评估医院卫生保健工作者无症状查的综合测试
Bethany Heath1, Stephanie Evans2,3, David S Robertson4
1MRC Biostatistics Unit, Univeristy of Cambridge, Robinson Way, Cambridge, CB2 0SR, Cambridgeshire, United Kingdom. bethany.heath@mrc-bsu.cam.ac.uk.
BMC infectious diseases
|December 22, 2023
概括
在COVID-19期间,医疗保健工作者进行集体测试适度减少了医院感染. 使用PCR和侧流装置进行基于病房的聚合测试,根据政策优先事项和病毒流行情况,提供了一个具有成本效益的策略.
科学领域:
- 传染病流行病学 传染病流行病学
- 医疗保健管理的管理
- 公共卫生政策 公共卫生政策
背景情况:
- 鼻腔感染,特别是在COVID-19大流行期间,对患者和医疗保健工作者 (HCW) 构成重大威胁.
- 实施了无症状测试方案,包括对HCW的聚合酶链反应 (PCR) 测试,以减轻传播.
- 聚合测试,即用单个测试分析多个样本,是用有限的资源最大限度地提高测试能力的策略.
研究的目的:
- 评估两种组合测试方案在典型的英国医院环境中对无症状医疗保健工作者进行测试的有效性.
- 为了比较组合测试策略与仅对症状HCW进行测试的基线.
- 分析不同SARS-CoV-2变种和封锁场景对聚合测试疗效的影响.
主要方法:
- 使用一个模拟SARS-CoV-2传播的基于个体的模型.
- 评估了两个组合测试方案:"病房" (单个病房的资格) 和"完整" (跨病房的资格).
- 模型适用于锁定下的Omicron前变种,以及在没有限制的"正常生活"期间的Omicron变种.
主要成果:
- 综合无症状测试显示,无论隔离状态如何,总体医院性HCW感染量略有,统计显著减少约2%,不论隔离状态如何.
- "病房"和"全面"的综合测试方案都显示出类似的感染减少,但"病房"测试的成本要低得多.
- 整合侧流装置 (LFD) 进行后续测试,降低了成本和时间,但与PCR相比,引入了不同的错误概况.
结论:
- 集体检测提供了适度但显著的减少医院内HCW感染.
- 单纯PCR或组合PCR和LFD病房检测之间的选择取决于政策优先级,当前的病毒流行率和封锁条件.
- 以病房为基础的聚合测试,特别是用LFDs,为管理HCW感染提供了潜在的成本效益的方法.
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