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Mevissen FEF, van Deursen B, Voeten HACM, Watzeels AJCM. 'We are not here to enforce; we are here for the people' Factors influencing performance of contact tracing during the COVID-19 pandemic: A qualitative study. J Public Health Res 2023; 12:22799036231208325. [PMID: 38020218 PMCID: PMC10676064 DOI: 10.1177/22799036231208325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 09/29/2023] [Indexed: 12/01/2023] Open
Abstract
Background Provider-initiated contact tracing (CT) is an important measure to slow down the spread of infectious diseases such as COVID-19. However, carrying out effective CT depends on the collaboration between the patient and the contact tracer. To improve CT, it is important to understand which factors influence contact tracers in being able to carry out CT during large pandemics. Methods We performed individual semi-structured interviews with nine contact tracers working for the COVID-19 unit of the Public Health Service (PHS) Rotterdam-Rijnmond, the Netherlands, to explore their experiences with carrying out CT. Data were collected between July 2020 and December 2020. The interview protocol was structured based on the CT tasks and guided by the literature and the framework explaining adherence to clinical practice guidelines. Results In general, CT seemed to be carried out satisfactorily. Individual factors (interviewing techniques and skills, attitude towards the patient and attitude towards CT), factors related to the patient (cooperativeness and engagement, emotions, language and culture and (mis)information), guideline-related factors (characteristics) and factors related to the organisation (interactions with colleagues, support from management, workload and training) were found to influence the carrying out of CT. Conclusion To be well prepared for future pandemics, it is important to explore strategies that can be effective to support the contact tracer in performing CT, support patients in feeling comfortable to be engaged and ways to reach more consistency in policies and protocols.
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Affiliation(s)
- Fraukje EF Mevissen
- Public Health Service (GGD) Rotterdam-Rijnmond, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Helene ACM Voeten
- Public Health Service (GGD) Rotterdam-Rijnmond, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anita JCM Watzeels
- Public Health Service (GGD) Rotterdam-Rijnmond, Rotterdam, The Netherlands
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Heaton D, Clos J, Nichele E, Fischer J. Critical reflections on three popular computational linguistic approaches to examine Twitter discourses. PeerJ Comput Sci 2023; 9:e1211. [PMID: 37346687 PMCID: PMC10280252 DOI: 10.7717/peerj-cs.1211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 12/19/2022] [Indexed: 06/23/2023]
Abstract
Although computational linguistic methods-such as topic modelling, sentiment analysis and emotion detection-can provide social media researchers with insights into online public discourses, it is not inherent as to how these methods should be used, with a lack of transparent instructions on how to apply them in a critical way. There is a growing body of work focusing on the strengths and shortcomings of these methods. Through applying best practices for using these methods within the literature, we focus on setting expectations, presenting trajectories, examining with context and critically reflecting on the diachronic Twitter discourse of two case studies: the longitudinal discourse of the NHS Covid-19 digital contact-tracing app and the snapshot discourse of the Ofqual A Level grade calculation algorithm, both related to the UK. We identified difficulties in interpretation and potential application in all three of the approaches. Other shortcomings, such the detection of negation and sarcasm, were also found. We discuss the need for further transparency of these methods for diachronic social media researchers, including the potential for combining these approaches with qualitative ones-such as corpus linguistics and critical discourse analysis-in a more formal framework.
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Affiliation(s)
- Dan Heaton
- School of Computer Science, University of Nottingham, Nottingham, United Kingdom
| | - Jeremie Clos
- School of Computer Science, University of Nottingham, Nottingham, United Kingdom
| | - Elena Nichele
- School of Computer Science, University of Nottingham, Nottingham, United Kingdom
| | - Joel Fischer
- School of Computer Science, University of Nottingham, Nottingham, United Kingdom
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Garousi V, Cutting D, Felderer M. Mining user reviews of COVID contact-tracing apps: An exploratory analysis of nine European apps. J Syst Softw 2022; 184:111136. [PMID: 34751198 PMCID: PMC8566091 DOI: 10.1016/j.jss.2021.111136] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 06/06/2021] [Accepted: 10/25/2021] [Indexed: 05/16/2023]
Abstract
CONTEXT More than 78 countries have developed COVID contact-tracing apps to limit the spread of coronavirus. However, many experts and scientists cast doubt on the effectiveness of those apps. For each app, a large number of reviews have been entered by end-users in app stores. OBJECTIVE Our goal is to gain insights into the user reviews of those apps, and to find out the main problems that users have reported. Our focus is to assess the "software in society" aspects of the apps, based on user reviews. METHOD We selected nine European national apps for our analysis and used a commercial app-review analytics tool to extract and mine the user reviews. For all the apps combined, our dataset includes 39,425 user reviews. RESULTS Results show that users are generally dissatisfied with the nine apps under study, except the Scottish ("Protect Scotland") app. Some of the major issues that users have complained about are high battery drainage and doubts on whether apps are really working. CONCLUSION Our results show that more work is needed by the stakeholders behind the apps (e.g., app developers, decision-makers, public health experts) to improve the public adoption, software quality and public perception of these apps.
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Affiliation(s)
- Vahid Garousi
- Queen's University Belfast, UK
- Bahar Software Engineering Consulting Corporation, UK
| | | | - Michael Felderer
- University of Innsbruck, Austria
- Blekinge Institute of Technology, Sweden
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Rahimi F, Bezmin Abadi AT. A Commentary on "Omicron SARS-CoV-2 variant: Reasons of emergence and lessons learnt" (Int J Surg 2022;97:106198) Contact-tracing and global vaccine equity: Crucial responses to emergence of the Omicron SARS-CoV-2 variant. Int J Surg 2022; 98:106244. [PMID: 35123010 PMCID: PMC8810272 DOI: 10.1016/j.ijsu.2022.106244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/15/2022]
Affiliation(s)
| | - Amin Talebi Bezmin Abadi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Gerli P, Arakpogun EO, Elsahn Z, Olan F, Prime KS. Beyond contact-tracing: The public value of eHealth application in a pandemic. Gov Inf Q 2021; 38:101581. [PMID: 36568852 PMCID: PMC9759029 DOI: 10.1016/j.giq.2021.101581] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 12/27/2022]
Abstract
This study adopts a public value perspective to examine the eHealth services deployed by national and regional governments to contain the coronavirus (Covid-19) pandemic, including symptoms checkers, information portals and contact-tracing applications. We analyse 50 cases of eHealth applications adopted in 25 European Economic Area (EEA) and outline how these systems and technologies map against four dimensions of public value: user orientation, participation, legality and equity. Our findings reveal that the public value of the eHealth applications adopted in the context of the current pandemic is affected by both endogenous and exogenous factors that undermine their ability to improve the quality of healthcare services and social wellbeing. We conclude by suggesting areas for further research to address such factors and the trade-offs emerging between different dimensions of public value.
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Affiliation(s)
| | - Emmanuel Ogiemwonyi Arakpogun
- Corresponding author at: Newcastle Business School, Northumbria University, City Campus East 1, Newcastle Upon Tyne NE1 8ST, United Kingdom
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Arakpogun EO, Elsahn Z, Prime KS, Gerli P, Olan F. Digital contact-tracing and pandemics: Institutional and technological preparedness in Africa. World Dev 2020; 136:105105. [PMID: 32834386 PMCID: PMC7396131 DOI: 10.1016/j.worlddev.2020.105105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Several countries in Africa have either deployed or considering using digital contact-tracing (DCT) as part of their Covid-19 containment strategy, amidst calls for the use of technology to improve the efficiency of traditional contact-tracing. We discuss some of the complexities entailed in using DCT in Africa. Adopting a socio-technical perspective, we argue that if DCT design and deployment are not well thought out, it can lead to unintended consequences, particularly in a continent like Africa with disproportionate levels of digital divides and other structural inequalities. We suggest that any adoption of DCT by African countries must take account of their compatibility with local resources, values, social structure, and domestic political factors. Accordingly, we propose a process of translation whereby DCT adaptation is made to accommodate the unique institutional and technological characteristics of African countries by leveraging local practices learned from previous pandemics like Ebola to develop a blended epidemiological approach to (digital) contact-tracing.
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Affiliation(s)
| | - Ziad Elsahn
- Newcastle Business School, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Karla Simone Prime
- Newcastle Business School, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Paolo Gerli
- Newcastle Business School, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Femi Olan
- Newcastle Business School, Northumbria University, Newcastle upon Tyne, United Kingdom
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Jung J, Jang H, Kim HK, Kim J, Kim A, Ko KP. The Importance of Mandatory COVID-19 Diagnostic Testing Prior to Release from Quarantine. J Korean Med Sci 2020; 35:e314. [PMID: 32864911 PMCID: PMC7458855 DOI: 10.3346/jkms.2020.35.e314] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 08/18/2020] [Indexed: 01/01/2023] Open
Abstract
A 14-day quarantine is implemented in many countries in response to the coronavirus disease pandemic. Korea implemented a mandatory quarantine for those who had close contact with infected patients and those returning from abroad. The present study explored the implications of mandatory coronavirus disease 2019 testing before releasing individuals from the 14-day quarantine in Incheon, Korea. From February 11 to July 5, 2020, 19,296 people were self-quarantined, and 56 (0.3%) of them were confirmed cases of COVID-19. Twenty (35.7%) were identified through the reporting of symptoms during quarantine, and 32 (57.1%) were identified using mandatory pre-release RT-PCR tests. Among the 32, 14 (25%) individuals reported mild symptoms and 18 (32.1%) were asymptomatic. It is suggested that mandatory diagnostic testing prior to release and the symptom-based surveillance after the 14-day quarantine may help control delayed or asymptomatic COVID-19 cases.
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Affiliation(s)
- Jaehun Jung
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | | | | | - Jieun Kim
- Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Arim Kim
- Incheon Communicable Diseases Center, Incheon, Korea
| | - Kwang Pil Ko
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
- Incheon Communicable Diseases Center, Incheon, Korea.
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Maghdid HS, Ghafoor KZ. A Smartphone Enabled Approach to Manage COVID-19 Lockdown and Economic Crisis. SN Comput Sci 2020; 1:271. [PMID: 33063052 PMCID: PMC7427696 DOI: 10.1007/s42979-020-00290-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/05/2020] [Indexed: 12/28/2022]
Abstract
The emergence of novel COVID-19 causes an over-load in health system and high mortality rate. The key priority is to contain the epidemic and prevent the infection rate. In this context, many countries are now in some degree of lockdown to ensure extreme social distancing of entire population and hence slowing down the epidemic spread. Furthermore, authorities use case quarantine strategy and manual second/third contact-tracing to contain the COVID-19 disease. However, manual contact-tracing is time-consuming and labor-intensive task which tremendously over-load public health systems. In this paper, we developed a smartphone-based approach to automatically and widely trace the contacts for confirmed COVID-19 cases. Particularly, contact-tracing approach creates a list of individuals in the vicinity and notifying contacts or officials of confirmed COVID-19 cases. This approach is not only providing awareness to individuals they are in the proximity to the infected area, but also tracks the incidental contacts that the COVID-19 carrier might not recall. Thereafter, we developed a dashboard to provide a plan for policymakers on how lockdown/mass quarantine can be safely lifted, and hence tackling the economic crisis. The dashboard used to predict the level of lockdown area based on collected positions and distance measurements of the registered users in the vicinity. The prediction model uses k-means algorithm as an unsupervised machine learning technique for lockdown management.
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Affiliation(s)
- Halgurd S. Maghdid
- Department of Software Engineering, Faculty of Engineering, Koya University, Koysinjaq, 4400 Kurdistan Region-F.R. Iraq
| | - Kayhan Zrar Ghafoor
- Department of Software Engineering, Salahaddin University-Erbil, Erbil, 4500 Iraq
- School of Mathematics and Computer Science, University of Wolverhampton, Wulfruna Street, Wolverhampton, WV1 1LY UK
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Ngonghala CN, Iboi E, Eikenberry S, Scotch M, MacIntyre CR, Bonds MH, Gumel AB. Mathematical assessment of the impact of non-pharmaceutical interventions on curtailing the 2019 novel Coronavirus. Math Biosci 2020; 325:108364. [PMID: 32360770 PMCID: PMC7252217 DOI: 10.1016/j.mbs.2020.108364] [Citation(s) in RCA: 278] [Impact Index Per Article: 69.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 04/23/2020] [Accepted: 04/23/2020] [Indexed: 01/24/2023]
Abstract
A pandemic of a novel Coronavirus emerged in December of 2019 (COVID-19), causing devastating public health impact across the world. In the absence of a safe and effective vaccine or antivirals, strategies for controlling and mitigating the burden of the pandemic are focused on non-pharmaceutical interventions, such as social-distancing, contact-tracing, quarantine, isolation, and the use of face-masks in public. We develop a new mathematical model for assessing the population-level impact of the aforementioned control and mitigation strategies. Rigorous analysis of the model shows that the disease-free equilibrium is locally-asymptotically stable if a certain epidemiological threshold, known as the reproduction number (denoted by ℛc), is less than unity. Simulations of the model, using data relevant to COVID-19 transmission dynamics in the US state of New York and the entire US, show that the pandemic burden will peak in mid and late April, respectively. The worst-case scenario projections for cumulative mortality (based on the baseline levels of anti-COVID non-pharmaceutical interventions considered in the study) decrease dramatically by 80% and 64%, respectively, if the strict social-distancing measures implemented are maintained until the end of May or June, 2020. The duration and timing of the relaxation or termination of the strict social-distancing measures are crucially-important in determining the future trajectory of the COVID-19 pandemic. This study shows that early termination of the strict social-distancing measures could trigger a devastating second wave with burden similar to those projected before the onset of the strict social-distancing measures were implemented. The use of efficacious face-masks (such as surgical masks, with estimated efficacy ≥ 70%) in public could lead to the elimination of the pandemic if at least 70% of the residents of New York state use such masks in public consistently (nationwide, a compliance of at least 80% will be required using such masks). The use of low efficacy masks, such as cloth masks (of estimated efficacy less than 30%), could also lead to significant reduction of COVID-19 burden (albeit, they are not able to lead to elimination). Combining low efficacy masks with improved levels of the other anti-COVID-19 intervention strategies can lead to the elimination of the pandemic. This study emphasizes the important role social-distancing plays in curtailing the burden of COVID-19. Increases in the adherence level of social-distancing protocols result in dramatic reduction of the burden of the pandemic, and the timely implementation of social-distancing measures in numerous states of the US may have averted a catastrophic outcome with respect to the burden of COVID-19. Using face-masks in public (including the low efficacy cloth masks) is very useful in minimizing community transmission and burden of COVID-19, provided their coverage level is high. The masks coverage needed to eliminate COVID-19 decreases if the masks-based intervention is combined with the strict social-distancing strategy.
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Affiliation(s)
| | - Enahoro Iboi
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ, 85287, USA
| | - Steffen Eikenberry
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ, 85287, USA
| | - Matthew Scotch
- Biodesign Institute, Arizona State University, Tempe, AZ, 85287, USA
| | | | - Matthew H Bonds
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Abba B Gumel
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ, 85287, USA.
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Glasauer S, Kröger S, Haas W, Perumal N. International tuberculosis contact-tracing notifications in Germany: analysis of national data from 2010 to 2018 and implications for efficiency. BMC Infect Dis 2020; 20:267. [PMID: 32252650 PMCID: PMC7137477 DOI: 10.1186/s12879-020-04982-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 03/19/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND International contact-tracing (CT) following exposure during long-distance air travel is resource-intensive, whereas evidence for risk of tuberculosis (TB) transmission during international travel is weak. In this study, we systematically analyzed the information from international requests for CT received at the national level in Germany in order to evaluate the continued utility of the current approach and to identify areas for improvement. METHODS An anonymized archive of international CT notifications received by the Robert Koch Institute between 2010 and 2018 was searched for key parameters for data collection. A total of 31 parameters, such as characteristics of TB patients and their identified contacts, were extracted from each CT notification and collated into a dataset. Descriptive data analysis and trend analyses were performed to identify key characteristics of CT notifications, patients, and contacts over the years. RESULTS 192 CT notifications, each corresponding to a single TB index case, were included in the study, increasing from 12 in 2010 to 41 in 2018. The majority of notifications (N = 130, 67.7%) concerned international air travel, followed by private contact (N = 39, 20.3%) and work exposure (N = 16, 8.3%). 159 (82.8%) patients had sputum smear results available, of which 147 (92.5%) were positive. Of 119 (62.0%) patients with drug susceptibility testing results, most (N = 92, 77.3%) had pan-sensitive TB, followed by 15 (12.6%) with multi-drug resistant TB. 115 (59.9%) patients had information on infectiousness, of whom 99 (86.1%) were considered infectious during the exposure period. 7 (5.3%) patients travelled on long-distance flights despite a prior diagnosis of active TB. Of the 771 contact persons, 34 (4.4%) could not be reached for CT measures due to lack of contact information. CONCLUSION The high variability in completeness of information contained within the international CT requests emphasizes the need for international standards for reporting of CT information. With the large proportion of TB patients reported to have travelled while being infectious in our study, we feel that raising awareness among patients and health professionals to detect TB early and prevent international long-distance travel during the infectious disease phase should be a cornerstone strategy to safeguard against possible transmission during international travel.
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Affiliation(s)
- Saskia Glasauer
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Stefan Kröger
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Walter Haas
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Nita Perumal
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
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Hosten E, Mehta M, Andre E, Abu Rumman K, Van der Linden D. Tuberculosis contact-tracing among Syrian refugee populations: lessons from Jordan. Confl Health 2018; 12:25. [PMID: 30026793 PMCID: PMC6047119 DOI: 10.1186/s13031-018-0164-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 04/16/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND In response to the influx of displaced Syrians since 2011, the Jordanian National Tuberculosis Program (NTP) implemented a specific Tuberculosis (TB) reduction strategy, including contact-tracing (CT). Contacts of all refugees diagnosed with pulmonary TB (PTB) were registered by the International Organization for Migration and screened for active & latent TB infection (LTBI) in 6 NTP centres.The objectives of this study were to assess prevalence of active TB and LTBI, risk factors for LTBI as well as program performance. METHODS We performed a retrospective study among contacts (N = 481) of all PTB cases diagnosed between March 2011 and May 2014 (N = 76). CT was performed using verbal screening of TB-related symptoms, tuberculin skin test (TST) and chest X-ray. RESULTS LTBI was diagnosed in 24.1% of contacts tested with TST while active TB was diagnosed in 2.1% of contacts. Main risk factors for positive TST included smear-positive index case (IC) (OR: 6.33) and previous TB infection in the family (OR: 4.94). Among children, the risk of LTBI was higher when their IC was a care-giving female (OR: 2.83). Prevalence of active TB was two times higher in children under five (U5 s) (5.3%) compared to adults (2.5%). CONCLUSION We found a high prevalence of active TB and LTBI among contacts of PTB cases in the Syrian refugee population, emphasizing the urgent need for host countries to implement CT strategies for refugees. Our results underscore the vulnerability of U5s and contacts of smear-positive IC highlighting the need for specific actions focusing on those groups.
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Affiliation(s)
- Edouard Hosten
- Paediatric Infectious Diseases, General Pediatrics, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | | | - Emmanuel Andre
- Department of Microbiology and Immunology, Laboratory of Clinical Bacteriology and Mycology, KU Leuven, Leuven, Belgium
| | - Khaled Abu Rumman
- National Tuberculosis Program, Chest Diseases Directorate, Amman, Jordan
| | - Dimitri Van der Linden
- Paediatric Infectious Diseases, General Pediatrics, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
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