Further observations on hydrogen peroxide antisepsis and COVID-19 cases among healthcare workers and inpatients.

BACKGROUND: The use of prophylactic antisepsis to protect against coronavirus disease 2019 (COVID-19) has been suggested. This study investigated hydrogen peroxide antisepsis (HPA) at two hospitals in Ghana. METHODS: Cases of COVID-19 among healthcare workers (HCWs) using hydrogen peroxide (HP-HCWs) or not using hydrogen peroxide (NHP-HCWs), vaccinated or unvaccinated, were recorded at Shai-Osudoku Hospital (SODH), Dodowa, and Mount Olives Hospital (MOH), Techiman, between May 2020 and December 2021. The effect of HPA in all inpatients at MOH was also observed. Permutation tests were used to determine P values. FINDINGS: At SODH, there were 62 (13.5%) cases of COVID-19 among 458 NHP-HCWs but no cases among eight HP-HCWs (P=0.622) from May to December 2020. Between January and March 2021, 10 (2.7%) of 372 NHP-HCWs had COVID-19, but there were no cases among 94 HP-HCWs (P=0.206). At MOH, prior to HPA, 17 (20.2%) of 84 HCWs and five (1.4%) of 370 inpatients had COVID-19 in July 2020. From August 2020 to March 2021, two of 54 (3.7%) HCWs who stopped HPA had COVID-19; none of 32 NHP-HCWs contracted COVID-19. At SODH, none of 23 unvaccinated HP-HCWs and 35 (64%) of 55 unvaccinated NHP-HCWs had COVID-19 from April to December 2021 (P<0.0001). None of 34 vaccinated HP-HCWs and 53 (13.6%) of 390 vaccinated NHP-HCWs had COVID-19 (P=0.015). No inpatients on prophylactic HPA (total 7736) contracted COVID-19. CONCLUSION: Regular, daily HPA protects HCWs from COVID-19, and curtails nosocomial spread of SARS-CoV-2.

Supreme Worth of Clinical Epidemiology in Africa : Bancroftian Filariasis as a Just One Case in Point

"Clinical epidemiology is going to be the Discipline par excellence of the next century; if not the millennium. Coming as it does from one who has spent decades in clinical medicine and therapeutics; this is a bold statement. Clinical epidemiology answers the questions what? Where? How? When? Who? Why? And Which? In matters of health and disease. It is because these questions have come to be answered effectively with respect to bancroftian Filariasis that it has been included in the world's six ""potentially eradicable"" diseases. In his impressive Review Article on page (); Dr. Gyapong takes us through answers to these epidemiology questions [1]. Filariasis occurs in 38 African countries where the mere presence of a hydrocele affords ""a rapid diagnostic index"" for infection [2]; while the so-called ""filarial dance sign"" is known to be present in intrascrotal lymphatics of microfilaraemic patients [3]. That the social and economic consequences of filarial morbidity are enormous on community preventive measures. People must be told that the mosquito; not juju or other ""supernatural factors: [1] is the culprit. I am old enough to remember the ""Town council Man"" in colonial Gold Coast. He would visit every house assigned to him; enforcing environmental sanitation and destroying pools of water and mosquito breeding places. If but one cocoanut shell was found in the compound with water in it;whether or not it contained a mosquito larva; the head of the household was given summons to go to court and pay a fine. Came independence and the community also became independent of the ""Town Council Man"" with the result that there are infinitely more mosquitoes now in independent Ghana than there were in the colonial Gold Coast. ""The WHO""; it is widely held; ""will do it for us"". Today; a vaccine is awaited for most things while the insects flourish. Deal with mosquito; and both malaria and Filariasis will be dealt a death blow. Fortunately; ivermectin will reduce the parasitic reservoir from which transmission occurs; and diagnosis of subclinical cases no longer has to rely on blood sampling at night or on Diethyl Carbamazine provocation tests [4]; but is reliably achieved using finger prick to detect Og4C3 circulating antigens day or night [5;6]. Mosquito nets reduce nocturnal bites and hence incidence of both malaria and Filariasis. Doctors should keep long-term records and ascertain whether insecticide impregnanted nets lead to pesticide resistance or not. Spraying should never be abandoned as it had often been on the rumour that ""it does no good; and produces insecticide resistance"". These preventive measures are best supervised through decentralised programmes [1;7] and are most effectively conducted in the mother tongue of the community at the grassroots [8]. Local businessmen and market women should be encouraged to assist chiefs and community leaders in giving monthly prizes in environmental sanitation while public health experts chart the effect of such sanitation on morbidity of Filariasis and mortality from malaria. We should go back to the ""Sanitary Branch"" institutions of the colonial days[9] when clinical epidemiology did much to protect the health of the community. Central government should fund trips to Japan; Taiwan; Solomon Islands; South Korea and some parts of China [1] for African health workers to learn first hand how those communities managed to eradicate lymphatic Filariasis. Even with the current AIDS problem; I remain convinced that clinical epidemiology is the answer [10]. Vaccines have achieved much this century; but to ""wait for WHO to give us vaccines"" while we neglect ourselves and our environment is wholly irresponsible."