Sterilization of gowns: making the most of a scarce commodity during the COVID-19 pandemic.

Baylor Clinic in Mbabane, Eswatini, convened a crisis meeting to tackle critical shortages of long-sleeved disposable gowns that resulted from COVID-19 pandemic constraints on available personal protective equipment (PPE). A strategy deemed safe, affordable and sustainable was adopted to autoclave and re-use gowns based on a risk-stratified approach. Key objectives were to ensure essential infection control and prevention (ICP) for medical doctors, nurses, and laboratory teams. Administrative, environmental and personal protective measures for ICP were enhanced through regular staff training. This strategy for gown re-use has been invaluable in motivating responsible stewardship and maximization of available gowns during the COVID-19 pandemic.

La Baylor Clinic de Mbabane, Eswatini, a convoqué une réunion de crise pour remédier à la grave pénurie de blouses jetables à manches longues due au manque d'équipements de protection individuelle (PPE) lié à la pandémie de COVID-19. Une stratégie jugée sûre, abordable et durable a été adoptée pour stériliser par autoclave et réutiliser les blouses en prenant appui sur une approche stratifiée des risques. Les objectifs clés étaient de garantir la prévention et le contrôle des infections (ICP) pour les médecins, les infirmiers et les équipes de laboratoire. Les mesures ICP d'ordre administratif, environnemental et de protection individuelle ont été renforcées par le biais de formations régulières du personnel. Cette stratégie de réutilisation des blouses a permis de promouvoir une gestion responsable et de tirer au maximum profit des blouses disponibles pendant la pandémie de COVID-19.

Geospatial and hot spot analysis of paediatric tuberculosis infection in Bohol, Philippines

Tuberculosis (TB) in children is a critical public health issue. In Bohol, Philippines, we found a high tuberculin skin test (TST)-positive prevalence (weighted prevalence = 6.4%) among 5476 children (<15 years) from 184 villages, with geographically isolated communities having prevalence as high as 29%. Therefore, we conducted a geospatial and hot spot analysis to examine the association between villages with high TST-positive prevalence (⩾6.5%) and access to medical care (distance (in kilometres and minutes of travel time) to the municipal Rural Health Units (RHU)), access to healthcare resources (distance to Provincial Health Office (PHO)) and socioeconomic determinants of health. Hot spot analysis revealed significant clusters of TST-positive prevalence in villages farthest from the PHO. Based on univariate analysis, the following variables associated with high prevalence were included in the multivariate model: minutes of travel time to the PHO, distance to the PHO, island villages and total deprivation based on socioeconomic indicators. In the final model, only distance to PHO in minutes was significant (P = 0.005). When evaluated further, greater than 1-hour drive significantly increased risk for TST-positivity (P = 0.003). Distance to healthcare resources likely increases the risk of TB transmission within the community. Expanding TB control efforts to geographically isolated areas is critical.