Identification of tuberculosis cases by port health screening in Essex 1997–2003

اختصاصی از فی موو Identification of tuberculosis cases by port health screening in Essex 1997–2003 دانلود با لینک مستقیم و پر سرعت .

Sally Millership and Amelia Cummins

Abstract
Between 1997 and 2003 an annual average of 1867 new
entrants seen at the port of arrival were notified to the
communicable disease teams who now form the Essex
Health Protection Unit. We examined the number of individuals
who made contact with health services by linking
port health and tuberculosis databases with combinations
of surname, forename and date of birth the number of new
entrants developing tuberculosis. We also searched paper
records for all incidents of active tuberculosis in health
and residential care workers. Eighteen individuals were in
both port health and tuberculosis data sets; only one was
identified by new entrant screening. In the same period
there were 35 cases of active tuberculosis in health care
workers, only one of whom had been screened on arrival
in the United Kingdom, resulting in follow-up of 371 contacts.
The new entrant screening programme in Essex
should be stopped and resources diverted to improve followup
of new entrants, especially those who are health care
workers.
Keywords: new entrant, port health, tuberculosis

Factors influencing health care workers’ adherence to work site tuberculosis screening and treatment policies

اختصاصی از فی موو Factors influencing health care workers’ adherence to work site tuberculosis screening and treatment policies دانلود با لینک مستقیم و پر سرعت .

Heather A. Joseph, MPH,a Robin Shrestha-Kuwahara, MPH,a Diane Lowry, MPH, MSW,a Lauren A. Lambert, MPH,a
Adelisa L. Panlilio, MD, MPH,b Beth G. Raucher, MD, MSHCM,c James M. Holcombe, MPPA,d Jan Poujade, RN, MS,e
Diane M. Rasmussen, RN,f and Maureen Wilce, MSa
Atlanta, Georgia, New York, New York, Jackson, Mississippi, Portland, Oregon, and Kansas City, Missouri
Background: Despite the known risk of tuberculosis (TB) to health care workers (HCWs), research suggests that many are not fully
adherent with local TB infection control policies. The objective of this exploratory study was to identify factors influencing HCWs’
adherence to policies for routine tuberculin skin tests (TSTs) and treatment of latent TB infection (LTBI).
Methods: Sixteen focus groups were conducted with clinical and nonclinical staff at 2 hospitals and 2 health departments.
Participants were segmented by adherence to TST or LTBI treatment policies. In-depth, qualitative analysis was conducted to
identify facilitators and barriers to adherence.
Results: Among all focus groups, common themes included the perception that the TSTwas mandatory, the belief that conducting
TSTs at the work site facilitated adherence, and a general misunderstanding about TB epidemiology and pathogenesis. Adherent
groups more commonly mentioned facilitators, such as the perception that periodic tuberculin skin testing was protective and the
employee health (EH) provision of support services. Barriers, such as the logistic difficulty in obtaining the TST, the perception that
LTBI treatment was harmful, and a distrust of EH, emerged consistently in nonadherent groups.
Conclusions: This information may be used to develop more effective interventions for promoting HCW adherence to TB
prevention policies. Informed efforts can be implemented in coordination with reevaluations of infection control and EH programs
that may be prompted by the publication of the revised TB infection control guidelines issued by the Centers for Disease Control
and Prevention in 2005. (Am J Infect Control 2004;32:456-61.)

Public health law and tuberculosis control in Europe

اختصاصی از فی موو Public health law and tuberculosis control in Europe دانلود با لینک مستقیم و پر سرعت .

R.J. Cokera,, S. Mounier-Jacka, R. Martinb

Summary Background: Tuberculosis control is an important public health challenge
in many European countries. Law is an important tool that policy-makers can
draw upon to support control efforts and, according to the World Health
Organization, represents a tangible expression of political commitment and will.
Despite this, little national research, and even less cross-national comparative
research, has been conducted to describe and analyse legislative approaches to
tuberculosis control.
Methods: We conducted a survey of 14 European countries to identify, describe,
map and analyse legislative tools used to support tuberculosis control.
Results: We found a wide range of legislative models. Legal measures available to
nation states, such as compulsory examination, compulsory screening, compulsory
detention, compulsory treatment and compulsory vaccination, vary widely in both
scope and number. We identified a typology of legal frameworks, from the most
authoritarian to the least restrictive. It seems likely that the application of some
laws might not withstand scrutiny under the European Convention for the Protection
of Human Rights and Fundamental Freedoms.
Conclusions: Harmonization of legislative response to infectious diseases, based
upon sound evidence, may be necessary if collaborative efforts in support of
infectious disease control, as envisaged in the new International Health Regulations,
are to be most effective and are to reflect more appropriately a globalized 21st
century world.