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Archives of Public Health (1)
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Braeckman, Lutgart (2)
De Keukeleire, David (1)
Duim, Birgitta (1)
Duquenne, Barbara (1)
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Routine dipstick urinalysis in daily practice of Belgian occupational physicians
Archives of Public Health
Little work has been done to assess the quality of health care and the use of evidence-based methods by occupational physicians in Belgium. Therefore, the main objective is to describe one aspect of occupational health assessments, namely the common use of dipstick urinalysis, and to compare the current practice with international guidelines.
A self-administered questionnaire was mailed to 211 members of the Scientific Association of Occupational Medicine in the Dutch speaking part of Belgium.
A total of 120 occupational physicians responded, giving a response rate of 57%. Dipstick urinalysis was a routine investigation for the vast majority of physicians (69%). All test strips screened for protein and in 90% also for blood. Occupational health services offered clinical tests to satisfy customer wants as international guidelines do not recommend screening for haematuria and proteinuria in asymptomatic adults. A lack of knowledge concerning positive testing and referral criteria was demonstrated in almost half of the study participants.
Belgian occupational physicians still routinely perform dipstick testing although there is no evidence to support this screening in healthy workers. To practice evidence-based medicine, occupational physicians need more instruction and training. Development and implementation of more guidelines is not only of use for the individual practitioner, it may also enhance professionalization and efficiency of occupational health care.
Evidence-based practice; Occupational health; Guidelines; Health surveillance
Evaluation of a Chlamydophila psittaci Infection Diagnostic Platform for Zoonotic Risk Assessment▿
De Keukeleire, David
Journal of Clinical Microbiology
Reports on zoonotic transmission of Chlamydophila psittaci originating from poultry are incidentally published. During recent studies in European turkeys we isolated C. psittaci genotypes A, B, D, E, F, and E/B, all considered potentially dangerous for humans. This encouraged us to analyze the zoonotic risk on a Belgian turkey farm, from production onset until slaughter, using a Chlamydophila psittaci diagnostic platform. Twenty individually marked hens, as well as the farmer and two scientists, were monitored medically. Bioaerosol monitoring, serology, isolation, and nested PCR demonstrated chlamydiosis on the farm leading to symptomatic psittacosis in all 3 persons involved. ompA sequencing confirmed the zoonotic transmission of C. psittaci genotype A. Strangely, two different antibody microimmunofluorescence (MIF) tests remained negative in all infected persons. The results demonstrate the value of the currently used diagnostic platform in demonstrating C. psittaci infections in both birds and humans but raise questions regarding use of the MIF test for diagnosing human psittacosis. In addition, our results suggest the underestimation of psittacosis in the poultry industry, stressing the need for a veterinary vaccine and recommendations for zoonotic risk reduction strategies.
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