Background
Methods
Cross-sectional study on knowledge and awareness of national recommendations for IMD contact management
Retrospective case study on costs associated with IMD contact management
Cost identification
Medications
Health care delivery
Staff cost
Data analysis
Ethical approval
Results
Implementation of national recommendations for IMD contact management
Contact category | No. LHAs that advised PEP | Total | % | |
---|---|---|---|---|
Household | All household members | 34 | 34 | 100 |
Kindergarten/preschool | All children in the facility | 10 | 34 | 29 |
Only the group of index case | 23 | 33 | 70 | |
Teacher of the index case | 31 | 32 | 97 | |
School | Only pupils sitting in neighbouring seat | 17 | 32 | 53 |
Class of the index case | 15 | 32 | 47 | |
Teacher of the index case | 17 | 32 | 53 | |
Students’ residence or similar (e.g. barracks, hotels) | All residents | 1 | 34 | 3 |
Only residents on the same floor | 13 | 34 | 38 | |
Only residents in the same room | 20 | 34 | 59 | |
Travellers* | Contact with oropharyngeal secretions of index case | 33 | 33 | 100 |
Sitting in proximity to index case | 31 | 32 | 97 | |
Contact longer than a specified time** | 9 | 30 | 30 | |
Healthcare workers | Any contact with index case | 11 | 34 | 32 |
Only if contact with oropharyngeal secretions of index case | 22 | 34 | 65 |
LHAs recommending antibiotic | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Rifampicin | Ciprofloxacin | Ceftriaxone i.m. | Other [which] | |||||||||
Contact category | n | N | % | n | N | % | n | N | % | n | N | % |
Infants
| 28 | 29 | 97 | 1 | 29 | 3 | - | - | - | 1 | 30 | 3 [unspecified] |
Toddlers
| 30 | 30 | 100 | 1* | 30 | 3 | 2* | 30 | 7 | - | - | - |
School children (5–11 years)
| 30 | 30 | 100 | 5* | 30 | 17 | - | - | - | - | - | - |
Adolescents (12–17 years)
| 28 | 30 | 93 | 4** | 30 | 13 | 7* | 30 | 23 | - | - | - |
Adults
| 16† | 30 | 53 | 27 | 30 | 90 | 3‡ | 30 | 10 | - | - | - |
Pregnant women
| 1 | 30 | 3 | 1 | 30 | 3 | 27 | 30 | 90 | 1 | 30‡‡ | 3 [azithromycin] |
IMD contact management
Category of IMD contact | No. contacts recommended PEP | No. cases with ≥1 contact | Contacts per case | % contacts recommended PEP | |
---|---|---|---|---|---|
Mean | Range | ||||
Household members 0–18 years
| 35 | 16 | 0.9 | 0-9 | 97 |
Household members >18 years
| 113 | 35 | 2.9 | 0-15 | 96 |
Healthcare workers
| 83 | 14 | 2.0 | 0-21 | 100 |
Kindergarten/preschool
| NA | 0 | 0 | - | NA |
School
| 34 | 3 | 1.1 | 0-21 | 72 |
Dormitory or similar
| 3 | 1 | 0.07 | 0-3 | 100 |
Family visit*
| 73 | 14 | 1.8 | 0-17 | 100 |
Children (<19 years) | 37 | 14 | 0.9 | - | 100 |
Adults (>18 years) | 36 | 14 | 0.9 | - | 100 |
Other contacts
| 110 | 20 | 2.8 | 0-42 | 97 |
Children (<19 years) | 21 | 4 | 0.4 | 0-10 | 100 |
Adults (>18 years) | 89 | 16 | 2.2 | 0-42 | 100 |
Costs of IMD contact management
FTE* staff | |||||
---|---|---|---|---|---|
Mean | Range | Mean person-days | Person-days (range) | Staff cost | |
Physicians
| 1.58 | 1-3 | 1.18 | 0.12-3.00 | €343 |
Hygiene inspectors
| 1.00 | 0-5 | 0.35 | 0.12-2.50 | €54 |
Other personnel
| 1.26 | 0-2 | 0.31 | 0-2.00 | €44 |
Total
| 3.84 | 1.84 | €441 |
IMD Contact persons | Antibiotics used | Cost of antibiotics (€) | Percent of contacts | Cost per average contact | No. of contacts per IMD case | Total cost per case |
---|---|---|---|---|---|---|
Children | Rifampicin syrup | 21.60 | 100% | 21.60 | 3 | 64.80 |
Adults | Rifampicin tablets | 39.47 | 20% | 19.29 | 8 | 154.34 |
Ciprofloxacin tablets | 14.36 | 79% | ||||
Ceftriaxone i.m. | 5.36 | 1% | ||||
Total | 219.14 |