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OBJECTIVES: Global trade and travel have facilitated infectious disease transmission. In 2022, over a short time, cross-border Mpox (monkeypox) outbreaks were reported. Since, most countries are at risk of cross-border Mpox transmissions, in this study, we developed a real-time risk assessment model for the cross-border transmission of Mpox. METHODS: This model includes priori indicators related to the source area before the Mpox outbreak and posterior indicators derived from the quantitative data evaluation afterward. Based on transportation, this model can also be used to assess the global import risk of Mpox for specific countries and cities. RESULTS: European risk values displayed high levels between May and July 2022 and gradually decreased after July. After September 2022, risk values elevated in most countries and regions in the Americas. As for China, high importation risk cities were highly exposed to the United States and moderately exposed to Australia and Germany. Some cities were exposed to the potential risks from only one source country. CONCLUSIONS: Dynamic surveillance of the cross-border spread of infectious diseases is essential. Importation risks vary widely across cities and regions, and developing risk prevention and control strategies specific to the traffic flow, medical care capabilities, and risk levels in the main source countries are essential.
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Mpox , Humanos , Surtos de Doenças , China , Cidades , Medição de RiscoRESUMO
BACKGROUND: Currently, the diagnosis of chronic obstructive pulmonary disease (COPD) is not uniform, COPD guidelines recommend fixed ratio (FR), whereas ATS and ERS define airflow obstruction based on lower limit of normal (LLN). We aim to determine if there is difference between the two diagnostic criteria for morbidity, mortality, exacerbation. METHODS: Four databases and all relevant studies from the references were searched from inception to June 25, 2019, to find studies that described the rate of comorbidity, the exacerbation rates, mortality in COPD patients. Data analysis was performed using STATA/SE 14.0 and followed the standard of Cochrane Collaboration. A sensitivity analysis was performed to find the source of heterogeneity. RESULTS: Thirteen studies and 154,447 participants were finally included in this meta-analysis. The 11 cohort studies and 2 cross-sectional studies were all high-quality. Patients with airflow limitation according to either FR or LLN had higher mortality (HRFR+/LLN- = 1.27, 95% CI = 1.14-1.42; HRFR-/LLN+ = 1.83, 95% CI = 1.17-2.86) than those who met neither criteria. When compared with the FR-/LLN- criteria, those who met the FR criteria were more likely to exacerbate (HR FR+/LLN- = 1.64, 95% CI = 1.09-2.46; HR FR-/LLN+ = 1.58, 95% CI = 0.70-3.55). The meta-analysis for comorbidities showed no significant difference between patients who met neither criteria and those who met LLN or FR criteria. CONCLUSION: The patients with airflow limitations according to FR were more likely to exacerbate than those with LLN only. Patients that met either FR or LLN were more likely to have higher mortality than FR-/LLN-. There was no difference between the FR+/LLN- and FR-/LLN+ groups for the occurrence of comorbidities.