Perceived Risk Of Infection Research Articles

The influence of awareness on epidemic spreading on random networks

During an outbreak, the perceived infection risk of an individual affects his/her behavior during an epidemic to lower the risk. We incorporate the awareness of infection risk into the Volz-Miller SIR epidemic model, to study the effect of awareness on disease dynamics. We consider two levels of awareness, the local one represented by the prevalence among the contacts of an individual, and the global one represented by the prevalence in the population. We also consider two possible effects of awareness: reducing infection rate or breaking infectious edges. We use the next generation matrix method to obtain the basic reproduction number of our models, and show that awareness acquired during an epidemic does not affect the basic reproduction number. However, awareness acquired from outbreaks in other regions before the start of the local epidemic reduces the basic reproduction number. Awareness always reduces the final size of an epidemic. Breaking infectious edges causes a larger reduction than reducing the infection rate. If awareness reduces the infection rate, the reduction increases with both local and global awareness. However, if it breaks infectious edges, the reduction may not be monotonic. For the same awareness, the reduction may reach a maximum on some intermediate infection rates. Whether local or global awareness has a larger effect on reducing the final size depends on the network degree distribution and the infection rate.

Cross-cultural validation of the short version of the Food Disgust Scale in ten countries

The cross-cultural testing of scales represents an important step in the scale validation process. The present study evaluated whether the eight-item short version of the recently developed Food Disgust Scale (FDS-short) is a reliable and valid tool for measuring food disgust sensitivity in ten countries: Australia, China, England, France, Germany, Mexico, South Africa, Spain, Sweden, and the USA. In an online survey, the participants (N = 6128) answered items from the FDS-short and other scales related to (food) disgust sensitivity so as to test the construct and criterion validity of the FDS-short. Confirmatory factor analysis of the one-factor structure of the FDS-short revealed an adequate to good model fit in all the countries except for China. Multiple group analysis to test measurement invariance showed the FDS-short to be metrically invariant in all the tested countries (except for China) relative to Australia. With regard to the construct validity, significant positive correlations were observed in all the countries between the FDS-short and pathogen disgust sensitivity, sexual disgust sensitivity, moral disgust sensitivity, germ aversion, and food neophobia. Criterion validity of the FDS-short in all the tested countries was confirmed by the positive correlations between it and having a sensitive stomach, experiencing gastrointestinal complaints after eating animal-based foods (except for France and Germany), and the perceived infection risk of food-borne diseases in one's country. The direction of the correlations indicated that for each country, those with higher FDS-short scores also scored higher on all the tested constructs than those with lower FDS-short scores. Taken together, the present results indicate that the FDS-short is a reliable and valid tool for assessing food disgust sensitivity across countries.

Effects of asymptomatic infection on the dynamical interplay between behavior and disease transmission in multiplex networks

Multiplex network theory is widely introduced to deepen the understanding of the dynamical interplay between self-protective behavior and epidemic spreading. Most of the existing studies assumed that all infected individuals can transmit disease- related information or can be perceived by their neighbors. However, owing to lack of distinct symptoms for patients in the initial stage of infection, the disease information cannot be transmitted in the population, which may lead to the wrong perception of infection risk and inappropriate behavior response. In this work, we divide infected individuals into Exposed-state (without obvious clinical symptoms) individuals and Infected-state (with evident clinical symptoms) individuals, both of whom can spread disease, but only Infected-state individuals can diffuse disease information. Then, in this work we establish UAU-SEIS (Unaware–Aware–Unaware–Susceptible–Exposed–Infected–Susceptible) model in multiplex networks and analyze the effect of asymptomatic infection and the isolation of Infected-state individuals on the density of infection and the epidemic threshold. Furthermore, we extend the UAU-SEIS model by taking the individual heterogeneity into consideration. Combined Markov chain approach and Monte-Carlo Simulations, we find that asymptomatic infection has an effect on the density of infected individuals and the epidemic threshold, and the extent of the effect is influenced by whether Infected-state individuals are isolated or treated. In addition, results show that the individual heterogeneity can lower the density of infected individuals, but cannot enhance the epidemic threshold.

Condom use attitude and self-efficacy, and STIs risk perception among Iranian female sex workers: A psychometric study

In this cross-sectional study, we aimed to investigate psychometric properties of the Persian versions of condom use self-efficacy (CUSES), attitude toward condom use (ATCUS), and sexually transmitted infection risk perception (STIsRP) scales among Iranian female sex workers (FSWs). We translated original versions of the scales into Persian, and through census, recruited and interviewed 140 FSWs. Appropriate validity, reliability, functionality and simplicity were demonstrated for the scales. We found the measurement model with a good fit to the data (χ2 [104] = 89.537, p < .01, CFI = 0.978, NFI = 0.931, TLI = 0.981, RMSEA = 0.055 [0.023–0.081]). Our findings supported the applicability of the Persian CUSES, ATCUS, and STIsRP in the Iranian and other Persian-speaking FSW populations.

Perceptions of Infection Risk With Immunomodulatory Medications.

Physicians of many specialties encounter patients treated with immunomodulatory medications and must weigh the risk of infection when making medical decisions. We explored how physician perceptions of the infection risk of immunomodulatory medications differ by specialty and level of experience. A survey was distributed to physicians from the internal medicine, family medicine, emergency medicine, rheumatology, dermatology, and infectious disease departments at 1 tertiary care institution. Physicians scored their level of concern for the risk of infection of 15 commonly used immunomodulatory medications hypothetically taken for 1 year. The survey was distributed to 634 people; 197 physicians completed the survey. Opinion of the risk of infection differed significantly by specialty for 8 of 15 medications. Experienced providers rated risk of infection differently from less experienced providers for prednisone 10 to 20 mg (P = 0.046), hydroxychloroquine (P = 0.013), dapsone (P = 0.029), and anti-tumor necrosis factor (TNF) therapy (P = 0.027). Most experienced physicians regarded dapsone (95%) and hydroxychloroquine (93%) as low risk, whereas many less experienced physicians scored them as medium- or high-risk medications. In contrast, experienced physicians were more likely to rate prednisone 10 to 20 mg as medium or high risk. Most less experienced physicians (55%) identified anti-TNF therapy as high risk, whereas experienced physicians were split evenly among low, medium, and high risk. There is substantial variability in physician perception of the risk of infection of many immunomodulatory medications. Experienced physicians are more concerned than peers about the risk of infection of intermediate doses of prednisone. Opinions regarding anti-TNF therapy range broadly even among experienced providers.

Effect of effort-reward imbalance and burnout on infection control among Ecuadorian nurses.

BackgroundNurses are frequently exposed to transmissible infections, yet adherence to infection control measures is suboptimal. There has been inadequate research into how the psychosocial work environment affects compliance with infection control measures, especially in low‐ and middle‐income countries.AimTo examine the association between effort‐reward imbalance, burnout and adherence to infection control measures among nurses in Ecuador.IntroductionA cross‐sectional study linking psychosocial work environment indicators to infection control adherence.MethodsThe study was conducted among 333 nurses in four Ecuadorian hospitals. Self‐administered questionnaires assessed demographic variables, perceived infection risk, effort‐reward imbalance, burnout and infection control adherence.ResultsIncreased effort‐reward imbalance was found to be a unique incremental predictor of exposure to burnout, and burnout was a negative unique incremental predictor of nurses' self‐reported adherence with infection control measures.DiscussionResults suggest an effort‐reward imbalance‐burnout continuum, which, at higher levels, contributes to reduce adherence to infection control. The Ecuadorean government has made large efforts to improve universal access to health care, yet this study suggests that workplace demands on nurses remain problematic.ConclusionThis study highlights the contribution of effort‐reward‐imbalance‐burnout continuum to the chain of infection by decreased adherence to infection control of nurses.Implications for Nursing PolicyHealth authorities should closely monitor the effect of new policies on psychosocial work environment, especially when expanding services and increasing public accessibility with limited resources. Additionally, organizational and psychosocial interventions targeting effort‐reward imbalance and burnout in nurses should be considered part of a complete infection prevention and control strategy. Further study is warranted to identify interventions that best ameliorate effort‐reward imbalance and burnout in low‐ and middle‐income settings.

Social Big Data Analysis of Information Spread and Perceived Infection Risk During the 2015 Middle East Respiratory Syndrome Outbreak in South Korea.

We investigated online diffusion of information, spread of fear, and perceived risk of infection to Middle East Respiratory Syndrome (MERS) as cases of MERS spread rapidly and dozens of fatalities occurred in South Korea in May-June of 2015. This study retrieved 8,671,695 MERS-related online documents from May 20 to June 18, 2015, from 171 Korean online channels and analyzed such documents by using multilevel models and data mining with Apriori algorithm association analysis. We used R software (version 3.2.1) for the association analysis data mining and visualization. Buzz with negative emotions (i.e., anxiety or fear) was more prevalent in online discussion boards, Twitter, and online cafes than news sites and blogs. News buzz (b = 0.21, p < 0.001), but not rumor buzz (b = 0.06, p = 0.308), was associated with positive MERS emotions (i.e., being calm or composed). The mention of eating immunity-boosting food in the news led to a 94 percent chance of a positive MERS emotion and that such a chance of showing a positive emotion was 4.75 times higher than that without such a mention (support of 0.001, confidence of 0.94, and lift of 4.75). Even with the same precautionary messages that were disseminated, they yielded the opposite emotional reactions to people depending on the channel through which the messages were communicated. In the face of a novel and highly contagious disease such as MERS, the government must deploy a response system that includes provision and dissemination of reliable information and inhibits online diffusion of false information.

Compliance with Standard Precautions and Associated Factors among Healthcare Workers in Gondar University Comprehensive Specialized Hospital, Northwest Ethiopia

Background. In many studies, compliance with standard precautions among healthcare workers was reported to be inadequate. Objective. The aim of this study was to assess compliance with standard precautions and associated factors among healthcare workers in northwest Ethiopia. Methods. An institution-based cross-sectional study was conducted from March 01 to April 30, 2014. Simple random sampling technique was used to select participants. Data were entered into Epi info 3.5.1 and were exported to SPSS version 20.0 for statistical analysis. Multivariate logistic regression analyses were computed and adjusted odds ratio with 95% confidence interval was calculated to identify associated factors. Results. The proportion of healthcare workers who always comply with standard precautions was found to be 12%. Being a female healthcare worker (AOR [95% CI] 2.18 [1.12–4.23]), higher infection risk perception (AOR [95% CI] 3.46 [1.67–7.18]), training on standard precautions (AOR [95% CI] 2.90 [1.20–7.02]), accessibility of personal protective equipment (AOR [95% CI] 2.87 [1.41–5.86]), and management support (AOR [95% CI] 2.23 [1.11–4.53]) were found to be statistically significant. Conclusion and Recommendation. Compliance with standard precautions among the healthcare workers is very low. Interventions which include training of healthcare workers on standard precautions and consistent management support are recommended.

Dynamics of public opinion under the influence of epidemic spreading

In this paper, we propose a novel model with dynamically adjusted confidence level of others to investigate the propagation of public opinion on whether to buy chicken in the case of avian influenza infection in humans. We study how people adjust their confidence level in other people’s opinions according to their perceived infection risk and how the opinion evolution and epidemic spreading affect each other on different complex networks by taking into account the spreading feature of avian influenza, that is, only people who buy chicken are possible to be infected. The simulation results show that in a closed system, people who support buying chicken and people who are infected can achieve a dynamic balance after a few time-steps, and the final stable state is mainly dependent on the level of people’s risk perception, rather than the initial distribution of the different opinions. Our results imply that in the course of the epidemic spread, transparent and timely announcement of the number of infections and the risk of infection can help people take the right self-protection actions, and thus help control the spread of avian influenza.

Reluctance to care for patients with HIV or hepatitis B / C in Japan.

BackgroundHealthcare workers are faced with various professional dilemmas in the workplace, including at times, a reluctance to care for particular patients. This study investigated personal attitudes and factors influencing Japanese nurses’ reluctance to care for patients infected with HIV, Hepatitis B Virus (HBV), or Hepatitis C Virus (HCV).MethodsParticipants completed an anonymous online survey focusing on potential attitudes towards hypothetical patients, awareness of infection risk and their confidence in using precautions to prevent infection. Statistical associations were analyzed using Poisson regression models.ResultsRegarding personal attitudes, 41 % and 18 % of nurses agreed or somewhat agreed that they would be reluctant to care for a hypothetical patient infected with HIV or HBV / HCV, respectively. Reluctance to care for patients with HIV or HBV / HCV was positively associated with prejudicial attitudes and negatively associated with confidence in personal safety precautions. Hypothetical reluctance to care for patients with HBV / HCV was negatively associated with actual previous experience caring for HBV / HCV patients. Older age among nurses (≥50 years) was positively associated with an increased reluctance to care for hypothetical patients with HIV.ConclusionsOverall, this study suggests that anxiety arising from perceived infection risk and having a prejudicial attitude might affect the acceptance of infected patients, while personal confidence in universal precautions probably mitigates this situation. Improving nurses’ confidence in using universal precautions therefore represents a positive measure that can help reduce prejudice and improve the quality of healthcare services in Japan, as elsewhere.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-0822-2) contains supplementary material, which is available to authorized users.

Indwelling peritoneal catheters in patients with cirrhosis and refractory ascites.

The prevalence of spontaneous bacterial peritonitis (SBP) in hospitalised cirrhotics with ascites is 10-30%. Treatment for refractory ascites includes paracenteses, transjugular intrahepatic portosystemic shunt or drain placement; the latter is discouraged due to a perceived infection risk. This study aimed to evaluate the risk of bacterial peritonitis (BP) with peritoneal drains in patients with Child-Pugh class B or C cirrhosis and determine their impact on survival. We conducted a retrospective review of end-stage liver disease (ESLD) patients with non-malignant, refractory ascites who had peritoneal drains placed for ≥3 days at Loyola University between 1999 and 2009. Cell counts were performed at drain placement and within 72 h. BP was defined as ascitic polymorphonuclear neutrophils >250/mm(3) . Univariate analysis assessed the association between demographics, laboratory markers and development of BP. Kaplan-Meier curve estimates by infection were constructed and survival distributions were compared using log-rank statistic. There were 227 drain placements during the study period. Twenty-two per cent were diagnosed with BP (12% had SBP at drain placement; 10% developed BP within 72 h). There was no association between BP and baseline characteristics. Patients who developed BP within 72 h of drain placement had 50% mortality at 5 months compared with 50 months in those without infection (log-rank P ≤ 0.003). In ESLD patients who received an indwelling peritoneal catheter, there was 10% risk of developing BP and significant mortality increase. Though placing drains is not the mainstay of treatment for refractory ascites, we confirm the theoretical adverse risk of peritoneal drains on infection and survival in cirrhotics.

The association between HIV/AIDS-related knowledge and perception of risk for infection: a systematic review.

This systematic review tries to elucidate the association between what people know about HIV/AIDS and how they perceive their risk of infection. The initial search for articles yielded 1,595 abstracts, 16 of which met the inclusion criteria. Five studies found a positive correlation, four reported a negative correlation and seven found no association between knowledge and risk perception. It was found that the existing psychometrically sound measure of HIV/AIDS risk perception had not been used in any of the studies. The context in which the risk is assessed is pivotal to whether an association between knowledge and the perceived risk is found. Biases in judgement such as optimistic bias, psychological distancing, anchoring bias and overconfidence also explain how knowledge may fail to predict risk perception. It was concluded that the association between HIV/AIDS knowledge and risk perception might follow a continuum from positive to no association and finally to negative. The hypothesis, however, still needs to be studied further.

HIV infection risk perception and stigmatizing attitude: Results of surveys of dwellers from the Central Administrative District of Moscow

To study human immunodeficiency virus (HIV) infection risk perception and stigmatizing attitudes in the dwellers of the Central Administrative District of Moscow. An anonymous survey was conducted using specially developed questionnaires. A total of 893 people were interviewed. Each of the given indicators was used to ask 98 to 254 respondents. Among the survey participants, there were 92 healthcare workers, including 66 physicians and 26 representatives of middle-level and junior medical staff. According to their replies, the respondents were divided into 2 groups: 1) healthcare workers; 2) representatives of the so-called general population. 91.3% of the healthcare workers gave a negative reply to the question: "Should contacts (intercourse) with people living with HIV (AIDS) be avoided to escape infection?". In Group 2, 58.8 and 23.5% of the respondents answered negatively and positively, respectively; and 17.6% had difficulty answering the question. In the general population group, 44.10% of the respondents answered negatively and 32.2% had difficulty answering the question: "Would you agree to live in the same room with anybody whom you know or suspect to be HIV positive?"; 23.8% agreed to do this. Among the healthcare workers, there were 46.7% of the respondents who answered positively. When the question: "Would you agree to send your child (grandson) to the kindergarten if you would learn that a HIV-infected child goes there?" was asked, 48.6 and 18.7% of the respondents in the general population group answered negatively and positively, respectively; 32.7% had difficulty answering. In the group of healthcare workers, 66.7% answered positively. Among both the healthcare workers and the representatives of the general population, more than 60% of the respondents agreed with the statement that "HIV-infected people lead a loose life". The specific features of perceiving a HIV infection risk and showing stigmatizing attitudes towards HIV-infected patients make the forming less dangerous behaviors difficult and restrict an access to care and support in infected patients. The training of healthcare workers in issues related to HIV infection should involve the identification of stigmatizing attitudes and the application of destigmatization strategies.

Deriving and Validating A Risk Estimation Tool for Screening Asymptomatic Chlamydia and Gonorrhea

There has been considerable interest in the development of innovative service delivery modules for prioritizing resources in sexual health delivery in response to dwindling fiscal resources and rising infection rates. This study aims to derive and validate a risk scoring algorithm to accurately identify asymptomatic patients at increased risk for chlamydia and/or gonorrhea infection. We examined the electronic records of patient visits at sexual health clinics in Vancouver, Canada. We derived risk scores from regression coefficients of multivariable logistic regression model using visits between 2000 and 2006. We evaluated the model's discrimination, calibration, and screening performance. Temporal validation was assessed in visits from 2007 to 2012. The prevalence of infection was 1.8% (n = 10,437) and 2.1% (n = 14,956) in the derivation and validation data sets, respectively. The final model included younger age, nonwhite ethnicity, multiple sexual partners, and previous infection and showed reasonable performance in the derivation (area under the receiver operating characteristic curve = 0.74; Hosmer-Lemeshow P = 0.91) and validation (area under the receiver operating characteristic curve = 0.64; Hosmer-Lemeshow P = 0.36) data sets. A risk score cutoff point of at least 6 detected 91% and 83% of cases by screening 68% and 68% of the derivation and validation populations, respectively. These findings support the use of the algorithm for individualized risk assessment and have important implications for reducing unnecessary screening and saving costs. Specifically, we anticipate that the algorithm has potential uses in alternative settings such as Internet-based testing contexts by facilitating personalized test recommendations, stimulating health care-seeking behavior, and aiding risk communication by increasing sexually transmitted infection risk perception through the creation of tailored risk messages to different groups.

Sexual History Taking in the Emergency Department – More Specificity Required

BackgroundChlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) are the most reported diseases in the United States, and emergency departments (ED) serve a population presenting with increased infection risk. However, identifying patients for whom sexually transmitted infection (STI) screening is appropriate requires accurate sexual history reporting. Study ObjectivesTo examine the consistency with which ED patients answer general and specific sexual activity questions, and how responses relate to perceived STI risk. MethodsUrban ED patients aged 15–34 years completed a sexual history survey containing sexual activity and perceived infection risk questions and provided urine and pharyngeal specimens for CT/GC analysis. ResultsParticipants included 192 males and 301 females with a mean age of 25.2 years and were 65.7% white and 33.3% black. Thirty-eight (7.7%) were infected with CT or GC. In patients denying sexual activity in the past year (general question), 40.7% of such males and 45.0% of females also reported some form of specific sexual activity (activity misclassification). Among self-identified heterosexuals, 7.2% males and 7.5% females reported some form of homosexual activity (orientation misclassification; OM). OM individuals were more likely to perceive themselves at risk of infection both orally (odds ratio 2.92, confidence interval 1.12-7.63) and genitally (odds ratio 3.36, confidence interval 1.55-7.30). ConclusionsGiven that reported sexual activity and age are the only criteria for routine female screening, and that homosexual activity is one of the few screening criteria for males, our results show that a substantial proportion of ED patients eligible for screening may not be identified by reliance upon general sexual history questions.

Barriers to the Use of PPE to Prevent Pertussis Exposures in a Pediatric Primary Care Network.

The resurgence of pertussis is contributing to mounting healthcare worker (HCW) exposures, especially within pediatric outpatient settings. Infection prevention and control (IPC) guidelines for ambulatory sites exist, but are not uniformly implemented. Our aim was to identify facilitators and barriers to the use of IPC practices to prevent pertussis transmission in ambulatory pediatric settings. HCWs at 18 of 25 (72%) clinics in a pediatric ambulatory network completed a theory-based questionnaire about pertussis and personal protective equipment (PPE). The questionnaire contained randomly distributed versions of two vignettes to create an experimental design assessing barriers to PPE use. Three hundred forty-three of 467 (73%) HCWs completed the survey: 234 (68%) clinical and 109 (32%) nonclinical. Seventy-one percent of clinical HCWs reported wearing PPE when caring for a patient with suspected pertussis; only 27% used PPE for patients with any respiratory symptoms. Among clinical HCWs, reported PPE use when caring for patients with suspected pertussis was independently associated with attitudes toward PPE (odds ratio [OR] 5.4, 95% confidence interval [CI] 1.8, 16.6), knowledge and skills (OR 4.6, 95% CI 1.4, 15.2), and lack of perceived barriers (OR 3.2, 95% CI 1.3, 7.9). HCWs who did not perceive PPE use as a norm were less likely to report using PPE (OR 0.2, 95% CI 0.1, 0.6) or distributing masks to patients with cough (OR 0.02, 95% CI 0.00, 0.2). Reported PPE use was not influenced by perceived infection risk or mask accessibility. Our results identified barriers to PPE use and targets for education to prevent pertussis transmission in ambulatory pediatric settings.

Pathogen inactivation

In the past 20 years, several pathogen inactivation technologies have been developed to be applied to blood components. This review is intended to summarize the data currently available about the technologies and the clinical use of products inactivated by those techniques. Technologies for inactivating pathogens in plasma and platelets are available, and are increasingly used in many countries. Cumulative experience over the last decade in routine use supports the concept of the safety and efficacy of the blood components treated with pathogen inactivation technologies. In recent years, an increase in the use of pathogen inactivation technologies for plasma and platelets has been observed. Their routine use in addition to experience generated in controlled clinical trials confirms that the treated blood components meet the required efficacy and safety criteria. Differences in epidemiology between countries, infectious risk perception, concerns about potential adverse effects associated with its use, and economic considerations of national blood systems might explain the differences observed in its implementation.

Preventive measures against MERS-CoV for Hajj pilgrims

Preventive measures against MERS-CoV for Hajj pilgrims

O23.3 Predictors of Self-Assessed Risk of Chlamydia Trachomatis Infection Among Adolescents in Norway

BackgroundAdolescents commonly underestimate their own risk of chlamydia infections. We aimed to examine the association between chlamydia prevalence and perceived risk of infection, and the predictors of perceived risk, among...

Camel Milk-Associated Infection Risk Perception and Knowledge in French Hajj Pilgrims

Cases of brucellosis have been recently reported in Hajj pilgrims following camel milk consumption. With the aim of evaluating French pilgrim's potential risk for raw camel milk-associated diseases, we conducted a knowledge, attitude, and practice study among 331 pilgrims departing to the 2011 Hajj. A proportion of 8.2% have drunk camel milk before, mostly in North Africa (62.9%) and Saudi Arabia (18.5%). A proportion of 13.9% declared they knew that drinking raw camel milk could cause diseases and 40.6% said that they would drink it if offered during the pilgrimage. Given that camel milk consumption in the Middle East is associated with several zoonotic infections in man, we recommend that Hajj pilgrims be cautioned against consuming unpasteurized dairy products.