Background: In health care workers SARS-CoV-2 has been shown to be an occupational health risk, often associated with transmission between health care workers. Yet, insufficient information on transmission dynamics has been presented to elucidate the precise risk factors for contracting SARS-CoV-2 in this group. Methods: In this cross-sectional study, we investigated association between questionnaire answers on potential exposure situations and SARS-CoV-2-positivity. Health care workers with and without COVID-19-patient contact at nine units at Skåne University Hospitals in Malm€ o and Lund, Sweden and university employees from Lund University, Sweden were enrolled. To limit impact of health care worker to health care worker transmission, units with known outbreaks were excluded. A SARS-CoV-2-positive case was defined by a previous positive PCR or anti-SARS-CoV-2 IgG in the ZetaGene COVID-19 Antibody Test. Results: SARS-CoV-2-positivity was detected in 11/51 (22%) health care workers in COVID-19-units, 10/220 (5%) in non-COVID-19-units and 11/192 (6%) University employees (p ¼ .001, Fischer's exact). In health care workers, SARS-CoV-2-positivity was associated with work in a designated COVID-19-unit (OR 5.7 (95CI 2.1-16)) and caring for COVID-19-patients during the majority of shifts (OR 5.4 (95CI 2.0-15)). In all participants, SARS-CoV-2-positivity was associated with a confirmed COVID-19 case (OR 10 (95CI 2.0-45)) in the household. Conclusion: Our study confirmed previous findings of elevated risk of acquiring SARS-CoV-2 in health care workers in COVID-19-units, despite exclusion of units with known outbreaks. Interestingly, health care workers in non-COVID-19-units had similar risk as University employees. Further measures to improve the safety of health care workers might be needed. KEY POINTS Previous findings of elevated risk of contracting SARS-CoV-2 in health care workers with COVID-19 patient contact was confirmed, despite exclusion of wards with known SARS-CoV-2 outbreaks. Further measures to improve the safety of health care workers might be needed.
Background/Aim: Cervical cancer is associated with poorer diagnosis among the elderly and pap-smear screening has a lower sensitivity. Self-sampling for detection of high-risk human papillomavirus (hr-HPV) may be an alternative screening method. The aim of this study was to analyze the response rate to vaginal HPV self-sampling and the HPV mRNA prevalence among women 69-70 years. Materials and Methods: An HPV self-sampling kit was sent to 1,000 women 69-70 years whom had not taken a cervical smear in ≥5 years. The samples were analyzed by the Aptima HPV mRNA assay. HPV-positive women were recalled for a follow-up examination. Results: The self-sample response rate was 43.3%. The HPV mRNA prevalence was 6.2%. All HPV-positive women attended follow-up. Conclusion: HPV self-sampling was accepted among older women. Although the HPV mRNA prevalence was 6.2%, no high-grade cytological abnormalities were found. Larger studies are needed to elucidate hr-HPV self-sampling as a tool to identify older women at risk of cervical cancer.In 2017 one out of five people were 65 years or older in Sweden and the number of people 80 years and older are expected to increase by 50% in less than 30 years (1). Cervical cancer is one of the most common cancers among women globally (2). Some studies show a bimodal distribution of cervical cancer incidence with a first peak among younger women around the age of 40 and a second peak among older women around the age of 65-79 (3, 4). In a Danish study, it was observed that the peak incidence of cervical cancer will shift to 75-79 years of age when correcting for hysterectomy (4). Considerations must be taken because cervical cancer is not only a disease of young women, but also an important disease in the elderly. Several previous studies have shown that older women to a greater extent are diagnosed with an advanced-stage disease (3, 5-9) and the prognosis is poor (7, 8). A pap smear has a lower sensitivity among postmenopausal women (10) as the transformation zone moves upwards into the cervical canal (11,12) in this age group, contributing to a higher risk of clinical sampling errors which may miss women with cervical dysplasia or invasive cancer.There is no consensus at what age to stop screening for cervical cancer. According to European guidelines, screening with cytology or human papillomavirus (HPV) could be stopped around 60-65 years, given the woman has had a recent negative test (13). In Sweden, the organized screening program for cervical cancer comprises women 23-64 years old, but the women must be recalled at the age of 70 years if no test is registered after the age of 64 years (11). A paradigm shift for cervical cancer screening is currently under way in several countries. Persistent infection with high-risk HPV (hr-HPV) is the main reason for 99.7% of cervical dysplasia and invasive cervical cancer (14). Screening for hr-HPV types has been shown to be more effective in preventing invasive cervical cancer compared to cytology for women ≥30 years, hence this method is now recomm...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.