Persistence and baseline determinants of seropositivity and reinfection rates in health care workers up to 12.5 months after COVID-19

We assessed the duration and baseline determinants of antibody responses to SARS-CoV-2 spike antigens and the occurrence of reinfections in a prospective cohort of 173 Spanish primary health care worker patients followed initially for 9 months and subsequently up to 12.5 months after COVID-19 symptoms onset. Seropositivity to SARS-CoV-2 spike and receptor-binding domain antigens up to 149–270 days was 92.49% (90.17% IgG, 76.3% IgA, 60.69% IgM). In a subset of 64 health care workers who had not yet been vaccinated by April 2021, seropositivity was 96.88% (95.31% IgG, 82.81% IgA) up to 322–379 days post symptoms onset. Four suspected reinfections were detected by passive case detection, two among seronegative individuals (5 and 7 months after the first episode), and one low antibody responder. Antibody levels significantly correlated with fever, hospitalization, anosmia/hypogeusia, allergies, smoking, and occupation. Stable sustainment of IgG responses raises hope for long-lasting COVID-19 vaccine immunity.

Persistence and baseline determinants of seropositivity and reinfection rates in health care workers up to 12.5 months after COVID-19

We assessed the duration and baseline determinants of antibody responses to SARS-CoV-2 spike antigens and the occurrence of reinfections in a prospective cohort of 173 Spanish primary health care worker patients followed up initially for nine months and subsequently up to 12.5 months after COVID-19 symptoms onset. Seropositivity to SARS-CoV-2 spike and receptor binding domain antigens up to 149-270 days was 92.49% (90.17% IgG, 76.3% IgA, 60.69% IgM). In a subset of 64 health care workers who had not yet been vaccinated by April 2021, seropositivity was 96.88% (95.31% IgG, 82.81% IgA) up to 322-379 days post symptoms onset. There were four suspected reinfections detected by passive case detection, two among seronegative individuals (five and seven months after the first episode), and one low antibody responder. Antibody levels significantly correlated with fever, hospitalization, anosmia/hypogeusia, allergies, smoking and occupation. Stable sustainment of IgG responses raises hope for long-lasting COVID-19 vaccine immunity.

Persistence and baseline determinants of seropositivity in health care workers up to nine months after COVID-19

We determined the duration and baseline determinants of antibody responses to SARS-CoV-2 up to nine months after COVID-19 symptoms onset in 173 primary health care worker patients from Spain. Seropositivity to SARS-CoV-2 spike and RBD antigens was 92.49% (60.69% IgM, 76.3% IgA, 90.17% IgG), with four suspected reinfection cases. Antibody levels significantly correlated with fever, hospitalization, anosmia/hypogeusia, allergies, smoking and occupation, and persisted 149-270 days in this cohort of patients

Daily life experiences of families determine the service delivery needs of children with disabilities; views of parents and service providers from three districts in Sri Lanka

Parents and service providers are the key care providers for children with disabilities (CWD) and understand their living circumstances best. These children are often invisible and face many challenges to full participation within their own communities. A qualitative phenomenological action research was carried out in three districts of Sri Lanka to explore the perspectives of parents and the service providers on the needs of CWD and how those were met by the present services. This qualitative study included interviews with families, and focus group discussions with service providers. Data was analyzed using a manual thematic analysis. The parents and service providers identified the needs under three main themes. The need for activity and participation, education and rehabilitation. The parents related the needs to the practical daily experiences of families while service providers identified these based on their experiences and knowledge about the medical conditions. Parents identified the public health midwife as the best first contact primary health care worker to coordinate services. The families from Sri Lanka defined initiatives to accomplish a service delivery model which would enable better inclusion of the children in community life.

Engaging primary health care workers in drug and alcohol and mental health interventions: challenges for service delivery in rural and remote Australia

Access to drug and alcohol treatment services is a particularly salient issue for Australia. The nation is paying considerable attention to risky drug and alcohol use. Indigenous Australians are particularly concerned about drug and alcohol related harms in their communities. Access to treatment is the most effective way of reducing drug related harm for disadvantaged populations. Primary health care is the optimal site for delivering drug and alcohol treatment. Semi-structured in-depth interviews with 47 primary health care, drug and alcohol and other health and welfare workers in rural and remote locations were conducted. Thematic analysis of interview data identified divergent perspectives according to a participant’s work role about drug and alcohol treatment, client needs and problems and service delivery approaches. Primary health care workers were conceptualised as locals. They tended to perceive that drug and alcohol interventions should quickly prevent individuals from on-going problematic use. Drug and alcohol workers were conceptualised as insiders. Most did not have knowledge or experience of the primary health care setting. Therefore they could not assist primary health care workers to integrate drug and alcohol interventions into their interactions with clients. Professional and organisational barriers constrain the primary health care worker role and limit the application of specialist interventions. Drug and alcohol work is only one of many competing demands in the primary health setting. The lack of understanding of the primary health care worker role and responsibilities is the most significant barrier to implementing specialist interventions in this role. Primary health care workers’ perceptions of substance misuse are more consistent with the individual moral or personal deficit philosophy of drug and alcohol treatment than harm minimisation approaches. This is a challenge for a specialist agency that is promoting harm minimisation and an adaptive approach to treatment within the primary care setting. Building the capacity of primary health care workers to do more varied tasks requires a good understanding of the pragmatic and practical realities of their day to day practice and the philosophies that underpin these.

Improving eye care in the primary health care setting

One of the challenges facing primary health care in South Africa is the delivery of quality eye care to all South Africans. In this regard the role of the primary health care worker, as the first point of contact, is crucial. This paper reports on the problems primary health care workers experience in providing quality eye care in Region B of the Free State. Problems identified by those involved in the study include the cumbersome referral system, the unavailability of appropriate medicine at clinics, the insufficient knowledge of primary health care workers regarding eye conditions and the lack of communication between the various eye care service providers. Suggestions to address the problems identified included more in-service training of primary health care workers regarding eye conditions, liaison with NGO’s providing eye care, decentralisation of services and the establishment of an eye care committee in the region.