Assessing healthcare workers’knowledge and confidence in the diagnosis,management and prevention of Monkeypox

BACKGROUND Monkeypox(Mpox),is a disease of global public health concern,as it does not affect only countries in western and central Africa.AIM To assess Burundi healthcare workers(HCWs)s’level of knowledge and confidence in the diagnosis and management of Mpox.METHODS We conducted a cross-sectional study via an online survey designed mainly from the World Health Organization course distributed among Burundi HCWs from June-July 2023.The questionnaire comprises 8 socioprofessional-related questions,22 questions about Mpox disease knowledge,and 3 questions to assess confidence in Mpox diagnosis and management.The data were analyzed via SPSS software version 25.0.A P value<0.05 was considered to indicate statistical significance.RESULTS The study sample comprised 471 HCWs who were mainly medical doctors(63.9%)and nurses(30.1%).None of the 22 questions concerning Mpox knowledge had at least 50%correct responses.A very low number of HCWs(17.4%)knew that Mpox has a vaccine.The confidence level to diagnose(21.20%),treat(18.00%)or prevent(23.30%)Mpox was low among HCWs.The confidence level in the diagnosis of Mpox was associated with the HCWs’age(P value=0.009),sex(P value<0.001),work experience(P value=0.002),and residence(P value<0.001).The confidence level to treat Mpox was significantly associated with the HCWs’age(P value=0.050),sex(P value<0.001),education(P value=0.033)and occupation(P value=0.005).The confidence level to prevent Mpox was associated with the HCWs’education(P value<0.001),work experience(P value=0.002),residence(P value<0.001)and type of work institution(P value=0.003).CONCLUSION This study revealed that HCWs have the lowest level of knowledge regarding Mpox and a lack of confidence in the ability to diagnose,treat or prevent it.There is an urgent need to organize continuing medical education programs on Mpox epidemiology and preparedness for Burundi HCWs.We encourage future researchers to assess potential hesitancy toward Mpox vaccination and its associated factors.

Mental health and insomnia problems in healthcare workers after the COVID-19 pandemic:A multicenter cross-sectional study

BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.

Study on Influencing Factors of Mental Health of Mobile Young White-Collar Workers in China

Mobile young white-collar workers not only have the characteristics of mobile young people,but also have the characteristics of general white-collar workers.Under the influence of both,their mental health may be suffering from“double disadvantage”.So,based on an ecological model of the stress process,this paper tries to use the data of the questionnaire on the mental health of mobile young white-collar workers in Zhejiang Province to explore the influence of some factors in the middle workplace and residence place on the mental health of micro individuals.The results show that:(1)The working environment with high control and low freedom and the workplace discrimination against the mobile status will have a negative impact on the mental health of mobile young white-collar workers;(2)Financial anxiety in daily life will lead to a decline in the mental health level of mobile young white-collar workers;(3)Good organizational support and neighborhood social relations can significantly relieve life pressure,so as to effectively improve the mental health of mobile young white-collar workers.It can be seen that we also need to pay more attention to the mental health of mobile young white-collar workers in order to improve their situation.

Variations, effectiveness and its associated factors of a nationwide web-based hypertension management training project in China: insights from a government-led campaign for 1.2 million lay health workers

OBJECTIVES To evaluate the effectiveness of a large-scale,web-based,in-service hypertension management training project among lay health workers(LHWs) at primary care health(PHC) settings in China,and to examine the factors contributing to the variations of effectiveness.METHODS We used data from a web-based national hypertension management training project implemented in 2018,it was designed to facilitate LHWs to learn,understand,and apply the relevant knowledge and skills in hypertension management through providing training courses by use of the web-based platform with unified standards.All LHWs were required to participate in the exams before and after training to acquire scores for the use of evaluating their performance of hypertension management knowledge.We first used descriptive analysis to present the variations of effectiveness in hypertension management knowledge among LHWs by important subgroups.Afterwards,we used multilevel logistic regression to examine the individual and regional factors contributing to the variations and quantify the magnitude of how these factors affected training effectiveness.RESULTS There were 1,208,610 LHWs who completed training and were certificated.Nationally,the scores of LHWs increased significantly from 62.87 ± 21.14 out of 100 in the pre-test to 88.30 ± 11.31 in the post-test by 25.43(95% confidence interval[CI]:25.40-25.47).Training contents involved in antihypertensive medication showed the lowest score(54.36) in the pre-test and soared the most after training,up to 84.22 by 54.94%.Individual factors associated with disparities in the knowledge of hypertension management decreased substantially after training,which included sex,age,education,practice type,professional level,and hierarchy of working institutions.Geographical variations were shown at the provincial level,with the majority of them being explained by factors at the regional level.CONCLUSIONS Accessible web-based training modality,government efforts,accompanied with experiences derived from the training,could be generalized to other low-and middle-income countries in facilitating the hypertension management capacity of LHWs.Localization and evaluation is warranted on the way to its further application.

Effectiveness of mindfulness-based interventions on the well-being of healthcare workers:a systematic review and meta-analysis

Background Growing evidence attests to the efficacy of mindfulness-based interventions(MBIs),but their effectiveness for healthcare workers remains uncertain.Aims To evaluate the evidence for MBIs in improving healthcare workers’psychological well-being.Methods A systematic literature search was conducted on Medline,Embase,Cumulative Index for Nursing and Allied Health Literature,PsycINFO and Cochrane Central Register of Controlled Trials up to 31 August 2022 using the keywords‘healthcare worker’,‘doctor’,‘nurse’,‘allied health’,‘mindfulness’,‘wellness’,‘workshop’and‘program’.Randomised controlled trials with a defined MBI focusing on healthcare workers and quantitative outcome measures related to subjective or psychological well-being were eligible for inclusion.R V.4.0.3 was used for data analysis,with the standardised mean difference as the primary outcome,employing DerSimonian and Laird’s random effects model.Grading of Recommendations,Assessment,Development and Evaluation framework was used to evaluate the quality of evidence.Cochrane’s Risk of Bias 2 tool was used to assess the risk of bias in the included studies.Results A total of 27 studies with 2506 participants were included,mostly from the USA,involving various healthcare professions.MBIs such as stress reduction programmes,apps,meditation and training showed small to large effects on anxiety,burnout,stress,depression,psychological distress and job strain outcomes of the participants.Positive effects were also seen in self-compassion,empathy,mindfulness and well-being.However,long-term outcomes(1 month or longer postintervention)varied,and the effects were not consistently sustained.Conclusions MBIs offer short-term benefits in reducing stress-related symptoms in healthcare workers.The review also highlights limitations such as intervention heterogeneity,reduced power in specific subgroup analyses and variable study quality.

Unveiling health rights:A call to action for sex workers'HIV care in the Philippines

We are writing in response to the article titled“Addressing the needs and rights of sex workers for HIV healthcare services in the Philippines”[1].The article calls for attention on the significant challenges faced by sex workers in the Philippines in accessing HIV healthcare.We appreciate the article’s effort to examine these issues in depth.We would like to present a constant flow of thoughts in this letter while highlighting the positive aspects,potential obstacles,and additional points that contribute to this ongoing discussion.

Assessment of Knowledge, Attitude and Practices among Healthcare Workers in a Tertiary Care Hospital on Needle Stick Injury

Purpose: Needle-stick injury (NSI) is one of the most potential occupational hazards for healthcare workers because of the transmission of blood-borne pathogens. As per recent data, around 30 lakh healthcare workers sustain Needle stick injuries each year. This study was conducted to assess healthcare workers’ knowledge, attitude and practices regarding needle stick injury. Materials & Methods: A cross-sectional study was conducted in a Tertiary Care Hospital over the period of 3 months. The study population consisted of Intern Doctors, Post Graduate resident Doctors, Staff Nurses, laboratory technicians of Government Medical College and New Civil Hospital, Surat (n = 300). The data were collected using a self-administered questionnaire via the means of Google Forms. Questionnaire was made with prior review literature. The data obtained were entered and analysed in Microsoft Excel. Results: The prevalence of NSI in our study was 46%, with a higher prevalence among the PG residents (72%). Overall scores regarding knowledge and attitude were better in PG residents (knowledge score > 7 in 71% and Attitude Score > 7 in 68% of PG Residents). Even though the PG residents scored highest in the knowledge category, the majority of them suffered needle stick injuries as a result of poor practice scores. Among those who had NSI (n = 139/300), 70% of study participants had superficial injuries, only 9% reported the incident, 18% got medical attention within 2 hours of the incident, and 7% followed up to recheck their viral markers status. Most incidents of NSI were due to hypodermic needles while recapping needles. Conclusion: Exposure to needle stick injuries and their underreporting remains a common problem. It is imperative that healthcare workers receive regular training on the proper handling of sharp objects. We can also draw the conclusion that preventing NSIs requires putting knowledge into practice.

Prevalence and Factors Associated with Low Back Pain among Healthcare Workers in Two Hospitals in Yaoundé-Cameroon: A Cross-Sectional Study

Background: Low back pain (LBP) is a very common health problem amongst the general population and a major cause of disability that affects work performance and well-being. Healthcare workers (HCWs) are especially at risk of developing LBP because of physical and emotional factors. Little is known about the burden of LBP in Cameroon. Objective: To determine the prevalence of low back pain and identify its associated factors among healthcare workers. Methods: A cross-sectional study using a self-administered questionnaire was conducted among healthcare workers in the Yaound Central Hospital and the Yaound University Teaching Hospital. The questionnaire collected data regarding recent, past year and lifetime occurrences of LBP, socio-demographics and work conditions. Data were analysed using IBM Statistical Package for Social Sciences (SPSS) version 26. Results: A total number of 268 HCWs participated in the study, including 197 (73.5%) females and 71 (26.5%) males. The mean age of the study participants was 40.60 8.38 years (extremes of 20 and 65 years). The lifetime, annual, and point prevalences of LBP among the participants were 67.5% (CI: 61.6 - 73.1), 61.5% (CI: 55.6 - 67.1) and 35.7% (CI: 29.7 - 41.5) respectively. Multivariate analysis confirmed a moderate stress level, a sedentary lifestyle, working in the medicine and specialities department, lifting heavy objects and bending to work as associated factors to LBP. Most sufferers had a minimal functional disability (65.7%) while 34.3% had a moderate to severe disability. Conclusions: Healthcare providers have a considerably high prevalence of low back pain. Factors associated with LBP found in this study were similar to those widely recognized in the literature. A substantial proportion of healthcare providers are suffering from functional disability associated with low back pain, affecting their social and work lives. There is a need for multilevel interventions to prevent and control low back pain in this highly vulnerable occupational group.

Influence of the continuing COVID-19 epidemic on sleep quality and psychological status of healthcare workers in private institutions

BACKGROUND On January 22,2020,Macao reported its first case of coronavirus disease 2019(COVID-19)infection.By August 2021,the situation had escalated into a crisis of community transmission.In response,the government launched a recruitment campaign seeking assistance and services of healthcare workers(HCWs)from the private sector throughout Macao.These participants faced concerns about their own health and that of their families,as well as the responsibility of maintaining public health and wellness.This study aims to determine whether the ongoing epidemic has caused them physical and psychological distress.AIM To examine the influence of COVID-19 on the sleep quality and psychological status of HCWs in private institutions in Macao during the pandemic.METHODS Data were collected from December 2020 to January 2022.Two consecutive surveys were conducted.The Pittsburgh Sleep Quality Index(PSQI)scale,Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were employed as investigation tools.RESULTS In the first-stage survey,32%of HCWs experienced a sleep disorder,compared to 28.45%in the second-stage survey.A total of 31.25%of HCWs in the first-stage survey and 28.03%in the second had varying degrees of anxiety.A total of 50.00%of HCWs in the first-stage survey and 50.63%in the second experienced varying degrees of depression.No difference in PSQI scores,SAS scores,or SDS scores were observed between the two surveys,indicating that the COVID-19 epidemic influenced the sleep quality and psychological status of HCWs.The negative influence persisted over both periods but did not increase remarkably for more than a year.However,a positive correlation was observed between the PSQI,SAS,and SDS scores(r=0.428-0.775,P<0.01),indicating that when one of these states deteriorated,the other two tended to deteriorate as well.CONCLUSION The sleep quality,anxiety,and depression of HCWs in private institution in Macao were affected by the COVID-19 epidemic.While these factors did not deteriorate significantly,the negative effects persisted for a year and remained noteworthy.

Violence study of healthcare workers and systems in the Caribbean:ViSHWaS-Caribbean study

BACKGROUND Violence against healthcare workers(HCWs)in the Caribbean continues to prevail yet remains underreported.Our aim is to determine the cause,traits,and consequences of violence on HCWs in the Caribbean.AIM To determine the cause,traits,and consequences of violence on HCWs in the Caribbean.METHODS This research adopted an online cross-sectional survey approach,spanning over eight weeks(between June 6th and August 9th,2022).The survey was generated using Research Electronic Data Capture forms and followed a snowballing strategy to contact individuals using emails,social media,text messages,etc.Logistic regression analysis was performed to evaluate the variables that influence violence,including gender,age,years of experience,institution type,and night shift frequency.RESULTS The survey was completed by 225 HCWs.Females comprised 61%.Over 51%of respondents belonged to the 21 to 35 age group.Dominica(n=61),Haiti(n=50),and Grenada(n=31)had the most responses.Most HCWs(49%)worked for government academic institutions,followed by community hospitals(23%).Medical students(32%),followed by attending physicians(22%),and others(16%)comprised the most common cadre of respondents.About 39%of the participants reported experiencing violence themselves,and 18%reported violence against colleague(s).Verbal violence(48%),emotional abuse(24%),and physical misconduct(14%)were the most common types of violence.Nearly 63%of respondents identified patients or their relatives as the most frequent aggressors.Univariate logistic regression analyses demonstrated that female gender(OR=2.08;95%CI:1.16-3.76,P=0.014)and higher frequency of night shifts(OR=2.22;95%CI:1.08-4.58,P=0.030)were associated with significantly higher odds of experiencing violence.More than 50%of HCWs felt less motivated and had decreased job satisfaction post-violent conduct.CONCLUSION A large proportion of HCWS in the Caribbean are exposed to violence,yet the phenomenon remains underreported.As a result,HCWs’job satisfaction has diminished.

Analysis of Hand Hygiene Knowledge,Compliance,and Influencing Factors Among Psychiatric Healthcare Workers

Objective:To evaluate the knowledge,compliance,and influencing factors of hand hygiene among psychiatric healthcare workers.Methods:68 healthcare workers who worked in the Department of Psychiatry between September 2023 and May 2024 were selected to assess their knowledge of hand hygiene and compliance by questionnaire as well as to analyze their influencing factors.Results:Knowledge of hand hygiene among healthcare workers was less than 90%,and doctors’knowledge was lower than that of nurses(P<0.05).The healthcare workers’compliance with hand hygiene was lower than 80%,and the adherence of doctors was lower than that of nurses(P<0.05).Analysis of influencing factors reveals that skepticism about the effectiveness of rapid disinfectants/hand washing,skin irritation from disinfectants/cleaning agents,and busy work schedules with time constraints are the main factors affecting healthcare workers’compliance with hand hygiene,with P<0.05 compared with the same group.Conclusion:Psychiatric healthcare workers’knowledge of hand hygiene as well as compliance with it is low,and there are various factors affecting it,so targeted training is required to strengthen their hand hygiene implementation.

Prevalence of Occupational Injury and Knowledge of Post-Exposure Prophylaxis Accessibility among Healthcare Workers in Mogadishu, Somalia

Introduction: Healthcare workers in Mogadishu, Somalia face significant occupational injury risks, particularly needle stick injuries, with 61.1% reporting incidents. This poses a serious threat to their health, leading to infections such as hepatitis B, hepatitis C, and HIV. Despite the high prevalence of injuries, awareness of Post-Exposure Prophylaxis (PEP) accessibility is relatively high, with 84.0% of respondents aware of it. However, there are gaps in knowledge and implementation, as evidenced by variations in availability of PEP. Improving workplace safety measures, providing comprehensive training on injury prevention and PEP protocols, and ensuring consistent availability of PEP in healthcare facilities are crucial steps to safeguard the well-being of healthcare workers in Mogadishu, Somalia. Methods: A cross-sectional study was conducted among hospital workers in Mogadishu, Somalia, focusing on professionals from various healthcare facilities. The study targeted nurses, doctors, laboratory personnel, and pharmacists. Purposive sampling was employed, resulting in a sample size of 383 calculated using Fisher’s sample size formula. Data were collected using coded questionnaires entered into Microsoft Excel 2019 and analyzed with SPSS software to generate frequencies and proportions, presented through frequency tables and pie figures. Results: The study in Mogadishu, Somalia, examined the prevalence of occupational injuries and knowledge of Post-Exposure Prophylaxis (PEP) accessibility among healthcare workers. Findings indicate a high prevalence of injuries, with 61.1% reporting incidents, predominantly needle stick injuries (60.6%). Despite the majority seeking prompt medical attention (72.0%), work-related illnesses affected 53.2% of respondents, notably work-related stress (59.5%). While most received training on injury and illness prevention (68.9%), gaps exist in PEP awareness, with 16.0% unaware of it. Nonetheless, 84.0% were aware, predominantly through health facilities (52.0%). Availability of PEP was reported by 71.3% in healthcare facilities, with variations in shift availability. The majority reported guidelines for PEP use (55.7%). Efforts are needed to bolster PEP awareness and ensure consistent availability in healthcare facilities to safeguard worker health. Conclusion: High prevalence of occupational injuries among healthcare workers, with needle stick injuries being the most common (60.6%). Despite this, 84.0% of respondents were aware of Post-Exposure Prophylaxis (PEP), primarily learning about it from health facilities (52.0%). While 71.3% reported the availability of PEP in their facility, 28.7% noted its unavailability. These results emphasize the need for improved education and accessibility of PEP to mitigate occupational injury risks.

Occupational health risks among healthcare workers during the COVID-19 pandemic in Saudi Arabia: preparing for the future pandemics

Background:This study aimed to assess the occupational risks encountered by Healthcare Workers(HCWs)in Saudi Arabia during the COVID-19 pandemic.Methods:A cross-sectional survey was carried out from May to October 2021.Using a multi-stage stratified random sampling technique,an online questionnaire was sent to the recruited HCWs,across Saudi Arabia.Results:Of the 768 HCWs recruited,702 participated in the survey.A significant majority(over 80%)reported working beyond 8 hours daily.COVID-19 infection,confirmed via PCR,was identified in 25%of the participants.Notably,infection was significantly correlated with direct or close contact(p=0.0007).Psychological distress was reported by 81%,with anxiety being the most prevalent(33%),followed by stress(19%),depression(17%),and insomnia(12%).Around 20%experienced headaches post-PPE use,while 14%reported adverse skin reactions,predominantly allergy and dermatitis.A concerning one-third of respondents reported exposure to violence.Conclusion:High infection rate,physical and psychological risks among HCWs especially those in direct contact with patients,reflect the need for enhancing the entirety of outbreak preparedness and response,specifically training.Active surveillance system,is crucial to adequately monitor and support HCWs during pandemic scenarios.

Work experience of special workers returning to work after the public health emergency:taking ICU nurses who have been infected with COVID-19 as example

Objective:The occurrence of some public health events inevitably endangers medical personnel,and medical personnel,as a special group,have to resume work on time to treat patients.This coronavirus disease-2019(COVID-19)infection is a good example,and what intensive care unit(ICU)nurses experience as the primary caregivers of critically ill patients after COVID-19 infection is our focus.To explore the work experience of ICU nurses after recovery from COVID-19,and to provide a theoretical basis for the intervention to improve the physical and mental health level and work experience of special workers in public health emergencies.Methods:We conducted an explorative descriptive study using an inductive thematic analysis.Using the maximum differential sampling method,a semi-structured interview was conducted among 13 ICU nurses suffered from COVID-19 in a tertiary grade A hospital in Qingdao,Shandong Province.This study carried on the theme analysis according to the inductive content analysis method and used MAXQDA 2020 Analytics Pro(VERBI Software GmbH,Berlin,Germany)to manage and summarize the interview data.Results:After being infected by the virus,SARS-Coronavirus-2(SARS-CoV-2),the pathogen of COVID-19,the work experience of ICU nurses was extracted from the following 5 themes:(1)Stress and challenge caused by the change of work focus;(2)downsizing,overtime,taking up work with illness,and physical discomfort;(3)dedication and family debt;(4)unknown fear and helplessness;and(5)professional responsibility and sense of benefit.Conclusions:Under the pressure of COVID-19,ICU nurses face multiple pressures and challenges,and their emotions are complex.We suggest that nursing managers should take corresponding measures to alleviate nurses'physical and psychological pressure and improve their work experience.

An Evaluation of STD/AIDS Health Education among Female Sex Workers in Entertainment Establishments in Jingjiang City

Objective: To explore effective ways of conducting STD/AIDS health education among female commercial sex workers in entertainment establishments and to promote implementation of an 100% condom use programme. Methods: In-depth interviews were carried out to collect qualitative information about demographic characteristics, STD/AIDS knowledge, attitude and risk behaviors of female sex workers. Female sex workers were selected by sampling and were given baseline survey and assessment after intervention. Based on the results of the interviews, a questionnaire was developed, and intervention measures were determined. These measures included face-to-face interviewing, counseling, and distribution of STD/AIDS information and condoms. Results: 196 and 182 female sex workers of the same population were interviewed separately before and after intervention. STDs/AIDS knowledge had significantly increased after one year's intervention (P <0.01). Knowledge increased in both the intervention group and the non-intervention group but the increase was more significant among sex workers who received the intervention. Risk behaviors remained at baseline levels in both groups. Conclusion: STD/AIDS health education among female sex workers in entertainment establishments was effective and may benefit society, but the strategies need to be adjusted to the female sex workers' lifestyles, particularly their high rates of mobility and high-risk behaviors.

Effectiveness of Adherence to Standardized Hypertension Management by Primary Health Care Workers in China:a Cross-sectional Survey 3 Years after the Healthcare Reform

The standardized hypertension management provided by primary health care workers is an important part of China＇s recent health care reform efforts. Investigating 5,116 hypertensive patients from a cross-sectional survey conducted by the Chinese Center for Disease Control and Prevention in 2012, this study found that adherence to standardized hypertension management is associated with positive effects on hypertension- related knowledge, healthy lifestyle behavior, antihypertensive medical treatments, and blood pressure control. It will be necessary to provide primary health care workers with sufficient training and reasonable incentives to ensure the implementation and effectiveness of hypertension management.

Hepatitis B virus and hepatitis C virus infection inhealthcare workers

Approximately 3 million healthcare workers per year receive an injury with an occupational instrument, with around 2000000 exposures to hepatitis B virus(HBV) and 1000000 to hepatitis C virus(HCV). Although an effective HBV vaccine has been available since the early eighties, and despite the worldwide application of universal vaccination programs started in the early nineties, HBV still remains a prominent agent of morbidity and mortality. There is no vaccine to limit the diffusion of HCV infection, which progresses to chronicity in the majority of cases and is a major cause of morbidity and mortality worldwide due to a chronic liver disease. Healthcare workers are frequently exposed by a mucosal-cutaneous or percutaneous route to accidental contact with human blood and other potentially infectious biological materials while carrying out their occupational duties. Mucosal-cutaneous exposure occurs when the biological material of a potentially infected patient accidentally comes in contact with the mucous membranes of the eyes or mouth or with the skin of a healthcare worker. Percutaneous exposure occurs when an operator accidentally injures himself with a sharp contaminated object, like a needle, blade or other sharp medical instrument. About 75% of the total occupational exposure is percutaneous and 25% mucosal-cutaneous, the risk of infecting a healthcare worker being higher in percutaneous than in mucosal-cutaneous exposure. All healthcare workers should be considered for HBV vaccination and should meticulously apply the universal prophylactic measures to prevent exposure to HBV and HCV.

Psychological impact of the COVID-19 pandemic on healthcare workers:a cross-sectional study in China

Background Healthcare workers fighting against the coronavirus disease 2019(COVID-19)pandemic are under tremendous pressure,which puts them at an increased risk of developing psychological problems.Aims This study aimed to investigate the prevalence of psychological problems in different healthcare workers(ie,physicians,medical residents,nurses,technicians and public health professionals)during the COVID-19 pandemic in China and explore factors that are associated with the onset of psychological problems in this population during this public health crisis.Methods A cross-sectional,web-based survey was conducted in February 2020 among healthcare workers during the COVID-19 pandemic.Psychological problems were assessed using the Generalized Anxiety Disorder Scale,Patient Health Questionnaire and Insomnia Severity Index.Logistic regression analyses were used to explore the factors that were associated with psychological problems.Results The prevalence of symptoms of anxiety,depression,insomnia and the overall psychological problems in healthcare workers during the COVID-19 pandemic in China was 46.04%,44.37%,28.75%and 56.59%,respectively.The prevalence of the overall psychological problems in physicians,medical residents,nurses,technicians and public health professionals was 60.35%,50.82%,62.02%,57.54%and 62.40%,respectively.Compared with healthcare workers who did not participate in front-line work,front-line healthcare workers had a higher risk of anxiety,insomnia and overall psychological problems.In addition,attention to negative or neutral information about the pandemic,receiving negative feedback from families and friends who joined front-line work,and unwillingness to join front-line work if given a free choice were three major factors for these psychological problems.Conclusions Psychological problems are pervasive among healthcare workers during the COVID-19 pandemic.Receiving negative information and participating in front-line work appear to be.important risk factors for psychological problems.The psychological health of different healthcare workers should be protected during the COVID-19 pandemic with timely interventions and proper information feedback.

Efficacy of Shanvac-B recombinant DNA hepatitis B vaccine in health care workers of Northern India

BACKGROUND: Health care workers (HCWs) constitute a high-risk population of HBV infection. There are limited data on the efficacy of vaccination in HCWs in India. This study was to evaluate the efficacy of indigenous recombinant hepatitis B vaccine, Shanvac-B, in HCWs. METHODS: In 597 HCWs screened before the vaccination, 216 (36.2%) showed the presence of at least one of the markers of HBV/HCV infection. Of the remaining 381 (63.8%) HCWs who were considered for vaccination, only 153 (age 18-45 years; 48 males and 105 females) were available for final assessment. These HCWs received 20 μg of vaccine at 0, 1 and 6 months. They were asked for the reactogenicity and monitored for the seroprotective efficacy of the vaccination. Anti-HBs titres were measured after vaccination at 1, 2 and 7 months. The presence of anti-HBs titers equal to 1 MIU/ml was considered as seroconversion and that of titres greater than 10 MIU/ml as seroprotection. RESULTS: After vaccination, 32 males (67%) and 76 females (72%) showed seroconvertion; finally 12 (25%) of the males and 47 (45%) of the females were seroprotected. Seroprotection at 2 and 7 months was more dominant in the females than in the males (96% vs. 56%, P=0.001, 100% vs. 85%, P=0.0001), respectively. Geometric mean titres of anti-HBs after vaccination were also higher in the females than in the males (257±19.7 vs. 29±1.88 MIU/ml, P=0.01, 1802±35.2 vs. 306±13.6 MIU/ml, P≤0.05, 6465±72 vs. 2142±73.6 MIU/ml, P<0.05). Seven male HCWs showed unsatisfactory response, non-response (n=3, 6%) and hypo-response (≤10 MIU/ml, n=4, 8%) at the end of vaccination. Smoking and alcoholism were significantly correlated with unsatisfactory response. No significant adverse effects of vaccination were observed in any HCW.CONCLUSIONS: The presence of HBsAg in HCWs indicates that a high proportion of HCWs are infected with HBV and HCV in India. Recombinant indigenous vaccine Shanvac-B is highly efficacious in HCWs, and its immunogenicity is significantly higher in females than in males. However, prevaccination screening of HCWs is strongly recommended in India.

Knowledge and attitude toward COVID-19 among healthcare workers at District 2 Hospital, Ho Chi Minh City

Objective:To assess the knowledge and attitude toward coronavirus disease-2019(COVID-19)among healthcare workers at District 2 Hospital in Ho Chi Minh City(HCMC).Methods:A cross-sectional study was performed between January 2020 and February 2020 at District 2 Hospital.A systematic random sampling strategy was carried out and the data was collected through a self-administered questionnaire of the knowledge and attitude of healthcare workers regarding COVID-19.Descriptive analysis was reported to describe the demographic,mean knowledge and attitude score of healthcare workers.Inferential statistics including t-test,ANOVA and Spearman’s correlation were used to evaluate the relationship between study variables.Results:A total of 327 eligible healthcare workers had a mean score of knowledge and attitude of 8.17±1.3(range 4-10)and 1.86±0.43(range 1-5),respectively.They showed good knowledge and a positive attitude.However,approximately two thirds of the participants knew the mode of transmission,the isolation period and treatment(67.0%,65.8%,and 58.4%,respectively),and 82.3%and 79.8%,respectively,held positive attitude regarding the risk of personal and family members getting illness.There was a negative correlation between knowledge scores and attitude scores(r=-0.21,P<0.001).Additionally,healthcare workerspredominately used social media to inform themselves about COVID-19(91.1%).Conclusions:The majority of healthcare workers had good knowledge and positive attitude toward COVID-19.However,the level of some knowledge and attitude lower than that expected for their position level towards the virus.Additional education interventions and campaigns are required for healthcare workers.