High Risk Of Transmission Research Articles

Screening of Schistosomiasis, Strongyloidiasis and Sexually Transmitted Infections in Nigerian Female Sex Workers Living in Rome

Female Sex Workers (FSWs) are at high risk for acquisition and transmission of sexually transmission infections (STIs). Although several studies investigated the diffusion of STIs in this population, none of them investigated the occurrence of helminth infections in FSW coming from endemic regions. This study aims to assess the prevalence of STIs and helminth infections in a cohort of FSWs. authors conducted a prevalent, observational, and descriptive study on 97 Nigerian FSWs aged 17 to 52 years from January to December 2020. a total of 97 FSWs were recruited. Of these, only 82 had completed screening for hepatitis B, C, syphilis, and HIV, while all 97 were screened for schistosomiasis and strongyloidiasis. The prevalence of STIs among FSWs in Rome was lower than in other European countries. The overall prevalence of HIV and HBsAg were 1.2%, (1/82) and 2.4% (2/82), respectively, while no case of hepatitis C and syphilis was found. Regarding parasitological screening, the overall prevalence of schistosoma species was 4.1% (4/97) while 5.15% (5/97) were positive for strongyloidiasis. our study shows a low prevalence of STIs in Nigerian FSWs except for Hepatitis B and a higher prevalence of schistosomiasis and strongyloidiasis. The permanent monitoring of STI and parasitic infections in sex workers coming from Africa is strongly warranted, especially for hepatitis B, schistosomiasis and strongyloidiasis, to allow a timely diagnosis and treatment, and to plan preventive strategies.

Molecular Transmission Network of Newly Reported HIV Infections in Pengzhou, Sichuan Province: A Study Based on Genomics and Spatial Epidemiology.

The objective of this study was to understand the molecular transmission characteristics of newly reported HIV infections in the city of Pengzhou, Sichuan Province, to analyze the risk factors of transmission network and spatial clustering and the transmission characteristics, and to provide a scientific basis for precision prevention and intervention. Anticoagulated whole blood was collected from newly reported HIV infections in Pengzhou from March 2019 to August 2021. After the plasma was isolated, the HIV-1 pol gene was amplified and sequenced by reverse transcriptase polymerase chain reaction (PCR). The obtained gene sequences were used to construct a maximum likelihood phylogenetic tree for the analysis of virus subtypes, and a molecular transmission network was constructed using the genetic distance method to evaluate the transmission pattern of people living with HIV/AIDS in Pengzhou. A logistic regression model was used to find out the potential risk factors for entering the molecular transmission network with the number of nodes ≥ 2. Spatial analysis is used to show the geographical pattern of the proportion of newly reported HIV infections entering the molecular transmission network, and a flow map is used to show the intensity of transmission within and between townships. A total of 463 newly reported HIV-infection sequences were obtained in this study, including 237 cases (51.19%) of CRF01_ AE, 159 cases (34.34%) of CRF07_BC, 45 cases (9.72%) of B, 15 cases (3.24%) of CRF08_BC and 7 cases (1.5%) of others. The number of clusters was the highest when the gene distance was 0.009, with a total of 246 sequences entering the network, forming 54 clusters, and the network entry rate was 55.36%. There were 170 sequences with more than two nodes in the network sequence. The logistic regression showed that compared with age < 50 years old, age ≥ 50 years old has a higher risk of transmission (OR = 3.43, 95% CI = 2.06-5.71); compared with farmers, the risk of transmission within industry is lower (OR = 0.046, 95% CI = 0.25-0.87); and compared with CRF07_BC, CRF01_AE (OR = 6.09, 95% CI = 3.60-10.30) and B (OR = 20.31, 95% CI = 8.94-46.13) had a higher risk of transmission. Men aged ≥ 50 years are mainly clustered with women between 50 and 70 years of age. In addition to being clustered with gay men, there are nine (50%) and three (16.7%) chains of transmission between gay men and heterosexual men and women, respectively. In the geographical space, there is no hot spot clustering of the molecular propagation network. The subtype B was mainly distributed in the town of Tianpeng and formed transmission networks in eastern Pengzhou;0020CRF01_AE is mainly distributed in the town of Lichun and formed transmission networks in the west and north of Pengzhou. This study reveals the characteristics and influencing factors of molecular network transmission in the region, as well as the spatial transmission characteristics of newly reported HIV infections in recent years, and reveals the geographical differences in HIV-1 transmission. The results provide a scientific basis for the development of local AIDS-specific intervention measures.

THE RELATIONSHIP BETWEEN STUDENTS PERCEPTION WITH COVID-19 PREVENTION BEHAVIORS ON EDI MANCORO BOARDING SCHOOL OF SEMARANG

Islamic Boarding School has a high risk of COVID-19 transmission. The COVID-19 transmission occurs due to the lack of students’ effort of COVID-19 prevention and does not disipline in following health protocols on islamic boarding school. This study analyzes the relationship between students’ perception with COVID-19 prevention behaviors on Edi Mancoro Boarding School of Semarang.This study used observational descriptive with cross-sectional study. The population of this study was 310 students and 75 students became participants and were determined based on purposive sampling method. Data was collected by fitting out questionnaires and was analyzed using Chi-square test. The analysis showed that 58,7% of respondents had well-implemented preventive behaviors of COVID-19. The mean gender was woman (60%), age of participants was more than equal to 20 years (66,7%). For most of them, the length of stay in an islamic boarding school was more than equal to 2 years (68%). Students had good knowledge (69,3%), had positively perceived susceptibility (58,7%), had positively perceived severity (50,7%), had positively benefits (77,3%) had positively perceived barrier (65,3%), had positive self-efficacy (93,3%) and had positive cues to action (64%). The result relationship test showed that gender (p=0,002), knowledge (p=0,022), perceived susceptibility (p=0,014), perceived severity (p=0,002) and perceived barriers (p=0,002) were releted with preventive behaviors of COVID-19. Unrelated factors are age, alllowance, the length of stay in islamic boarding school, perceived benefits, cues to action and self-efficacy with COVID-19 prevention behavior on Edi Mancoro boarding school of Semarang. Keyword : Islamic Boarding School, COVID-19 Prevention Behavior

Use of a Negative Pressure Containment Pod Within Ambulance-Workspace During Pandemic Response.

Emergency medical service (EMS) providers have a higher potential exposure to infectious agents than the general public (Nguyen et al., 2020, "Risk of COVID-19 Among Frontline Healthcare Workers and the General Community: A Prospective Cohort Study," Lancet Pub. Health, 5(9), pp. e475-e483; Brown et al., 2021, "Risk for Acquiring Coronavirus Disease Illness Among Emergency Medical Service Personnel Exposed to Aerosol-Generating Procedures," Emer. Infect. Disease J., 27(9), p. 2340). The use of protective equipment may reduce, but does not eliminate their risk of becoming infected as a result of these exposures. Prehospital environments have a high risk of disease transmission exposing EMS providers to bioaerosols and droplets from infectious patients. Field intubation procedures may be performed causing the generation of bioaerosols, thereby increasing the exposure of EMS workers to pathogens. Additionally, ambulances have a reduced volume compared to a hospital treatment space, often without an air filtration system, and no control mechanism to reduce exposure. This study evaluated a containment plus filtration intervention for reducing aerosol concentrations in the patient module of an ambulance. Aerosol concentration measurements were taken in an unoccupied research ambulance at National Institute for Occupational Safety and Health (NIOSH) Cincinnati using a tracer aerosol and optical particle counters (OPCs). The evaluated filtration intervention was a containment pod with a high efficiency particulate air (HEPA)-filtered extraction system that was developed and tested based on its ability to contain, capture, and remove aerosols during the intubation procedure. Three conditions were tested (1) baseline (without intervention), (2) containment pod with HEPA-1, and (3) containment pod with HEPA-2. The containment pod with HEPA-filtered extraction intervention provided containment of 95% of the total generated particle concentration during aerosol generation relative to the baseline condition, followed by rapid air cleaning within the containment pod. This intervention can help reduce aerosol concentrations within ambulance patient modules while performing aerosol-generating procedures.

Pandemi Döneminde COVID Dışı Yoğun Bakımlardaki Postoperatif Hastaların Retrospektif Değerlendirilmesi

Objective: During the pandemic period, hospital admissions for reasons other than COVID-19 infection decreased compared to the pre-pandemic period. In our study, it was aimed to examine the surgical (emergency and elective) and anesthesia (general and regional) type, clinical and demographic characteristics, COVID-19 (Polymerase Chain Reaction (PCR) status, length of stay and mortality rates of postoperative patients hospitalized in the non-COVID-19 intensive care unit during the pandemic, retrospectively. Methods: The files of the patients hospitalized in the postoperative intensive care unit between March, 2021 and March, 2022 were reviewed retrospectively. The patients were divided into two groups as emergency (Group A) and elective surgery (Group E). Age, gender, reason and duration of hospitalization, accompanying comorbidities, COVID-19 PCR results, Acute Physiology and Chronic Health Evaluation II (APACHE) score, Glasgow coma scale and mortality rates of the patients were recorded. Results: Gender, APACHE II score and Glasgow coma scale were similar in both groups. However, there was a difference between the two groups in terms of age, length of stay, accompanying comorbidities, COVID-19 PCR results and mortality rates. Conclusion: The positive effect of the PCR test taken from elective surgeries in the preoperative period was observed. We think that the risk of COVID-19 infection is higher in patients undergoing emergency surgery and because of the high risk of transmission, isolation intensive care units are needed for these patients. Keywords: COVID-19, surgery, critical care

A quantitative evaluation of aerosol generation during awake tracheal intubation.

Aerosol-generating procedures are medical interventions considered high risk for transmission of airborne pathogens. Tracheal intubation of anaesthetised patients is not high risk for aerosol generation; however, patients often perform respiratory manoeuvres during awake tracheal intubation which may generate aerosol. To assess the risk, we undertook aerosol monitoring during a series of awake tracheal intubations and nasendoscopies in healthy participants. Sampling was undertaken within an ultraclean operating theatre. Procedures were performed and received by 12 anaesthetic trainees. The upper airway was topically anaesthetised with lidocaine and participants were not sedated. An optical particle sizer continuously sampled aerosol. Passage of the bronchoscope through the vocal cords generated similar peak median (IQR [range]) aerosol concentrations to coughing, 1020 (645-1245 [120-48,948]) vs. 1460 (390-2506 [40-12,280]) particles.l-1 respectively, p=0.266. Coughs evoked when lidocaine was sprayed on the vocal cords generated 91,700 (41,907-166,774 [390-557,817]) particles.l-1 which was significantly greater than volitional coughs(p < 0.001). For 38 nasendoscopies in 12 participants, the aerosol concentrations were relatively low, 180 (120-525 [0-9552]) particles.l-1 , however, five nasendoscopies generated peak aerosol concentrations greater than a volitional cough. Awake tracheal intubation and nasendoscopy can generate high concentrations of respiratory aerosol. Specific risks are associated with lidocaine spray of the larynx, instrumentation of the vocal cords, procedural coughing and deep breaths. Given the proximity of practitioners to patient-generated aerosol, airborne infection control precautions are appropriate when undertaking awake upper airway endoscopy (including awake tracheal intubation, nasendoscopy and bronchoscopy) if respirable pathogens cannot be confidently excluded.

Evaluation of Midwives' Practises on Herpetic Infections during Pregnancy: A French Vignette-Based Study.

(1) Background: One out of two pregnant women has a history of herpes infection. Initial infections have a high risk of neonatal transmission. Our objective was to analyse the professional practises of midwives regarding the management of herpes infections during pregnancy in France; (2) Methods: A national survey conducted via an online self-questionnaire, including clinical vignettes for which the midwives proposed a diagnosis, a drug treatment, a mode of birth, and a prognosis. These responses were used to evaluate the conformity of the responses to the guidelines, as well as the influence of certain criteria, such as mode of practise and experience; (3) Results: Of 728 responses, only 26.1% of the midwives reported being aware of the 2017 clinical practise guidelines. The midwives proposed taking the appropriate actions in 56.1% of the responses in the case of a recurrence, and in 95.1% of the responses in the case of a primary infection. For the specific, high-risk case of a nonprimary initial infection at 38 weeks of gestation, reporting knowledge of the recommendations improved the compliance of the proposed care by 40% (p = 0.02). However, 33.8% of the midwives underestimated the neonatal risk at term after a primary initial infection, and 43% underestimated the risk after a primary initial infection at term; (4) Conclusions: The majority of reported practises were compliant despite a low level of knowledge of the guidelines. The dissemination of guidelines may be important to improve information and adherence to appropriate therapeutic practise.

Changes in Personal Protective Equipment Practices of Craniofacial Surgeons during COVID-19: A Cross-sectional Study.

Two identical electronic survey studies, one in 2020 and one in 2022, were conducted on the use of PPE before, during, and after the pandemic among active craniomaxillofacial surgeons. Statistical changes in behaviors and preferences and differences across time points and demographic groups were evaluated. The initial study included responses from 48 surgeons, and the follow-up study consisted of 36 responses. Although only 4.3% of surgeons wore N95 masks or powered air purifying respirator for craniomaxillofacial operations before the pandemic, 91.5% wore these measures during the early pandemic (P < 0.001). However, this fell to 74.3% 2 years later. Similarly, more than 95% of surgeons wore a mask in clinic during the pandemic at both time points compared to only 40.3% before the pandemic (P < 0.001). In 2020, 31.9% of surgeons planned to continue using N95 masks or powered air purifying respirator for craniofacial cases after the pandemic was over, but that fell to 11.4% in the follow-up study. Craniofacial surgeon practices have shifted significantly toward more protective PPE over the course of the coronavirus disease 2019 pandemic. However, this effect was dampened over the course of a protracted pandemic. Despite this, our studies indicate a long-term shift in surgeon preference that is likely to persist after the pandemic is over.

Entomological parameters and population structure at a microgeographic scale of the main Colombian malaria vectors Anopheles albimanus and Anopheles nuneztovari.

Population subdivision among several neotropical malaria vectors has been widely evaluated; however, few studies have analyzed population variation at a microgeographic scale, wherein local environmental variables may lead to population differentiation. The aim of the present study was to evaluate the genetic and geometric morphometric structure of Anopheles nuneztovari and Anopheles albimanus in endemic localities of northwestern Colombia. Genetic and phenetic structures were evaluated using microsatellites markers and wing geometric morphometrics, respectively. In addition, entomological indices of importance in transmission were calculated. Results showed that the main biting peaks of Anopheles nuneztovari were between 20:00 and 22:00, whereas Anopheles albimanus exhibited more variation in biting times among localities. Infection in An. nuneztovari by Plasmodium spp. (IR: 4.35%) and the annual entomological inoculation rate (30.31), indicated high vector exposure and local transmission risk. We did not detect Plasmodium-infected An. albimanus in this study. In general, low genetic and phenetic subdivision among the populations of both vectors was detected using a combination of phenotypic, genetic and environmental data. The results indicated high regional gene flow, although local environmental characteristics may be influencing the wing conformation differentiation and behavioral variation observed in An. albimanus. Furthermore, the population subdivision detected by microsatellite markers for both species by Bayesian genetic analysis provides a more accurate picture of the current genetic structure in comparison to previous studies. Finally, the biting behavior variation observed for both vectors among localities suggests the need for continuous malaria vector surveys covering the endemic region to implement the most effective integrated local control interventions.

A Global-Scale Ecological Niche Modeling of the Emerging Pathogen Serratia marcescens to Aid in its Spatial Ecology.

Serratia marcescensis a big emerging concern for human health and coral biodiversity. Spatial ecology and the influencing factors on pathogen ecology, however, remain unknown. The study forms the first global risk assessment ofS. marcescens. MaxEnt niche modeling was applied using two biotic and sixteen abiotic variables. The world was classified into five risk-level categories based on the pathogen ecology, and the world population exposed toS. marcescensinfection was then quantified. The prepared model showed an area under the curve value of 0.918 ± 0.028, implying excellent prediction ability. The highly and moderately suitable areas occupied around 0.52% and 17.9% of the total global land area. The order of probability of havingS. marcescens-related infections was Asia > North America > South America > Europe > Africa > Australia. Human population density and temperature were the most influential factors in the distribution. The moderate to high transmission risk zones contained 0.20% (1.61 billion people) of the human population. In brief, these results give novel insights into its spatial ecology and provide the risk maps that can be utilized to plan targeted strategic control measures against future invasions of this emerging pathogen.

Discrimination Experienced by Women Living with HIV and AIDS Accessing Reproductive Health Services

Women with disclosed HIV status experience different barriers and are stigmatized and discriminated against in health services. The sexual and reproductive health of women living with HIV is critical when compared to those who are not living with HIV. Discriminatory behaviour in health settings decreases the morale of women and limits the care of their health. Women living with HIV hide their status because of fear of discrimination, which puts the health personnel at high risk of transmission. The goal of this study was to learn more about the reasons for and types of discrimination faced by HIV-positive women seeking reproductive health services in healthcare settings. The researcher found three significant findings. To begin with, pre-existing social attitudes, perceptions, and information regarding women with HIV are at the foundation of stigma and discrimination in healthcare settings. Second, the forms of stigma and prejudice that WLHIV perceived or experienced differed from each other, regardless of which service under reproductive health they sought. Finally, due to such discrimination, WLHIV refuses to disclose their HIV status, delaying or avoiding seeking medical help, experiencing emotional stress, and having low self-esteem.

Transfusion Transmission of Syphilis and HIV from Earlobe Piercing in Tattoo Clinic – A Case Study from the Coal Capital of India

The practices of body piercing and tattoos have gained popularity, but, they also pose a risk of transmitting diseases. This article details a case of a young male individual who acquired HIV subsequent to undergoing earlobe piercing at a nearby tattoo parlour. A 28-year-old male, who was in good condition overall, received a diagnosis of HIV following testing positive for treponema pallidum hemagglutination assay (TPHA) after frontal palmar rashes. The diagnosis of syphilis and HIV was incongruous with his stated behaviour, and the stated reasons were not acknowledged by the counsellors. The patient was notified about our research emphasis in the Department of Community Medicine and requested our aid in identifying the underlying reason for his HIV and TPHA positive. The patient and his parents had a thorough history assessment, which eliminated all recognised potential modes of HIV transmission. After ruling out all other possible means of transmission, it was determined that the patient’s HIV and TPHA positivity may be attributed to the use of a tattoo gun for earlobe piercing to insert diamond studs at a local tattoo parlour. The widespread establishment of tattoo parlours throughout the nation presents a potential hazard to adolescents, who may acquire HIV without participating in activities associated with the high risk of transmission. Tattoo parlours must provide education to their clients, adhere to strict hygienic and sterile protocols and undergo government inspections to verify compliance with hygiene and sterilisation regulations.

Direct and indirect vaccination effects on SARS-CoV-2 infection in day-care centres: Evaluating the policy for early vaccination of day-care staff in Germany, 2021.

To mitigate the known high transmission risk in day-care facilities for children aged 0-6years, day-care staff were given priority for SARS-CoV-2 vaccination in Rhineland-Palatinate, Germany, in March 2021. This study assessed direct and indirect effects of early vaccination of day-care staff on SARS-CoV-2 transmission in daycares with the aim to provide a basis for the prioritisation of scarce vaccines in the future. Data came from statutory infectious disease notifications in educational institutions and from in-depth investigations by the district public health authorities. Using interrupted time series analyses, we measured the effect of mRNA-based vaccination of day-care staff on SARS-CoV-2 infections and transmission. Among 566 index cases from day-care centres, the mean number of secondary SARS-CoV-2 infections per index case dropped by -0.60 case per month after March 2021. The proportion of staff among all cases reported from daycares was around 60% in the pre-interruption phase and significantly decreased by 27 percentage points immediately in March 2021 and by further 6 percentage points each month in the post-interruption phase. Early vaccination of day-care staff reduced SARS-CoV-2 cases in the overall day-care setting and thus also protected unvaccinated children. This should inform future decisions on vaccination prioritisation.

Spatial patterns of new leprosy cases in a northeastern state of Brazil, 2011-2021.

To analyze the spatial patterns of leprosy in Pernambuco from 2011 to 2021. This is an ecological epidemiological study, carried out with data from the Notifiable Diseases Information System, based on new cases of leprosy among inhabitants of Pernambuco, between 2011-2021. An empirical Bayesian analysis of local and spatial dependence was performed with the global and local Moran indices. 25,008 new cases of leprosy were registered with an annual case detection rate in the general population of 16.51 cases/100,000 inhabitants - which is considered high. Among those younger than 15 years of age, there were 5.16 cases/100,000 inhabitants (high) and 0.89/100,000 inhabitants with degree II of physical disability (low); there were also many high-risk cases with an overall Moran index of 0.33 (p<0.001), active transmission (0.26; p<0.001), and subsequent diagnosis of the disease (0.12; p<0.006), as well as distribution in macro-region 1 and macro-region 4. There was a heterogeneous spatial distribution in the state, showing two overviews, the first being the presence of municipalities with high risk of disease transmission and the second with clusters of silent municipalities, reinforcing the character of leprosy neglect as a major public health problem. This study brings reflections for leprosy control actions, due to the identification of priority areas to combat this disease in Pernambuco.

The Coordinating Research on Emerging Arboviral Threats Encompassing the Neotropics (CREATE-NEO).

Arthropod-borne viruses, such as dengue, Zika and Mayaro, are emerging at an accelerating rate in the neotropics. The Coordinating Research on Emerging Arboviral Threats Encompassing the Neotropics (CREATE-NEO) project, a part of the NIH funded Centers for Research in Emerging Infectious Diseases (CREID) network provides a nimble and flexible network of surveillance sites in Central and South America coupled to cutting-edge modeling approaches in order to anticipate and counter these threats to public health. Collected data and generated models will be utilized to inform and alert local, regional and global public health agencies of enzootic arboviruses with high risk of spillover, emergence and transmission among humans, and/or international spread. Critically, CREATE-NEO builds capacity in situ to anticipate, detect and respond to emerging arboviruses at their point of origin, thereby maximizing the potential to avert full-blown emergence and widespread epidemics.

Economic impact of highly pathogenic avian influenza outbreaks in Western Java smallholder broiler farms

Highly Pathogenic Avian Influenza (HPAI) H5N1 is considered endemic in most parts of Indonesia and constitutes an important risk for broiler production, especially in Western Java which has the highest poultry population in the country. Most broiler farms in Western Java are smallholder farms that operate under different business types: independent (i.e., revenues based on market price and live bird weight), price-contract (i.e., revenues based on a contract selling price and live bird weight) or makloon (i.e., revenues based on a management fee per sold bird). Many studies focus on the epidemiological impacts of HPAI at the regional level, and insights into the economic impact at the farm level are scarce, especially in the Indonesian context. Meanwhile, a single HPAI outbreak could disrupt smallholder broiler farmers’ primary source of income. Therefore, this study aimed to evaluate the economic impact of HPAI outbreaks under different response scenarios (i.e., no action, stamping out, and early selling) on typical Western Java smallholder broiler farms. Furthermore, the effect of different farm business types and the existence of a sick-bird market on the economic effects of HPAI outbreaks were evaluated. We developed a dynamic stochastic bio-economic simulation model to simulate epidemiological and economic impacts of HPAI outbreaks on a typical Western Java smallholder broiler farm during one production round. Our results show that the economic consequences of HPAI outbreaks for independent and price-contract farms are considerable, ranging from, on average, 1.2–62.7 million Indonesian Rupiah (IDR) losses (€76.9 to €3919), depending on the moment of and response to infection, compared to an expected gross margin of 5.3 million IDR (€331) under normal circumstances. The economic loss for makloon farms was substantially lower than for other business types, reducing their incentive to implement biosecurity. The economic impacts were sensitive to changes in a diverse set of parameters, including disease transmission rate, detection threshold, and stamping-out compensation. The losses in a scenario with stamping out were higher than in other scenarios, especially when stamping out happened near the end of the production round. Moreover, reacting to an outbreak by selling chickens early gave the lowest economic losses, incentivizing farmers to engage in behavior with a high disease transmission risk. Therefore, the results of this study suggest that it is important to consider the economic perspective of individual farmers when designing HPAI mitigation programs. Financial incentives for farmers to control HPAI differ largely between farm business types.

GLOVES: DOS AND DON’TS

Standard infection-prevention and control procedures must be in place during all healthcare contacts, regardless of whether a patient is known to be contagious or not, to stop the transmission of infection. As with all the items of personal protective equipment, the need for gloves must be subject to careful risk assessment of the task to be carried. Having decided that gloves should be used, a choice between sterile and non-sterile gloves must be made depending on the tasks undertaken.&#x0D; Sterile gloves are worn to prevent the transmission of microorganisms from healthcare workers (HCWs) to patients. In addition, they also protect against blood and body fluids during surgical and aseptic procedures. The recommendation to wear sterile gloves includes all surgical interventions, vaginal delivery, Insertion of indwelling devices (IV line, urinary catheter, etc.), performing lumber punctures, giving epidurals, etc., invasive radiological procedures, preparing total parenteral nutrition and chemotherapeutic agents (1). &#x0D; Non-sterile gloves are used to protect the HCWs from acquiring microorganisms from patients and contaminated environments, coming in direct contact with blood and body fluids by contact with non-intact skin or mucous membranes, e.g., vaginal examination, oral/dental care, emptying urine bags, suctioning of endotracheal tubes and by contact with the potential presence of infectious agents, e.g., MRSA both on intact and non-intact skin. Non-sterile gloves are also to be worn by contacting blood and body fluids indirectly by handling and cleaning contaminated items and equipment, handling clinical waste, and cleaning up spills of blood and body fluids (1).&#x0D; However, misuse and carelessness while wearing gloves can lead to cross-contamination, and infection spread rather than infection prevention and control. Possible microbial transmission has been documented where used gloves were not removed or changed before performing care activities requiring asepsis, not changing gloves while moving from one patient to the other, taking care of multiple patients with the same pair of gloves, wearing layers of gloves and then removing the outer layer as they move from room to room (2).&#x0D; Failure to change or remove contaminated gloves is also a significant cause of poor compliance with hand hygiene, creating a high risk of microbial transmission. Gloves are never meant to be worn in lieu of hand hygiene. Healthcare workers should wash their bare hands according to the World Health Organization's five moments of hand hygiene (3) Hand hygiene has to be followed strictly before donning and after the doffing of gloves. Gloves should only be worn in cases of the indications listed above. In some areas, HCWs are usually seen wearing gloves when there is no need. Besides contact precautions, gloves are not recommended while taking vitals, injecting intramuscularly and subcutaneously, giving oral medicines, vascular line manipulation in the absence of blood leakage, using the telephone, writing in patients’ charts, and moving patients’ furniture. Gloves should never be worn in the hallways or elevators, moving from one place to another within the hospital premises, or serving multiple patients. Gloves are not meant to be worn over and over or washed in between usage (4).&#x0D; Adhering to hand hygiene and rationalizing the use and type of gloves in any healthcare setting can help prevent microbial contamination of the environment and for the safety of patients and HCWs from microorganisms.

Effects of in Utero SARS-CoV-2 Exposure on Newborn Health Outcomes

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 600 million people worldwide, including millions of pregnant women. While newborns exposed to other viruses in utero are sometimes at high risk for vertical transmission, a substantial body of literature since early 2020 has demonstrated that vertical transmission of SARS-CoV-2 from infected mother to neonate is rare, and that newborns who do become infected with SARS-CoV-2 generally have favorable outcomes. In this review, the authors evaluate the existing literature on vertical transmission of SARS-CoV-2 and its potential mechanisms and discuss short- and long-term health outcomes in newborns who were exposed to SARS-CoV-2 in utero. The authors conclude that vertical transmission and adverse neonatal and infant/child outcomes are unlikely, but that neonates exposed to prenatal maternal SARS-CoV-2 infection may be at slightly higher risk for preterm birth, possibly related to increased risk of severe COVID-19 disease in pregnant women, placental changes, or infection timing. Ultimately, the need for additional and longer-term follow-up data in this population is highlighted.

Vaccination Strategies against Seasonal Influenza in Long Term Care Setting: Lessons from a Mathematical Modelling Study

seasonal influenza in nursing homes is a major public health concern, since in EU 43,000 long term care (LTC) facilities host an estimated 2.9 million elderly residents. Despite specific vaccination campaigns, many outbreaks in such institutions are occasionally reported. We explored the dynamics of seasonal influenza starting from real data collected from a nursing home located in Italy and a mathematical model. Our aim was to identify the best vaccination strategy to minimize cases (and subsequent complications) among the guests. after producing the contact matrices with surveys of both the health care workers (HCW) and the guests, we developed a mathematical model of the disease. The model consists of a classical SEIR part describing the spreading of the influenza in the general population and a stochastic agent based model that formalizes the dynamics of the disease inside the institution. After a model fit of a baseline scenario, we explored the impact of varying the HCW and guests parameters (vaccine uptake and vaccine efficacy) on the guest attack rates (AR) of the nursing home. the aggregate AR of influenza like illness in the nursing home was 36.4% (ward1 = 56%, ward2 = 33.3%, ward3 = 31.7%, ward4 = 34.5%). The model fit to data returned a probability of infection of the causal contact of 0.3 and of the shift change contact of 0.2. We noticed no decreasing or increasing AR trend when varying the HCW vaccine uptake and efficacy parameters, whereas the increase in both guests vaccine efficacy and uptake parameter was accompanied by a slight decrease in AR of all the wards of the LTC facility. from our findings we can conclude that a nursing home is still an environment at high risk of influenza transmission but the shift change room and the handover situation carry no higher relative risk. Therefore, additional preventive measures in this circumstance may be unnecessary. In a closed environment such as a LTC facility, the vaccination of guests, rather than HCWs, may still represent the cornerstone of an effective preventive strategy. Finally, we think that the extensive inclusion of real life data into mathematical models is promising and may represent a starting point for further applications of this methodology.

Karakteristik Remaja Terinfeksi HIV yang Memanfaatkan Program Pencegahan Penularan HIV ke Anak di RSUP P Kota Jakarta Timur

Abstract – Cases of adolescents infected with HIV in Indonesia continue to show numbers that show an increase. Ignorance of adolescents is one of the factors driving this increase. Thus the need for insight regarding how HIV is transmitted in order to provide assistance for adolescents to avoid HIV and its transmission to children. Adolescents are categorized as an age with a very high risk of transmission. The rate of HIV transmission from mother to child has increased from year to year. In this case, the government implements the Prevention of HIV Transmission from Mother to Child or known as PPIA. PPIA's first program was the provision of information related to HIV/AIDS to pregnant women during pregnancy checks. This study uses a quantitative approach which is presented descriptively with a sample of 97 adolescents. Data collection was carried out using a questionnaire which was afterwards presented in table form with percentages and cross-tabulations between variables. The results showed that 75% of the respondents were aged 14-16 years, with the majority having high school education (48%), working (54%), and having good knowledge of HIV transmission (71%). Good knowledge is not always directly proportional to a supportive attitude towards the PPIA program. Thus it is necessary to improve integrated antenatal care services related to the integration of counseling services and HIV testing.