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Background: Before, during, and after the COVID-19 pandemic, doctor shortages led many countries to expand nurses' role in their mass vaccination programs. Nonetheless, nurses often express marked vaccine hesitancy. Simultaneously, their working conditions have been deteriorating., Objectives: To study 1) the association between nurses' perceptions of their working conditions and their vaccination-related behaviors (vaccination recommendations to their patients), and 2) the mediating role in this associations of their trust in health authorities, vaccine confidence, and vaccine proactive efficacy., Design: A cross-sectional survey., Settings: Salaried, community (self-employed) and mixed nurses in France., Participants: 18,888 nurses registered with the French national order of nurses (ONI, registration is mandatory) (N = 439,323)., Methods: In February 2023, this cross-sectional study used an online questionnaire to survey the nurses mandatorily registered with the French national order of nurses. Seven items adapted from models of psychosocial risk factors at work assessed their satisfaction with their working conditions. The international short version of the Pro-VC-Be (health professionals, vaccine confidence and behaviors), a validated instrument measuring psychosocial determinants of health-care professionals' vaccine behaviors) evaluated their vaccine-related attitudes and behaviors. Multiple group mediation analysis with structural equation modeling measured the associations between satisfaction at work, trust in health authorities, vaccine confidence, proactive efficacy (commitment and self-efficacy) in vaccination, and vaccination recommendations (against seasonal influenza for those with a chronic disease and against COVID-19 among adults)., Results: Among the 18,888 participants, satisfaction at work had generally deteriorated, and only 47 % considered vaccines safe. Among salaried nurses (61 %), satisfaction at work was statistically significantly associated (p < 10 -3 ) with trust in health authorities (β = 0.26 [0.24; 0.28]), vaccine confidence (total effect: β = 0.35 [0.31; 0.38]), proactive efficacy (total effect: β = 0.18 [0.16; 0.21]), and, to a smaller extent, with seasonal influenza and Covid-19 vaccine recommendations (total effect: β = 0.13 [0.09; 0.16]). Trust in health authorities played a statistically significant role (p < 10 -3 ) mediating the associations of satisfaction at work with vaccine confidence and proactive efficacy. These three dimensions in turn mediated the relation between satisfaction at work and frequency of vaccination recommendations. These relations were similar among community nurses., Conclusions: Satisfaction at work appears to enhance nurses' vaccination attitudes and behaviors, which are likely to reinforce their capacity to promote their patients' vaccination. Significant improvement in their working conditions is needed to enable them to accomplish this role serenely., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: - Despite the competence-building framework and interventions, the success of HIV/AIDS prevention and treatment programs remains unsatisfactory with scanty empirical evidence on the significance of professional competence to the success of HIV/AIDS control programs., Methods: - Using a triangulation of quantitative and qualitative data, from 40 health-care workers and 9 managers of the HIV/AIDS program in Kagadi District, this article analyzes the professional and cultural competencies among health-care workers and the significance of the competencies to the success of HIV/AIDS control programs. Descriptive statistics were generated to describe health-care workers' opinions on their competence and success of HIV/AIDS control programs. In addition, a regression model was fitted to estimate the contribution of health-care workers' competence to the success of HIV/AIDS control programs. This quantitative analysis was triangulated with a thematic analysis of key informants' views., Results: - Findings indicate that health-care workers' competence bears a positive statistically significant contribution to the success of HIV/AIDS control programs. Employee competence is necessary but not sufficient to foster the full realization of desired results from HIV/AIDS control programs., Conclusion: - Managers of HIV/AIDS control programs need to prioritize and continuously train health-care workers to boost their professional and cultural skills to effectively deliver interventional activities under HIV/AIDS control programs. Additionally, improving the working environment of health-care workers is critical to improve their motivation towards greater success of HIV/AIDS control programs., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Byamugisha et al.)

Wogene Negash,1 Nega Assefa,2 Negga Baraki,3 Tara Wilfong3 1Nursing Department, School of Health Science, Madda Walabu University Goba Referral Hospital, Goba, Ethiopia; 2School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia; 3School of Public Health, College of Health and Medical Sciences, Haramaya University, Haramaya, EthiopiaCorrespondence: Wogene Negash Tel +251 917796758Email Wogenenegash@gmail.com; Wogene.Negash@mwu.edu.etBackground: Medical malpractice, poor patient outcome and medical suits among health-care workers result from improper consenting practices. Therefore, this study aimed to assess practice and factors associated with the informed consenting process for major surgical procedures among health-care workers in public hospitals of Bale Zone, South Eastern Ethiopia.Methods: An institutional-based cross-sectional study was conducted from March 9 to 24, 2020, among all nurses, midwives, doctors (general physicians, surgeons, gynecologists), emergency surgery officers, anesthetists) who were working at Bale Zone public hospitals during the study period. A self-administered pretested questionnaire was employed. Variables with a p-value of less than 0.25 (age group, sex, educational profession, working unit, work experience, adequate content of consent form, training on informed consent, policy/regulation in institution, administrative support, average number of patient cared per shift, time spent for consent process, knowledge, attitude) at 95% confidence interval in the binary logistic regression analysis were considered for multivariable regression model to control for possible confounding effect.Results: Of the total sample size (639 health-care workers), 621 (97.2%) were included in this study, of which 311 (50.1%, 95% CI: 46.1– 53.8) practiced proper informed consent during major surgical procedures. Being age above 35 (AOR: 3.032, 95% CI: 1.148– 8.010), male (AOR: 1.607, 95% CI: 1.047– 2.465), above 10 years of working experience (AOR: 2.339, 95% CI: 1.104– 4.955), adequate content of consent form (AOR: 2.785, 95% CI: 1.772– 4.377), having training on informed consent (AOR: 2.305, 95% CI: 1.204– 4.414), spending more time (> 30minutes) for consent process (AOR: 3.014, 95% CI: 1.095– 8.298), having good knowledge (AOR: 1.808, 95% CI: 1.195– 2.737) and favorable attitude (AOR: 2.188, 95% CI: 1.456– 3.287) were significantly associated with good informed consent practice.Conclusion: Only half of health-care workers practiced good informed consent. Further emphasis needs to be given to improve consent practice.Keywords: practice, informed consent, health-care workers, public hospitals

Abstract Background Pre-exposure prophylaxis (PrEP) is a promising strategy to break COVID-19 transmission. Although hydroxychloroquine was evaluated for treatment and post-exposure prophylaxis, it is not evaluated for COVID-19 PrEP yet. The aim of this study was to evaluate the efficacy and safety of PrEP with hydroxychloroquine against placebo in healthcare workers at high risk of SARS-CoV-2 infection during an epidemic period. Methods We conducted a double-blind placebo-controlled randomized clinical trial in three hospitals in Barcelona, Spain. From 350 adult healthcare workers screened, we included 269 participants with no active or past SARS-CoV-2 infection (determined by a negative nasopharyngeal SARS-CoV-2 PCR and a negative serology against SARS-CoV-2). Participants allocated in the intervention arm (PrEP) received 400 mg of hydroxychloroquine daily for the first four consecutive days and subsequently, 400 mg weekly during the study period. Participants in the control group followed the same treatment schedule with placebo tablets. Results 52.8% (142/269) of participants were in the hydroxychloroquine arm and 47.2% (127/269) in the placebo arm. Given the national epidemic incidence decay, only one participant in each group was diagnosed with COVID-19. The trial was stopped due to futility and our study design was deemed underpowered to evaluate any benefit regarding PrEP efficacy. Both groups showed a similar proportion of participants experiencing at least one adverse event (AE) (p=0.548). No serious AEs were reported. Almost all AEs (96.4%, 106/110) were mild. Only mild gastrointestinal symptoms were significantly higher in the hydroxychloroquine arm compared to the placebo arm (27.4% (39/142) vs 15.7% (20/127), p=0.041). Conclusions Although the efficacy of PrEP with hydroxychloroquine for preventing COVID-19 could not be evaluated, our study showed that PrEP with hydroxychloroquine at low doses is safe. Trial registration ClinicalTrials.gov NCT04331834 . Registered on April 2, 2020.

This study aimed to explore whether an acceptance and commitment (ACT) approach to stress management training improved the levels of depression, anxiety, and stress among a group of twenty-two health professionals from an intensive care unit. Questionnaires were administered before and after training, and follow-up was carried out one month after training, including semi-structured interviews with nine participants. The results reflected that the quasi-experimental group reduced their depression and stress levels significantly and showed improvements in stress in the follow-up. A qualitative thematic analysis of interviews showed that nurses were seeking a tool that would help them to cope more effectively with stressful situations and increase their knowledge of stress management. The themes in the professionals’ comments claimed specific improvements in their health, well-being, relationships, and psychological processes. In conclusion, ACT-based trainings offer a possible framework for mental health promotion in health care organizations.

Abstract Background Our study sought to determine the frequency of Needlestick injuries (NSIs) among Healthcare Workers (HCWs) working at governmental hospital and to study the factors that associated with occurrence of NSIs, and to develop recommendations for a comprehensive program for prevention. Methods Retrospective study of all reported cases of NSIs in the period from April 2016 to May 2018 among healthcare workers at a governmental hospital. Results Incidence of NSIs over 26 months was 8.4% among all participants. Nurses were the most affected staff (52.5%) resulted commonly from disposing syringes (58.9%). In contrast, the incidence of NSIs among physicians was 24.9% where surgical devices were the primary source of NSIs among them (40%). Failure to complete all required hepatitis B vaccination was common among expatriates of the participants of this study. Conclusions NSIs was common among HCWs participated in this study. Preventive measures should be implemented including adequate hepatitis B immunization.

Aim: This study aimed to investigate the prevalence of psychological health outcomes and associated factors among health-care workers (HCWs) during COVID-19 pandemic. Subject and Methods: This observational cross-sectional study was conducted on 550 HCWs at 4 different clinics (fever, clean, telemedicine, and mixed clinics) in Dubai Health Authority from July 2020 to September 2020. Severity of depression, anxiety, and stress was examined by calculating the Depression Anxiety Stress Scale (DASS-21) for each subscale, while insomnia was determined by Insomnia Severity Index (ISI) score. Factors associated with psychological symptoms were identified by univariate (ANOVA and independent t test), and independent factors were detected by multivariate linear regression analysis after controlling other variables. p value of

Vaccinating health-care workers against influenza during the COVID-19 pandemic can effectively prevent and control influenza and reduce COVID-19 strain on health systems. This study was conducted to explore influenza vaccination coverage and determinants among health-care workers during the COVID-19 pandemic in 2020/2021 influenza season in Ningxia. This cross-sectional survey included demographic characteristics of health-care workers, influenza vaccination status, reasons for not getting vaccinated, and whether influenza vaccination was recommended for others. We found that influenza vaccine rate of health-care workers was 39.6%. A binary logistic regression analysis showed that health-care workers’ vaccination coverage was higher when the individuals were aware of the effect of the influenza vaccine (OR = 0.624, 95% CI: 0.486–0.802). Health-care workers who from internal medicine (OR = 1.494, 95% CI: 1.146–1.948), pediatrics (OR = 2.091, 95% CI: 1.476–2.962), and surgery departments (OR = 1.373, 95% CI: 1.014–1.859) had a lower coverage than those who worked in vaccination and infectious disease departments. The main reasons that some stated for not getting vaccinated were that they felt it was unnecessary (52.22%). Health-care workers who were vaccinated against influenza were more likely to recommend influenza vaccination to their patients than health-care workers who had not been vaccinated. The incidence of influenza among health-care workers was higher than that of the general population in Ningxia. Under the policy of voluntary and self-pay influenza vaccination in Ningxia, the coverage rate of influenza vaccine among health-care workers was far below the vaccination requirements of influenza vaccine in influenza season even during the COVID-19 epidemic.

Introduction: The nose and throat are areas of high viral load, which could place otolaryngologists at an even higher risk for COVID-19 than other health-care workers. Objective: To investigate the prevalence of antibodies against SARS-CoV-2 in otorhinolaryngologists in southern Brazil, its relationship to demographic data, professional practice and reported symptoms of COVID-19, and compare it with official data on other health-care workers of the state and the general population in the same period. Methods: In this cross-sectional multicenter study, otolaryngologists actively practicing officially registered in Rio Grande do Sul were screened for IgM and IgG antibodies against SARS-CoV-2 from August 1 to September 15, 2020. A questionnaire was also applied. Results: We screened 358 (80.1%) of 447 actively practicing otolaryngologists (195 [54.5%] male; mean [SD] age, 47.77 [13.57] years; range, 26–84 years). Twenty-three were positive for IgM and/or IgG (6.4%). This result was significantly associated with reports of infected household contacts (19/315 negatives and 8/23 positives; p

Objective: To study SARS-CoV-2 reinfections in health-care workers (HCWs) of the University Health Agency Giuliano-Isontina (ASUGI), covering the provinces of Trieste and Gorizia (northeastern Italy) routinely screened for SARS-CoV-2 via nasopharyngeal swab. Design: Cohort study of HCWs (N = 8205) followed since the start of the pandemic (1 March 2020) through 31 January 2023. The risk of reinfection during the Omicron transmission period (after 30 November 2021) among HCWs previously infected by SARS-CoV-2 was estimated based on days since last dose of COVID-19 vaccine received, adjusting for age, sex, job task, workplace, number of doses of COVID-19 vaccines and number of swab tests performed. In the crude as well as adjusted incidence rate analysis, reinfections occurring 15+ days after a first dose of COVID-19 vaccine or 8+ days following a second or more dose were counted. Results: In a highly vaccinated population, during the entire study period (1 March 2020–31 January 2023) 5253 HCWs incurred at least one SARS-CoV-2 infection, 4262 HCWs were infected only once, and 1091 were reinfected. Reinfections almost entirely (99.1% = 1071/1091) occurred after 30 November 2021, peaking in July 2022 (N = 161). Six hundred eighty-three reinfections followed a pre-Omicron primary event against 408 reinfections following an Omicron event. Reinfections during the Omicron transmission period occurred a mean of 400 ± 220 days after primary SARS-CoV-2 infection; 512 ± 205 days following a pre-Omicron primary event, as opposed to 218 ± 74 days after an Omicron primary infection. Thirty-four hospitalizations were observed, all before the Omicron wave, following 18 (0.4%) primary SARS-CoV-2 infections and 16 (1.5%) reinfections. By excluding events occurring Conclusions: SARS-CoV-2 reinfections were frequent during the Omicron transmission period, though featured by mild or no symptoms. Whilst the impact of occupation on biological risk was relatively marginal, COVID-19 vaccination had the strongest protective effect against reinfection, with a 93% VE by second booster following an Omicron primary infection.

Aim: To identify barriers in the understanding and provision of optimal palliative care to Aboriginal children with cancer by health‐care staff, with the aim to support education and training that highlights the importance of cultural, physical and spiritual needs at end‐of‐life. Methods: Medical and nursing staff working in Departments of Palliative Care, Metabolic Medicine and Haematology/Oncology at the Women's and Children's Hospital in Adelaide, South Australia, were asked to complete a survey regarding their experience in treating Aboriginal children receiving palliative care. The survey addressed the understanding of cultural and spiritual needs, barriers encountered and opinions for improved services. Results: The survey was completed by 34 participants. 91.2% (n = 31) had provided care to Aboriginal children who were receiving care during palliative and end‐of‐life phases for a diagnosis of cancer, 58.8% (n = 20) of which had supported children returning home. Only 23.5% of participants reported comfort in communicating about spiritual/cultural needs with patients and families. There was minimal previous exposure to education (17.6%), yet all participants were interested in future education opportunities. Conclusion: This study highlights a paucity in understanding and comfort among health‐care workers in treating Aboriginal children at end‐of‐life. New models, including the training of staff, educational resources and involvement of Aboriginal health‐care workers, may improve care. [ABSTRACT FROM AUTHOR]

Introduction: Among people living with HIV (PLHIV), fertility desire which is the desire to have more children is increasing due to the improvement in quality of life and survival resulting from anti-retroviral treatment and also improved sexual and reproductive health services. Fertility desires can result in increased risk of HIV transmission, especially in unprotected heterosexual intercourse. There is limited information regarding the fertility desires and predictors among PLHIV in our environment. Methods: This study was aimed at assessing the fertility desires and predictors in PLHIV in Northcentral Nigeria. Study was descriptive cross-sectional. Semi-structured interviewer administered pretested questionnaires was used to get information from 170 PLHIV accessing care in a secondary health-care facility selected by the systematic sampling technique. Data were analyzed using the SPSS software version 23.0. At 95% confidence interval (CI), a P < 0.05 was considered to be statistically significant. Chi-square and logistic regression. Results: Fertility desire was found among 64.1% of the respondents. Younger age (odds ratio [OR] = 0.2270; 95% CI = 0.0662–0.7791, P = 0.0184), having no child or a smaller number of children (OR = 0.0432; CI = 0.0046–0.4050; P = 0.0059) and suppressed viral loads (OR = 4.1069; CI = 1.1650–14.4784; P = 0.0280) were the predictors for fertility desire. Conclusion: This study showed that PLHIV had high fertility desires but do not know any safe method of conception, hence intensified effort should be made by primary care providers and other health-care workers to include sexual and reproductive health counselling during routine HIV clinic visits to enable PLHIV make informed decision about their fertility desires. [ABSTRACT FROM AUTHOR]

Background: Contact tracing (CT) is an effective tool for breaking the chains of transmission in infectious disease outbreaks. This study was conducted to observe the trend of isolation and quarantine, assess the source of infection and contacts, and assess the effectiveness of CT in the early detection of infection among health-care workers (HCWs). Methods: This study was conducted using secondary analysis of routine CT records of HCWs of a tertiary care hospital in Mumbai from April 9, 2020, to December 31, 2020. Details of all HCWs exposed or infected with COVID-19 were collected in a standard format developed for this purpose telephonically. The exposed HCWs were further divided into high-risk (HR)/low-risk (LR) contacts and quarantined. Results: A total of 744 HCWs were isolated during this period and 1486 contacts were quarantined against them. Majority of the HCWs affected from COVID-19 were resident doctors, interns, and nursing staff. More than 81% of the positive HCWs were symptomatic. The overall ratio between isolated HCWs and quarantined HCWs is 1:2. A total of 88 (6%) HCWs tested positive from quarantine. The test positivity rate among HR contacts was 9.01% and among LR contacts was 2.72%. Conclusions: Effective CT of positive HCWs greatly aids in the early identification of contacts and timely quarantine. Over a period of time, the number of HCWs getting isolated or quarantined is found to decrease. This is the true success of CT. This strategy can be implemented among other medical colleges and hospitals too. [ABSTRACT FROM AUTHOR]

Context: Health-care workers (HCWs) are facing stigma during the COVID-19 pandemic. Stigma is associated with poor mental health. Aims: This study aimed to assess the prevalence and psychological impact of COVID‑19‑related stigma and different coping mechanisms among physicians in Mumbai. Settings and Design: An online cross-sectional survey was conducted. Subjects and Methods: One hundred and seventy physicians from Mumbai were administered questionnaires on perceived stress, anxiety, COVID-19-related stigma, and coping strategies. Statistical Analysis Used: Data were analyzed using descriptive statistics, correlation tests, and binary logistic regression in the SPSS, version 20.0. Results: The prevalence of stress and anxiety was 57.6% and 20.0%, respectively. 34.7% of physicians felt stigmatized due to COVID‑19. Stress was significantly associated with COVID‑19‑related stigma (P = 0.009), and emotion-oriented coping (P = 0.000), as was anxiety (P = 0.000, P = 0.000, respectively). Conclusions: COVID-19-related stigma is a major issue among physicians. Stigma and emotion-oriented coping mechanisms are predictive of mental distress in this population. [ABSTRACT FROM AUTHOR]

Background and Objectives: Health-care workers (HCWs) are playing an instrumental role in combating coronavirus infection (COVID-19). While rendering their services, they also run the risk of cross-contamination. Hence, it is important to evaluate and correlate the knowledge and attitude of HCWs of Saudi Arabia about COVID-19. Materials and Methods: A prospective, nationwide, questionnaire-based survey was conducted after getting the approval from the institutional ethical board. A validated and reliable questionnaire was constructed, developed on the Qualtrics software, and circulated through an electronic medium across the country. The questionnaire had a total of 29 questions regarding knowledge and attitude about COVID-19. Through convenience sampling, the data were collected from a total sample of 1553 HCWs. Based on the primary area of expertise, the sample was categorized into three study groups with 1040 medical health-care professionals (MHCPs) (Group I), 318 dental health-care professionals (DHCPs) (Group II), and 195 allied health-care professionals (AHCPs) (Group III). Univariate and multivariate logistic regression analysis was done using SPSS v. 21, where P < 0.05 was considered statistically significant. Results: Female HCWs (P = 0.003) were shown to have a higher (adjusted odds ratio [aOR]: 1.46; confidence interval [CI]: 1.19-1.79) risk of inadequate knowledge in comparison to male HCWs. With respect to qualification, HCWs with doctorate qualification (P = 0.005) (aOR: 0.39; CI: 0.2-0.75) had shown to have adequate knowledge compared to their counterparts. AHCPs were shown inadequate knowledge (P < 0.001; aOR: 2.36; CI: 1.65-3.38), but adequate attitude (P < 0.001; aOR: 0.13; CI: 0.09-0.2) compared to MHCPs and DHCPs. Conclusion: MHCPs were shown to have the most appropriate level of knowledge, whereas AHCPs outscore other counterparts of HCWs with respect to attitude toward COVID-19. Emphasis should be directed to the whole community of HCWs in enhancing their awareness and practice attitude toward the novel infection of COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: The emotional well-being of health-care employees is critical to the quality of patient care and the efficient operation of health services. Not only has the coronavirus disease-2019 (COVID-19) virus caused significant rates of morbidity and mortality around the world but it has also caused sleep disruption, stress, and pandemic-related anxiety among health-care workers. The current study examines associations among COVID-related fear, stress, and sleep quality in health professionals. Methods: From January to June 2021, a cross-sectional survey was done in Kerala among doctors, nurses, paramedical workers, and housekeeping employees. About 822 health-care providers from various districts took part in the study by completing a Google forms-based semi-structured, self-administered questionnaire. The data were coded, entered, and analyzed using SPSS 20.0. Descriptive statistical analysis, percentages, and ratios were employed to summarize the data. Results: The majority of participants were between the ages of 46 and 55 (35%). Forty-four percent and 46% of respondents, respectively, were concerned about contracting COVID-19 and spreading the virus to others. COVID-19 restrictions were the primary concern of psychological distress among respondents (90%). Approximately one-fourth of the subjects reported using sleep medication, 42% took 30 min or longer to fall asleep, and 39% slept for 6 h or less. Poor sleep quality was reported to be prevalent in 62% of the population. Conclusion: The COVID-19 pandemic has the potential to cause significant levels of fear, stress, and sleep disruption in health-care professionals. As a result, the COVID-19 pandemic represented a significant threat to their psychological health, and public health strategies should focus on improving it. [ABSTRACT FROM AUTHOR]

Background: The coronavirus pandemic (coronavirus disease 2019 [COVID-19]) has brought the entire world to a standstill, causing an unprecedented impact on people's lives. The most affected population is the frontline health-care workers, including the on-duty doctors and paramedical staff members providing treatment and care to the COVID patients in the wards and intensive care units. Aim: The present study aimed to evaluate, compare, and correlate the prevalent levels of stress, depression, and anxiety among the doctors and the paramedical personnel treating COVID-19 patients. Materials and Methods: Two hundred and eight consecutive medical professionals and 209 consecutive paramedical personnel, fulfilling the inclusion criteria, were evaluated. Sociodemographic and clinical data were gathered using a semi-structured proforma. Assessments were further done using the Depression, Anxiety, and Stress Scale. Chi-square test was used to compare the groups (medical and paramedical staff) and their correlates. Results: Depression was present in significantly higher number of paramedical staff (43.54%) compared to medical personnel (33.17%). Among doctors, the total duty hours had a significant positive correlation (P < 0.05) to the depressive symptoms. In contrast, the anxiety levels were significantly lower (P < 0.05) among those paramedical staff members who performed their COVID duty for more than 2 weeks. Conclusion: The relentless management of COVID patients by the health-care warriors has begotten a high level of psychiatric morbidity among them. Provision of better facilities, adequate information, and appropriate interventions are required in this regard. [ABSTRACT FROM AUTHOR]

Background: Swab collection is a challenging task, and the health-care workers (HCWs) have to face many difficulties while collecting swab samples of suspected patients. They often need to counsel the suspects as some think they do not have an infection but carry fear. Appropriate precautions should be taken in collecting specimens since this may expose HCWs to respiratory secretions from the suspects. Purpose: The purpose of the study was to assess awareness, anxiety, and stress among HCWs deployed in swab collection during the COVID-19 pandemic in Andhra Pradesh, India. Materials and Methods: A total of 102 HCWs filled out the questionnaire in this cross-sectional study. Google Forms were sent through WhatsApp and email. The participants were asked to forward the link to other known people who were also deployed in swab collection. The study took place in Nellore, Andhra Pradesh, for 1 month. Results: About 73.5% of HCWs underwent training in swab collection. 90% of the undergraduates and 89% of the postgraduates were unhappy while staying away from family. Most of the study participants continued to wear personal protective equipment until completion of the working period. 39 of 44 undergraduates felt that swab collection was a high-risk job, and 42 of 55 postgraduates felt the same. Conclusion: Most of the HCWs are unhappy staying away from their family while deployed in swab collection. Majority of them reported swab collection as a high-risk job. As they are frontline workers, an enhanced variety of support should be offered. Psychosocial support and effective measures should be made readily available to them. [ABSTRACT FROM AUTHOR]

Background: Accredited Social Health Activists (ASHAs) and Anganwadi workers are grassroots-level health activists who are involved in health education and community mobilization and form a bond between the community and the primary health-care delivery system in India. The cross-sectional study was conducted to assess the dental health-care utilization and to estimate the dentition and periodontal status of ASHA and Anganwadi workers. Materials and Methods: The study was conducted at the primary health centers and subcenters of Lucknow District. ASHA and Anganwadi workers presented on the day of the examination were included in the study. The study pro forma was used to record demographic details and dental utilization. Dentition status and periodontal status were used to record dental caries and periodontal status using the World Health Organization Oral Health Assessment Form 2013. Data were analyzed using the SPSS version 21; descriptive statistics, Chi-square test, and regression analysis were used to assess factors related to health-care utilization and P < 0.005 was considered statistically significant. Results: The final study sample comprised 500 health-care workers (220 ASHA and 280 Anganwadi workers). Among the study population, 30% utilized dental services and was found to be statistically significant with age, occupation, and oral findings. However, 56.0% had both dental caries and periodontal diseases followed by dental caries‒32.0%, periodontal disease‒8.0%. There was a significant difference (P < 0.005) in the proportion of dental care utilization and oral diseases among participants. Conclusions: The dental care utilization was found to be short and is not comparative to the diseases among participants. [ABSTRACT FROM AUTHOR]

Background: Health care workers (HCW) exposed to COVID-19 risk experiencing psychological distress. Little is known regarding longitudinal perspectives and evolutions of psychological distress within this population. The objective of this study is to extend the results of our previous study to the pandemic's second wave. Method: This prospective cohort study was conducted from May 8, 2020, to January 24, 2021, and includes 787 HCW. Symptoms of anxiety and depression were assessed using the Generalised Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Descriptive statistics illustrated the evolution of psychological distress indicators, whereas latent class analysis helped identify trajectories. Results: The results showed that a lower proportion of HCW exceeded the clinical threshold during the second wave (36,5% vs. 31,1%). As in the first wave, most of our sample fell onto the resilient trajectory (67.22%). We adapted the name of the remaining trajectories to better suit their evolution: rapid recovery (15.76%), slow recovery (9.66%), and delayed (7.37%). Conclusion: Approximately two-thirds of the HCW did not manifest significant distress. For those who did, the distress was transient. We observed a trend of positive adaptability among HCW, considering that the proportion of HCW experiencing psychological distress exceeding clinical threshold remained lower than during the first wave. Our data highlight the dynamic nature of psychological distress. To be able to detect psychological distress as it arises, HCW should use self-monitoring as an essential tool. This vigilance would allow institutions to offer timely support and resources for those experiencing psychological distress. [ABSTRACT FROM AUTHOR]

Background: Sleep is vital for every aspect of human life. Inadequate sleep has a massive negative impact on health and work. There is very limited information about the impact of COVID-19 on the sleep disturbance of health-care workers. In our current study, we aim to find answers to certain questions about the impact of the COVID-19 pandemic on sleep patterns on nurses working in COVID care area. Methods: A cross-sectional study was conducted on 305 health-care workers who were purposively enrolled for this study. The study was conducted at the Postgraduate Institute of Medical Education and Research, Chandigarh, India, from April to June 2021. An e-survey method was used to collect data. A questionnaire including sociodemographic characteristics, queries about sleep disturbances, and the patient health questionnaire-9 scale to assess anxiety among participants are among the research tools. Results: Mean age of health-care workers was 26.3 years (SD = 6.3). Most of them were women (81%) with a bachelor's degree in nursing (62%), nursing interns (46%), and married (71%). The majority of nurses (85%) were not infected with COVID and were given suitable personal protective equipment (46%) in the hospital. The majority of participants (45%) got 6–8 h of sleep per night did not receive any sleep therapy (90%). The most of participants (42%) reported that they did not enjoy performing activities and were under moderate stress (15.4). Conclusion: Health-care workers are struggling to cope with the COVID-19 pandemic with limited and almost hackneyed resources. Healthy sleep is everyone's right. The current situation of the pandemic has a great impact on the psychological health of frontline health-care workers by affecting their professional performance. [ABSTRACT FROM AUTHOR]

Objective: Health-care workers (HCWs) are often seen as the most reliable source of vaccine-related information for their patients; nevertheless, various studies show that HCWs experience vaccine hesitation. In this study, the aim was to determine the reasons for vaccine hesitation among HCWs working in a large public hospital and its affiliated units in Istanbul. Methods: A descriptive method for collecting qualitative data was designed for this study. The data of the HCWs were analyzed in line with the vaccine hesitancy factors put forward by the World Health Organization (WHO). Results: The most important vaccine hesitancy theme that emerged was the fear and lack of confidence in the vaccines, which was expressed at a higher rate than any other theme in all HCWs. The most cited reason for fear/lack of confidence in the vaccine was the fear of its side effects. It was observed that the HCWs who reported hesitation about vaccination due to pregnancy and breastfeeding consisted of women. The second most common theme for vaccine hesitation was reported as an inconvenience in accessing the vaccines. Although HCWs have priority, they stated that their reason for vaccine hesitancy was due to heavy personal issues or workloads. The final theme was about complacency, or thinking they do not need the vaccine. Conclusions: Vaccine hesitation is a challenge that can be overcome with detailed monitoring and policy-making. Although the vaccine seems to be more significant, we do not want to see vaccine hesitancy grow more than the vaccine itself. [ABSTRACT FROM AUTHOR]

The aim of the study was to assess the measles immunity level among employees of medical organizations of various specialties, young subjects, and neonates. Materials and Methods. The measles immunity status was assessed for all the employees of St. Petersburg State Budgetary Healthcare Institution Maternity Hospital No. 10 (386 subjects), civilian medical staff of the clinics of the Military Medical Academy named after S.M. Kirov (Military Medical Academy) (1399 subjects), cadets of the Military Medical Academy (304 subjects) and 34 neonates. Laboratory testing was performed by using ELISA with test kits “VektoKor-IgG” (RF). Results. Medical workers displayed high total level of protection against measles virus serologically confirmed in 87.5% of the maternity hospital staff and 81.6% of the employees at the Military Medical Academy clinics. No differences in the immune status between the varying categories of medical personnel from the departments of various specialties were revealed. Lower population immunity was observed in the 20-40-year age group. Among the employees of the maternity hospital, the proportion of measles virus seropositive subjects aged 20—40 years was 75.9% (95%, CI 67.2—82.9%), 40—59 years — 91.5% (95%, CI 86.7—94.7%), 60 year and older subjects were all seropositive (95%, CI 94.6—100%). Dual vaccination did not guarantee emergence of effective measles immunity. The majority of seronegative subjects were dually vaccinated, hence, even in case of previous dual measles vaccination, it is necessary to perform a serological examination prior to recruitment to medical facilities. Females comprised more than 90% of medical workers. Therefore, women of fertile age previously dually vaccinated, but immunologically seronegative, are at risk of measles and intrauterine fetal infection, as well as the risk of its development is increased in vaccination age children. It was confirmed by demonstrating that as few as 70.6±15.3% of neonates were immune to the measles virus. The proportion of seronegative infants (29.4±15.3%) was comparable to that one in seronegative subjects aged 20—40 years (24.1±8.1%) working at the maternity hospital. Among the younger age group (aged 18—23 years) such as cadets of the Military Medical Academy, a significantly higher proportion of seronegative individuals was found — 48.3±5.6%, thereby increasing probability for measles outbreak therein. Conclusions. In order to eradicate measles, it is necessary to develop a screening program for detecting antibodies against measles among young and middle-aged subjects.

Healthcare-workers are at risk of contact with measles patients and disease transmission. Measles-infected employees of healthcare facilities may contribute to the nosocomial measles spread and serve as a source of infection for most susceptible cohorts such as pregnant women, neonates, and immunocompromised patients. In order to study the humoral immunity against measles in healthcare workers and reveal factors associated with seronegative status, we performed a cross-sectional study by enrolling 847 healthcare workers of the Arkhangelsk Regional Clinical Hospital. Anti-measles virus serum immunoglobulin G antibodies were quantified by using VectorMeasles-IgG ELISA kit (Vector-Best, Russia). According to the manufacturer's recommendations specific IgG anti-measles titer cut-off value higher than 0.18 IU/ml, equal to 0.12—0.17 IU/ml, or lower than 0.12 IU/ml was considered as positive (protective), equivocal, or negative, respectively. Assessing an impact of employee's gender, age, affiliation (department), current position was carried out by using binary logistic regression analysis while analyzing seronegative status of healthcare workers. Study participants dominated by females (92.1%). The median age was 48 (39; 57) years. The employees of somatic departments prevailed (26.7%). It was found that 93.7% of medical workers had concentration of anti-measles antibodies exceeding magnitude of protective titer (above 0.18 IU/ml), 4.4% and 1.9% were measles seronegative and equivocal, respectively. The level of antibodies against measles was associated with age of healthcare workers, but not with gender. All employees older than 60 years were measles seropositive, whereas those younger than 35 or within range 35 to 60 years of age had protective antibody titer in 77% and 95.5% of cases, respectively. The proportion of subjects with seronegative results did not depend on employee's position (doctor, nurse, cleaning worker), but varied a lot between different hospital departments. According to the data of logistic regression, the odds to have a seronegative test result among employees from somatic and remaining departments were 4.4-fold higher. Importantly, the rate of seronegative results was by 10-fold lower in employees born between 1968 and 1984 than those found in subjects born after 1985. On the other hand, subjects older than 60 years of age were seronegative at 50-fold lower rate than those who were under 35. The median concentration of measles immunoglobulin G among vaccinated healthcare workers vs. subjects recovered after natural infection was significantly lower reaching 0.56 IU/ml and 4.2 IU/ml (p < 0.001), respectively. Five-year monitoring showed that titer of measles IgG antibodies decreased by 1.2-1.9-fold (average — 1.5). Thus, a cohort of healthcare workers from multidisciplinary healthcare facility demonstrated that the proportion measles-susceptible subjects was 6.3%. Importantly, age of examined subjects mainly affected seronegative status. Taking into consideration age-related lowered serum antibody level in vaccinated healthcare workers, seroprevalence studies and subsequent revaccination of seronegative people should be performed at least once every 5 years to prevent measles spread in healthcare facilities.

There were reports of severe acute respiratory syndrome coronavirus 2 infection cases among health-care workers from all around the world. We did a cross sectional study among 533 COVID19 affected health-care workers. About 87.43% of participants were involved in duties not directly related to COVID-19 management. About 19.6% contracted the disease from their colleagues. About 15% of the affected health-care workers had at least one comorbidity and diabetes mellitus was the most common (5%). 57% of participants presented with fever followed by body ache in 40%. Only 0.4% of the participants needed ventilator support during treatment. 36% of the participants reported household transmission from them. Adequate personal protective equipment (PPE) usage and functioning infection control committee in their hospital were reported by most of the participants. The study points towards the need of adequate PPE use in the nonCOVID settings and the need for periodical assessment of infection control practices.

Background: In December 2020, Sputnik V was incorporated to the National COVID-19 Immunization Plan in Argentina. Studies had shown 98% of antibody response rate. To date, data on immunogenicity and antibody persistence in Argentina are scarce.The objective was to assess humoral immune response after two doses of Sputnik V in Health Care Workers (HCWs) at the Ricardo Gutierrez Children’s Hospital (RGCH). Methods: A prospective, cohort study in HCWs immunized with two doses of Sputnik V between February and March 2021. The following variables were assessed: age, gender, risk factors for severe COVID-19 or mortality, immunosuppressive therapy and history of SARS-CoV-2. Blood samples were drawn on the day of the first dose, 28 days and 180 days after the second. Anti-Spike IgG was measured using an ELISA assay. Differences in immune response were evaluated according to study variables. Comparison analyses between groups with or without history of infection were performed, with T-test and ANOVA or Mann-Whitney tests. For each subject, we compared baseline values with 28 days and 180 days after the second vaccine.STATA version 14 and R Sofware were used for data analyses. Results: We included 528 individuals, mean age 41.5 years, 82.9% female, 14.4% (76/528) reported previous SARS-CoV-2 infection.All subjects developed antibodies post-vaccination. At day 28, concentrations were significantly higher in previously infected than naïve subjects (p

Abstract Aim Many health‐care workers exposed to coronavirus disease 2019 (COVID‐19) are psychologically distressed. This study aimed to investigate the psychological impact of the COVID‐19 pandemic on hospital workers under the emergency declaration in Japan. Methods This cross‐sectional, survey‐based study collected sociodemographic data and responses to 19 stress‐related questions and the Impact of Event Scale‐Revised (IES‐R), which measures post‐traumatic stress disorder (PTSD) symptoms, from all 3217 staff members at Kobe City Medical Center General Hospital from April 16, 2020 to June 8, 2020. Exploratory factor analysis was applied to the 19 stress‐related questions. Multiple regression models were used to evaluate the association of personal characteristics with each score of the four factors and the IES‐R. Results We received 951 valid responses; 640 of these were by females, and 311 were by respondents aged in their 20s. Nurses accounted for the largest percentage of the job category. Women, those aged in their 30s–50s, nurses, and frontline workers had a high risk of experiencing stress. The prevalence of stress (IES‐R ≥ 25) was 16.7%. The psychological impact was significantly greater for those aged in their 30s–50s and those who were not medical doctors. Conclusions This is the first study to examine the stress of hospital workers, as measured by the IES‐R, under the emergency declaration in Japan. It showed that women, those aged in their 30s–50s, nurses, and frontline workers have a high risk of experiencing stress. Health and medical institutions should pay particular attention to the physical and psychological health of these staff members.

Aim:Intensive care unit (ICU) workers have a greater risk of being infected due to procedures requiring intensive contact with the coronavirus disease-2019 (COVID-19 ) patient. We aimed to explain how we applied the protection of healthcare workers against the contagion of COVID-19 infection in the ICU of a university hospital.Methods:The study was performed in ICUs of the Goztepe Training Research Hospital with 650 beds which was affiliated to Medeniyet University in Istanbul, Turkey. We recorded the number of COVID-19 patients. We also recorded ICU workers (doctor, nurse, and others), and their working layouts. The frequency of the contagion of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) to ICU workers was investigated. We also evaluated precautions for the prevention and evaluated the arrangement of ICUs for COVID-19 patients.Results:Between March 17th 2020 and May 26th 2020 totaly, a total of 120 hospitalized COVID-19 patients were treated in ICUs. Laboratory confirmed COVID-19 was detected in only one health-care worker in ICUs.Conclusion:Our experience showed that the correct and proper use of personal protective equipment according to the protocols are effective in protecting ICU workers against the contagion of SARS-CoV-2.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly transmits in general population, mainly between health-care workers (HCWs) who are in close contact with patients. Objective: To study the seropositivity of HCWs as a high-risk group compared to general population. Methods: 72 samples were obtained from HCWs working in Masih Daneshvari hospital as one of the main COVID-19 admission centers in Tehran, during April 4 to 6, 2020. Also we collected 2021 blood samples from general population. The SARS-CoV-2 specific IgM, and IgG antibodies in the collected serum specimens were measured by commercial ELISA kits. Results: Based on the clinical manifestations, 25.0%, 47.2%, and 27.8% of HCWs were categorized as symptomatic with typical symptoms, symptomatic with atypical symptoms, and asymptomatic, respectively. Symptomatic individuals with typical and atypical symptoms were 63.2% and 36.8% positive in RT-PCR test, respectively. Anti-SARS-CoV-2 IgM and IgG antibodies were detected in 15.3% and 27.8% of HCWs samples, respectively. Antibody testing in the general population indicated that SARS-CoV-2 specific IgM and IgG were found in (162/2021) 8%, and (290/2021) 14.4%, respectively. The frequency of positive cases of IgM and IgG were significantly increased in HCWs compared to general population (p= 0.028 for IgM and p= 0.002 for IgG). Conclusion: The frequency of SARS-CoV-2 specific antibodies in HCWs was higher than general population indicating a higher viral transmission via close exposure with COVID-19 patients.

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Vaccination of healthcare professionals (HCPs) is a key measure to prevent infections in healthcare facilities, but uptake rates often remain low. Mandatory vaccination policies have been occasionally implemented to increase compliance among HCPs, but this remains an issue of controversy. The purpose of this survey was to assess the attitudes and beliefs of trainee HCPs towards mandatory occupational vaccination and further explore the factors that determine their decision. In this cross-sectional survey, trainees consisted of medical residents and medical and nursing students undergoing their clinical clerkship. An anonymous questionnaire was distributed following pilot testing. In total, 410 trainees participated (response rate: 90.1%), of whom 194 (47.3%) were residents, 154 (37.6%) medical and 62 (15.1%) nursing students. Most participants (320/410, 78%) supported mandatory occupational vaccination, stating that it should be applied to promote public welfare and benefit (294/320, 91.9%) or should be a prerequisite for employment (271/320, 84.7%). Only 22/410 (5.4%) of HCPs opposed to mandatory occupational vaccination. The primary reasons for a negative attitude were the belief that personal rights outweigh public benefit (10/22, 45.5%) and the fear of side effects (9/22, 40.9%). Univariate analysis revealed that HCPs that have been informed by vaccination campaigns or had higher knowledge scores, were more likely to support mandatory occupational vaccination (OR 1.7, 95% CI: 1.1–2.7, p 0.038 and OR 1.7, 95% CI: 1.02– 2.7. p 0.044, respectively). In conclusion, most medical and nursing trainees in this study supported mandatory vaccination for HCPs. Focusing on continuing professional education on vaccines is important to positively determine HCPs' attitudes towards occupational vaccination and increase their vaccination uptake rates. [ABSTRACT FROM AUTHOR]

Background: The uncontrolled spread of the COVID-19 disease in India’s second wave post-February 2021, put to task the public health system across the nation. This, in turn, exhausted our health-care workforce both physically and mentally. To establish the prevalence of psychological symptoms and guide the action plan in place, the present study was undertaken among COVID-19 health-care workers(HCWs) at tertiary-care public hospital, Mumbai. Materials and Methods: The present cross-sectional study was conducted after due institutional ethical clearance among 212 HCWs engaged in the management of COVID-19 patients during the second wave. A Google Form® was created in English, Hindi, and Marathi languages for self-administration. Data were collected under three domains; informed consent, sociodemographic and workplace-related details, and DASS-21 Questionnaire scores. This was further subjected to statistical analysis using SPSS® software. Results: This study included 90 (42.5%) doctors, 91 (42.9%) nurses, and 31 (14.6%) other categories of HCWs. Depression was prevalent in 44.3% HCWs, while 43.9% and 36.3% of the HCWs were affected by anxiety and stress, respectively. Younger population, female gender, and doctors were associated (P < 0.05) with an increased likelihood of either of the prevalent psychological symptoms. Other significantly associated (P < 0.05) factors included COVID-19 vaccination status of the HCW, history of COVID-19 infection, infected colleague at workplace, workplace housing facilities and commute, number of dependents on the HCW and hospitalized family member or close friend. Conclusion: The COVID‑19 HCWs were found to be under considerable psychological strain. In essence, screening, identifying, and effectively targeting HCWs for psychological interventions is needed to protect and strengthen the health-care system. [ABSTRACT FROM AUTHOR]

With the advent of the novel coronavirus (COVID-19) pandemic, health-care workers have been faced with an inordinately high level of trauma as frontline providers. The Medical College of Wisconsin (MCW) partnered with affiliate hospitals and community partners to mobilize a matrix of available support and interventions to deliver psychological services to reach all levels of health-care providers in timely, accessible formats. While virtual peer support groups were the most utilized resource among the support group options, other opportunities also provided unique benefits to learners whose education had been disrupted by the pandemic. Mental health must be prioritized for health-care workers in the event of future public health crises. Lessons learned from this pandemic indicate that it is critical to involve learners early on in the process in order to meet their educational needs and to increase access to evidence-based care. [ABSTRACT FROM AUTHOR]

Background: To plan suitable policy against COVID-19 pandemic, it is important that the nurses have updated knowledge related to prevention, diagnosis, treatment, and management of COVID-19 and have an optimistic attitude and good practices in managing the patients during the pandemic crisis. Thus, we conducted a study on the knowledge, attitude, and practices (KAP) related to COVID-19 among Indian nursing professionals. Methodology: A cross-sectional study was conducted from April 22 to May 22, 2020 using a pretested 37-item-self-reported e-questionnaire among nursing professionals above 18 years of age, working in health-care setting across 25 states. The questionnaire consisted of four sections: demographic details, knowledge (26 items), attitude (6 items), and practice (5-itmes). KAP questionnaire was shared through e-mail, SMS, and WhatsApp groups. Results: A total of 1182 participants responded to the online survey with 94% completion rate. The study analyzed the data for 1110 nurses with a mean age of 30 ± 6.7 years and 68% being females. The mean KAP score was 16.82 ± 3.3, 9.77 ± 2.03, and 18.37 ± 3.29, respectively. Knowledge was significantly correlated with attitude (r = 0.1316) and practice (r = 0.1526). Practice and attitude were also found to be positively correlated (r = 0.4398). Good knowledge related to COVID-19 was significantly affected by age, gender, location, and type of facility (

The coronaviruses are single-stranded RNA viruses, one of which is responsible for the current outbreak of coronavirus disease-19. COVID-19 has affected health-care workers including laboratory personnel worldwide in an alarming and unprecedented manner. In India too, the huge number of infected health-care staff has further weighed down our already over-burdened health-care system. While their protection is of paramount importance, it is also essential that these personnel adhere to the specific bio-safety practices to minimize their exposure to this disease. In this article, our objective is to provide guidelines for laboratories while working with COVID-19 samples to reduce the human and economic burden in the current pandemic. A risk assessment of all policies must be done and standard operating procedures on all 'Safe Laboratory Practices and Procedures' must be readily available for the staff. Dividing the laboratory functions into three broad phases, namely pre-examination, examination and post-examination, the precautions outlined for each stage must be followed stringently with the frequency defined as per the workload of the laboratory. The safety measures must cover all the laboratory processes including sample disposal. Decontamination too plays a major role and must be performed as per the standard national and international guidelines. Hence, following special precautions in the laboratory while working through the COVID-19 pandemic will not only minimize the risk of infection to the laboratory staff and but also help reduce the mortality and morbidity associated with this disease.

Introduction: The COVID-19 outbreak has created unpredictable stress physically and mentally in all sections of population. There is no exception for health-care workers being in frontline during this crisis period. Due to the virus rapid transmission and the pattern of clinical presentation, uncertainty, is created in the form of health emergency all over. There is a need to address mental health issues during this pandemic outbreak of COVID-19 in those who are in frontline. Subjects and Methods: It is an observational cross-sectional study performed in social health-care workers (accredited social health activist [ASHA]) to know the psychological disturbances during COVID-19 outbreak. This study has been done in primary health centers located in and around Karimnagar City, Telangana. The scale used to perform this study is Depression, Anxiety, and Stress Scale of 21 questions. Results: Out of 181 ASHA workers interviewed, majority of ASHA workers were at normal emotional states of depression (81.8%) and stress (91.2%), but about half (91, 50.3%) of them had moderate level of anxiety and 16 (9%) had severe anxiety level. Only 12 (6.6%) and 4 (2.2%) had moderate depression level, and stress level, respectively. Out of 91 ASHA workers who had moderate level of anxiety, only one had moderate level of depression and out of 16 who had severe level of anxiety, all of them had normal level of depression and stress. Conclusion: Frontline health care workers experience psychological disturbances during pandemics like COVID-19 to a certain degree. Administrators should be aware that the mental health support of health care workers is an important part of the COVID- 19 response. Educational interventions, to ensure understanding and use of infectious control measures. Psychological support, like counselling services and development of support systems among colleagues.

Introduction: The COVID-19 pandemic has infected millions with a high mortality rate. Thousands of frontline health-care workers (HCWs) have been infected with SARS-CoV-2. Protecting HCWs is important. Aim: We sought to develop an innovative barrier to prevent COVID-19 virus transmission while performing bronchoscopy and endotracheal intubation. Settings and Design: We have designed and developed a barrier called bronchoscopy safety box (BSB). Materials and Methods: BSB is made up of acrylic and polyvinyl chloride (PVC) sheets. We have designed two prototypes of BSBs, namely Prototype 1 and Prototype 2. We performed bronchoscopy procedures and intubation procedures with BSBs. Advantages and limitations were noted and analyzed. Results: The advantages of BSB include the additional presence of the bronchoscopy aperture and an assistant aperture. All the apertures are covered by PVC sheets or hand gloves, thus minimizing risk of aerosol coming out of these apertures. The presence of PVC sheet fixed at the patient's end restricts the amount of aerosol coming out while the presence of a negative suction port is important in reducing the aerosol content inside the BSB. The BSB is a multi-utility box which can be used by clinicians for endotracheal intubation or bronchoscopy as the need arises. The BSB can be effectively used for the treatment of suspected as well as confirmed COVID-19 patients. Conclusions: We conclude that the BSB is a reusable, multipurpose aerosol safety barrier which can be utilized for multiple procedures of bronchoscopy as well as intubation to help protect HCWs against COVID-19.

Introduction: The objectives of the present survey are to estimate the seroprevalence and sero-conversion of SARS CoV2 among the health-care workers (HCWs) in health-care establishments and to analyze the various characteristics (risk factors) associated with SARS CoV-2 infection with the overall aim to generate evidence for planning and preventive measures in the Armed Forces. Methodology: Eight hospitals have been chosen based on the hospital admission rates of COVID-19 patients and local epidemiological situation of COVID-19 prevalent in the region. A total of 3800 HCWs would be enrolled in the cross-sectional survey. For longitudinal study, 1000 personnel would be followed up at 3 and 6 months. Population proportion to size would be used for enrolment at various stages. A validation study is inbuilt in the study. From each site, a nodal officer would be designated for facilitating. Real-time data monitoring and quality checks would be done. Sero-surveillance would be done using ELISA-based immunoglobulin antibody. Results: The present study would provide the estimates of seroprevalence and rate of seroconversion among the HCWs. The factors associated with seroprevalence and seroconversion would be delineated. Discussion: The protocol lays down the plan of action to implement the multi-centric serosurveillance project. The survey will provide an assessment of seroprevalence of COVID-19 infection among the health-care workers of hospitals of central ministry from the various parts of the country and its trend over a period of time.

Aims: Glove fitting is an essential factor that affects health-care workers' performance. This study aimed to evaluate health-care workers' opinion about medical gloves fitting. Materials and Methods: This study was conducted on 525 health-care workers in the hospitals of five cities in Iran (response rate was 95.45%). The Medical Gloves Assessment Tool was used for collecting the required data. The data were analyzed using the SPSS 22 software. Results: The results showed that the health-care workers were not satisfied with the size of medical gloves in different areas of fingertips, between fingers, and the wrist. Accordingly, more than 70% of the participants were

Introduction: Health-care workers (HCWs) need to have adequate knowledge, the right attitude, and should practice disinfection procedures diligently. The study aimed to assess the knowledge, attitude, and practice (KAP) of HCWs and the role of training in KAP of HCWs. Materials and Methods: The study population consists of all HCWs undergoing training for disinfection. A structured training module for paramedicals, i.e., module for paramedics in disinfection (MoPDis), was designed. The knowledge, attitude, and practice were assessed before and after the training. Results: A total of 183 male HCWs participated in the study. The mean age of the participants was 31.33 ± 6.8 years and ranges from 21 to 49 years. The mean years of experience were 11.5 ± 7.1 years. The mean pretraining and posttraining scores were 8.1 ± 2.4 and 10 ± 1.9, respectively. The score increases from 53% pretraining score to 66.6% posttraining score. Age, experience, and specialty did not have any association with the gain in knowledge. Conclusions: The training program had significantly increased the KAP levels of the HCWs and hence may improve disinfection practices in hospitals, thus preventing the spread of infection.

Background: The utility of interferon-gamma release assays (IGRAs) for latent tuberculosis infection (LTBI) screening among health-care workers (HCWs) in low- and middle-income countries (LMICs) remains unclear. Methods: This was a prospective cohort study among HCW trainees undergoing annual LTBI screening via tuberculin skin test (TST) and QuantiFERON® TB Gold Test-in-tube (QFT-GIT) in Pune, India. TST induration ≥ 10 mm and QFT-GIT ≥ 0.35 IU/ml were considered positive. Test concordance was evaluated at entry among the entire cohort and at 1 year among baseline TST-negative participants with follow-up testing. Overall test agreement was evaluated at both timepoints using the kappa statistic: fair (k < 0.40), good (0.41 ≥ k ≤0.60), or strong (k > 0.60). Results: Of 200 participants, prevalent LTBI was detected in 42 (21%) via TST and 45 (23%) via QFT-GIT; QFT-GIT was positive in 27/42 (64%) TST-positive and 18/158 (11%) TST-negative trainees. Annual TST conversion was 28% (40/142) and included 11 trainees with baseline TST-/IGRA+; QFT-GIT was positive in 17/40 (43%) TST-positive and 5/102 (5%) TST-negative trainees. Overall test concordance was 84% (k = 0.52; 95% confidence interval [CI]: 0.38–0.66) and 80% (k = 0.44; 95% CI: 0.29–0.59) at baseline and 12 months, respectively. Conclusions: We observed good overall agreement between TST and QFT-GIT, and QFT-GIT detected additional LTBI cases among TST-negative trainees with possible early detection of LTBI conversion. Overall, our results support the use of IGRA for annual LTBI screening among HCWs in a high burden LMIC setting.

Objective: Healthcare-associated infection (HCAI) has become a potential peril in intensive care unit (ICU), operation theater (OT) as well as postoperative wards. Those infections are often caused by multidrug-resistant (MDR) organisms. Health-care workers (HCWs), who are taking care of sick patients, often colonize and transmit microorganism from infected to noninfected patient causing HCAIs. The purpose of this study was for surveillance of potential pathogens as hand carriage among HCWs. Materials and Methods: Hand swabs were collected from palmar surface and interdigital space of predominant hands of HCWs working in ICU, OT, and postoperative wards. Antimicrobial susceptibility profile of the potential pathogen isolates including Staphylococcus spp. was also determined for several antibiotics. Methicillin resistance was detected using cefoxitin 30 μg disc. Results: In our study, among 199 HCWs, there was a high carriage rate of Staphylococcus spp. in hands 98 (49.2%) (male: female 1:1). Among Staphylococcus spp., Coagulase-negative staphylococci (CoNS) was around 69 (34.6%) and Staphylococcus aureus was around 29 (14.5%). (including methicillin-resistant S. aureus [MRSA] and methicillin-resistant coagulase-negative Staphylococci [MR-CoNS]). Nearly 65% in MRSA and 75% MR-CoNS were macrolide resistant also. The MRSA hand carriage was significantly high in HCWs having

Context: COVID-19 outbreak has had a huge impact on health-care facilities, and challenges of health-care providers would compromise their physical and mental well-being during this epidemic. Aims: This study aimed to find out stress, anxiety, insomnia, and depression among the health-care workers during COVID-19 outbreak. Settings and Design: This was a 3-month, cross-sectional, observational, single-center study of health-care workers of designated COVID-19 hospital. Subjects and Methods: Study objectives were explained to health-care workers, and written consent was obtained. Participants were approached in their department as per their convenience and requested to fill the pro forma. Depression, Anxiety, and Stress Scale-21 and Insomnia Severity Index were used to detect psychological issues in the form of stress, anxiety, insomnia, and depression. Statistical Analysis: Descriptive statistics and Chi-square test were used for analysis of variables in the study. Results: Overall 27.41% and 29.18% of the health-care workers reported stress and anxiety symptoms, respectively, while 18.78% reported clinically significant insomnia and depression. Among them, being female, married, elderly, presence of medical illness, frontline workers, frequently watching COVID news, and excessive fear of COVID emerged as statistically significant variables associated with stress, anxiety, insomnia, and depression. Conclusions: Health-care workers experienced many mental health issues while performing duties during COVID-19 outbreak. Such issues are alarming and need to be addressed with appropriate health-care policy.

Background and Objectives: The World Health Organization estimates that 2 million health-care workers (HCWs) are at risk of occupational exposure to hepatitis B virus (HBV), with the majority (90%) of such infections arising in sub-Saharan Africa. This study aimed to determine HBV knowledge and vaccination uptake among HCWs. Materials and Method: This was a cross sectional analytical study conducted among 392 HCWs from two major health institutions in Calabar i.e. the University of Calabar Teaching Hospital (UCTH) and the General Hospital Calabar (GHC), Cross river State. Multi-staged sampling method comprising of two stages was used to recruit participants into the study. The study population comprised of doctors, nurses, laboratory scientists/technologist, and other categories of HCWs such as pharmacists, ward orderlies, and mortuary attendants. A semi-structured self-administered questionnaire was used to obtain data on the socio-demographic characteristics of HCWs, the knowledge of HCWs regarding HBV and vaccine. The analysis of data was done using the Statistical Package for Social Sciences version 20. Study Design: This was a cross-sectional, study of HCWs in Calabar. Sampling Method: Multi-staged sampling method was used to select participants from two major health institutions in Calabar, i.e., the University of Calabar Teaching Hospital (UCTH) and the General Hospital Calabar (GHC). Thereafter, through balloting, simple random sampling technique was used to recruit the participants. Study Population: Three hundred and ninety-two HCWs were recruited from UCTH and GHC under the following categories: doctors, nurses, laboratory scientists/technologist, and other categories of HCWs such as pharmacists, ward orderlies, and mortuary attendants. Data Management: A semi-structured self-administered questionnaire was used to obtain data on the socio-demographic characteristics of HCWs, the knowledge of HCWs regarding HBV and vaccine. The analysis of data was done using the Statistical Package for Social Sciences version 20. Results: Overall, 67.9% of the respondents were found to have adequate knowledge of HBV vaccination and infection. Less than half (43.4%) of HCWs admitted receiving three doses (i.e., full coverage) of the vaccine. Difficulty in accessing the vaccine (48, 23.4%) was identified as the major reason given for suboptimal vaccination. Conclusion: The knowledge of HBV infection and vaccination is quite modest among HCWs in Calabar. Despite this observation, the vaccination status among HCWs is unsatisfactory. The implication of the findings of our study for health policy and practice is to prevent further occupational exposure of HCWs to HBV infection through mandatory vaccination.

Introduction: Health-care professionals of all cadres are the utmost valuable resource during pandemics and maintaining an adequate workforce of health professionals during an emergency is critical to ensure uninterrupted provision of services that are essential for patient care. Aim: Examine readiness of health-care workers (HCWs) to provide service in the course of the COVID-19 pandemic and the factors influencing their decision. Methodology: This was a cross-sectional study of Nigerian health sector workers HCWs in the course of the COVID-19 pandemic. The respondents were recruited using HCWs focus groups on WhatsApp and Telegram social medial platforms. Results: A total of 481 HCWs were recruited, consisting of 288 females and 193 males (M: F, 1:1.5), mean age = 30.71 ± 5.9 years. Most HCWs (97.3%) showed a willingness to provide service during the pandemic; 73.3% of the HCWs were willing to work if supplied with adequate personal protective equipment (PPE) although 5.8% were less willing to work without proper PPE. Factors supporting unwillingness to work during the pandemic were: concerns about the lack of adequate testing for COVID-19 (48.9%), lack of disability insurance plan (40.1%), fear of being infected (47.2%), and the risk of infection in family members (24.5%). The readiness to work was related to the job cadres of the HCWs (P = 0.001), while the provision of additional incentives and a change in the working conditions would influence the readiness of the HCWs to work. Conclusion: HCWs were ready to provide service in the course of the COVID-19 pandemic if there was a safe work environment, although the availability of PPE and other personal factors would influence their willingness to work, while improvement in working conditions would motivate HCWs to work.

Abstract Background and Aim In the present coronavirus disease‐19 (COVID‐19) era, health‐care workers (HCWs) warrant special attention because of their higher risk and potential to transmit the disease. Gastroenterology services include emergency and critical care along with the endoscopy procedures, which have aerosol‐generating potential. This study was aimed at auditing the COVID‐19 impact on HCWs working in the Gastroenterology department of our hospital. Methods The COVID‐19 status of 117 HCWs was collected using either polymerase chain reaction (PCR) or Immunoglobulin G (IgG) seroassay. COVID‐19 positivity was correlated with demographic characteristics, job profile, area of work, and medical history. Results Thirty‐eight HCWs (32.48%) showed evidence of COVID‐19 using PCR (23.93%) or only IgG assay (8.55%). Endoscopy technicians (68.75%) exhibited significantly higher (P = 0.003) COVID‐19 incidence compared to doctors (20.69%). Those working in the critical care units exhibited a trend toward higher COVID‐19 incidence (42.86%). None of the six HCWs who received adequate hydroxychloroquine prophylaxis developed evidence of COVID‐19. All the HCWs with COVID‐19 disease recovered. However, there was a considerable loss of “man‐days.” Conclusions In our setting, we observed a high COVID‐19 risk for HCWs working in the Gastroenterology department, with the highest risk among the endoscopy technicians. A more stringent triaging and pretesting of patients, as well as HCWs, might decrease the risk of COVID‐19. Further multicenter studies are needed to evaluate the risk and related parameters.

Background: Hepatitis B virus infection is a major public health problem in India, and all health-care workers (HCWs) need to be immunized to prevent occupational exposure. This study was done to find the hepatitis B vaccination rates, immune response, and predictors of titer 35 (odds ratio [OR]: 3.85, 95% confidence interval [CI]: 2.12–6.99]), last dose >10 years (OR: 5.01, 95% CI: 2.94–8.55), no boosters or revaccination (OR: 2.94, 95% CI: 1.42–6.07), and body mass index (BMI) >25 (OR: 2.51, 95% CI: 1.44–3.39) were associated with nonprotective titer. Conclusion: More than a quarter of the study population who were at high risk of exposure were unvaccinated or partially vaccinated. Even after taking the full course of hepatitis B vaccine, 12.3% had titer 35 years, last dose taken >10 years ago, no boosters/revaccination, and BMI ≥25.

Background: Health-care workers (HCWs) in COVID-19 pandemic have faced the major impact in providing care to infected persons. Most of the studies on mental health impact among HCW have not incorporated paramedical staff. Furthermore, they have not compared psychological morbidity among HCW on the basis of high COVID exposure (HCE) and low COVID exposure (LCE). To address the above gap, this study aimed at evaluating mental health impact among HCW and its associated risk factors. Materials and Methods: Consecutive 200 HCWs each in the HCE and LCE groups (between the age group of 18 and 60 years) were enrolled from two tertiary care hospitals providing COVID-19 treatment from August 1, 2020. After collection of sociodemographic data, participants were administered Impact of Event Scale-Revised, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 Scale. Results: The difference in stress, depression, and anxiety symptom scores between the HCE and LCE groups was not statistically significant. Multiple regression analysis revealed that female sex was associated with higher scores in all the three domains. The effect remained significant even after adjusting for effect of other risk factors. Conclusion: HCE or LCE was associated with similar impact in terms of stress, depression, and anxiety among HCWs. Female HCWs had a higher prevalence of stress, depression, and anxiety. Doctors, nurses, and paramedics had a similar prevalence of stress, depression, and anxiety when odds were adjusted.

Aim: We aimed to assess the consequences of dealing with patients during the COVID-19 pandemic lockdown period on the mental state of health-care workers. Materials and Methods: An anonymous online survey was conducted with 353 participants using a self-made questionnaire comparing the prevalence of low mood, apprehension, tension, and coping skills used and the Depression, Anxiety, and Stress Scale-21. The data were analyzed to compare the mental health of male and female doctors. To identify predictors of mental health outcomes, a multivariate logistic regression was carried out. Results: Both men and women were almost equally affected in terms of developing features of low mood, with easy physical and mental exhaustion. While the feeling of being isolated and irritability was slightly higher in females, both sexes were equally affected by the media. It was observed that the prevalence of smoking (tobacco/marijuana, etc.) had increased in both with slightly higher percentage in males as compared to females while there was a considerable increase in caffeine and alcohol consumption in males. The sleeping pattern and appetite were equally affected in both sexes. The sexual drive was also altered in both male and female residents, but the change was considerably more in males. The significant predictors of anxiety were age, depression, mental exhaustion, burden of increased quantity of work, and feeling of having no choice but to work due to obligation. Conclusion: Both male and female doctors working during the COVID-19 pandemic developed anxiety and depression. While substance use and altered sexual drive were more in males, exhaustion and stress were more in females.

Objective: The objective of the study is to determine the oral health knowledge, attitude, and practices among the health-care workers (HCWs). Materials and Methods: The present questionnaire-based survey among 473 HCW comprising of doctors, nurses, pharmacists, technicians, and interns was carried out to know the oral health knowledge, attitude, and practices among different HCW. Responses were recorded and data were assessed through descriptive statistics and by applying analysis of variance, Chi-square, and z-tests. Results: Maximum of doctors (98.7%), nurses (80.4%), interns (73.3%), pharmacists (70.8%), and technicians (67.1%) responded correctly that oral health is related to systemic health followed by treating a decayed tooth is equally important as treating other body ailments. Doctors revealed higher mean knowledge scores in comparison with other HCW. A significant difference is noted with regard to frequency of dental visit (P = 0.000), reason behind dental visit (P = 0.001), and barrier for not visiting the dentist (P = 0.013) among males and females. Similarly, a significant difference is noted with regard to frequency of dental visit (P = 0.001), dentist familiarizing about the treatment (P = 0.001), and his concern about the patients (P = 0.001) among between different HCW. Conclusion: From the results of the present study, a variation in oral health knowledge was observed among different HCW. All the participants showed a positive attitude toward professional dental care.