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Volume 15 - January 1994

Contents

Page 1 of 16

Editorial

  • HIV Screening for Healthcare Providers: Can We Provide Sense and Sensibility Without Pride or Prejudice?

  • David K. Henderson
  • Published online by Cambridge University Press: 02 January 2015, pp. 631-634
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Letters to the Editor

  • STERIS SYSTEM 1 in Germany

  • Franz Daschner
  • Published online by Cambridge University Press: 02 January 2015, p. 294
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  • Control of MRSA in a Long-Term Care Facility

  • Andrew E. Simor, Anne Augustin, John Ng, Stephen Betschel, Margaret McArthur
  • Published online by Cambridge University Press: 02 January 2015, pp. 69-70
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  • Aspergillosis Due to Carpet Contamination

  • Stanton L. Gerson, Pamela Parker, Michael R. Jacobs, Richard Creger, Hillard M. Lazarus
  • Published online by Cambridge University Press: 02 January 2015, pp. 221-223
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  • Isolation Rooms for TB Control

  • Lawrence Mintz
  • Published online by Cambridge University Press: 02 January 2015, p. 570
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  • Measles Immunization in HCWs

  • Kevin G. Huang, Michael R. Spence, Adamadia Deforest, Alicia T Bradley
  • Published online by Cambridge University Press: 02 January 2015, p. 4
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  • Universal Maximal Sterile Barrier Precautions May Be Unnecessary

  • F. Kapadia, C. Rodrigues
  • Published online by Cambridge University Press: 02 January 2015, p. 685
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  • Disagreement over CDC Draft Guideline

  • Karim Adal, Anne M. Anglim, Yardena Siegman-Igra, Barry M. Farr, Jack M. Gwaltney, Jr, W. Michael Scheld
  • Published online by Cambridge University Press: 02 January 2015, p. 366
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Editorial

  • Why CIPI?

  • Jean-Claude Pechere
  • Published online by Cambridge University Press: 02 January 2015, p. 427
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Letters to the Editor

  • Postexposure Varicella Management Further Comments

  • Donna Haiduven, David A. Stevens, Carmen Hench
  • Published online by Cambridge University Press: 02 January 2015, p. 740
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  • Pitfalls in Infection Control

  • Barry C. Fox, Teresa Rahn
  • Published online by Cambridge University Press: 02 January 2015, p. 507
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  • Pseudoinfection of a Total Knee Arthroplasty

  • Jeanne A. Linquist, Becky Riemer, Paul E. Hazelrig
  • Published online by Cambridge University Press: 02 January 2015, p. 141
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Original Articles

  • HIV Screening of Surgeons and Dentists: A Cost-Effectiveness Analysis

  • Randall L. Sell, Albert J. Jovell, Joanna E. Siegel
  • Published online by Cambridge University Press: 02 January 2015, pp. 635-645
  • Objective:

    To assess the cost-effectiveness of human immunodeficiency virus (HIV) screening strategies of surgeons and dentists.

    Design:

    We constructed a model to project costs and HIV transmissions prevented over 15 years for four screening scenarios: 1) one-time voluntary screening, 2) one-time mandatory screening, 3) annual voluntary screening, and 4) annual mandatory screening. One-time screening occurs only in the first year of the program; annual screening occurs once each year. Under mandatory screening, all practitioners are tested and risks of practitioner-to-patient transmission are eliminated for all practitioners testing positive. Voluntary screening assumes 90% of HIV-positive and 50% of HIV-negative practitioners are tested, and risks of transmission in the clinical setting are eliminated for 90% of HIV-positive surgeons and dentists. All costs and benefits are discounted at 5% per annum over 15 years.

    Results:

    Using “best-case” scenario assumptions, we find for surgeons that a one-time voluntary screening program would be most cost-effective, at $899,336 for every HIV transmission prevented. For dentists, the one-time voluntary program also is the most cost-effective, at $139,571 per transmission prevented. Annual mandatory programs were least cost-effective for both surgeons and dentists, at $63.3 million and $2.2 million per transmission prevented, respectively.

    Conclusions:

    HIV screening of surgeons and dentists ranks among the more expensive medical lifesaving programs, even using liberal assumptions about program effectiveness. Frequency of screening and whether testing is mandatory or voluntary dramatically affect cost per transmission prevented; these features should be considered carefully in designing specific HIV screening programs.

Letters to the Editor

  • The author replies

  • Dennis G. Maki
  • Published online by Cambridge University Press: 02 January 2015, pp. 685-686
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Correction

Editorial

  • Measles and Healthcare Workers

  • William L. Atkinson
  • Published online by Cambridge University Press: 02 January 2015, pp. 5-7
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Letters to the Editor

  • Statistical Process Control Charts

  • James T. Lee
  • Published online by Cambridge University Press: 02 January 2015, p. 223
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  • The authors reply

  • Robert Harrison, Janet Macher, Joan Sprinson, Mark Nicas, Sarah Royce
  • Published online by Cambridge University Press: 02 January 2015, pp. 570-571
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Page 1 of 16