Evidence map›Paper›PMID 34734176›Full record

ReviewAfrican journal of thoracic and critical care medicine2021

A position statement and practical guide to the use of particulate filtering facepiece respirators (N95, FFP2, or equivalent) for South African health workers exposed to respiratory pathogens including

K Dheda, S Charalambous, A S Karat, A von Delft, U G Lalloo, R van Zyl Smit, R Perumal, B W Allwood, A Esmail, M L Wong and 21 more

Open access · diamondAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in African journal of thoracic and critical care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. A systematic review andPreventive medicine reports · 2023
    Review
  4. Review
  5. Review
  6. Position statement for adult and paediatric spirometry in South Africa: 2022 update.African journal of thoracic and critical care medicine · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors at 14 institutions in 3 countries.

K DhedaCentre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute and South African MRC/UCT Centre for the Study of Antimicrobial Resistance, University of Cape Town, Cape Town, South Africa.
S CharalambousThe Aurum Institute, Johannesburg, South Africa.
A S KaratTB Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom.
A von DelftSchool of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
U G LallooGateway Private Hospital Medical Centre, Umhlanga Ridge, South Africa.
R van Zyl SmitDivision of Pulmonology and Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
R PerumalCentre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute and South African MRC/UCT Centre for the Study of Antimicrobial Resistance, University of Cape Town, Cape Town, South Africa.
B W AllwoodDivision of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
A EsmailClinical Trials Unit, University of Cape Town Lung Institute, South Africa.
M L WongDivision of Pulmonology, Department of Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
A G DuseClinical Microbiology & Infectious Diseases, School of Pathology of the NHLS & University of the Witwatersrand, Johannesburg, South Africa.
G RichardsDepartment of Critical Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
C FeldmanDepartment of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
M MerDepartment of Medicine, Divisions of Pulmonology and Critical Care, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
K NyamandeDepartment of Pulmonology, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa.
U LallaDivision of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
C F N KoegelenbergDivision of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
F VenterEzintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
H DawoodGreys Hospital, Pietermaritzburg, South Africa.
S AdamsDivision of Occupational Medicine, School of Public Health and Family Medicine, University of Cape Town, South Africa.
N A B NtusiDivision of Cardiology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
H-M van der WesthuizenTB Proof, South Africa.
M-Y S MoosaDepartment of Infectious Diseases, Division of Internal Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
N A MartinsonPerinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa.
H MoultrieNational Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa.
J NelDivision of Infectious Diseases, Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa.
H HauslerTB HIV Care, Cape Town, South Africa.
W PreiserDivision of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service Tygerberg, Cape Town, South Africa.
L LasersohnSouth African Society of Anaesthesiologists.
H J ZarDepartment of Paediatrics & Child Health, Red Cross Children's Hospital and SAMRC Unit on Child and Adolescent Health, University of Cape Town, South Africa.
G J ChurchyardThe Aurum Institute, Johannesburg, South Africa.
University of the Witwatersrand · ZAUniversity of Cape Town · ZAGroote Schuur Hospital · ZALondon School of Hygiene & Tropical Medicine · GBStellenbosch University · ZATygerberg Hospital · ZAUniversity of KwaZulu-Natal · ZAGrey's Hospital · ZAJohannesburg Hospital · ZARed Cross War Memorial Children's Hospital · ZASouth African Society of Anaesthesiologists · ZASouth African Tuberculosis Vaccine Initiative · ZAUniversity of Oxford · GBVanderbilt University · US

Funding

Aurum Clinical Trials UnitUM1AI154463 · NIAID · AURUM INSTITUTE NPC · PI Gavin John Churchyard · 2021 to 2026
$8.1M
Medical Research Council MR/S03563X/1Medical Research Council MR/V028782/1NIAID NIH HHS UM1 AI154463
6 · The paper itself

Abstract

summarySevere acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is transmitted mainly by aerosol in particles <10 µm that can remain suspended for hours before being inhaled. Because particulate filtering facepiece respirators ('respirators'; e.g. N95 masks) are more effective than surgical masks against bio-aerosols, many international organisations now recommend that health workers (HWs) wear a respirator when caring for individuals who may have COVID-19. In South Africa (SA), however, surgical masks are still recommended for the routine care of individuals with possible or confirmed COVID-19, with respirators reserved for so-called aerosol-generating procedures. In contrast, SA guidelines do recommend respirators for routine care of individuals with possible or confirmed tuberculosis (TB), which is also transmitted via aerosol. In health facilities in SA, distinguishing between TB and COVID-19 is challenging without examination and investigation, both of which may expose HWs to potentially infectious individuals. Symptom-based triage has limited utility in defining risk. Indeed, significant proportions of individuals with COVID-19 and/or pulmonary TB may not have symptoms and/or test negative. The prevalence of undiagnosed respiratory disease is therefore likely significant in many general clinical areas (e.g. waiting areas). Moreover, a proportion of HWs are HIV-positive and are at increased risk of severe COVID-19 and death. RECOMMENDATIONS: Sustained improvements in infection prevention and control (IPC) require reorganisation of systems to prioritise HW and patient safety. While this will take time, it is unacceptable to leave HWs exposed until such changes are made. We propose that the SA health system adopts a target of 'zero harm', aiming to eliminate transmission of respiratory pathogens to all individuals in every healthcare setting. Accordingly, we recommend: the use of respirators by all staff (clinical and non-clinical) during activities that involve contact or sharing air in indoor spaces with individuals who: (

Identifiers

PMID34734176
PMCPMC8545268
OpenAlexW3210773608

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.