statistically significant(all P ＜0.05).Conclusions It is necessary to strengthen the screening of tuberculosis among college students,and to find out the infected persons and patients as early as possible,so as to prevent the outbreak of tuberculosis.
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Middle East respiratory syndrome (MERS) is an emerging zoonosis caused by the novel MERS corona virus isolated in 2012. Most MERS cases have been reported from Arab countries of the Middle East, including Saudi Arabia, United Arab Emirates, Qatar, and Jordan. There have been a few imported cases in many countries, but the exception is Korea, which reported 186 confirmed cases originating from one imported case in a two-month outbreak in 2015. There are many lessons to be learned from the MERS outbreak in Korea, among them, management of contacts. The definition of "close contact" used by the Korean Centers for Disease Control and Prevention (KCDC) for MERS response was not clear and not compatible with the definition of the World Health Organization. This incorrect definition allowed the KCDC make serious mistakes in contact tracing and management in the early epidemic stage of MERS. After the rapid expansion of the outbreak, the KCDC redefined a "close contact" according to the definition of the US CDC. The total number of close contacts was 16,693 in this outbreak, and they were all forced to conduct a self-quarantine for 14 days after the last contact with a MERS patient. It was not clear whether self-quarantine of close contacts was effective to control the outbreak. Given the lack of prepared guidelines or a social support system for them, these measures for the massive number of asymptomatic contacts caused a great deal of confusion in the field A clear response guideline is needed for contact management based on robust evidence from this MERS epidemic in Korea.
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Humans , Contact Tracing , Coronavirus Infections , Jordan , Korea , Middle East , Qatar , Saudi Arabia , United Arab Emirates , World Health OrganizationABSTRACT
Objective To study the feasibility of in vitro release of γ-interferon tests (IGRA) in screening of tuberculosis for children with close TB contacts. Methods 185 children with close TB contacts were detected by IGRA at the pediatric clinic in our hospital. Results In IGRA-positive group, the rate of strong positive PPD (PDD≥15 mm) was 50.9%, which was higher than 9.1% in IGRA-negative group (X2 =37.263, P < 0.00). The morbidity rate for children with close TB contacts was 30.2% in IGRA-positive group, and it was significantly higher than 3.0% in IGRA-negative group (X2 = 28.928, P < 0.00). The sensitivity was 80% and the specificity was 77.6% for IGRA screening in children who had close contacts with TB patients. The sensitivity would be 95.0%, as the test was combined with PPD test. Conclusions IGRA screening in children with close TB contacts can increase the detection rate of tuberculosis and reduce imaging screening.
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A cohort of 123 adult contacts was followed for 18‐24 months (86 completed the follow-up) to compare conversion and reversion rates based on two serial measures of QuantiFERON (QFT) and tuberculin skin test (TST) (PPD from TUBERSOL, Aventis Pasteur, Canada) for diagnosing latent tuberculosis (TB) in household contacts of TB patients using conventional (C) and borderline zone (BZ) definitions. Questionnaires were used to obtain information regarding TB exposure, TB risk factors and socio-demographic data. QFT (IU/mL) conversion was defined as <0.35 to ≥0.35 (C) or <0.35 to >0.70 (BZ) and reversion was defined as ≥0.35 to <0.35 (C) or ≥0.35 to <0.20 (BZ); TST (mm) conversion was defined as <5 to ≥5 (C) or <5 to >10 (BZ) and reversion was defined as ≥5 to <5 (C). The QFT conversion and reversion rates were 10.5% and 7% with C and 8.1% and 4.7% with the BZ definitions, respectively. The TST rates were higher compared with QFT, especially with the C definitions (conversion 23.3%, reversion 9.3%). The QFT conversion and reversion rates were higher for TST ≥5; for TST, both rates were lower for QFT <0.35. No risk factors were associated with the probability of converting or reverting. The inconsistency and apparent randomness of serial testing is confusing and adds to the limitations of these tests and definitions to follow-up close TB contacts.
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Adult , Female , Humans , Male , Middle Aged , Family Characteristics , Latent Tuberculosis/diagnosis , Latent Tuberculosis/transmission , Tuberculin Test/methods , Contact Tracing , Disease Progression , Environmental Exposure , Evaluation Studies as Topic , Follow-Up Studies , Latent Tuberculosis/classification , Latent Tuberculosis/epidemiology , Mexico/epidemiology , Risk Factors , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
Objective To conduct a survey on the prevalence of active pulmonary tuberculosis among 65 year olds or above. Study subjects would include those with characteristics of TB suspicious symptoms,diabetes and close contacts. Methods Purpose-sampling method was applied to choose 3 counties in Shandong province as the study sites,relying on the local basic public health service,for those elderly under 65 years old or above. The study team would introduce the process and contents of this study to the subjects followed by chest X-ray and sputum smears on those registered tuberculosis suspects,patients with diabetes,TB close contacts in the past 2 years,from January to September,2013. Results 82 active pulmonary TB cases were identified among 9 041 cases who received the examination,with a crude prevalence rate as 9.1‰. From patients having both suspicious TB and diabetic symptoms,patients with diabetes or having suspicious symptoms of TB,the prevalence rates of active TB were 115‰,3.4‰,0.9‰respectively. No active pulmonary TB case was found in the TB close contacts,patients with diabetes,or those people with suspicious TB symptoms. TB prevalence rates among all the above mentioned groups were significantly different(χ2=697.478, P=0.000). Prevalence rate of active pulmonary TB with diabetes was 18 times(RR=17.951)higher than those non-diabetic patients,and 2 times higher than those with suspicious symptoms (RR=3.860). Results from single factor analysis showed that diabetes were closely related to the prevalence of pulmonary tuberculosis(χ2=46.637,P=0.000),the longer duration of diabetes and the higher risk of tuberculosis (RR>1). Conclusion Our data showed that active pulmonary TB prevalence was high in elderly diabetes patients which suggesting that‘Key crowd screening program’should be introduced into case-finding strategy on TB,with special focus on TB patients with diabetes or those people having suspicious symptoms of TB.
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Objective To conduct a survey on the prevalence of active pulmonary tuberculosis among 65 year olds or above. Study subjects would include those with characteristics of TB suspicious symptoms,diabetes and close contacts. Methods Purpose-sampling method was applied to choose 3 counties in Shandong province as the study sites,relying on the local basic public health service,for those elderly under 65 years old or above. The study team would introduce the process and contents of this study to the subjects followed by chest X-ray and sputum smears on those registered tuberculosis suspects,patients with diabetes,TB close contacts in the past 2 years,from January to September,2013. Results 82 active pulmonary TB cases were identified among 9 041 cases who received the examination,with a crude prevalence rate as 9.1‰. From patients having both suspicious TB and diabetic symptoms,patients with diabetes or having suspicious symptoms of TB,the prevalence rates of active TB were 115‰,3.4‰,0.9‰respectively. No active pulmonary TB case was found in the TB close contacts,patients with diabetes,or those people with suspicious TB symptoms. TB prevalence rates among all the above mentioned groups were significantly different(χ2=697.478, P=0.000). Prevalence rate of active pulmonary TB with diabetes was 18 times(RR=17.951)higher than those non-diabetic patients,and 2 times higher than those with suspicious symptoms (RR=3.860). Results from single factor analysis showed that diabetes were closely related to the prevalence of pulmonary tuberculosis(χ2=46.637,P=0.000),the longer duration of diabetes and the higher risk of tuberculosis (RR>1). Conclusion Our data showed that active pulmonary TB prevalence was high in elderly diabetes patients which suggesting that‘Key crowd screening program’should be introduced into case-finding strategy on TB,with special focus on TB patients with diabetes or those people having suspicious symptoms of TB.
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Background: Previous study showed leprosy patients have low zinc status. Yet the status of zinc in close-contact, which indicated by IgM anti-PGL1 level, have not determined. The aim of the study was to determine the association of zinc plasma and IgM anti-PGL-1 levels among close contact of leprosy patients in Indonesia. Methods: This was an observational study. Subjects were 186 close-contact leprosy patients. Measurement of zinc plasma status used atomic absorption spectrophotometer while examination of IgM anti-PGL1 level used ELISA (Polyclonal rabbit anti human IgM/HRP/(Dako®). Results: The average level of IgM anti-PGL1 and zinc plasma were 804 unit/mL (± 439.4) and 16.6 μmol/L (± 3.5) consecutively. There was significant correlation between zinc plasma and IgM anti-PGL1 (r = - 0.230; p = 0.002). Conclusion: There is a significant correlation between zinc plasma and IgM anti-PGL1 in close contact of leprosy