Compared hand hygiene compliance among healthcare providers before and after the COVID-19 pandemic: A rapid review and meta-analysis.

BACKGROUND: Hand hygiene (HH) is a cost-effective measure to reduce health care-associated infections. The overall characteristics and changes of hand hygiene compliance (HHC) among health care providers during the COVID-19 pandemic provided evidence for targeted HH intervention measures. AIM: To systematically review the literature and conduct a meta-analysis of studies investigating the rate of HHC and the characteristics of HH during the COVID-19 pandemic. METHODS: The PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, VIP, and CBM databases were searched. All the original articles with valid HHC data among health care providers during the COVID-19 pandemic (from January 1, 2020 to October 1, 2021) were included. Meta-analysis was performed using a DerSimonian and Laird model to yield a point estimate and a 95% CI for the HHC rate. The heterogeneity of the studies was evaluated using the Cochrane Q test and I2 statistics and a random-effects model was used to contrast between different occupations, the WHO 5-moments of HH and different observation methods. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were followed. FINDINGS: Seven studies with 2,377 health care providers reporting HHC were identified. The estimated overall HHC was 74%, which was higher than that reported in previous studies (5%-89%). Fever clinic has become a new key place for HHC observation. Nurses had the highest HHC (80%; 95% CI:74%-87%) while auxiliary workers (70%; 95%CI:62%-77%) had the lowest. For the WHO 5-moments, the health care providers had the highest HHC after contact with the body fluids of the patients (91%; 95% CI:88%-94%), while before contact with patient's health care providers had the lowest HHC (68%; 95% CI:62%-74%) which was consistent with before the pandemic. There existed great HHC differences among different monitoring methods (automatic monitoring system:53%; 95% CI:44%-63% versus openly and secretly observation: 91%; 95% CI: 90%-91%). CONCLUSIONS: During the COVID-19 pandemic, the compliance of health care providers' HH showed a great improvement. The fever clinics have become the focused departments for HH monitoring. The HHC of auxiliary workers and the HH opportunity for "before contact with patients" should be strengthened. In the future, it will be necessary to develop standardized HH monitoring tools for practical work.

Meta-analysis of the diagnostic efficiency of the questionnaires screening for schistosomiasis.

Schistosomiasis is the second widespread tropical disease that affects the health of over 240 million people of 78 countries. Questionnaires have been commonly used to diagnose schistosomiasis, while no meta-analysis of their efficacy had been reported previously. This meta-analysis was conducted to assess their diagnostic accuracy of schistosomiasis. Studies published prior to December 1, 2014, that had used questionnaires as a diagnostic tool were searched in PubMed, Medline, EMBASE, and China National Knowledge Infrastructure (CNKI) database. A total of 32 studies with 72,812 cases were identified for the meta-analysis. The best diagnostic odds ratio (DOR) was obtained from Schistosoma haematobium (67.68, 95 % confidence interval (CI) = 31.48 to 145.54), followed by Schistosoma japonicum (11.74, 95 % CI = 4.59 to 30.05) then Schistosoma mansoni (2.98, 95 % CI = 1.95 to 4.54). Pooled sensitivity and specificity were respectively 0.82, 0.88, and 0.46, and 0.59, 0.86, and 0.81 for S. japonicum, S. haematobium, and S. mansoni. The multivariable subgroup analyses showed that the questionnaires which had been pretested and standardized had better diagnostic performance. The result suggested that questionnaires can be used to diagnose schistosomiasis with moderate sensitivity and specificity and the questionnaires for diagnosing S. haematobium performed best.

[Risk assessment of schistosomiasis transmission on rescue workers involved in "Oriental Star shipwreck event"].

OBJECTIVE: To assess the impact of the "Oriental Star shipwreck event" on the risk of schistosomiasis transmission in Jianli County, Hubei Province, so as to provide the evidence for formulating appropriate measures of schistosomiasis prevention and control. METHODS: Based on the field observation and investigation, the data of the on-the-spot rescue and the historical endemic situation of schistosomiasis in Jianli County were collected and analyzed. Meanwhile, the focus group discussion and risk matrix were conducted to assess the risk of schistosome infection of the rescuers. RESULTS: Over 10 000 rescuers participated in the search operation, including the armed police forces, local people, reservists and so on. The armed police forces were the major components, which accounted for 39%. Jianli country was schistosomiasis endemic area with a high infection level in history, but the endemic situation had been mitigated significantly after years of positive prevention and treatment; the schistosome infection rate of population was 0.44% in 2014 and the Oncomelania hupensis snail area was only 6.6 hm2 around the rescue areas in the upstream and downstream. In addition, the snail density was not high, and no infected snails had been found for 11 years. The risk of schistosome infection was in the medium level. CONCLUSIONS: Though there exists the schistosome infection risk in the water area where the accident happened, the probability of occurrence is not high. In order to prevent the outbreak and endemic of schistosomiasis, the protection measures and health education to the rescuers as well as snail control and monitoring, and early-warning should be strengthened.