scholarly journals New approach for tuberculosis contact tracing implemented in the two regions of Kyrgyz Republic during 2017-2018

2020 ◽  
Vol 14 (11.1) ◽  
pp. 109S-115S
Author(s):  
Bakyt Dzhangaziev ◽  
Aizat Kulzhabaeva ◽  
Nune Truzyan ◽  
Abdykadyr Zhoroev ◽  
Dinagul Otorbaeva ◽  
...  
Keyword(s):  
Contact Tracing ◽  
Kyrgyz Republic ◽  
National Guidelines ◽  
Cross Sectional ◽  
New Approach ◽  
Tb Control ◽  
Contact Investigation ◽  
The Mean ◽  
Index Cases ◽  
Close Contacts

Introduction: Tuberculosis (TB) contact investigation as a proved approach for finding new TB cases, is not fully performed in Kyrgyzstan. In 2018, the country started aligning the National Guidelines for tracking contacts with the WHO recommendations by expanding the definition for TB index cases to all close contacts, regardless of their TB risk status. Methodology: This cross-sectional census aimed to determine the active case detection changes among TB contacts after implementation of a new TB tracing strategy using the National Surveillance data. We compared populations in Chui and Issyk-Kul regions of Kyrgyzstan who had contacts with TB index cases before (2017) and after (2018) strategic changes for the rates of indexes, contacts, screened contacts, and detected TB among screened contacts. Results: New TB tracing strategy resulted in increased numbers of indexes (21%) and contacts (36%). Though the smaller number of contacts (1730 vs. 1590) have been screened in 2018, the proportion of TB diagnosed was substantially higher (95% CI: 0.024-0.005; p = 0.002) in 2018 vs. 2017. The mean numbers of TB contacts per-one-index-case also has increased dramatically by 117% (1.8 vs. 3.9) in Chui and by 43% (3.0 vs. 4.3) in Issyk-Kul regions (95% CI: 3.20-3.37; p < 0.001 and 95% CI: 2.97-3.09; p < 0.001, respectively) between 2018 and 2017. Conclusion: Extending new tracing approach to other regions of Kyrgyzstan will increase the number of identified contacts, leading to better TB control in the country and prevention of more severe TB development among the unidentified contacts.

scholarly journals Should NICE reconsider the 2016 UK guidelines on TB contact tracing? A cost-effectiveness analysis of contact investigations in London

Thorax ◽  
2018 ◽  
Vol 74 (2) ◽  
pp. 185-193 ◽  
Author(s):  
Sean M Cavany ◽  
Emilia Vynnycky ◽  
Charlotte S Anderson ◽  
Helen Maguire ◽  
Frank Sandmann ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Contact Tracing ◽  
National Guidelines ◽  
Cross Sectional ◽  
Life Years ◽  
The Uk ◽  
The Cost ◽  
Sectional Analysis ◽  
Index Cases

BackgroundIn January 2016, clinical TB guidance in the UK changed to no longer recommend screening contacts of non-pulmonary, non-laryngeal (ETB) index cases. However, no new evidence was cited for this change, and there is evidence that screening these contacts may be worthwhile. The objective of this study was to estimate the cost-effectiveness of screening contacts of adult ETB cases and adult pulmonary or laryngeal TB (PTB) cases in London, UK.MethodsWe carried out a cross-sectional analysis of data collected on TB index cases and contacts in the London TB register and an economic evaluation using a static model describing contact tracing outcomes. Incremental cost-effectiveness ratios (ICERs) were calculated using no screening as the baseline comparator. All adult TB cases (≥15 years old) in London from 2012 to 2015, and their contacts, were eligible (2465/5084 PTB and 2559/6090 ETB index cases were included).ResultsAssuming each contact with PTB infects one person/month, the ICER of screening contacts of ETB cases was £78 000/quality-adjusted life-years (QALY) (95% CI 39 000 to 140 000), and screening contacts of PTB cases was £30 000/QALY (95% CI 18 000 to 50 000). The ICER of screening contacts of ETB cases was £30 000/QALY if each contact with PTB infects 3.4 people/month. Limitations of this study include the use of self-reported symptomatic periods and lack of knowledge about onward transmission from PTB contacts.ConclusionsScreening contacts of ETB cases in London was almost certainly not cost-effective at any conventional willingness-to-pay threshold in England, supporting recent changes to National Institute for Health and Care Excellence national guidelines.

scholarly journals Cardiovascular risk quantification using QRISK-3 score in people with intellectual disability

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S52-S53
Author(s):  
Jamie Sin Ying Ho ◽  
Vikram Rohra ◽  
Laura Korb ◽  
Bhathika Perera
Keyword(s):  
Intellectual Disability ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Outpatient Setting ◽  
National Guidelines ◽  
Cvd Risk ◽  
Management Options ◽  
Cross Sectional ◽  
Accessible Information ◽  
The Mean

AimsThe prevalence of cardiovascular diseases (CVD) in people with intellectual disability (ID) is around 14%, higher than the general population. However, CVD risk assessments are not consistently performed. Given the high risk of premature deaths in people with ID, it is important to identify preventable risk factors and follow evidence-based interventions. QRISK-3 is a validated risk-stratification tool, which calculates the 10-year risk of developing a heart attack or stroke (https://qrisk.org/three/index.php). There are no published studies on the use of QRISK-3 in people with ID. This project aimed to understand the use of QRISK-3 in an ID clinic and to quantify individual CVD risks to recommend appropriate management options.MethodA cross sectional study was performed on 143 patients open to an ID psychiatry clinic. Patients and carers were sent an accessible information leaflet on this study. Basic demographic data and information on psychiatric diagnoses were collected. Patients were grouped according to the presence of severe mental illness (SMI) defined as schizophrenia, bipolar disorder and other psychotic illnesses. QRISK-3 ≥ 10% was defined as elevated risk in accordance with NICE guidelines. Patients who had a high QRISK-3 score were advised to contact their GP.ResultOf 143 patients, 73 (51.0%) had a mild ID and the remaining had a moderate to severe ID. The mean age was 43.3 years, 53.1% were male. Overall, 28 (19.6%) participants had an elevated CVD risk, of whom 16 (57.1%) were not on statins, which is the recommended treatment. The mean QRISK-3 score was 6.31 (standard deviation [SD] 8.95), and the relative risk is 3.50 (SD 7.13). The proportion of QRISK-3 ≥ 10% and mean score were not significantly different in those with SMI, but those with SMI were more likely to be prescribed statins than those without (14 [31.1%] vs 10 [10.2%], p = 0.002). Statins were given to 24 (16.8%) participants, of whom 12 (50%) had elevated CVD risk. 89% had a blood pressure recording within the past 5 years, 87% had height and 88% had weight recorded. 73% had lipid serology results recorded.ConclusionElevated CVD risk was common in this ID study population, and more than half with elevated QRISK-3 were not on the medical treatment recommended by national guidelines. QRISK-3 could feasibly be implemented in the outpatient setting. Increased routine CVD risk assessment and management should be considered as another measure to reduce morbidity and mortality.

scholarly journals Feasibility and utility of rapid antigen testing for COVID-19 in a university residence: a cross sectional study

2021 ◽  
Author(s):  
Sabrina Wong ◽  
Marc Gabriel Romney ◽  
Kristen Haase ◽  
Nancy Matic ◽  
Manon Ranger ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Contact Tracing ◽  
Rapid Testing ◽  
Asymptomatic Group ◽  
Easy Method ◽  
Cross Sectional ◽  
University Of British Columbia ◽  
The Mean ◽  
Asymptomatic Individuals ◽  
Antigen Testing

Importance: Understanding feasibility of rapid testing in congregate living setting provides critical data to reduce the risk of outbreaks in these settings. Objective: Use rapid antigen screening to detect SARS-CoV-2 in an asymptomatic group of university students and staff. Design: Cross-sectional Setting: University of British Columbia, Vancouver, Canada. Participants: Students and staff living or working in congregate housing. Intervention: Health care professional administered rapid antigen test Main Outcomes and measures: Use of BD Veritor rapid antigen testing and asymptomatic participants experiences with rapid testing Results: A total of 3536 BD Veritor tests were completed in 1141 unique individuals. One third of participants completed between two to four tests and 21% were screened five or more times. The mean number of tests completed per person was three. The mean length of time between those who had more than one test was seven days. There were eight false positives and 25 PCR confirmed COVID-19 positive individuals identified through this work. All individuals reported having no symptoms that they attributed to COVID-19. Almost all (n=22, 88%) COVID-19 positive cases were found in male participants. A total of 86 additional students from multiple different student residences (n=9) were asked to self-isolate while they waited for their COVID-19 diagnostic test results. An average of seven additional students positive for COVID-19 living in congregate housing were identified through contact tracing by finding one positive case. Conclusions and relevance: Rapid testing is a relatively inexpensive and operationally easy method of identifying asymptomatic individuals with COVID-19.

scholarly journals High Rate of SARS-CoV-2 Transmission due to Choir Practice in France at the Beginning of the COVID-19 Pandemic

2020 ◽  
Author(s):  
Nathalie CHARLOTTE
Keyword(s):  
Attack Rate ◽  
Transmission Rate ◽  
High Rate ◽  
Individual Risk ◽  
High Transmission ◽  
The Mean ◽  
The Individual ◽  
Practice Methods ◽  
Index Cases ◽  
Close Contacts

Background: There has been little focus on the individual risk of acquiring COVID-19 related to choir practice. Methods: We report the case of a high transmission rate of SARS-CoV-2 linked to an indoor choir rehearsal in France in March 2020 at the beginning of the COVID-19 pandemic. Results: A total of 27 participants, including 25 male singers, a conductor and an accompanist attended a choir practice on March 12, 2020. The practice was indoor and took place in a non-ventilated space of 45 m2. No choir member reported having been symptomatic for COVID-19 between March 2 and March 12.The mean age of the participants was 66.9 (range 35-86) years. 70% of the participants (19 of 27) were diagnosed with COVID-19 from 1 to 12 days after the rehearsal with a median of 5.1 days. 36% of the cases needed a hospitalization (7/19), and 21% (4/19) were admitted to an ICU. The index cases were possibly multiple. Discussion: The choir practice was planned in March 2020 at a period when the number of new cases of COVID-19 began to grow exponentially in France because SARS-CoV-2 was actively circulating. The secondary attack rate (70%) was much higher than it is described within households (10-20%) and among close contacts made outside households (0-5%). Singing might have contributed to enhance SARS-CoV-2 person-to-person transmission through emission of droplets and aerosolization in a closed non ventilated space with a relative high number of people including multiple pre-symptomatic suspected index cases. Conclusion: Indoor choir practice should be suspended during SARS-CoV-2 outbreaks. Further studies are necessary to test the spread of the virus by the act of singing. As the benefits of the barrier measures and social distancing are known to be effective in terms of a reduction in the incidence of the COVID-19, experts recommendations concerning the resuming of choir practice are necessary.

scholarly journals Epidemiological characteristics of COVID-19 cases among Indians residing in Kuwait

2021 ◽  
Author(s):  
Jagan K. Baskaradoss ◽  
Aishah Alsumait ◽  
Shaheer Malik ◽  
Jitendra Ariga ◽  
Amrita Geevarghese ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Contact Tracing ◽  
Indian Community ◽  
Asymptomatic Patients ◽  
Serial Interval ◽  
The World ◽  
Early Increase ◽  
The Mean ◽  
Epidemiological Characteristics ◽  
Close Contacts

Background: The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread to most countries around the world. Disproportionate spread of COVID-19 among the Indian community in Kuwait prompted heightened surveillance in this community. Aims: To study the epidemiological characteristics of COVID-19 patients and their contacts among the Indian community in Kuwait. Methods: Data collection was done as a part of contact tracing efforts undertaken by the Kuwaiti Ministry of Health. Results: We analysed contact-tracing data for the initial 1348 laboratory-confirmed Indian patients and 6357 contacts (5681 close and 676 casual). The mean (standard deviation) age of the patients was 39.43 (10.5) years and 76.5% of the cases were asymptomatic or had only mild symptoms. Asymptomatic patients were significantly older [40.05 (10.42) years] than patients with severe symptoms [37.54 (10.54) years] (P = 0.024). About 70% of the patients were living in shared accommodation. Most of the close contacts were living in the same household, as compared with casual contacts, who were primarily workplace contacts (P < 0.001). Among the different occupations, healthcare workers had the highest proportion of cases (18.4%). Among the 216 pairs of cases with a clear relationship between the index and secondary cases, the mean serial interval was estimated to be 3.89 (3.69) days, with a median of 3 and interquartile range of 1–5 days. Conclusion: An early increase in the number of COVID-19 cases among the Indian community could be primarily attributed to crowded living conditions and the high proportion of healthcare workers in this community.

scholarly journals A comparison of COVID-19 secondary attack rate in household and close contacts compared to current risk stratification guidelines of the Kerala government

2021 ◽  
pp. 004947552110020
Author(s):  
Balram Rathish ◽  
Arun Wilson ◽  
Sonya Joy
Keyword(s):  
High Risk ◽  
Risk Stratification ◽  
Attack Rate ◽  
Low Risk ◽  
Contact Tracing ◽  
Index Cases ◽  
Current Risk ◽  
Close Contacts

COVID-19 has been found to be highly infectious with a high secondary attack rate with a R0 of 3.3. However, the secondary attack rate based on risk stratification is sparsely reported, if ever. We studied the contact tracing data for two index cases of COVID-19 with some overlap of contacts. We found that 60% of high-risk contacts and 0% of low-risk contacts of symptomatic COVID-19 patients contracted the infection, in keeping with the Kerala government contact risk stratification guidelines.

scholarly journals Source Case Investigation for Children with TB Disease in Pune, India

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Debalina De ◽  
Aarti Kinikar ◽  
P. S. Adhav ◽  
Sunanda Kamble ◽  
Prasanna Sahoo ◽  
...  
Keyword(s):  
Preventive Therapy ◽  
Contact Tracing ◽  
Cross Sectional ◽  
Missed Opportunities ◽  
Tb Treatment ◽  
Resource Limited ◽  
Source Case ◽  
Pediatric Tb ◽  
Index Cases ◽  
Special Risk

Setting.Contact tracing is broadly encouraged for tuberculosis (TB) control. In many high-burden countries, however, little effort is made to identify contacts of newly diagnosed TB patients. This failure puts children, many of whom live in poor crowded communities, at special risk.Objectives.To perform source-case investigations for 50 pediatric TB cases in Pune, India.Design.A descriptive cross-sectional observational study of pediatric TB cases < 5 years of age. Information was collected about the index case and household contacts.Results.In 15 (30%) of the 50 pediatric index cases, the household contained known TB contacts, 14 (86%) of whom were adults. Prior to their own diagnosis of TB, only one of the 15 pediatric index cases who met criteria for isoniazid preventive therapy received it. The index cases with known household TB contacts had a longer delay in initiating TB treatment than those without TB contacts (17.5 versus 2 days;P=0.03). Use of contact tracing identified 14 additional household TB suspects, 8 (57%) of whom were children.Conclusions.This study identified missed opportunities for TB prevention, as contact tracing is poorly implemented in resource-limited countries, like India. Further strategies to improve the implementation of TB prevention, especially in young children, are urgently needed.

scholarly journals Household Clusters of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Suzhou, China

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Lin Yao ◽  
Peijun Tang ◽  
Hui Jiang ◽  
Binbin Gu ◽  
Ping Xu ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Clinical Characteristics ◽  
Secondary Infection ◽  
High Rate ◽  
Cross Sectional ◽  
Emerging Virus ◽  
Transmission Capability ◽  
Index Cases ◽  
Substantial Morbidity ◽  
Close Contacts

Objectives. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging virus causing substantial morbidity and mortality worldwide. We performed a cross-sectional investigation of SARS-CoV-2 clusters in Suzhou to determine the transmissibility of the virus among close contacts and to assess the demographic and clinical characteristics between index and secondary cases. Methods. We review the clustered patients with SARS-CoV-2 infections in Suzhou between 22 January and 29 February 2020. The demographic and clinical characteristics were compared between index and secondary cases. We calculated the basic reproduction number ( R 0 ) among close contacts with SLI model. Results. By 22 February, 87 patients with SARS-CoV-2 infection were reported, including 50 sporadic and 37 clustered cases, who were generated from 13 clusters. On admission, 5 (20.8%) out of 24 secondary cases were asymptomatic. The male ratio of index cases was significantly higher than that of secondary cases. Additionally, the index cases were more likely to have fever and increased CRP levels than the secondary cases. The R 0 values of clusters displayed a significantly declining trend over time for all clusters. The relative risk of infection in blood-related contacts of cases versus unrelated contacts was 1.60 for SARS-CoV-2 (95% CI: 0.42-2.95). Conclusions. In conclusion, SARS-CoV-2 has great person-to-person transmission capability among close contacts. The secondary cases are more prone to have mild symptoms than index cases. There is no increased RR of secondary infection in blood relatives versus unrelated contacts. The high rate of asymptomatic SARS-CoV-2 infections highlights the urgent need to enhance active case finding strategy for early detection of infectious patients.

scholarly journals Worker safety in Designated Microscopy Centers (DMC) and Tuberculosis unit (TU) under Revised National Tuberculosis Control programme (RNTCP) in state of Bihar – Contribution & Role of DTST

2013 ◽  
Vol 3 (1) ◽  
pp. 18-21
Author(s):  
Lalitha Krishnappa
Keyword(s):  
Capacity Building ◽  
Rural Areas ◽  
Control Programme ◽  
Worker Safety ◽  
Current Status ◽  
National Guidelines ◽  
Cross Sectional ◽  
Tb Control ◽  
The Impact

Damien Foundation India Trust (DFIT), one of the members of International Federation of Anti-Leprosy associations (ILEP) are involved in providing technical and financial support in leprosy and TB control through its projects spread across the country. While support to leprosy control started way back in 1982 through its own project, support to TB control started only in 2003. This study was part of evaluation taken to assess the role of DTST in achieving the planned objectives and to assess the impact of DFIT’s involvement in TB control. To assess the current status of worker safety in DMC/TUs of RNTCP centers in state of Bihar and the role and contribution of DTST in ensuring the same. This cross sectional evaluation study was undertaken in randomly selected 8 DMCs/ TUs in rural areas of two districts of Bihar state in 2007. Evaluation was done using pre-tested observational checklist and personal discussions with key personnel. Evaluation included assessment of role & contribution of DTST with respect to infrastructure & resource availability; Training and capacity building; Practice regarding safe disposal of infected materials & worker safety. Most of the civil works was complete in functional DMC/ TUs visited. Sharp pits for sharp disposal were available in only 50% of DMCs/TUs. Staffing position complete to nearly 80%. DTST role in capacity building training, infrastructure availably and monitoring of the programme has been remarkable. However there is a need to emphasis on importance of the worker safety and universal precautions during training. Effective implementation of clearly laid down National guidelines & policy keeping in lieu of the worker safety is the need of the hour when the programme gets streamlined in the general health system.   

scholarly journals Total and Pediatrics Course load of Brazilian Medical Schools

2020 ◽  
Vol 44 (3) ◽  
Author(s):  
Judah Benhur Campos ◽  
Suely Grosseman
Keyword(s):  
Medical Schools ◽  
Descriptive Statistics ◽  
Categorical Variables ◽  
First Year ◽  
Continuous Variables ◽  
National Guidelines ◽  
Cross Sectional ◽  
Brazilian Society ◽  
Course Load ◽  
The Mean

Abstract: Introduction: Brazilian guidelines for undergraduate medical courses recommend a minimum curricular course load (CL) of 7,200 hours and the Brazilian Society of Pediatrics recommends that 10% of this load be allocated to pediatrics. The aim of this study was to analyze the total course load and the course load in pediatrics of Brazilian medical schools’ curriculum. Method: Cross-sectional and descriptive study. Of the 294 existing medical schools in Brazil in October 2017, those with curricular matrix/grid or political-pedagogical project of the course and pediatrics CL available on their homepage were included. The studied variables included total curricular CL, pediatrics CL and year of inclusion of pediatrics in the curriculum. Data were analyzed using descriptive statistics, calculating absolute and relative frequencies for categorical variables and mean and Standard Deviation (SD) and median and 25-75 percentile (P25-75) for continuous variables. Results: One hundred and fifty-one medical schools were included (51.4% of the total). The curriculum CL median was 7,975 hours (P25-75=7,440-8,550), with a mean of 4,665.7 hours (SD=593.8) before clerkship and 3,388.1 hours (SD=430.3) during clerkship. The mean pediatrics’ CL was 778.2 hours (SD=180.8), with a median CL of 220 hours (P25-75=160-300) before clerkship and 514 (P25-75= 405-640) during clerkship. The median pediatrics practice course load before clerkship (n=70) was 123 (SD=90-180). The mean of the proportion between general pediatrics and the curricular CL was 9.7% (SD= 2,2), and 68.5% schools had a CL >720 hours. The median of the proportion between the CL in pediatrics clerkship and in the course was 16% (P25-75=12.5-18.9), ranging from 6% to 26%. The median of the proportion between pediatrics CL before pediatrics clerkship and course load was 4.7% (P25-75=3.6-6.5), ranging from 1% to 13%. Two schools started the teaching of pediatrics in the first year (1,3%), 19 in the second (12.6%), 63 in the third (41.7%) e 67 in the fourth year of the medical course (44.4%). Conclusions: The schools meet the minimum curricular course load established by the national guidelines, tending to exceed it, and not all of them meet the minimum pediatrics course load requirement of 720 hours recommended by the Brazilian Society of Pediatrics.

Sign in / Sign up

Export Citation Format

Share Document