Pandeminin ilk döneminde bir üniversite hastanesinde sağlık çalışanlarında COVID-19 kümelerinin epidemiyolojik incelemesi
Öz
Amaç: Çalışmanın amacı bir üniversite hastanesinde COVID-19 tanısı almış sağlık çalışanlarının hastane içinde oluşturdukları kümelerin epidemiyolojik olarak değerlendirilmesi ve bulaş özellikleri açısından incelenmesidir.
Yöntem: Hastanemizde pandeminin başından itibaren COVID-19 olan çalışanların ve temaslılarının telefon görüşmesi ile takibi ve risk değerlendirmesi yapılmaktadır. Bu tanımlayıcı çalışmada, bir üniversite hastanesi’nde 20 Mart 2020 ile 10 Eylül 2020 tarihleri arasında oluşan kümelerdeki epidemiyolojik veriler kullanılmıştır. Aynı birimde, aynı zaman diliminde 3 ve üzeri sağlık çalışanının tanı aldığı durumlar küme olarak kabul edilmiştir. Yaş, cinsiyet, meslek, semptom varlığı temas risk durumu gibi tanımlayıcı özellikler yanında her küme için bulaş zinciri takvimleri oluşturulmuştur. Atak hızları, %95 güven aralığı ile birlikte hesaplanmıştır.
Bulgular: Çalışmada değerlendirilen tarihlerde toplam 98 sağlık çalışanı COVİD-19 tanısı almış, bu çalışanlar içinde toplam 4 küme tespit edilmiştir. Kümelerde toplam 19 olgu vardır, 9’u erkek (%47.4), 10’u kadındır (%52.6); yaş ortalaması 35.6 (±6.96)’dır. Olgulardan 8’i (%42.1) doktor, 6’sı (%31.6) hemşiredir. Kümelerdeki olgularla temaslı toplam 171 kişi vardır, toplam 314 temas değerlendirmesi yapılmıştır. Bu temaslılardan 14 kişi COVID-19 tanısı almıştır. Hastane içi sekonder atak hızı %8.19 (%95 GA: 4.74-13.05) bulunmuştur.
Sonuç: Sağlık çalışanlarının yüksek riskli bir çalışma ortamı olmakla birlikte, kendi aralarındaki iş nedenli ya da sosyal temaslar da bu riski artırmaktadır. Küçük ve iyi havalandırması olmayan odaları paylaşmak, kalabalık çalışma ortamı, nöbet koşulları, uzun mesai saatleri hastane içi riski artıran nedenlerdendir. Çalışmamız, düzenli sürveyans ile toplanan verilerin belirli aralıklarla değerlendirilerek kümelerin epidemiyolojik özelliklerinin belirlenmesini sağlamış, bulaşın azaltılmasına yönelik önlemlerin alınmasına katkıda bulunmuştur.
Anahtar Kelimeler
Kaynakça
- WHO. Coronavirus [Internet]. Available from: https://www.who.int/health-topics/ coronavirus. Accessed April 11,2022
- Meyerowitz-Katz G, Merone L. A systematic review and meta-analysis of published research data on COVID-19 infection fatality rates. International Journal of Infectious Diseases. 2020 Dec 1;101:138– 48.
- WHO. Coronavirus disease (COVID-19): How is it transmitted? [Internet]. Available from: https://www.who.int/news-room/ questions-and-answers/item/coronavirus-disease-covid-19-how-is-it-transmitted. Accessed April 11,2022
- Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo C-G, Ma W, et al. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Health. 2020 Sep;5(9):e475–83.
- CDC. Health Departments [Internet]. Centers for Disease Control and Prevention. 2020. Available from: https://www. cdc.gov/coronavirus/2019-ncov/php/ community-mitigation/prioritizing-non-healthcare-assessments.html. Accessed April 11,2022
- Böhmer MM, Buchholz U, Corman VM, Hoch M, Katz K, Marosevic DV, et al. Investigation of a COVID-19 outbreak in Germany resulting from a single travel-associated primary case: a case series. The Lancet Infectious Diseases. 2020 Aug 1;20(8):920–8.
- Pisani M, Anderson L, Hatas G, Safdar N. A systems approach to understanding SARS-CoV-2 transmission among healthcare workers in a cluster. American Journal of Infection Control. 2022 Apr 1;50(4):459– 61.
- Leducq V, Jary A, Bridier-Nahmias A, Daniel L, Zafilaza K, Damond F, et al. Nosocomial transmission clusters and lineage diversity characterized by SARS-CoV-2 genomes from two large hospitals in Paris, France, in 2020. Sci Rep. 2022 Jan 20;12(1):1094.
- Dündar E, Kaya F, Pirincci E. Knowledge, Attitude and Practice Towards COVID-19 Among People in Adiyaman, Turkey. Kafkas J Med Sci. 2021;11(2):288–94.
- İnce F, Evcil FY. Covid-19’un Türkiye’deki İlk Üç Haftası The First Three Weeks Of The Covid-19 In Turkey. :6.
- Zhang M, Zhou M, Tang F, Wang Y, Nie H, Zhang L, et al. Knowledge, attitude, and practice regarding COVID-19 among healthcare workers in Henan, China. Journal of Hospital Infection. 2020 Jun 1;105(2):183–7.
- Emecen AN, Keskin S, Boncukcu Eren E, Yildirim Ustuner B, Celik SG, Suner AF, et al. Impact of social contacts on SARS-CoV-2 exposure among healthcare workers. Occupational Medicine. 2021 Oct 11;kqab141.
- Piccoli L, Ferrari P, Piumatti G, Jovic S, Rodriguez BF, Mele F, et al. Risk assessment and seroprevalence of SARS-CoV-2 infection in healthcare workers of COVID-19 and non-COVID-19 hospitals in Southern Switzerland. The Lancet Regional Health - Europe. 2021 Feb 1;1:100013.
- Freund Y. The challenge of emergency medicine facing the COVID-19 outbreak. European Journal of Emergency Medicine. 2020 Jun;27(3):155.
- Nsubuga P, White ME, Thacker SB, Anderson MA, Blount SB, Broome CV, et al. Public Health Surveillance: A Tool for Targeting and Monitoring Interventions. In: Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, et al., editors. Disease Control Priorities in Developing Countries [Internet]. 2nd ed. Washington (DC): World Bank; 2006. Available from: http://www. ncbi.nlm.nih.gov/books/NBK11770/ . Accessed April 11,2022
- van der Valk JPM, in ’t Veen JCCM. SARS-Cov-2: The Relevance and Prevention of Aerosol Transmission. Journal of Occupational and Environmental Medicine. 2021 Jun;63(6):e395.
- Shah K, Saxena D, Mavalankar D. Secondary attack rate of COVID-19 in household contacts: a systematic review. QJM: An International Journal of Medicine. 2020 Dec 1;113(12):841–50.
Epidemiological investigation of COVID-19 clusters in healthcare workers in a univercity hospital at the first period of the pandemic
Öz
Objective: The aim of the study is to evaluate the clusters of healthcare workers diagnosed with COVID-19 in a university hospital in terms of epidemiological characteristics and transmission dynamics.
Methods: Since the beginning of the pandemic, healthcare workers who have been diagnosed with COVID-19 and their contacts in our hospital are followed up and risk assessments are made by phone call. In this descriptive study, epidemiological data of clusters formed between March 20-September 10, 2020 at a university hospital were used. Cases, where 3 or more healthcare workers were diagnosed in the same unit in the same time period, were considered a cluster. In addition to descriptive features, transmission chains were created for each cluster. Attack rates were calculated with a (95%) confidence interval.
Results: A total of 98 healthcare workers were diagnosed with COVID-19 on the dates evaluated in the study. There were 4 clusters, and a total of 19 cases in the clusters, 9 of which were male (47.4%), mean age is 35.6 (±6.96). There are a total of 171 people in contact with the cases in the clusters. Of these contacts, 14 people were diagnosed with COVID-19. In-hospital secondary attack rate was 8.19% (95% CI: 4.74-13.05).
Conclusion: Although healthcare workers have a high-risk working environment, work-related or social contacts among themselves also increase this risk. Our study enabled the determination of the epidemiological characteristics of the clusters by periodically evaluating the data collected through regular surveillance, and contributed to taking measures to reduce the transmission.
Anahtar Kelimeler
Kaynakça
- WHO. Coronavirus [Internet]. Available from: https://www.who.int/health-topics/ coronavirus. Accessed April 11,2022
- Meyerowitz-Katz G, Merone L. A systematic review and meta-analysis of published research data on COVID-19 infection fatality rates. International Journal of Infectious Diseases. 2020 Dec 1;101:138– 48.
- WHO. Coronavirus disease (COVID-19): How is it transmitted? [Internet]. Available from: https://www.who.int/news-room/ questions-and-answers/item/coronavirus-disease-covid-19-how-is-it-transmitted. Accessed April 11,2022
- Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo C-G, Ma W, et al. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Health. 2020 Sep;5(9):e475–83.
- CDC. Health Departments [Internet]. Centers for Disease Control and Prevention. 2020. Available from: https://www. cdc.gov/coronavirus/2019-ncov/php/ community-mitigation/prioritizing-non-healthcare-assessments.html. Accessed April 11,2022
- Böhmer MM, Buchholz U, Corman VM, Hoch M, Katz K, Marosevic DV, et al. Investigation of a COVID-19 outbreak in Germany resulting from a single travel-associated primary case: a case series. The Lancet Infectious Diseases. 2020 Aug 1;20(8):920–8.
- Pisani M, Anderson L, Hatas G, Safdar N. A systems approach to understanding SARS-CoV-2 transmission among healthcare workers in a cluster. American Journal of Infection Control. 2022 Apr 1;50(4):459– 61.
- Leducq V, Jary A, Bridier-Nahmias A, Daniel L, Zafilaza K, Damond F, et al. Nosocomial transmission clusters and lineage diversity characterized by SARS-CoV-2 genomes from two large hospitals in Paris, France, in 2020. Sci Rep. 2022 Jan 20;12(1):1094.
- Dündar E, Kaya F, Pirincci E. Knowledge, Attitude and Practice Towards COVID-19 Among People in Adiyaman, Turkey. Kafkas J Med Sci. 2021;11(2):288–94.
- İnce F, Evcil FY. Covid-19’un Türkiye’deki İlk Üç Haftası The First Three Weeks Of The Covid-19 In Turkey. :6.
- Zhang M, Zhou M, Tang F, Wang Y, Nie H, Zhang L, et al. Knowledge, attitude, and practice regarding COVID-19 among healthcare workers in Henan, China. Journal of Hospital Infection. 2020 Jun 1;105(2):183–7.
- Emecen AN, Keskin S, Boncukcu Eren E, Yildirim Ustuner B, Celik SG, Suner AF, et al. Impact of social contacts on SARS-CoV-2 exposure among healthcare workers. Occupational Medicine. 2021 Oct 11;kqab141.
- Piccoli L, Ferrari P, Piumatti G, Jovic S, Rodriguez BF, Mele F, et al. Risk assessment and seroprevalence of SARS-CoV-2 infection in healthcare workers of COVID-19 and non-COVID-19 hospitals in Southern Switzerland. The Lancet Regional Health - Europe. 2021 Feb 1;1:100013.
- Freund Y. The challenge of emergency medicine facing the COVID-19 outbreak. European Journal of Emergency Medicine. 2020 Jun;27(3):155.
- Nsubuga P, White ME, Thacker SB, Anderson MA, Blount SB, Broome CV, et al. Public Health Surveillance: A Tool for Targeting and Monitoring Interventions. In: Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, et al., editors. Disease Control Priorities in Developing Countries [Internet]. 2nd ed. Washington (DC): World Bank; 2006. Available from: http://www. ncbi.nlm.nih.gov/books/NBK11770/ . Accessed April 11,2022
- van der Valk JPM, in ’t Veen JCCM. SARS-Cov-2: The Relevance and Prevention of Aerosol Transmission. Journal of Occupational and Environmental Medicine. 2021 Jun;63(6):e395.
- Shah K, Saxena D, Mavalankar D. Secondary attack rate of COVID-19 in household contacts: a systematic review. QJM: An International Journal of Medicine. 2020 Dec 1;113(12):841–50.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Aralık 2022 |
| Gönderilme Tarihi | 15 Nisan 2022 |
| Kabul Tarihi | 20 Kasım 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 20 Sayı: 3 |
Kaynak Göster
TURKISH JOURNAL OF PUBLIC HEALTH - TURK J PUBLIC HEALTH. online-ISSN: 1304-1096
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