MUSCULOSKELETAL DISORDERS DURING COVID-19 INFECTION: A SURVEY OF HEALTHCARE WORKERS

BackgroundCOVID-19 infection has revealed a considerable number of extra-pulmonary manifestations, especially rheumatological. The detection of these manifestations, which herald the infection, is of great value in the early diagnosis of the disease, especially in health care workers (HCWs) who are at considerable risk of infection. Although myalgia is a common clinical feature of COVID-19, other musculoskeletal disorders (MSDs) have been rarely described.ObjectivesTo describe MSDs during SARS-COV2 infection in HCWs.MethodsProspective descriptive study conducted at the department of occupational pathology and fitness for work of Charles Nicolle Hospital in Tunis, having included the HCWs affected by COVID-19 during the period from 01 September 2020 to 28 February 2021. Data collection was carried out by regular telephone follow-up during the containment period using a pre-established form.ResultsDuring the study period, 656 HCWs were infected with SARS COV 2, of whom 134 (20.4%) had at least one musculoskeletal event. The mean age was 42±9 years with a sex ratio (M/F) of 0.2. The most represented occupational category was nurses (33.6%) followed by health technicians (23.1%). The median professional length of service was 12 [7;20] years. The presence of comorbidity was noted in 58.2% of HCWs. A pre-existing osteoarticular disease was found in 8.2% of cases. Obesity was noted in 25.4% of the population. Active smoking was reported by 14.3% of respondents. A known vitamin D deficiency was noted in 16.5% of patients. Spinal pain was the most reported MSD, present in 87.3% of cases. Low back pain was the most frequent spinal pain (56.7%) followed by back pain (37.4%) and neck pain (5.9%). MSDs of the lower limbs were found in 12.7% of patients. They were represented by gonalgia in 11.9% of cases, ankle pain in 5.2% of cases and hip pain in 4.3% of cases. MSDs of the upper limbs were described by 7.5% of the patients, 92.5% of whom presented with shoulder pain. The median duration of MSDs during COVID-19 was 5 [3;8] days. These manifestations were persistent on return to work in 21.1% of cases.ConclusionKnowledge of the frequency and consequences of musculoskeletal manifestations related to COVID-19 infection is of great importance, particularly in HCWs, in order to optimise management and ensure a rapid return to work.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

PARE MUSCULOSKELETAL DISORDERS IN THE ERA OF THE COVID-19 PANDEMIC

BackgroundIn Tunisia, during the last decade, the number of MSDs declared as compensable occupational diseases has been increasing. So, what is the impact of the COVID-19 pandemic on the MSD reporting rate.ObjectivesTo describe the socio-professional characteristics of workers with musculoskeletal disorders (MSDs) and to determine the reporting rate of MSDs as occupational diseases.MethodsA descriptive cross-sectional study among workers with work-related MSDs who consulted the occupational medicine department of the Charles Nicolle Hospital for medical advice between January 2021 and September 2022.ResultsA total of 109 workers with MSDs were included in this study. The workers were 64.2% female. The average age was 46 ± [21-61 years]. The sectors most prone to MSDs were the health sector (27.5%), food processing (16.5%) and textiles (15.6%). The workers reported MSDs of the upper limb in 31.2%, MSDs of the lower limb in 33.9% and of the spine in 69.7%. These MSDs reported included 5/13 cases of rotator cuff tendinopathy, 6/13 cases of carpal tunnel syndrome, one case of achilles tendonitis and one case of Dequervain's tenosynovitis.ConclusionDuring the COVID-19 pandemic, the reporting of MSDs as occupational diseases has declined considerably. This decline can be explained by the difficult access to hospital facilities.References[1]https://www.emro.who.int/emhj-volume-23-2017/volume-23-issue-11/prevalence-et-determinants-des-troubles-musculo-squelettiques-des-membres-superieurs-chez-les-artisans-tunisiens.html.[2]http://medecinetravail.canalblog.com/archives/2011/10/04/22196851.htmlAcknowledgements:NIL.Disclosure of InterestsNone Declared.

Differentiating Acute Infectious and Post-Infectious Cerebellitis: A Tunisian Pediatric Case Series

Background: Acute cerebellitis is the most frequent cause of acute ataxia in children. A clear definition of infectious versus post infectious cerebellitis is lacking in the literature. The outcome is usually favorable although the initial clinical picture varies greatly between patients. The aim of this study was to compare infectious versus post-infectious cerebellitis in terms of clinical features, imaging and outcome. Material(s) and Method(s): We conducted a retrospective descriptive study including patients who were hospitalized at the neuropediatrics department at the national Institute of Neurology of Tunisia, between 2005-2022, having a diagnosis of acute cerebellitis at discharge and a minimal follow-up period of six months. The SARA (Scale for Assessment and Rating of Ataxia) was used to evaluate ataxia at onset and follow-up. Symptoms of ataxia occurring alongside infectious symptoms were considered para-infectious. Result(s): A total of 37 patients were included with a sex ratio of 1,17. Post infectious cerebellitis represented 76% (28 cases). Mean age of onset was 5,79 +/- 3,74 years with no significant difference between groups. A history of infection was found in 84% of patients (31 cases) with a mean time of 7,43 +/- 6,31 days. Mean time of onset from infection was shorter in the para-infectious group (p=0,001) and concomitant fever was more frequently found (p=0,02). Onset was acute in 89% of cases in both groups. Mean SARA score at onset was 9,35 +/- 4,14 with no significant difference between groups. Aetiology was unknown in 51% of cases (19 patients). Two covid-19 related cerebellitis were noted both in the para-infectious group. No difference between groups in terms of imaging or cerebral spinal fluid analysis was noted. There were no sequalae in 78% and 89% of cases in the post-infectious and para-infectious groups respectfully and no difference in terms of outcome or SARA score at follow-up was noted. Conclusion(s): In our cases series, significant differences were noted between the post-infectious and para-infectious cerebellitis subgroups. Mean time of onset from infectious episode was shorter and fever was more frequent in the para-infectious group. A clear definition of para-infectious cerebellitis is needed in order to determine the real proportion of this entity and allow a better management.Copyright © 2022

Contribution of SARS-CoV-2 antigen rapid diagnostic tests for diagnosis of SARS-CoV-2 infection among health care professionals

Introduction: Health care workers (HCWs) are a high-risk group for SARS-CoV-2 infection, therefore there is an urgent need for rapid, simple, and sensitive tests to diagnose COVID-19 infection among health care settings. Aim(s): The aim of our study was to assess the contribution of the SARS-CoV-2 antigen rapid diagnostic tests (AgRDTs) with RT-PCR which is the gold standard for the diagnosis of COVID-19. Method(s): A retrospective descriptive study of HCWs at Charles Nicolle Hospital who consulted the Occupational Medicine health Department during the period from January 3, 2022, to January 31, 2022, for symptoms suggestive of COVID-19 infection. The Panbio antigen rapid diagnostic tests were used in all suspected cases. In case of negative Ag-RDTs, we completed with RT-PCR. Result(s): Our population consisted mainly of nurses (n=146), blue-collar workers (n=100), trainees (n=105) and senior technicians (n=84). We performed 638 Ag-RDTs and 177 RT-PCR during the study period. Ag-RDTs were positive in 461 cases (72.25%). 146 HCPs tested negative by both methods. Discordant results were obtained in 31 cases (17.51%). RT-PCR was positive in 31 cases. Conclusion(s): In our series, the Ag -RDT seems a reliable way for the diagnosis of covid 19 in symptomatic HCWs.

Troubles du sommeil chez 140 soignants travaillant au circuit COVID-19.

Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets.Copyright © 2023

Impact de l'infection au SARS-CoV-2 sur le sommeil du personnel soignant affecte au circuit COVID : etude comparative.

Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets.Copyright © 2023

Reasons for reluctance to covid-19 vaccination among health care workers

Introduction: At the end of 2020, several vaccines against covid-19 have been validated by the World Health Organization in order to stop this pandemic. However, a growing number of people, including health care workers (HCWs), express reluctance to be vaccinated against covid-19. Aim(s): To determine the causes of reluctance towards the covid-19 vaccine expressed by health care personnel. Method(s): This was a descriptive and cross-sectional study that interested the HCWs of the Charles Nicolle Hospital of Tunisia reluctant to the anti-covid-19 vaccination during the period from October 25, 2021, to January 31, 2021. The causes of renunciation were studied through a pre-established questionnaire. Result(s): Our population consisted of 112 HCWs. The average age was 41.1 +/-10.2 years old. Females were predominant (66.1%). The average professional seniority was 12.4 +/- 11.3 years. Our population consisted mainly of blue-collar workers (29.1% of cases) followed by senior technicians (26.4% of cases) and nurses (24.5% of cases). The HCWs belonged to the medical services in 45% of the cases. Previous infection with SARS -Cov2 virus was noted in 55.4% of the HCWs. The reasons for renunciation were: the potential adverse effects that the vaccine could cause in the long term (59.8%), the speed of clinical trials is a source of concern (30.4%), and at the use of new vaccine technologies, particularly mRNA vaccines remains a factor of distrust (26.8%). Conclusion(s): It is imperative to strengthen the confidence of the HCWs towards the different vaccines against covid19 while insisting on the benefit-risk balance which always remains in favor of vaccination.

Comparaison des troubles du sommeil en fonction du nombre d'episodes infectieux par le SARS-CoV-2 chez les residents en medecine.

Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets.Copyright © 2023

Particularites des troubles du sommeil pendant la 6e vague de COVID-19 (Omicron) chez le personnel de soin.

Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets.Copyright © 2023

Messenger RNA COVID-19 vaccine: What side effects?

COVID-19 vaccination is one of the most effective ways to prevent the spread of SARS-CoV2. However,these vaccines are not devoid of adverse effects requiring post-vaccination follow-up. Aim(s): Determine the frequency of adverse events(AEs)of an anti-COVID-19 messenger RNA vaccine (mRNA) collected among health care workers(HCW) at Charles Nicolle Hospital in Tunis. Method(s): Descriptive cross-sectional study carried out in September 2021, involving the HCW of the Charles Nicolle hospital in Tunis who had received the first dose of an mRNA anti-COVID 19 vaccine during a mobile vaccination campaign in the workplace. The data collection was carried out using a pre-established questionnaire containing the adverse vaccine reactions defined by the Tunisian Ministry of Health technical sheets. Result(s): The study population was composed of 139 HCW. Post-vaccine AEs were reported in 78% of cases. A predominance of women was noticed(78%). The age group most affected was between 40 and 45 years old. The most common AEs were injection site pain in 65% of cases, fever in 30% of cases, headache in 15% of cases and myalgia in 14% of cases. In addition, four cases of dizziness, two cases of generalized pruritus and one case of lymphadenopathy and acute peripheral facial paralysis were reported. The time to onset of AEs ranged from the same day to three days. The average duration of these AEs ranged from one to seven days. Five percent of our population took time off work which variated from one to three days. Conclusion(s): The occurrence of AEs following vaccination with an mRNA vaccine should not destabilize the promotion of vaccination in the workplace. However, close post-vaccination surveillance is necessary to ensure good occupational activity in the care setting.

A Comparative Study for Some Mathematical Models of Epidemic Diseases with Application to Strategic Management

A local performance of the SIR model on actual data is introduced. A good approximation of the SIR model parameters in Saudi Arabia during a period of 275 days (the first of April 2020 to the end of December 2020) is determined. The parameters are estimated from the recorded data and used to predict the values in the next subsequent period. The performance of the standard fourth order Runge-Kutta method is considered for the classical SIR models over different periods. A comparison of the recorded data and the predicted values during the considered period illustrated the effectiveness of the treatment. The mathematical properties and initial conditions are considered within the estimated parameter values. It is shown that lockdown and social distance attitudes effectively controlled the spread of the disease. The maximum number of daily active infected cases is 63,026, and occurs in July and this agrees with the calculated values. To make the graphs representable, we considered a fixed closed population, the effective sample during the considered period of size N = 400,000 only (represents only 1% of the overall population susceptible, this must be associated, with great thanks, to the authorities in KSA).

Caracteristiques cliniques et professionnelles de la pneumopathie a SARS-CoV-2 chez le personnel soignant

Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets. Copyright © 2022

Qualite de vie chez les professionnels de la sante un an apres une infection au SARS-CoV-2

Introduction: La pandemie COVID-19 a eu d'importantes repercussions sur la sante physique et psychologique des personnes infectees par le virus du SARS-CoV-2. Neanmoins, cet impact s'est avere encore plus significatif chez le personnel de sante (PS) place en premiere ligne dans la gestion de cette crise sanitaire. L'objectif de notre etude etait d'evaluer la qualite de vie du PS un an apres une infection par le SARS-CoV-2. Methodes: Etude transversale ayant interesse le PS de l'hopital Charles Nicolle, pour lequel un diagnostic de COVID-19 avait ete pose durant la periode allant du 1er au 30 juin 2021. Les donnees collectees portaient sur les caracteristiques sociodemographiques et professionnelles. La qualite de vie des PS etait evaluee un an apres l'infection, en utilisant le questionnaire SF12 dans ses deux dimensions physique et mentale. Resultats: La population d'etude comportait 170 PS atteints de COVID-19. Le taux de reponse etait de 67 %. L'age moyen etait de 43,2 +/- 10 ans avec un sex-ratio (H/F) de 0,6. La categorie professionnelle la plus representee etait celle des infirmiers dans 46,4 % des cas et des ouvriers dans 31,2 % des cas. A un an en post-infection, la qualite de vie physique (PCS) et mentale (MCS) etait satisfaisante avec un score SF12 moyen de 61,9 %, PCS moyen a 60,5 % et MCS moyen a 62,7 %. Une difference statistiquement significative etait notee avec la categorie professionnelle (SF12 moyen : p < 10-3, PCS : p = 0,39, MCS : p < 10-3, IC = 95 %). Aucune difference statistiquement significative n'a ete trouvee selon le sexe. Conclusion(s): Notre etude suggere que la COVID-19 n'a pas affecte la qualite de vie des professionnels de sante un an apres l'infection. Toutefois, un suivi regulier reste necessaire. Copyright © 2022

Distance teaching in media departments in times of the COVID-19 pandemic. Experiences from six Arab countries

The present study describes, assesses, and compares the experiences of distance teaching in media and communication departments in six Arab countries, including Egypt, Tunisia, Iraq, Yemen, Oman, and Qatar, during the early phase of the COVID-19 pandemic in the spring of 2020. Three research questions were answered through a cross-country comparison. 1) Which organizational steps and arrangements had to be taken by the administration and teaching staff to transition to distance teaching? 2) How was distance teaching perceived by students in the six countries? 3) How was the transition evaluated by the teaching staff, and which suggestions can be made for the future? To answer the questions, we collected empirical data from different groups involved in the teaching process, including teachers, administration, and students, through interviews, focus groups and a questionnaire. Results show that the necessity of teaching online from a distance took most Arab universities by surprise. A lack of infrastructure and financial means proved to be the most relevant problem in conflict-ridden countries like Iraq and Yemen, but also in Egypt and Tunisia. Given their low expectations, students were generally satisfied with the digital tools used in their institution, even though in some countries, the skills of the teachers were underdeveloped, and the infrastructure was lacking. The teaching staff, however, highlighted that they saw these changes as a move toward the modernization of their teaching. © 2022 Inas Abou Youssef and Carola Richter.

Intérêt du scanner thoracique dans la déclaration de la Covid-19 comme maladie professionnelle chez le personnel de santé

Introduction La pandémie de COVID-19 est une crise sanitaire mondiale. Compte tenu des résultats faux négatifs de la RT-PCR, technique diagnostique de référence, le scanner thoracique joue un rôle pivot dans le diagnostic positif de l’infection COVID-19 et la réparation de la maladie en milieu de soins. L’objectif de notre travail était de décrire les caractéristiques démographiques, professionnelles et cliniques des professionnels de la santé (PS) atteints de la COVID-19 avec une confirmation scannographique. Méthodes Il s’agissait d’une étude descriptive rétrospective des PS de l’hôpital Charles Nicolle consultants le service de Médecine du Travail et de Pathologie Professionnelle durant la période allant du premier septembre au 31 août 2021 pour des symptômes évocateurs d’infection à COVID-19 avec une confirmation scannographique. Résultats Nous avons recensé 1318 infections à SARS-COV2. La confirmation diagnostique était faite par RT-PCR dans 94,76% des cas, par un test rapide antigénique dans 3,19% des cas, par une sérologie anti SARS-COV2 dans 1, 36% des cas et par un scanner thoracique dans 0,53% des cas (n=7). Il s’agissait de trois infirmiers, deux médecins et deux ambulanciers. Ils étaient cinq femmes et deux hommes. L’âge variait entre 22 et 59 ans. Ils avaient des antécédents médicaux dans quatre cas. Tous les patients étaient symptomatiques: fièvre (n=6) toux (n=5), courbatures (n=5), asthénie(n=3), céphalées (n=2), dyspnée(n=2), maux de gorge (n=2), vertiges (n=1), lombalgies (n=1), anosmie (n=1) et agueusie (n=1). Les RT-PCR pratiquées chez six personnels étaient négatives et un patient était diagnostiqué d’emblée par un scanner thoracique. Le scanner thoracique a trouvé une atteinte minime (n=3), modérée (n=2), étendue (n=1) et sévère (n=1). L’extension des lésions au scanner montrait (n=2) patients ayant une atteinte ≥50% contre (n=5) patients ayant une atteinte<25%. Le délai moyen entre le début des symptômes et la réalisation du scanner était de 3 à 10jours. La durée de l’arrêt du travail variait entre 12 à 49jours. Tous les patients ont bénéficié d’une déclaration de maladie professionnelle conformément aux dispositions du tableau n 86 de la liste des tableaux des maladies professionnelles en vigueur en Tunisie. Conclusion Le scanner thoracique, en plus d’être un outil diagnostique de l’infection COVID-19, aurait un intérêt médico-légal dans la réparation de la maladie chez les professionnels de la santé symptomatiques avec RT-PCR négatives.