Investigation of a COVID-19 outbreak in a University Cardio-Thoracic Hospital in Cairo: exploration of the risk to healthcare workers and patients

Background: Corona virus Disease 2019 (COVID-19) pandemic has posed a challenge to health sectors all over the world. The pandemic arrived in Egypt a few weeks after Europe and Asia, with rapidly rising numbers.  Health care workers (HCWs) are front liners sustaining a major risk of acquiring the infection. Aim: In this work, we analyse an outbreak of COVID-19 in a University hospital in Cairo involving HCWs of different categories, patients and patients’ accompanying relatives. Methods: Following the reporting of the first COVID-19 confirmed case; a 55-year-old nurse at the hospital, a total of 645 healthcare workers, patients and patients' accompanying relatives were tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (rRT-PCR) assay. Results: Twenty four out of 589 HCWs, 3 out of 42 patient and 4 out of 14 patients' accompanying relatives tested positive for COVID-19. No physicians, pharmacists or technicians were infected. Nursing staff and housekeeping staff were the most at risk of contracting the infection with a risk ratio of 4.99 (95%CI: 1.4-17.6) and 5.08 (95%CI: 1.4-18.4) respectively. Clustering of infected HCWs was observed in paediatrics’ ICU and in the 6th floor of the hospital. Conclusions: Nursing and housekeeping staff sustain a significantly higher risk of COVID-19 infection compared to other staff categories. The nature of their duties and the frequent unprotected contact between members of these categories may play a role in increasing their risk. &nbsp

A novel wide scale well-baby clinic mobile application: an Egyptian pilot study

Abstract Background Utilization of under 5-year-old child healthcare services in Egypt is considered low, the highest proportion of well-baby visits is mainly for immunization in the first 2 years of age. Mobile health (mHealth) interventions have the potential to be a useful and low-cost way to disseminate information about proper nutrition, can be used to monitor children’s growth using the official charts of World Health Organization, can also help in accessing vaccine-related information and schedules. Objectives To assess needs and requirements for a new comprehensive well-baby clinic mobile application (app) covering well-baby clinic service components. Thereafter, to develop the app prototype and validate it. Methods This study was conducted in four phases: User requirements, development, validation and usage. In user requirement phase, the need for the new app was assessed by performing literature review, market app research and an online survey. In development phase, we developed the novel well-baby clinic app that constituted all well-baby clinic services for children’s health monitoring relying on evidence-based information and honoring data safety. In validation phase, after a series of testing, the app was validated using Mobile app rating scale (MARS) by public health and pediatrics consultants to assess its quality. Finally, the app was launched and made available to the public on Android platform. Results Sehhat Tefly app was developed based on the demands and requirements of mothers of under 5-year-old children. The app constituted caregiver, child information and seven service elements: physical growth, developmental milestones, immunizations, nutrition, teething, safety & emergency measures and report. The app quality mean was rated 3.7 out of 5 by the panel of experts. The app was downloaded 1445 times in a 4 month period. Conclusions Sehhat Tefly app can meet the need for a free, easy and accessible tool for caregivers to track the progress of children’s development and wellbeing. It can also provide advice for referral to physician consultation in case of deviation from normal measures

Hepatitis C virus infection and risk factors among patients and health-care workers of Ain Shams University hospitals, Cairo, Egypt

International audienceBackgroundHospitals are suspected of playing a key role in HCV epidemic dynamics in Egypt. This work aimed at assessing HCV prevalence and associated risk factors in patients and health-care workers (HCWs) of Ain Shams University (ASU) hospitals in Cairo.MethodsWe included 500 patients admitted to the internal medicine or surgery hospital from February to July, 2017, as well as 50 HCWs working in these same hospitals. Participants were screened for anti-HCV antibodies and HCV RNA. A questionnaire was administered to collect data on demographic characteristics and medical/surgical history. For HCWs, questions on occupational exposures and infection control practices were also included.ResultsThe overall prevalence of anti-HCV antibodies was 19.80% (95% CI: 16.54–23.52) among participating patients, and 8.00% (95% CI: 0.48–15.52) among participating HCWs. In HCWs, the only risk factors significantly associated with anti-HCV antibodies were age and profession, with higher prevalence in older HCWs and those working as cleaners or porters. In patients, in a multivariate logistic regression, age over 50 (aOR: 3.4 [1.9–5.8]), living outside Cairo (aOR: 2.1 [1.2–3.4]), admission for liver or gastro-intestinal complaints (aOR: 4.2 [1.8–9.9]), and history of receiving parenteral anti-schistosomiasis treatment (aOR: 2.7 [1.2–5.9]) were found associated with anti-HCV antibodies.ConclusionsWhile HCV prevalence among patients has decreased since the last survey performed within ASU hospitals in 2008, it is still significantly higher than in the general population. These results may help better control further HCV spread within healthcare settings in Egypt by identifying at-risk patient profiles upon admission