On 16 Sep 2021, Thailand's Division of Epidemiology, was notified of an outbreak of coronavirus disease 2019 (COVID-19) in a garment factory in Tak Province. An outbreak investigation was conducted to determine epidemiological characteristics of cases, identify risk factors associated with infection, and recommend appropriate preventive measures. A review of COVID-19 surveillance data and outbreak reports was performed. An active case finding was conducted among the factory workers. We interviewed the manager and workers of the factory and performed an environmental observation and conducted a case-control study. Logistic regression models were employed. Of 242 workers tested for severe acute respiratory syndrome coronavirus 2 by rapid antigen test kit, 90 (37.2%) were found positive. The attack rate was highest in the sewing department (47.4%) and among female workers (53.8%). The prevalence of asymptomatic infection was 15.6%. One case with pneumonia was found and there were no deaths. Working in the sewing department was a significant risk factor [adjusted odds ratio (OR) 3.15, 95% confidence interval (CI) 1.01–9.79] while mask wearing [adjusted OR 0.34, 95% CI 0.14–0.82] was a protective factor. Overcrowding and poorly ventilated conditions were observed in the workplace. Our investigation confirmed a COVID-19 outbreak in a garment factory. Reorienting the environment and strengthening individual protective measures, such as mandatory mask wearing and physical distancing amongst the workers, are recommended.
Leprosy has been a public health problem in Myanmar for many centuries. This study aims to explore the situation of leprosy and the association between leprosy and social determinants at the township level in seven endemic regions in Myanmar. The objectives of the study are to (i) describe the incidence and severity of leprosy and the disability due to leprosy in Myanmar between 2016 and 2019, and (ii) determine the correlation between leprosy incidence and social determinants in Myanmar in 2019. We used annual surveillance data of leprosy cases between 2016 and 2019 from the National Leprosy Control Program, Myanmar, and social determinant variables from the 2019 General Administration Department Census Report of Myanmar. An ecological cross-sectional study was conducted. Univariable and multivariable analyses applying zero-inflated negative binomial regression models were used. A geographic information system mapping was used to visualize leprosy cases, disease severity, and disability due to leprosy between 2016 and 2019. The number of all leprosy indicators changing pattern was seen obvious between regions. The eastern region showed relatively an increase in detection of new cases in 2019 compared with years 2017 and 2018. The increase in the detection of multibacillary leprosy cases was also observed in the eastern region during this period. Yet, the detection of Grade-II disability cases across regions remained relatively stable throughout study years. The number of tuberculosis cases per 1,000 population was significantly correlated with leprosy incidence at the township level (risk ratio 1.27, 95% confidence interval 1.04–1.55). These findings highlight the importance of enhancing active case finding campaigns in high-endemic regions, especially the eastern states of Myanmar. Integration of leprosy and tuberculosis case-finding programmes is likely to help leverage resources and maximize efforts to cope with leprosy problems in Myanmar.
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