Institut Pasteur de Madagascar, Antananarivo, Madagascar.
Centre Hospitalier Universitaire Joseph Raseta Befelatanana, Antananarivo, Madagascar.
Influenza Other Respir Viruses. 2022 Nov;16(6):994-1003. doi: 10.1111/irv.13022. Epub 2022 Jun 26.
Health care workers (HCWs) represent a vulnerable population during epidemic periods. Our cohort study aimed to estimate the risk of infection and associated factors among HCWs during the first wave of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Madagascar.
A prospective cohort study was carried out in three hospitals that oversaw the first cases of COVID-19. Monthly ELISA-based serological tests were conducted, and nasopharyngeal swabs were collected in the case of symptoms linked to COVID-19 for RT-PCR analysis. Survival analyses were used to determine factors associated with SARS-CoV-2 infection.
The study lasted 7 months from May 2020. We included 122 HCWs, 61.5% of whom were women. The median age was 31.9 years (IQR: 26.4-42.3). In total, 42 (34.4%) had SARS-CoV-2 infections, of which 20 were asymptomatic (47.6%). The incidence of SARS-CoV-2 infection was 9.3% (95% CI [6.5-13.2]) person-months. Sixty-five HCWs presented symptoms, of which 19 were positive by RT-PCR. When adjusted for exposure to deceased cases, infection was more frequent in HCWs younger than 30 years of age (RR = 4.9, 95% CI [1.4-17.2]).
Our results indicate a high incidence of infection with SARS-CoV-2 among HCWs, with a high proportion of asymptomatic cases. Young HCWs are more likely to be at risk than others. Greater awareness among young people is necessary to reduce the threat of infection among HCWs.
在疫情期间，医护人员（HCWs）属于弱势群体。本队列研究旨在估计马达加斯加首例严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）期间医护人员感染的风险和相关因素。
在三家医院进行了前瞻性队列研究，这些医院负责首例 COVID-19 病例。每月进行基于 ELISA 的血清学检测，并且在出现与 COVID-19 相关的症状时采集鼻咽拭子进行 RT-PCR 分析。采用生存分析来确定与 SARS-CoV-2 感染相关的因素。
研究从 2020 年 5 月持续了 7 个月。共纳入 122 名医护人员，其中 61.5%为女性。中位年龄为 31.9 岁（IQR：26.4-42.3）。共有 42 名（34.4%）医护人员感染 SARS-CoV-2，其中 20 名无症状（47.6%）。SARS-CoV-2 感染的发生率为 9.3%（95%CI[6.5-13.2]）人月。65 名医护人员出现症状，其中 19 名 RT-PCR 检测呈阳性。调整接触死亡病例后，30 岁以下的医护人员感染的风险更高（RR=4.9，95%CI[1.4-17.2]）。
我们的结果表明，医护人员感染 SARS-CoV-2 的发生率较高，且无症状病例比例较高。年轻的医护人员比其他人更有可能面临风险。需要提高年轻人的意识，以降低医护人员感染的威胁。
