ABSTRACT
Objectives: This research aimed to study the seroconversion among frontline staff at the highest risk of exposure to SARS-CoV-2 infections, including emergency department, critical care, and COVID-19 isolation wards in all healthcare job categories. Methods: We conducted a prospective cohort study on the incidence of seroconversion among frontline health care workers (HCWs) at the Royal Hospital, Muscat, Oman. Two sera were collected 12 weeks apart to look for seroconversion. We used proportions with 95% confidence interval (CI) for categorical data and mean/median as appropriate for continuous data. Results: Fourteen out of 328 HCWs seroconverted in this study accounting for an incidence rate of 3.6%, excluding four HCWs that were positive at baseline. The median age was 43.5 (range = 28-57). About 75.0% of HCWs were between 31-49 years old, with a seroconversion rate of 4.9% (95% CI: 2.7-8.1). Females accounted for most seroconverted HCWs (14/257) at a rate of 5.4% (95% CI: 3.1-8.8). Omanis seroconverted with a rate of 6.4% (95% CI 2.6-12.8), whereas non-Omanis seroconverted at a rate 4.3% (95% CI: 2.2-7.5). Ninety-two percent (302/328) of the staff lived in the capital area, and a minority lived outside the capital (3/26). Thirteen Muscat citizens seroconverted at a rate of 4.3% (95% CI: 2.4-7.1). Nurses comprised the majority (accounting for about 81%) followed by doctors (19%) at rates of 5.6% (95% CI: 3.2-9.2) and 4.2% (95% CI: 1.07-10.9), respectively. Staff covering COVID-19 isolation wards and intensive care unit comprised over 60% (n = 10) of those who seroconverted with a rate of 5.4% (95% CI: 2.8-9.5) followed by infectious diseases doctors and adult emergency at 19.0% (n = 3) and 12.5% (n = 1), respectively. Approximately 81.3% (n = 13) of HCWs performed aerosol-generating procedures at a seroconversion rate of 4.3% (95% CI: 2.4-7.1). About 50.0% of those who seroconverted had a positive polymerase chain reaction (PCR) before seroconversion, 25.0% had a negative PCR before second serology testing, and 25.0% were not tested with PCR. Approximately 20.0% of seroconverted staff had no reported symptoms compared to 80.0% who reported symptoms such as sore throat (70.0%), fever (50.0%), myalgia (20.0%), and a less frequency (15.0%) runny nose, loss of smell, and headache. Conclusions: Detection of infection among HCWs is important to prevent further transmission, especially asymptomatic carriers. A combined screening strategy of symptoms, serology, and PCR might help detect potential infections and asymptomatic carriage.
ABSTRACT
OBJECTIVES: As coronavirus disease (COVID-19) was pervading different parts of the world, little has been published regarding responses undertaken within primary health care (PHC) facilities in Arabian Gulf countries. This paper describes such responses from January to mid-April 2020 in PHC, including public health measures in Muscat, Oman. METHODS: This is a descriptive study showing the trends of the confirmed positive cases of COVID-19 and the undertaken responses to the evolving epidemiological scenario. These responses were described utilizing the World Health Organizations' building blocks for health care systems: Leadership and governance, Health workforce, Service delivery, Medical products and technologies, and health information management. RESULTS: In mid-April 2020, cases of COVID-19 increased to 685 (particularly among non-nationals). As the cases were surging, the PHC responded by executing all guidelines and policies from the national medical and public health response committees and integrating innovative approaches. These included adapting comprehensive and multi-sectoral strategies, partnering with private establishments, and strengthening technology use (in tracking, testing, managing the cases, and data management). CONCLUSIONS: Facilities in the Muscat governorate, with the support from national teams, seemed to continuously scale-up their preparedness and responses to meet the epidemiological expectations in the management of COVID-19.
ABSTRACT
BACKGROUND: To evaluate the changes in Preoperative and Postoperative keratometry results and rapid visual rehabilitation in Cataract surgery by our phaco-sandwich technique through the self sealing sclero-corneal tunnel incision without phacoemulsification. METHODS: 96 eyes of 88 patients with age-related cataracts underwent small incision suture less cataract surgery without phacoemulsification. All eyes were operated by the phaco-sandwich technique through sclerocorneal tunnel with 6 mm frown-shaped external scleral incision. 6 mm single piece PMMA lens was implanted in the capsular bag. Patients were evaluated at 1 week, 4 weeks and 12 weeks post-operatively. RESULTS: Ninety six eyes of eighty eight patients were our cohort. During the first post-operative week 8 eyes (8.3%) had uncorrected visual acuity (UCVA) of 6/6. By the end of 12 post-operative weeks, 33 eyes (34.5%) had UCVA of 6/6. 64 (66.7%), 72 (75%) and 80 (83.3%) eyes had best correctable visual acuity (BCVA) of 6/6 after 4 weeks, 8 weeks and 12 weeks respectively. 64 (66.7%) eyes after 4 weeks, 72 (75%) after 8 weeks and 80 (83%) after 12 weeks had best correctable visual acuity (BCVA) of 6/6. CONCLUSION: Suture less, small-incision cataract surgery is an economical, safe and effective method of managing cataract cases. This technique also ensures satisfactory and rapid rehabilitation for patients. This procedure can be effectively applied to clear the backlog of cataract-related blindness in places wherein the resources for phaco facilities are not available.
