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[PMID]:27776589
[Au] Autor:Daftary A; Padayatchi N
[Ad] Endereço:McGill International TB Centre, McGill University, Montreal, Canada; Centre for the AIDS Programme of Research in South Africa (CAPRISA), SA Medical Research Council Extramural TB Pathogenesis Research Unit, University of KwaZulu-Natal, Durban, South Africa.
[Ti] Título:Provider perspectives on drug-resistant tuberculosis and human immunodeficiency virus care in South Africa: a qualitative case study.
[So] Source:Int J Tuberc Lung Dis;20(11):1483-1488, 2016 Nov.
[Is] ISSN:1815-7920
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To examine influences on health care workers' (HCWs') capacity to deliver health care for multi- and/or extensively drug-resistant tuberculosis (MDR/XDR-TB) and human immunodeficiency virus (HIV) infection in South Africa. DESIGN: Qualitative data were collected via group and individual interviews with a purposive sample of 17 HCWs at a centralised, tertiary TB facility and analysed using grounded theory. RESULTS: Four themes were identified: 1) personal infection control practices among HCWs may be weakened by a workplace culture comprising low motivation, disparate risk perceptions and practices across workforce hierarchies, physical discomfort, and problems managing patients with treatment-induced hearing loss. 2) Patient-provider interactions are likely stronger among nurses, and in HIV vs. MDR/XDR-TB service delivery, due to greater attention to patient empowerment and support. Stigma associated with MDR/XDR-TB, considered worse than HIV, may be perpetuated within non-specialised facilities less familiar with MDR/XDR-TB. 3) HCWs who struggle with the daily tedium of MDR/XDR-TB treatment supervision are becoming increasingly supportive of treatment literacy and self-administration. 4) Effective integration of HIV and MDR/XDR-TB services may be impeded by administrative restrictions, workplace norms and provider mindsets. CONCLUSION: Comprehensive, decentralised management of MDR/XDR-TB and HIV coinfection requires the creation of patient-provider trust and treatment literacy in MDR/XDR-TB programmes, and defying workplace norms that could provoke nosocomial TB exposure and fragmented service provision.
[Mh] Termos MeSH primário: Assistência à Saúde/organização & administração
Tuberculose Extensivamente Resistente a Medicamentos/epidemiologia
Infecções por HIV/epidemiologia
[Mh] Termos MeSH secundário: Antirretrovirais/uso terapêutico
Antituberculosos/uso terapêutico
Gerenciamento Clínico
Tuberculose Extensivamente Resistente a Medicamentos/tratamento farmacológico
Tuberculose Extensivamente Resistente a Medicamentos/prevenção & controle
Infecções por HIV/tratamento farmacológico
Infecções por HIV/prevenção & controle
Alfabetização em Saúde
Pessoal de Saúde
Seres Humanos
Transmissão de Doença Infecciosa do Paciente para o Profissional
Relações Profissional-Paciente
Pesquisa Qualitativa
Fatores de Risco
África do Sul/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Retroviral Agents); 0 (Antitubercular Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:28449921
[Au] Autor:Nwaiwu CA; Egro FM; Smith S; Harper JD; Spiess AM
[Ad] Endereço:University of Pittsburgh School of Medicine, Pittsburgh, PA.
[Ti] Título:Seroconversion rate among health care workers exposed to HIV-contaminated body fluids: The University of Pittsburgh 13-year experience.
[So] Source:Am J Infect Control;45(8):896-900, 2017 Aug 01.
[Is] ISSN:1527-3296
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The studies enumerating the risk of HIV transmission to health care workers (HCWs) as 0.3% after percutaneous exposure to HIV-positive blood, and 0.09% after a mucous membrane exposure, are weakened by dated literature. Our study aims to demonstrate the seroconversion rate after exposure to HIV-contaminated body fluids in a major academic center in the United States. METHODS: A prospectively maintained database of reported occupational injuries occurring between 2002 and 2015 at an academic medical center was analyzed. Data collected included the type of injury, injured body part, type of fluid, contamination of sharps, involvement of resident physicians, use of postexposure prophylaxis, and patients' HIV, hepatitis B virus, and hepatitis C virus status. RESULTS: A total of 266 cases were included in the study. Most exposures were caused by percutaneous injuries (52.6%), followed by 43.2% mucocutaneous injuries. Of the injuries, 52.6% were to the hand and 33.5% to the face and neck. Blood exposure accounted for 64.3% of all cases. Of the patients, 21.1% received postexposure prophylaxis. None of the HCWs exposed to HIV-contaminated body fluids seroconverted (seroconversion rate, 0%). CONCLUSIONS: HIV does not seem to be as easily transmitted by needlestick, laceration, or splash injuries as previously surmised. Further large-scale and multicenter studies are needed for a more accurate estimation of the risk of transmission of HIV in U.S. health care workers.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/administração & dosagem
Líquidos Corporais/virologia
Infecções por HIV/transmissão
Soropositividade para HIV/epidemiologia
Profilaxia Pós-Exposição/métodos
[Mh] Termos MeSH secundário: Fármacos Anti-HIV/uso terapêutico
Pessoal de Saúde
Hospitais Universitários
Seres Humanos
Transmissão de Doença Infecciosa do Paciente para o Profissional
Exposição Ocupacional
Pennsylvania
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:29182228
[Au] Autor:McGuire-Wolfe C; Haiduven D
[Ti] Título:Unexpected Transmission. Standard PPE can't prevent all viruses from spreading.
[So] Source:JEMS;41(9):20-3, 2016 09.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Pessoal Técnico de Saúde
Controle de Infecções/métodos
Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle
Exposição Ocupacional/prevenção & controle
Equipamento de Proteção Individual
Viroses/prevenção & controle
Viroses/transmissão
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:29211793
[Au] Autor:Flick RJ; Munthali A; Simon K; Hosseinipour M; Kim MH; Mlauzi L; Kazembe PN; Ahmed S
[Ad] Endereço:Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.
[Ti] Título:Assessing infection control practices to protect health care workers and patients in Malawi from nosocomial transmission of Mycobacterium tuberculosis.
[So] Source:PLoS One;12(12):e0189140, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Transmission of Mycobacterium tuberculosis (TB) in health settings threatens health care workers and people living with HIV in sub-Saharan Africa. Nosocomial transmission is reduced with implementation of infection control (IC) guidelines. The objective of this study is to describe implementation of TB IC measures in Malawi. We conducted a cross-sectional study utilizing anonymous health worker questionnaires, semi-structured interviews with facility managers, and direct observations at 17 facilities in central Malawi. Of 592 health care workers surveyed, 34% reported that all patients entering the facility were screened for cough and only 8% correctly named the four most common signs and symptoms of TB in adults. Of 33 managers interviewed, 7 (21%) and 1 (3%) provided the correct TB screening questions for use in adults and children, respectively. Of 592 health workers, only 2.4% had been screened for TB in the previous year. Most (90%) reported knowing their HIV status, 53% were tested at their facility of employment, and half reported they would feel comfortable receiving ART or TB treatment at their facility of employment. We conclude that screening is infrequently conducted and knowledge gaps may undercut its effectiveness. Further, health care workers do not routinely access TB and HIV diagnostic and treatment services at their facility of employment.
[Mh] Termos MeSH primário: Infecção Hospitalar/transmissão
Pessoal de Saúde
Controle de Infecções/métodos
Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle
Tuberculose/prevenção & controle
[Mh] Termos MeSH secundário: Acesso aos Serviços de Saúde
Seres Humanos
Controle de Infecções/normas
Malaui
Mycobacterium tuberculosis/isolamento & purificação
Tuberculose/microbiologia
Tuberculose/transmissão
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171229
[Lr] Data última revisão:
171229
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189140


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[PMID]:28865865
[Au] Autor:Brewer JD; Elston DM; Vidimos AT; Rizza SA; Miller SJ
[Ad] Endereço:Division of Dermatologic Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address: brewer.jerry@mayo.edu.
[Ti] Título:Managing sharps injuries and other occupational exposures to HIV, HBV, and HCV in the dermatology office.
[So] Source:J Am Acad Dermatol;77(5):946-951.e6, 2017 Nov.
[Is] ISSN:1097-6787
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Dermatologists and their staff are at risk for needlestick injuries and exposures to body fluids. Despite the availability of treatment to reduce the risk of blood-borne infection, many exposures go unreported. This paper identifies current recommendations and the specific details for response to occupational exposures to HIV, hepatitis B virus, and hepatitis C virus in the dermatology office. Issues surrounding each virus are discussed individually, and a summary step-by-step algorithm of how to proceed in the event of an occupational exposure is presented. In addition, a focused Practice Improvement Activity that is based on this paper and provides Maintenance of Certification credit has been developed. To view and participate, visit https://secure.dataharborsolutions.com/abdermorg/.
[Mh] Termos MeSH primário: Patógenos Transmitidos pelo Sangue
Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle
Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle
Exposição Ocupacional/efeitos adversos
Saúde do Trabalhador
[Mh] Termos MeSH secundário: Dermatologia
Infecções por HIV/transmissão
Hepacivirus/isolamento & purificação
Hepatite B/transmissão
Vírus da Hepatite B/isolamento & purificação
Hepatite C/transmissão
Seres Humanos
Masculino
Ferimentos Penetrantes Produzidos por Agulha/epidemiologia
Visita a Consultório Médico
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170904
[St] Status:MEDLINE


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[PMID]:28700843
[Au] Autor:Negredo A; de la Calle-Prieto F; Palencia-Herrejón E; Mora-Rillo M; Astray-Mochales J; Sánchez-Seco MP; Bermejo Lopez E; Menárguez J; Fernández-Cruz A; Sánchez-Artola B; Keough-Delgado E; Ramírez de Arellano E; Lasala F; Milla J; Fraile JL; Ordobás Gavín M; Martinez de la Gándara A; López Perez L; Diaz-Diaz D; López-García MA; Delgado-Jimenez P; Martín-Quirós A; Trigo E; Figueira JC; Manzanares J; Rodriguez-Baena E; Garcia-Comas L; Rodríguez-Fraga O; García-Arenzana N; Fernández-Díaz MV; Cornejo VM; Emmerich P; Schmidt-Chanasit J; Arribas JR; Crimean Congo Hemorrhagic Fever@Madrid Working Group
[Ad] Endereço:From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.
[Ti] Título:Autochthonous Crimean-Congo Hemorrhagic Fever in Spain.
[So] Source:N Engl J Med;377(2):154-161, 2017 07 13.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Crimean-Congo hemorrhagic fever (CCHF) is a widely distributed, viral, tickborne disease. In Europe, cases have been reported only in the southeastern part of the continent. We report two autochthonous cases in Spain. The index patient acquired the disease through a tick bite in the province of Ávila - 300 km away from the province of Cáceres, where viral RNA from ticks was amplified in 2010. The second patient was a nurse who became infected while caring for the index patient. Both were infected with the African 3 lineage of this virus. (Funded by Red de Investigación Cooperativa en Enfermedades Tropicales [RICET] and Efficient Response to Highly Dangerous and Emerging Pathogens at EU [European Union] Level [EMERGE].).
[Mh] Termos MeSH primário: Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação
Febre Hemorrágica da Crimeia
[Mh] Termos MeSH secundário: Colo/patologia
Busca de Comunicante
Evolução Fatal
Feminino
Vírus da Febre Hemorrágica da Crimeia-Congo/classificação
Vírus da Febre Hemorrágica da Crimeia-Congo/genética
Febre Hemorrágica da Crimeia/patologia
Febre Hemorrágica da Crimeia/transmissão
Febre Hemorrágica da Crimeia/virologia
Seres Humanos
Transmissão de Doença Infecciosa do Paciente para o Profissional
Fígado/patologia
Masculino
Meia-Idade
Necrose
Reação em Cadeia da Polimerase
Espanha
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1615162


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[PMID]:28445222
[Au] Autor:Arora G; Hoffman RM
[Ad] Endereço:G. Arora is assistant clinical professor, Department of Pediatrics, Division of Palliative Medicine, Children's Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, California. R.M. Hoffman is associate clinical professor, Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California.
[Ti] Título:Development of an HIV Postexposure Prophylaxis (PEP) Protocol for Trainees Engaging in Academic Global Health Experiences.
[So] Source:Acad Med;92(11):1574-1577, 2017 Nov.
[Is] ISSN:1938-808X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PROBLEM: Global health (GH) education programs have become increasingly common in U.S. medical schools and graduate medical education programs, with growing numbers of medical students, residents, and fellows participating in clinical experiences in settings with high HIV prevalence and limited resources. However, there are no guidelines for provision of HIV postexposure prophylaxis (PEP) to trainees engaging in these academic GH experiences. APPROACH: Faculty of the Global Health Education Programs (GHEP) at the David Geffen School of Medicine at UCLA and GH partner institutions recognized the need for PEP access for trainees engaged in GH experiences. In 2013-2014, key UCLA faculty collaborated in the development of the UCLA GHEP PEP Protocol, which includes provision of PEP medications to trainees prior to departure, an on-call infectious disease/HIV specialist to advise trainees who have exposures, and a system for following up with exposed trainees while on the GH rotation and after their return. OUTCOMES: Between February 2014 and September 2016, 112 medical students and 110 residents received education on the PEP protocol during their predeparture orientation. The protocol was used for 28 exposures (27 occupational, 1 nonoccupational), with PEP recommended in 3 occupational cases (all needlesticks) and the single nonoccupational case. There were no reported HIV seroconversions. NEXT STEPS: The authors plan to formally evaluate the PEP protocol, conduct a qualitative assessment with trainees and both UCLA and GH partner faculty, and discuss best practices with institutions across the United States and with GH partners.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/uso terapêutico
Protocolos Clínicos
Infecções por HIV/prevenção & controle
Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle
Ferimentos Penetrantes Produzidos por Agulha/tratamento farmacológico
Exposição Ocupacional
Profilaxia Pós-Exposição/organização & administração
[Mh] Termos MeSH secundário: Assistência ao Convalescente
Educação de Pós-Graduação em Medicina
Educação de Graduação em Medicina
Saúde Global
Seres Humanos
Internato e Residência
Corpo Clínico Hospitalar
Profilaxia Pós-Exposição/métodos
Estudantes de Medicina
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1097/ACM.0000000000001684


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[PMID]:28397938
[Au] Autor:Al-Sehaibany FS
[Ad] Endereço:Division of Pediatric Dentistry, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail. falsehaibany@ksu.edu.sa.
[Ti] Título:Middle East respiratory syndrome in children. Dental considerations.
[So] Source:Saudi Med J;38(4):339-343, 2017 Apr.
[Is] ISSN:0379-5284
[Cp] País de publicação:Saudi Arabia
[La] Idioma:eng
[Ab] Resumo:As of January 2016, 1,633 laboratory-confirmed cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection and 587 MERS-related deaths have been reported by the World Health Organization globally. Middle East Respiratory Syndrome Coronavirus  may occur sporadically in communities or may be transmitted within families or hospitals. The number of confirmed MERS-CoV cases among healthcare workers has been increasing. Middle East Respiratory Syndrome Coronavirus may also spread through aerosols generated during various dental treatments, resulting in transmission between patients and dentists. As MERS-CoV cases have also been reported among children, pediatric dentists are at risk of MERS-CoV infection. This review discusses MERS-CoV infection in children and healthcare workers, especially pediatric dentists, and considerations pertaining to pediatric dentistry. Although no cases of MERS-CoV transmission between a patient and a dentist have yet been reported, the risk of MERS-CoV transmission from an infected patient may be high due to the unique work environment of dentists (aerosol generation).
[Mh] Termos MeSH primário: Infecções por Coronavirus/prevenção & controle
Infecções por Coronavirus/transmissão
Infecção Hospitalar/prevenção & controle
Infecção Hospitalar/transmissão
Assistência Odontológica para Crianças/efeitos adversos
Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle
[Mh] Termos MeSH secundário: Aerossóis
Criança
Odontólogos
Hospitais
Seres Humanos
Dispositivos de Proteção Respiratória/utilização
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Aerosols)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170412
[St] Status:MEDLINE
[do] DOI:10.15537/smj.2017.4.15777


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[PMID]:28335802
[Au] Autor:He W; Chen BD; Lv Y; Zhou Z; Xu JP; Lv PX; Zhou XH; Ning FG; Li CH; Wang DP; Zheng J
[Ad] Endereço:Beijing Chest Hospital, Capital Medical University, No. 97 Beimachang, Tongzhou District, Beijing, 101149, China.
[Ti] Título:Use of low-dose computed tomography to assess pulmonary tuberculosis among healthcare workers in a tuberculosis hospital.
[So] Source:Infect Dis Poverty;6(1):68, 2017 Mar 24.
[Is] ISSN:2049-9957
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: According to the World Health Organization, China is one of 22 countries with serious tuberculosis (TB) infections and one of the 27 countries with serious multidrug-resistant TB strains. Despite the decline of tuberculosis in the overall population, healthcare workers (HCWs) are still at a high risk of infection. Compared with high-income countries, the TB prevalence among HCWs is higher in low- and middle-income countries. Low-dose computed tomography (LDCT) is becoming more popular due to its superior sensitivity and lower radiation dose. However, there have been no reports about active pulmonary tuberculosis (PTB) among HCWs as assessed with LDCT. The purposes of this study were to examine PTB statuses in HCWs in hospitals specializing in TB treatment and explore the significance of the application of LDCT to these workers. METHODS: This study retrospectively analysed the physical examination data of healthcare workers in the Beijing Chest Hospital from September 2012 to December 2015. Low-dose lung CT examinations were performed in all cases. The comparisons between active and inactive PTB according to the CT findings were made using the Pearson chi-square test or the Fisher's exact test. Comparisons between the incidences of active PTB in high-risk areas and non-high-risk areas were performed using the Pearson chi-square test. Analyses of active PTB were performed according to different ages, numbers of years on the job, and the risks of the working areas. Active PTB as diagnosed by the LDCT examinations alone was compared with the final comprehensive diagnoses, and the sensitivity and positive predictive value were calculated. RESULTS: A total of 1 012 participants were included in this study. During the 4-year period of medical examinations, active PTB was found in 19 cases, and inactive PTB was found in 109 cases. The prevalence of active PTB in the participants was 1.24%, 0.67%, 0.81%, and 0.53% for years 2012 to 2015. The corresponding incidences of active PTB among the tuberculosis hospital participants were 0.86%, 0.41%, 0.54%, and 0.26%. Most HCWs with active TB (78.9%, 15/19) worked in the high-risk areas of the hospital. There was a significant difference in the incidences of active PTB between the HCWs who worked in the high-risk and non-high-risk areas (odds ratio [OR], 14.415; 95% confidence interval (CI): 4.733 - 43.896). Comparisons of the CT signs between the active and inactive groups via chi-square tests revealed that the tree-in-bud, cavity, fibrous shadow, and calcification signs exhibited significant differences (P = 0.000, 0.021, 0.001, and 0.024, respectively). Tree-in-bud and cavity opacities suggest active pulmonary tuberculosis, whereas fibrous shadow and calcification opacities are the main features of inactive pulmonary tuberculosis. Comparison with the final comprehensive diagnoses revealed that the sensitivity and positive predictive value of the diagnoses of active PTB based on LDCT alone were 100% and 86.4%, respectively. CONCLUSIONS: Healthcare workers in tuberculosis hospitals are a high-risk group for active PTB. Yearly LDCT examinations of such high-risk groups are feasible and necessary.
[Mh] Termos MeSH primário: Doenças Profissionais/diagnóstico por imagem
Tuberculose Pulmonar/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
China
Feminino
Pessoal de Saúde/estatística & dados numéricos
Hospitais de Doenças Crônicas/estatística & dados numéricos
Seres Humanos
Incidência
Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos
Masculino
Meia-Idade
Doenças Profissionais/epidemiologia
Doenças Profissionais/microbiologia
Prevalência
Estudos Retrospectivos
Fatores de Risco
Tomografia Computadorizada por Raios X/economia
Tomografia Computadorizada por Raios X/métodos
Tuberculose Pulmonar/epidemiologia
Tuberculose Pulmonar/transmissão
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170501
[Lr] Data última revisão:
170501
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE
[do] DOI:10.1186/s40249-017-0274-6


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[PMID]:28256382
[Au] Autor:Nathavitharana RR; Bond P; Dramowski A; Kotze K; Lederer P; Oxley I; Peters JA; Rossouw C; van der Westhuizen HM; Willems B; Ting TX; von Delft A; von Delft D; Duarte R; Nardell E; Zumla A
[Ad] Endereço:TB Proof, Cape Town, South Africa; Beth Israel Deaconess Medical Center, Division of Infectious Diseases, Boston, MA 02215, USA. Electronic address: rnathavi@bidmc.harvard.edu.
[Ti] Título:Agents of change: The role of healthcare workers in the prevention of nosocomial and occupational tuberculosis.
[So] Source:Presse Med;46(2 Pt 2):e53-e62, 2017 Mar.
[Is] ISSN:2213-0276
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:Healthcare workers (HCWs) play a central role in global tuberculosis (TB) elimination efforts but their contributions are undermined by occupational TB. HCWs have higher rates of latent and active TB than the general population due to persistent occupational TB exposure, particularly in settings where there is a high prevalence of undiagnosed TB in healthcare facilities and TB infection control (TB-IC) programmes are absent or poorly implemented. Occupational health programmes in high TB burden settings are often weak or non-existent and thus data that record the extent of the increased risk of occupational TB globally are scarce. HCWs represent a limited resource in high TB burden settings and occupational TB can lead to workforce attrition. Stigma plays a role in delayed diagnosis, poor treatment outcomes and impaired well-being in HCWs who develop TB. Ensuring the prioritization and implementation of TB-IC interventions and occupational health programmes, which include robust monitoring and evaluation, is critical to reduce nosocomial TB transmission to patients and HCWs. The provision of preventive therapy for HCWs with latent TB infection (LTBI) can also prevent progression to active TB. Unlike other patient groups, HCWs are in a unique position to serve as agents of change to raise awareness, advocate for necessary resource allocation and implement TB-IC interventions, with appropriate support from dedicated TB-IC officers at the facility and national TB programme level. Students and community health workers (CHWs) must be engaged and involved in these efforts. Nosocomial TB transmission is an urgent public health problem and adopting rights-based approaches can be helpful. However, these efforts cannot succeed without increased political will, supportive legal frameworks and financial investments to support HCWs in efforts to decrease TB transmission.
[Mh] Termos MeSH primário: Defesa do Consumidor
Infecção Hospitalar/prevenção & controle
Pessoal de Saúde
Doenças Profissionais/prevenção & controle
Tuberculose/prevenção & controle
[Mh] Termos MeSH secundário: Infecção Hospitalar/epidemiologia
Infecção Hospitalar/transmissão
Feminino
Pessoal de Saúde/educação
Direitos Humanos
Seres Humanos
Controle de Infecções/legislação & jurisprudência
Controle de Infecções/organização & administração
Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle
Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle
Pessoal de Laboratório
Tuberculose Latente/epidemiologia
Masculino
Doenças Profissionais/epidemiologia
Exposição Ocupacional
Serviços de Saúde do Trabalhador/organização & administração
Retorno ao Trabalho
Fatores de Risco
Estudantes de Medicina
Tuberculose/epidemiologia
Tuberculose/transmissão
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170406
[Lr] Data última revisão:
170406
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170304
[St] Status:MEDLINE



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