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Pandeminin ilk döneminde bir üniversite hastanesinde sağlık çalışanlarında COVID-19 kümelerinin epidemiyolojik incelemesi

Year 2022, Volume: 20 Issue: 3, 375 - 390, 01.12.2022
https://doi.org/10.20518/tjph.1103438

Abstract

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.

References

  • 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

Year 2022, Volume: 20 Issue: 3, 375 - 390, 01.12.2022
https://doi.org/10.20518/tjph.1103438

Abstract

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.

References

  • 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.
There are 17 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Research
Authors

Edanur Sezgin 0000-0001-9248-1670

Neslişah Şiyve 0000-0001-9055-4573

Saadet Göksu Çelik 0000-0001-6073-4258

Buket Yıldırım Üstüner 0000-0002-9318-0869

Salih Keskin 0000-0003-4032-319X

Ecem Başoğlu Şensoy 0000-0002-9938-1012

Gamze Bayrak 0000-0003-0467-2165

Nurcan Şentürk Durukan 0000-0002-7592-4086

Ayşe Coşkun Beyan 0000-0002-3731-2978

Ahmet Naci Emecen 0000-0003-3995-0591

Gül Ergör 0000-0002-2263-7526

Publication Date December 1, 2022
Submission Date April 15, 2022
Acceptance Date November 20, 2022
Published in Issue Year 2022 Volume: 20 Issue: 3

Cite

APA Sezgin, E., Şiyve, N., Çelik, S. G., Yıldırım Üstüner, B., et al. (2022). Pandeminin ilk döneminde bir üniversite hastanesinde sağlık çalışanlarında COVID-19 kümelerinin epidemiyolojik incelemesi. Turkish Journal of Public Health, 20(3), 375-390. https://doi.org/10.20518/tjph.1103438
AMA Sezgin E, Şiyve N, Çelik SG, Yıldırım Üstüner B, Keskin S, Başoğlu Şensoy E, Bayrak G, Şentürk Durukan N, Coşkun Beyan A, Emecen AN, Ergör G. Pandeminin ilk döneminde bir üniversite hastanesinde sağlık çalışanlarında COVID-19 kümelerinin epidemiyolojik incelemesi. TJPH. December 2022;20(3):375-390. doi:10.20518/tjph.1103438
Chicago Sezgin, Edanur, Neslişah Şiyve, Saadet Göksu Çelik, Buket Yıldırım Üstüner, Salih Keskin, Ecem Başoğlu Şensoy, Gamze Bayrak, Nurcan Şentürk Durukan, Ayşe Coşkun Beyan, Ahmet Naci Emecen, and Gül Ergör. “Pandeminin Ilk döneminde Bir üniversite Hastanesinde sağlık çalışanlarında COVID-19 kümelerinin Epidemiyolojik Incelemesi”. Turkish Journal of Public Health 20, no. 3 (December 2022): 375-90. https://doi.org/10.20518/tjph.1103438.
EndNote Sezgin E, Şiyve N, Çelik SG, Yıldırım Üstüner B, Keskin S, Başoğlu Şensoy E, Bayrak G, Şentürk Durukan N, Coşkun Beyan A, Emecen AN, Ergör G (December 1, 2022) Pandeminin ilk döneminde bir üniversite hastanesinde sağlık çalışanlarında COVID-19 kümelerinin epidemiyolojik incelemesi. Turkish Journal of Public Health 20 3 375–390.
IEEE E. Sezgin, “Pandeminin ilk döneminde bir üniversite hastanesinde sağlık çalışanlarında COVID-19 kümelerinin epidemiyolojik incelemesi”, TJPH, vol. 20, no. 3, pp. 375–390, 2022, doi: 10.20518/tjph.1103438.
ISNAD Sezgin, Edanur et al. “Pandeminin Ilk döneminde Bir üniversite Hastanesinde sağlık çalışanlarında COVID-19 kümelerinin Epidemiyolojik Incelemesi”. Turkish Journal of Public Health 20/3 (December 2022), 375-390. https://doi.org/10.20518/tjph.1103438.
JAMA Sezgin E, Şiyve N, Çelik SG, Yıldırım Üstüner B, Keskin S, Başoğlu Şensoy E, Bayrak G, Şentürk Durukan N, Coşkun Beyan A, Emecen AN, Ergör G. Pandeminin ilk döneminde bir üniversite hastanesinde sağlık çalışanlarında COVID-19 kümelerinin epidemiyolojik incelemesi. TJPH. 2022;20:375–390.
MLA Sezgin, Edanur et al. “Pandeminin Ilk döneminde Bir üniversite Hastanesinde sağlık çalışanlarında COVID-19 kümelerinin Epidemiyolojik Incelemesi”. Turkish Journal of Public Health, vol. 20, no. 3, 2022, pp. 375-90, doi:10.20518/tjph.1103438.
Vancouver Sezgin E, Şiyve N, Çelik SG, Yıldırım Üstüner B, Keskin S, Başoğlu Şensoy E, Bayrak G, Şentürk Durukan N, Coşkun Beyan A, Emecen AN, Ergör G. Pandeminin ilk döneminde bir üniversite hastanesinde sağlık çalışanlarında COVID-19 kümelerinin epidemiyolojik incelemesi. TJPH. 2022;20(3):375-90.

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