ABSTRACT
Introduction - The CeGIDDs are centres of information, screening and diagnosis for HIV, viral hepatitis and bacterial sexually transmitted infections (STIs), a network of French free-to-use clinics created in 2016. This article describes the characteristics of CeGIDD visitors as well as the screening and diagnostic activities carried out by the structures for the year 2020, comparing them with 2018. Method - We present a repeated cross-sectional study, based on continuous monitoring data from the SurCeGIDD system, which relies on the secure transmission of individual visitor data according to a predefined format. The socio-demographic and behavioural data of the visitors, and their reasons for consultation, are described. The proportions of visitors tested and the positivity rates for HIV, hepatitis B (HBV) and C (HCV), syphilis, gonococcus (NG), Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG) are described according to sexual practices. Results - In 2020, 336,333 consultations were reported by 50.3% of the 336 CeGIDDs identified in 2020. Attendance at CeGIDDs fell sharply in the second quarter of 2020 (-58% compared to the first quarter). In 2020, the visitors were mostly men (62.1%) and young people under 30 (64.5%). About a quarter (23.5%) of the visitors were born abroad. The proportion of men having sex with men (14.8%) and trans people (0.38%) had increased compared to 2018. The most frequent reasons for consultation remained risk exposure (60.4%) and systematic screening (43.3%). Some reasons for consultation increased between 2018 and 2020, such as initiating or monitoring a post-exposure prophylaxis. An increase in positivity rate between 2018 and 2020 is observed for HIV (from 0.37% to 0.41%), but especially for NG (from 2.8% to 4.0%), undoubtedly related to changes in visitor characteristics. At the same time, positivity rates decreased for HBV (from 1.3% to 0.93%) and HCV (from 0.94% to 0.60%). They are relatively stable for CT (7.0% in 2020), MG (6.8%) and syphilis (1.0%). Conclusion - Despite a drop in consultations in 2020 related to the COVID-19 pandemic, the CeGIDDs continued to carry out their screening/diagnostic missions in a comprehensive sexual health approach. SurCeGIDD surveillance provides elements for monitoring the national sexual health strategy, hence the need to improve the comprehensiveness and completeness of the data collected.
ABSTRACT
Introduction - The CeGIDD (French STI clinics) were implemented in 2016. This study analyzes testing activity for HIV, hepatitis B and C and other STIs using individual data from the SurCeGIDD surveillance. Method - SurCeGIDD relies on secured transmission of individual data in a predefined format. Sociodemographic data, tests for HIV, hepatitis B or C, syphilis, gonococcus (NG), Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG), diagnoses and sexual behaviors were analysed. Proportion of tested attendees and positivity rates were estimated for each pathogen by exposed populations. Results - In 2018, 382,890 consultations were reported by 44.6% (n=143) of CeGIDDs. Majority of consultants (59.8%) were men, 40.0% women and 0.2% transgender people. The positivity rates were 0.37% for HIV, 1.31% for HBV, 0.94% for HCV, 7.16% for CT, 2.83% for NG, 1.04% for syphilis and 5.96% for MG. Considering pathogens, positivity rates were higher among men who have sex with men, people born abroad, transgender population and people visiting CeGIDDs in the French overseas departments and Paris area. Further analysis might give a better understanding of the vulnerability for these populations. Conclusion - Despite perfectible coverage and completeness, the SurCeGIDD data enable a better understanding of the vulnerability of populations visiting CeGIDDs. Contextualized analysis of these data will help to adjust the national sexual health strategy to territories and populations.
ABSTRACT
BACKGROUND: The COVID-19 pandemic has caused a severe shortage of personal protective equipment (PPE), especially N95 respirators. Efficient, effective and economically feasible methods for large-scale PPE decontamination are urgently needed. AIMS: (1) to develop protocols for effectively decontaminating PPE using vaporized hydrogen peroxide (VHP); (2) to develop novel approaches that decrease set-up and take-down time while also increasing decontamination capacity; (3) to test decontamination efficiency for N95 respirators heavily contaminated by make-up or moisturizers. METHODS: We converted a decommissioned Biosafety Level 3 laboratory into a facility that could be used to decontaminate N95 respirators. N95 respirators were hung on metal racks, stacked in piles, placed in paper bags or covered with make-up or moisturizer. A VHP® VICTORY™ unit from STERIS was used to inject VHP into the facility. Biological and chemical indicators were used to validate the decontamination process. FINDINGS: N95 respirators individually hung on metal racks were successfully decontaminated using VHP. N95 respirators were also successfully decontaminated when placed in closed paper bags or if stacked in piles of up to six. Stacking reduced the time needed to arrange N95 respirators for decontamination by approximately two-thirds while almost tripling facility capacity. Make-up and moisturizer creams did not interfere with the decontamination process. CONCLUSIONS: Respirator stacking can reduce the hands-on time and increase decontamination capacity. When personalization is needed, respirators can be decontaminated in labelled paper bags. Make up or moisturizers do not appear to interfere with VHP decontamination.
Subject(s)
COVID-19/prevention & control , Decontamination/methods , Equipment Reuse , N95 Respirators/standards , Decontamination/economics , Humans , Hydrogen Peroxide/pharmacology , N95 Respirators/supply & distribution , SARS-CoV-2 , VolatilizationABSTRACT
In response to the COVID-19 crisis, and in absence of dedicated structures, an ambulatory medical centre dedicated to patients suspected of being infected with SARS-CoV-2 was created by a group of general practitioners (GP). Objective was to take care of patients under hygienic conditions satisfactory to physicians and patients. Ten days were needed to set up the center in a gymnasium. The center allowed complete medical management of patients (consultation, sampling and diagnosis, follow-up) in adequate hygienic conditions (patient and caregiver circuits with "forward walking", dedicated rooms, hygiene equipment, waste management, etc.). The objectives of the article are to describe the organization of the COVID-19 center, to present the epidemiological and clinical characteristics of suspected COVID-19 patients tested for SARS-CoV-2 and confirmed cases for patients who consulted between the April 7 and May 15, 2020. From April 1 to June 12, 2020, 824 consultations were carried out and 11 patients were hospitalized. Patients were referred to the center by their general practitioner (58%), hospital doctors or the Samu-Center 15, the French emergency call center (15%). The consultations were 70% initial and 30% follow-up consultations, especially after hospitalization. The proportion of patients tested for SARS-CoV-2 has increased over time (from 39%, week 15 to 66%, week 20) and the positive rate of samples has decreased (from 28% to 0%). The most frequently tested patients were those with criteria of severity, those in contact with fragile people, healthcare professionals (HCP) and those who consulted from week 18 to 20. The most frequently positive patients for SARS-CoV-2 were women, those aged 60 years and over, HCP and those with ageusia, those with seriousness criteria and those who consulted from week 15 to 17. No cases of COVID-19 have been reported among professionals due to their activities in the center. Situated between community and hospital care, the COVID-19 center provided an emergency response to an unprecedented epidemic caused by a contagious infectious agent. Such an organization would deserve to be supported by professionalized structures with financial resources that could be mobilized urgently.