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1.
Przegl Epidemiol ; 77(4): 466-475, 2024 May 20.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-38783655

RESUMO

BACKGROUND: The incidence of gonorrhoea at the European level increased over 2012-2019, decreased in 2020, and then reached higher values in 2021 than in 2019. OBJECTIVE: Analysis in the descriptive epidemiology scheme of gonorrhoea notification in surveillance in Poland in 2021 (being the second year of the COVID-19 pandemic). MATERIAL AND METHODS: Case-base data from surveillance of gonorrhoea were used: confirmed case (meeting laboratory criteria), probable (meeting clinical criteria and contact with confirmed case) and possible (only in Poland - physician diagnosed gonorrhoea, no information available for proper classification). Statistic Poland data was used to calculate the indicators. Data on patients treated in dermatology-venereology clinics between 2019-2021 were taken from the Bulletins of the Ministry of Health. RESULTS: The incidence of gonorrhoea in Poland in 2021 was only a fraction of recorded in the EU/EEA (0.74 vs. 13.7/100000)-similar to the first pandemic year and were about half of those notified in the 2019 (the peak year; 281 vs. 522 cases). There were 15.5 men per one female (incidence: 1.6/100000 men, 0.1/100000 women). Every second case was among aged 25-34 (49.62%), every fourth-aged 35-44 (23.11%). Under 15, no cases were reported. The predominant site was the genitourinary (excluding missing data: 85.3%). The cases with missing information on transmision increased (49.1%; aged 45+: 72.0%, women: 76.5%). Delays in reporting data were identified (greater than in 2019, however, less than in 2020), ~17% cases were from 2019-2020. Dermatology-venerology clinics treated 385 people - less than in 2020, however, more than reported in epidemiological surveillance (vs. 281). CONCLUSIONS: The COVID-19 pandemic has influenced on the surveillance system in Poland. There are difficulties in interpreting the epidemiological trend. It is necessary to: 1) intensify systemic solutions in the area of prevention, including sexual partners; 2) raise the awareness of healthcare professionals and sanitary inspection workers on the role of collecting epidemiological information.


Assuntos
COVID-19 , Gonorreia , Humanos , Polônia/epidemiologia , Gonorreia/epidemiologia , Gonorreia/diagnóstico , Masculino , Feminino , Adulto , Incidência , COVID-19/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem , SARS-CoV-2 , Adolescente , Distribuição por Idade , Distribuição por Sexo , População Urbana/estatística & dados numéricos , Idoso , População Rural/estatística & dados numéricos
2.
Przegl Epidemiol ; 77(2): 220-232, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37860855

RESUMO

Background: In 2021, the COVID-19 pandemic continued, however, due to the implementation of vaccination, fewer disruptions were observed in healthcare. In the detection of HCV - inextricably linked to access to testing - there was an incomplete return to the pre-pandemic level of diagnostics (in the EU/EEA in 2021, 4.1 infections/100,000, in 2019 - 8.8). The aim of the article was to present the HCV situation in 2021 according to the data of the epidemiological surveillance in Poland compared to 2015-2020. Material and methods: We used the data: 1) from individual epidemiological surveillance; 2) from bulletins for the years 2015-2021 (diagnosis rates) and 3) regarding deaths from the Statistics Poland, Demographic Surveys and Labour Market Department. Results: In 2021, a 30% increase in the detection of new HCV infections was observed (3.26/100,000, 1,244 cases) - about 70%, more than 2,500 cases, are missing to return to the pre-pandemic level. The demographic distribution was different than in Europe: 1) the ratio of women to men 1:1.07; 2) people <25 years: 2.4% of all diagnoses - this may imply worse access to testing among men than women (tested during pregnancy), especially in younger age groups. In Poland, a large percentage of diagnoses involves people outside the high- risk population - mainly exposures related to medical procedures (>75%). The role of primary health care in diagnosing HCV has strengthened (38.6%) - despite the fact that the tests were not yet available within health insurance benefits. The burden on healthcare and sanitary inspection continued to reduce the quality of data. There were more deaths due to acute hepatitis C in 2020-2021 (4 and 6 cases) compared to 2018 2019 (0 and 1 death). Conclusions: The highlighted gaps in diagnosing HCV infections in Poland should be taken into consideration while developing the policy for HCV infections elimination. Poland still lacks in long term solutions, acceptable by and reaching the target population.


Assuntos
COVID-19 , Hepatite C , Masculino , Humanos , Feminino , Lactente , Polônia/epidemiologia , Pandemias , Distribuição por Idade , População Rural , População Urbana , Incidência , Sistema de Registros , COVID-19/epidemiologia , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Surtos de Doenças
3.
Healthcare (Basel) ; 11(4)2023 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-36833046

RESUMO

INTRODUCTION: Sickness presence is used to denote an employee who feels unwell but still attends work, thus avoiding absence. The intention of this paper is to compare sickness presence in a group of the following professions: teachers, nurses and private sector office workers. MATERIAL AND METHODS: For the purpose of this study, a survey based on the original PAPI form (Paper-and-Pen Personal Interview) was carried out. Non-probability sampling, the snowball method (N = 507: teachers n = 174, nurses n = 165 and private sector office workers n = 168), covering the whole of Poland, was adopted. Non-parametric hypotheses were verified using the chi-squared test with a statistical significance α = 0.05. RESULTS: Compared to nurses and private sector office workers, teachers more frequently attended work when sick (p < 0.05). Out of the reported ailments that respondents worked with, teachers more often indicated rhinitis (p < 0.05), sore throat and cough (p < 0.05) and increased temperature (p < 0.05). This may be associated with a threat to the health of individuals in their charge. Teachers commonly complained about joint and bone pain (p < 0.05) and gastrointestinal disorders (p < 0.05). Contrary to nurses and private sector office workers, teachers did not point to 'lack of a replacement' as the reason for their presence at work when sick (p < 0.05). Exclusively, teachers added financial issues and difficulties in access to healthcare if they are working fewer hours to the list of reasons for attending work when sick. CONCLUSIONS: Results suggest that there is a need for further studies on the presence of sick employees in the workplace, especially for teachers. The sickness presence of teachers and nurses may be a threat from a public health perspective. The workplace itself is a significant place to prevent many diseases.

4.
BMC Public Health ; 22(1): 2260, 2022 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-36463162

RESUMO

Healthcare-associated transmission was the second most common hepatitis B (HBV) and hepatitis C (HCV) transmission route according to 2006-2012 European surveillance data, but data quality and completeness issues hinder comprehensive characterisation of this important issue. We carried out a systematic review of published literature on healthcare-associated transmission of HBV or HCV in European Union (EU) and European Economic Area (EEA) countries and the United Kingdom to complement surveillance data and identify higher-risk settings. We searched the PubMed and Embase databases and grey literature over the period January 2006 to September 2021, for publications reporting transmission events after 2000 in the EU/EEA and UK related to a healthcare setting or procedure. We collected data on the country, number of patients, setting type and route of transmission. In 65 publications from 16 countries, 43 HBV and 48 HCV events were identified resulting in 442 newly infected patients. Most events were reported from Italy (7 HBV and 12 HCV), Germany (8 HBV and 5 HCV) and the United Kingdom (8 HBV and 5 HCV). The number of patients infected from a single source within an event ranged from 1 to 53. Five large outbreaks of over 20 cases were identified, including two in Poland and one each in Belgium, Hungary and Slovakia. The majority of transmission events occurred through blood transfusions or in dialysis units. However, there were a number of outbreaks in seemingly low risk settings such as CT/MRI scanning units. A failure to adequately follow infection prevention control (IPC) precautions was reported in 30% of included studies. Healthcare-associated transmission of hepatitis B and C continues to occur in a range of community and hospital settings across EU/EEA countries and often results in large outbreaks, although the true extent of the situation cannot be fully determined due to under-reporting. Strict IPC precautions should be implemented across all healthcare settings and regularly audited, and surveillance systems strengthened and standardised to allow for comprehensive and consistent reporting of nosocomial transmission of hepatitis across the EU.


Assuntos
Hepatite B , Hepatite C , Humanos , União Europeia , Surtos de Doenças , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Hepacivirus , Reino Unido/epidemiologia , Atenção à Saúde
5.
Przegl Epidemiol ; 76(3): 391-401, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36524901

RESUMO

PURPOSE: The aim of the study was to assess the epidemiological situation of syphilis cases in Poland in 2020 in comparison to previous years. MATERIAL AND METHODS: Analysis of the epidemiological situation was based on case-based data from reports of newly detected syphilis cases received from doctors and laboratories in 2020. Additionally aggregated data from MZ-56 reports on infectious diseases, infections and poisoning from 2014 to 2018 sent from Sanitary Inspections to NIPH NIH -NRI was used. Also, data about treatment patients in dermatology/venerology clinics in 2020 reported on MZ-14 forms and published in statistics bulletin on Ministry of Health on e-health system website (actually: https://e-zdrowie.gov.pl; https://cez.gov.pl) and NIPH NIH - NRI website were used. RESULTS: In 2020 in Poland 686 newly diagnosed syphilis cases were reported (diagnosis rate was 1.79 per 100,000), including 18 cases among non-Polish citizens. The frequency of newly detected syphilis cases decreased by 54.6% compared to the previous year and similar decreased 52.5% compared to the median in 2014-2018 years. The syphilis cases were most often detected in the age group between 20 and 39 years (68.9%) and among men (86.2%). On the other hand, places where syphilis cases are treated, reported 1,529 cases - less by 4% than in 2019 year, including 979 cases on early stage of syphilis. CONCLUSION: In 2020, the number of reported a newly detected syphilis cases decreased more than by half compared to the previous year, what is probably related to the COVID-19 pandemic and action taken to reduce it. A huge difference in some regions in Poland for diagnosis rates and not visible a significant decrease in the number of treated person, indicate on problem with reporting a newly diagnosed infections, as a main explanation about increasing observed in 2020.


Assuntos
COVID-19 , Sífilis , Masculino , Humanos , Lactente , Adulto Jovem , Adulto , Sífilis/diagnóstico , Sífilis/epidemiologia , Incidência , Polônia/epidemiologia , Pandemias , Sistema de Registros , Distribuição por Idade , Surtos de Doenças , População Urbana , População Rural
6.
Przegl Epidemiol ; 76(2): 233-242, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36218178

RESUMO

BACKGROUND: The year 2020 in the extent of HCV infection was set for the first milestones on the road to the eradication of HCV infection in 2030. In addition, in 2020 there was a global public health crisis - the COVID-19 pandemic. The aim of this paper was to assess the epidemiological situation of HCV infection based on epidemiological surveillance data in Poland in 2020. MATERIAL AND METHODS: Analysis of: 1) individual data from surveillance in 2020 conducted by EpiBaza system; 2) diagnosis rate from bulletins "Infectious diseases and poisonings in Poland" for the years 2014-2020; and 3) data about deaths due to hepatitis C from the Demographic Surveys and Labour Market Department of Statistics Poland. RESULTS: In 2020, there was a significant decrease in the number of reported cases and thus in the diagnosis rate of HCV infection in Poland - 955 HCV infections were reported (2.49/100,000 - in comparison with 2019, 3.5 times less). The decrease occurred in all voivodeships (ranging from 0.50 to 6.37/100,000), we observe more districts in which HCV infections were not detected (in 2020 - 35.3%; in 2019 - 16.8%). The diagnosis rate of HCV infection in women and men was at a similar level. However, large disproportions are visible if age groups are considered in addition to gender. For years, we have observed a variation of the diagnosis rate of HCV infection depending on the environment of residence - also in 2020, higher values were reported overall in residents of urban than in rural areas (2.90 vs. 1.88/100,000). In 2.9% of newly diagnosed HCV infections, at the same time cirrhosis was already present, 0.4% had liver failure, and 0.1% had hepatocellular carcinoma. Among exposures of HCV infection, those related to nosocomial transmission still dominate (59%), also in acute hepatitis C (60%). One-third of reported infections were diagnosed in primary health care, and one in four were diagnosed during hospitalization. CONCLUSIONS: The data presented in this paper show that the COVID-19 pandemic deepened the inequalities observed for years in HCV areas. Establishing a diverse system of testing and linking to care in Poland, reaching those in the greatest risk of ongoing transmission of HCV infection, and providing methodologically correct studies to assess progress in the eradication of HCV infection is becoming increasingly urgent to achieve the planned 2030 WHO targets.


Assuntos
COVID-19 , Hepatite C , Distribuição por Idade , COVID-19/epidemiologia , Surtos de Doenças , Feminino , Hepacivirus , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Humanos , Incidência , Lactente , Masculino , Pandemias , Polônia/epidemiologia , Sistema de Registros , População Rural , Distribuição por Sexo , População Urbana
7.
Sci Signal ; 15(721): eabd9303, 2022 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-35167339

RESUMO

Cellular signaling responses show substantial cell-to-cell heterogeneity, which is often ascribed to the inherent randomness of biochemical reactions, termed molecular noise, wherein high noise implies low signaling fidelity. Alternatively, heterogeneity could arise from differences in molecular content between cells, termed molecular phenotypic variability, which does not necessarily imply imprecise signaling. The contribution of these two processes to signaling heterogeneity is unclear. Here, we fused fibroblasts to produce binuclear syncytia to distinguish noise from phenotypic variability in the analysis of cytokine signaling. We reasoned that the responses of the two nuclei within one syncytium could approximate the signaling outcomes of two cells with the same molecular content, thereby disclosing noise contribution, whereas comparison of different syncytia should reveal contribution of phenotypic variability. We found that ~90% of the variance in the primary response (which was the abundance of phosphorylated, nuclear STAT) to stimulation with the cytokines interferon-γ and oncostatin M resulted from differences in the molecular content of individual cells. Thus, our data reveal that cytokine signaling in the system used here operates in a reproducible, high-fidelity manner.


Assuntos
Interferon gama , Transdução de Sinais , Variação Biológica da População , Oncostatina M/genética , Transdução de Sinais/fisiologia
8.
Przegl Epidemiol ; 76(4): 591-603, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-37017460

RESUMO

PURPOSE: The aim was the assessment of the epidemiological situation of gonorrhoea in Poland in 2019 and 2020. MATERIAL AND METHODS: Case-based data on gonorrhoea from surveillance were used (to calculate the rate, data from the Statistics Poland on the number of population was used), which were compared with data from previous years. Data on patients treated in dermatology-venereology clinics in 2019-2020 were taken from the Statistical Bulletins of the Ministry of Health. The surveillance definition is: a confirmed case (means meeting the laboratory criteria), probable case (clinical criteria and an epidemiological link - contact with a confirmed case of gonorrhoea) and a possible case (the doctor diagnosed gonorrhoea). RESULTS: Year 2019 was the one with the highest number of reported gonorrhoea cases over the 2014-2020 period - 522 cases and 1.37/100,000 population. In 2020, there was a decrease in cases by 47.13% (246 cases and 0.64/100,000 inhabitants). Delays in reporting were identified - between the diagnosis and the first notification for 2019 and 2020, on average, intervened 36 and 52 days, respectively. On the other hand, in dermatologyvenereology clinics, the number of people treated for gonorrhoea did not change - 448 in 2019 and 442 in 2020. CONCLUSION: 1) The COVID-19 pandemic has deepened the problems of reporting good quality gonorrhoea data in epidemiological surveillance - the planning of appropriate preventive measures in central/local health policies is not possible. Improving surveillance and reporting of complete data on gonorrhoea cases is essential for reliable evaluation of the epidemiological situation. 2) Extensive prophylactic measures should be implemented (including for those under 18 years of age), targeting the source of and to cross routes of infection, including the promotion of safer sexual behaviors and informing the sexual partner.


Assuntos
Gonorreia , Adolescente , Humanos , Gonorreia/epidemiologia , Incidência , Polônia/epidemiologia , Comportamento Sexual
9.
Nat Commun ; 12(1): 4175, 2021 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-34234126

RESUMO

Although we can now measure single-cell signaling responses with multivariate, high-throughput techniques our ability to interpret such measurements is still limited. Even interpretation of dose-response based on single-cell data is not straightforward: signaling responses can differ significantly between cells, encompass multiple signaling effectors, and have dynamic character. Here, we use probabilistic modeling and information-theory to introduce fractional response analysis (FRA), which quantifies changes in fractions of cells with given response levels. FRA can be universally performed for heterogeneous, multivariate, and dynamic measurements and, as we demonstrate, quantifies otherwise hidden patterns in single-cell data. In particular, we show that fractional responses to type I interferon in human peripheral blood mononuclear cells are very similar across different cell types, despite significant differences in mean or median responses and degrees of cell-to-cell heterogeneity. Further, we demonstrate that fractional responses to cytokines scale linearly with the log of the cytokine dose, which uncovers that heterogeneous cellular populations are sensitive to fold-changes in the dose, as opposed to additive changes.


Assuntos
Ensaios de Triagem em Larga Escala/métodos , Interferon Tipo I/metabolismo , Leucócitos Mononucleares/metabolismo , Modelos Imunológicos , Células 3T3 , Animais , Voluntários Saudáveis , Humanos , Interferon Tipo I/imunologia , Leucócitos Mononucleares/imunologia , Camundongos , Modelos Estatísticos , Cultura Primária de Células , Transdução de Sinais/imunologia , Análise de Célula Única , Software
10.
Przegl Epidemiol ; 75(4): 502-514, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35543444

RESUMO

PURPOSE: The aim of the study was to assess the epidemiological situation of newly sexually transmitted infections in Poland in 2013-2018 in comparison to other European countries based on infectious diseases surveillance. MATERIAL AND METHODS: Analysis of the epidemiological situation was based on aggregated data from MZ-56 reports on infectious diseases, infections and poisoning sent from Sanitary Inspections to NIPH NIHNRI. Case-based data for gonorrhoea were analyzed in relation to transmission route and first place of medical diagnosis between 2017-2018. RESULTS: Between 2013-2018 in Poland 8,436 syphilis cases were diagnosed (mean diagnosis rate was 3.66 per 100,000), 2,395 gonorrhoeae cases, whereas number of Chlamydia trachomatis infections from 2014 to 2018 were 1,179 cases. In this time the decrease of 26.2% in newly recognized gonorrhoea cases were observed, whereas the diagnosis rate for chlamydia was stable grew up: from 0.42 per 100,000 in 2014 year to 0.80 in 2018 year. Most STI cases were recognized among men: male to female ratio for syphilis was 5:1, for gonorrhoea 11:1, whereas for chlamydia there is reverse tendency, there are more cases registered among women (0.8:1). CONCLUSION: There are lower STI diagnosis rates in Poland compare to European countries and there are visible big disproportion between number of cases among men and women. Distribution of cases in all voivodeships in Poland and often huge disproportion in the number of new cases between these voivodeships indicate on underreporting problem in Poland.


Assuntos
Doenças Transmissíveis , Gonorreia , Infecções Sexualmente Transmissíveis , Sífilis , Doenças Transmissíveis/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Gonorreia/diagnóstico , Gonorreia/epidemiologia , Humanos , Incidência , Masculino , Polônia/epidemiologia , Infecções Sexualmente Transmissíveis/epidemiologia , Sífilis/diagnóstico , Sífilis/epidemiologia
11.
Przegl Epidemiol ; 75(4): 613-625, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35543572

RESUMO

PURPOSE: The aim of the study was to assess the epidemiological situation of syphilis cases in Poland in 2019 in comparison to previous years. MATERIAL AND METHODS: Analysis of the epidemiological situation was based on case-based data from reports of newly detected syphilis cases received from doctors and laboratories. Additionally aggregated data from MZ-56 reports on infectious diseases, infections and poisoning from 2013 to 2018 sent from Sanitary Inspections to NIPH NIH - NRI was used. Also, data about treatment patients in dermatology/venerology clinics in 2019 reported on MZ-14 forms and published in statistics bulletin on Ministry of Health on e-health system website (actually: https://e-zdrowie.gov.pl; https://cez.gov.pl) and NIPH NIH - NRI website were used. RESULTS: In 2019 in Poland 1,511 syphilis cases were recognized (diagnosis rate was 3.96 per 100,000), including 79 cases among non-Polish citizens. The frequency of newly detected syphilis cases increased by 5% compared to the previous year and was higher by 13% compared to the median in 2013-2017 years. The syphilis cases were most often detected in the age group between 30 and 34 (20.7%) and among men (86.9%). Most cases were recognized among men who have sex with men (42%). CONCLUSION: In 2019, the number of newly detected syphilis cases increased compared to the previous year. Preventive initiatives should be taken, especially among key population as young people, men who have sexual contact with men, and who have risky sexual behaviors. Low syphilis diagnosis rate compared to European countries and a huge difference in some regions in Poland for diagnosis rates indicate on problem with recognition and reporting. To improve the functioning of national surveillance is essential to adequate assessment of epidemiological situation.


Assuntos
Minorias Sexuais e de Gênero , Sífilis , Adolescente , Distribuição por Idade , Surtos de Doenças , Homossexualidade Masculina , Humanos , Incidência , Lactente , Masculino , Polônia/epidemiologia , Sistema de Registros , População Rural , Sífilis/diagnóstico , Sífilis/epidemiologia , População Urbana
12.
Biotechnol Bioeng ; 118(1): 72-81, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32880912

RESUMO

Diseases leading to terminal hepatic failure are among the most common causes of death worldwide. Transplant of the whole organ is the only effective method to cure liver failure. Unfortunately, this treatment option is not available universally due to the serious shortage of donors. Thus, alternative methods have been developed that are aimed at prolonging the life of patients, including hepatic cells transplantation and bridging therapy based on hybrid bioartificial liver devices. Parenchymal liver cells are highly differentiated and perform many complex functions, such as detoxification and protein synthesis. Unfortunately, isolated hepatocytes display a rapid decline in viability and liver-specific functions. A number of methods have been developed to maintain hepatocytes in their highly differentiated state in vitro, amongst them the most promising being 3D growth scaffolds and decellularized tissues or coculture with other cell types required for the heterotypic cell-cell interactions. Here we present a novel approach to the hepatic cells culture based on the feeder layer cells genetically modified using lentiviral vector to stably produce additional amounts of hepatocyte growth factor and show the positive influence of these coculture conditions on the preservation of the hepatic functions of the liver parenchymal cells' model-C3A cells.


Assuntos
Fator de Crescimento de Hepatócito/biossíntese , Hepatócitos/metabolismo , Fígado/metabolismo , Modelos Biológicos , Pele/metabolismo , Linhagem Celular , Técnicas de Cocultura , Fibroblastos/citologia , Fator de Crescimento de Hepatócito/genética , Hepatócitos/citologia , Humanos , Fígado/citologia , Pele/citologia , Engenharia Tecidual
13.
Przegl Epidemiol ; 75(3): 379-389, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35170294

RESUMO

BACKGROUND: HCV infection continues to be a significant public health problem in Europe. The aim of the study was to assess the epidemiological situation of hepatitis C in Poland in 2019, based on data collected as part of epidemiological surveillance in 2019, comparing them to data from previous years. MATERIAL AND METHODS: The following were analyzed: 1) data from epidemiological surveillance in 2019 2) diagnosis rates from "Infectious Diseases and Poisonings in Poland" bulletins for the years 2013-2019 3) data on deaths due to hepatitis C from the Demographic Surveys and Labour Market Department of the Statistics Poland. RESULTS: In 2019, the HCV diagnosis rate was 8.71 per 100 thousand - a total of 3 343 cases of HCV infection were reported. This was a slight decrease compared to 2018. Still we observe the rate differentiation, territorial (differences in the value of the diagnosis rate are noticeable already at the voivodeship and poviat level) and demographic (higher rates in men than in women, higher rates in urban than in rural areas), which is probably related to HCV testing accessibility. Among acute hepatitis C cases according to the EU definition, indicative of current HCV transmission, exposures related to health care (haemodialysis and nosocomial transmission) were identified, followed by non-medical injection (community needle stick injuries, tattoos, piercings) and sexual contact. A low number of diagnoses (5.9%; 196/3343) among people who inject drugs indicate diagnostic difficulties. CONCLUSIONS: For years, the overview of hepatitis C in Poland, observed in epidemiological surveillance, has been determined by the availability of HCV testing. Developing the comfortable testing + treatment system in Poland that reaches people exposed to the current transmission of HCV infection (bearing in mind the possibility of re-infection) is the only possibility of eradication of HCV infections.


Assuntos
Hepatite C , População Rural , Distribuição por Idade , Surtos de Doenças , Feminino , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Humanos , Incidência , Lactente , Masculino , Polônia/epidemiologia , Sistema de Registros , População Urbana
14.
Przegl Epidemiol ; 74(2): 209-222, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33112105

RESUMO

OBJECTIVE: Analysis of data on hepatitis C, collected as part of epidemiological surveillance in 2018, compared to previous years. MATERIAL AND METHODS: Analysis of: 1) individual data from surveillance in 2018 2) diagnosis rate from bulletins "Infectious diseases and poisonings in Poland" for the years 2012-2018 and 3) data about deaths due to hepatitis C from the Demographic Surveys and Labour Market Department of the Central Statistical Office. RESULTS: In 2018, there was a decrease in the number of reported hepatitis C cases (3,442 cases) and the diagnosis rate (8.96 per 100,000; taking into account the territorial distribution: from 3.29 per 100,000 in the Podkarpackie voivodeship to 13.69 per 100,00 in the Lubuskie voivodeship). The disproportion of the rates between the sexes returned (in men 9.34 per 100,000 vs. women: 8.61 per 100,000). The disproportion of the diagnosis rate depending on the place of residence was still evident (urban: 10.84 per 100,000 vs. rural: 6.12 per 100,000). There are differences in the values of the diagnosis rates, analyzed in terms of gender, age groups and the place of residence. Based on the EU definition, 14 acute hepatitis C were reported, while according to the PL definition, 88 cases (0.4% and 2.6% of all reported cases, respectively). HCV infections due to medical procedures are still the main route of transmission, also in cases of acute hepatitis C - which indicates the current route of transmission. According to the Demographic Surveys and Labour Market Department of the Central Statistical Office, 119 deaths related to hepatitis C were reported. CONCLUSIONS: For years, the general picture of hepatitis C in Poland, observed through epidemiological surveillance, is determined by the availability of testing for HCV infections. The analysis identified subpopulations in which primary prevention activities (e.g. safer medical procedures, intensifying activities in the area of harm reduction for people who inject drugs) as well as secondary prevention (access to testing and quick inclusion in treatment) should be particularly strengthened. According to the micro-elimination strategy, the improvement of testing in particularly affected groups, including marginalized populations, is necessary to achieve the WHO goal of eliminating HCV by 2030.


Assuntos
Hepatite C/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Criança , Pré-Escolar , Surtos de Doenças/estatística & dados numéricos , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Distribuição por Sexo , Adulto Jovem
15.
Patient Educ Couns ; 103(5): 978-987, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31866197

RESUMO

OBJECTIVES: Lesbian, gay, bisexual, trans and intersex (LGBTI) people experience health inequalities and barriers to accessing healthcare at a greater rate than the general population. This paper aims to present the Health4LGBTI training course for healthcare workers and the results of its pilot implementation. METHODS: Funded by the European Parliament, the training course was developed by a multidisciplinary team including LGBTI organisations as part of the Health4LGBTI Project. 110 healthcare professionals from diverse medical fields attended the pilot training in six European Member States. Knowledge and attitudes were compared on the basis of a pre-post evaluation design utilising an ad hoc questionnaire. RESULTS: Knowledge scores increased after the training, irrespective of age and sexual orientation of participants. Attitudes scores generally improved, particularly in terms of inclusivity and a greater acknowledgement of LGBTI health needs and self-competence. CONCLUSION: The Health4LGBTI training course is both feasible and effective in training healthcare professionals and support staff to improve cultural competence and thereby promoting inclusive healthcare practice. PRACTICE IMPLICATIONS: The Health4LGBTI training course can be implemented in different healthcare contexts. Piloting of the course provided an opportunity for healthcare professionals and for support staff to improve their knowledge of, and attitudes towards, LGBTI people.


Assuntos
Competência Clínica , Competência Cultural/educação , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Sexualidade/psicologia , Sexualidade/estatística & dados numéricos , Adolescente , Adulto , Atitude do Pessoal de Saúde , Discriminação Psicológica , Feminino , Disparidades em Assistência à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Minorias Sexuais e de Gênero , Estigma Social
16.
Przegl Epidemiol ; 73(2): 167-178, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385675

RESUMO

OBJECTIVE: The aim of this article was to analyze the epidemiological situation of HCV in Poland in 2017, based on data collected as part of epidemiological surveillance. MATERIAL AND METHODS: The analysis was carried out based on: 1) individual data collected as part of epidemiological interviews with persons diagnosed with HCV infection in 2017, 2) diagnosis rate from bulletins "Infectious diseases and poisonings in Poland" for the years 2011-2017 and 3) data about deaths due to hepatitis C from the Demographic Surveys and Labour Market Department of the Central Statistical Office. RESULTS: In 2017, the diagnosis rate of HCV infection stayed on high level: 10.44 per 100,000 (4010 cases were reported). Stabilization of hepatitis C epidemiological situation was observed in the following issues: 1) diagnosis rate reported in men and women remained at a similar level (10.55 vs. 10.33 per 100,000); 2) diagnosis rate still showed variation depending on the voivodship (from 4.09 to 18.48 per 100,000) and the location of residence (urban/rural, 12.7 vs. 7.0 per 100,000); 3) the percentage of hospitalization accompanying the new cases of HCV infection has shown downward trend (36% in 2017); 4) the decreasing hepatitis C mortality trend was continued (175 cases of death in 2017); 5) the most common possible transmission route were still medical procedures. In 2017, the outbreak of HCV infection in the Lubelskie was registered. (8 patients, 291 exposed persons, with whom computer tomography with a contrast from multi-dose packaging was conducted, using an automatic injection device). CONCLUSIONS: Epidemiological situation of hepatitis C since 2015 is stable. The role of medical care in the transmission of HCV infections in Poland is worrying.


Assuntos
Hepatite C/epidemiologia , Sistema de Registros , Adolescente , Adulto , Distribuição por Idade , Idoso , Criança , Pré-Escolar , Feminino , Hepatite C/mortalidade , Hepatite C/prevenção & controle , Hepatite C/transmissão , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , População Rural , Distribuição por Sexo , População Urbana , Adulto Jovem
17.
Przegl Epidemiol ; 72(2): 175-187, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30111080

RESUMO

AIM: The aim of the study was to assess the epidemiological situation of newly diagnosed HIV infections and AIDS cases in Poland in 2016 in comparison to the previous years. MATERIALS AND METHODS: Descriptive analysis of the epidemiological situation was based on reports of newly detected HIV cases and AIDS cases and the results of the annual survey of HIV testing conducted among the laboratories throughout the country. Data from the Department of Demographic and Labor Market Research of the Central Statistical Office on deaths due to HIV / AIDS were also used. RESULTS: In 2016 there were 1,313 HIV cases newly diagnosed in Poland (diagnosis rate: 3.42 per 100,000), including 44 among non-Polish citizens. The number of newly detected HIV infections increased by nearly 10% compared to the previous year and by almost 19% compared to the median in 2010-2014. The total number of AIDS cases was 102 (incidence 0.27 per 100,000), and 102 people died of HIV disease (0.27 per 100,000). New HIV diagnoses were reported mainly in men (87.3%) and among people aged 20 to 39 years (71.2%). 81.2% of cases in men with known transmission category concerned men who had sexual contact with men (MSM). CONCLUSIONS: The majority of new HIV cases are diagnosed in the MSM group. However, the assessment of the epidemiological situation is limited by the missing data on the likely route of transmission of newly detected HIV infections.


Assuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , Infecções por HIV/epidemiologia , Sistema de Registros , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/mortalidade , Adulto , Distribuição por Idade , Feminino , Infecções por HIV/mortalidade , Homossexualidade Masculina , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Fatores de Risco , Distribuição por Sexo , Adulto Jovem
18.
Przegl Epidemiol ; 72(2): 157-167, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30111082

RESUMO

INTRODUCTION: In 2016, the World Health Organization implemented a Global Strategy to eliminate viral hepatitis. For Hepatitis C, the goals of this Strategy include increased harm reduction coverage, improved safety of medical procedures and an increase the percentage of people diagnosed and treated. OBJECTIVE: This article aims are evaluating the epidemiological situation of HCV infections in Poland in 2016 in reference to the data from previous years. MATERIAL AND METHODS: Analysis of epidemiological situation of hepatitis C in Poland in 2016 was carried out on case-based data collected through routine surveillance system. Data on hepatitis C mortality from the Demographic Surveys and Labour Market Department of the Central Statistical Office were also included. RESULTS: In 2016, a total of 4,261 cases were reported. Diagnosis rate was 11.09 per 100,000, on the similar level as in 2015 (1% decrease), but in comparison to the median for the years 2010-2014 it increased by 88%. The most common possible route of HCV infection were medical procedures accounting for 69.8% of all cases and for 58.2% of acute hepatitis C virus infection cases. In 2016, 224 deaths due to hepatitis C were registered. In 2016, a hepatitis C outbreak was reported in malopolskie voivodeship (11 patients of the Hemato-oncolology Department, 129 people exposed). CONCLUSIONS: The increase of HCV diagnosis rate, which has been reported for last three years, is probably a consequence of improved the surveillance, including mandatory reporting of positive laboratory results, but also increased availability of HCV laboratory screening. Medical exposures are still an important route of transmission of HCV in Poland.


Assuntos
Hepatite C/epidemiologia , Sistema de Registros , Adolescente , Adulto , Distribuição por Idade , Idoso , Criança , Pré-Escolar , Surtos de Doenças , Feminino , Hepatite B/complicações , Hepatite B/epidemiologia , Hepatite C/complicações , Hepatite C/mortalidade , Hepatite C/transmissão , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , População Rural , Distribuição por Sexo , População Urbana , Adulto Jovem
19.
BMC Infect Dis ; 18(1): 164, 2018 04 10.
Artigo em Inglês | MEDLINE | ID: mdl-29631545

RESUMO

BACKGROUND: Efficient control of acute hepatitis B requires identification of current transmission routes. Countries in Central-Eastern Europe including Poland attribute an important fraction of cases to nosocomial transmission, as opposed to Western European countries. However, due to possible multiple exposures during the incubation time such assignment may be debatable. This study aimed at assessing of most affected groups and current transmission pattern of acute hepatitis B. METHODS: We investigated exposures reported by acute hepatitis B cases notified to routine surveillance system in Poland in 2010-2014 in comparison to data on hospitalization rates in general population. RESULTS: Hospitalization during incubation time significantly increased the risk of HBV infection (RR 3.13, 95%CI 2.58-3.80). Overall hospitalization population attributable risk (PAR%) was 25.7% (95% CI 20.3%-31.1%) as compared to 35% of acute cases assigned to hospital transmission in surveillance database. PAR% increased from 9.5% (1.12%-17.8%) in the age group 25-34 to 41.1% (28.2% - 53.9%) among those 65 +. In addition, cases < 40 more frequently than the older ones reported history of injecting drugs and risky sexual contacts (25% vs 5%). 27% of men < 40 did not report any exposure at all, drawing attention to possible underreporting of risk behaviors. CONCLUSIONS: The distribution of probable transmission routes differed by age and gender. Further improvement of HBV control requires better coverage of vaccination in risk groups but also strengthening the blood-borne infections control in hospitals.


Assuntos
Infecção Hospitalar/epidemiologia , Hepatite B/epidemiologia , Hospitais/estatística & dados numéricos , Doença Aguda , Adulto , Idoso , Infecção Hospitalar/transmissão , Bases de Dados Factuais , Feminino , Hepatite B/transmissão , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Sistema de Registros , Fatores de Risco
20.
Przegl Epidemiol ; 71(3): 379-390, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29182222

RESUMO

AIM: AIM. The aim was to describe the epidemiological situation of newly diagnosed HIV infections and AIDS cases in Poland in 2015 in comparison to the previous years. MATERIALS AND METHODS: Descriptive analysis of newly detected HIV cases and AIDS cases was performed based on routine notifications by clinicians and laboratories. Data on the number of HIV tests from annual survey among laboratories were also used. RESULTS: In 2015 there were 1,281 HIV cases newly diagnosed in Poland (diagnosis rate 3.33 per 100,000 population), including 23 among non-Polish citizens. The rate of new cases rose by 15% compared to the previous year as well as to the median in 2009 - 2013. The total number of AIDS cases was 128 (incidence 0.38 per 100,000) and 41 AIDS patients died (0.11 per 100,000). HIV infection was mainly detected among people aged from 20 to 39 years (71.3%) and among males (84.8%). Among men, 67.6% of newly diagnosed infections with known transmission category were acquired by men who have sex with men (MSM). The percentage of infected men in this group, compared to 2014, increased from 64.5% to 67.6%. The percentage of newly diagnosed persons infected by heterosexual contact decreased from 24.1% to 21.1% (persons with known transmission category). The percentage of people with HIV diagnosed at the same time as AIDS diagnosed decreased in comparison with 2014 (from 9.2% to 6.9% of newly detected HIV infections). CONCLUSIONS: HIV epidemic continues to develop among MSM in Poland. However, assessment of epidemiological situation is limited by the missing data on the probable transmission route in a large percentage of reported newly detected HIV infection.

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