Establishment of a risk assessment model based early warning system for infectious diseases / 现代医院

Objective To establish a risk assessment model based infectious disease early warning system and promote the improvement of infectious disease management level.Methods By collecting and organizing the latest research results,and referring to the theoretical framework of the relevant infectious disease early warning evaluation index system,a risk assessment model based infectious disease early warning system is constructed.Results A total of 12 experts were included in this study,and three primary indicators were selected,including pre-epidemic indicators,typical symptom period indicators,atypical symp-tom period indicators,and 7 secondary indicators.The average score for necessity of the system was 8.27±0.24 points,and the average score for accessibility was 7.74±0.34 points.Conclusion The establishment of an infectious disease early warning sys-tem based on risk assessment models is conducive to timely following the epidemic trend of infectious diseases in the local area,analyzing the distribution trend of survey indicators,and proposing corresponding early warning plans,which can provide relevant basis for effective prevention of infectious diseases.

Application of BOPPPS combined with various teaching methods in internship course of pediatric infectious diseases / 中华医学教育探索杂志

Objective:To explore the effects of participatory interactive teaching in the clinical internship course of pediatric infectious diseases.Methods:217 undergraduate students of grade 2018 majoring in pediatrics were selected as the experimental group, and 208 undergraduate students of grade 2017 majoring in pediatrics were selected as the control group. The experimental group used the teaching method of BOPPPS combined with case-based learning and team-based learning, while the control group adopted the traditional teaching method. Evaluate the learning effectiveness by comparing the formative evaluation and theoretical exam scores of the two groups , and a questionnaire survey was conducted for the students in the experimental group to investigate teaching feedback. SPSS 19.0 was used to perform the t test for data analysis. Results:The experimental group had significantly better scores than the control group in final theoretical examination [(75.04±9.12) vs. (71.03±9.51), P<0.05] and formative evaluation [(81.03±6.13) vs. (70.02±10.32), P<0.05]. According to the results of the questionnaire survey on teaching satisfaction, the students were satisfied with the interactive participatory teaching method in the four aspects of improving learning interest, improving learning ability, classroom satisfaction level, and course acceptance level. Conclusions:The pragmatic teaching reform in the internship of pediatric infectious diseases is highly accepted by students and beneficial to improving students' clinical thinking ability and comprehensive quality, which is worth further application and promotion.

Epidemic trends and strategies of major infectious diseases in 2023 / 中华临床感染病杂志

In 2023，World Health Organization（WHO）announced that the pandemic of COVID-19 is over；while there was an epidemic of multi-pathogenic infections in the respiratory tract by the end of the year in China，indicating that high attention still need to be paid to infectious diseases. In the past one year，some breakthroughs for infectious diseases have been achieved.This article reviews the major events and research progress in the diagnosis，prevention and treatment of infectious diseases in 2023.

Trends in incidence of notifiable infectious diseases in Huzhou City from 2005 to 2023 / 预防医学

Objective@#To investigate the trends in incidence and epidemiological characteristics of notifiable infectious diseases in Huzhou City, Zhejiang Province from 2005 to 2023, so as to provide insights into optimizing infectious disease surveillance and control.@*Methods@#Data of notifiable infectious disease cases in Huzhou City from 2005 to 2023 were collected from the Infectious Disease Report Information System of Chinese Disease Prevention and Control Information System. Trends in incidence were analyzed using annual percent change (APC) and average annual percent change (AAPC). The population distribution and seasonal characteristics were descriptively analyzed.@*Results@#From 2005 to 2023, a total of 504 283 cases of notifiable infectious diseases were reported in Huzhou City, with an annual crude incidence rate of 892.65/105 and a standardized incidence rate of 989.21/105. The incidence rate of notifiable infectious diseases in Huzhou City showed an upward trend (AAPC=8.886%, P<0.05), of which there was an obvious upward trend from 2021 to 2023 (APC=95.996%, P<0.05). After the removal of COVID-19 incidence, the incidence trend was basically unchanged (AAPC=7.970%, P<0.05). From 2005 to 2023, the incidence rate of class A and B notifiable infectious diseases showed no obvious trend (P>0.05), and the incidence rate of class A and B respiratory infectious diseases showed an upward trend (AAPC=6.958%, P<0.05). After the removal of COVID-19 incidence, the two showed a downward trend (AAPC=-7.680% and -8.660%, both P<0.05). The incidence rate of class A and class B intestinal infectious diseases, blood-borne and sexually transmitted infectious diseases showed a downward trend (AAPC=-14.849% and -5.977%, both P<0.05), while the incidence rates of natural and insect-borne infectious diseases did not show a significant trend (P>0.05). The overall incidence rate of class C infectious diseases showed an upward trend (AAPC=13.058%, P<0.05). The incidence rate ratio (IRR) of notifiable infectious diseases between males and females was 1.26 (95%CI: 1.25-1.27). A total of 204 043 cases under 10 years were reported, accounting for 40.46%. The peak incidence of class A and B respiratory infectious diseases was in January, May and June, while that of class A and B intestinal infectious diseases was from June to October. The peak incidence of class C respiratory infectious diseases was in January, March, April and December, while that of class C intestinal infectious diseases was from May to August and from November to December.@*Conclusions@#The incidence rate of notifiable infectious diseases in Huzhou City showed an upward trend from 2005 to 2023, which was more obvious from 2021 to 2023. Men and children under 10 years were the high-risk population. The incidence of respiratory and intestinal infectious diseases had obvious seasonal characteristics.

Infection Status of Common Infectious Diseases among Patients in Specialized Cancer Hospital / 中山大学学报(医学科学版)

ObjectiveTo understand the current status of human immunodeficiency virus （HIV）， Treponema pallidum （TP）， hepatitis C virus （HCV） and hepatitis B virus （HBV） infections among patients undergoing screening tests in a specialized cancer hospital in South China， and to analyze the completion of further testing for confirmation， so as to provide a reference for management of common infectious diseases and prevention of nosocomial infections. MethodsWe analyzed the positive rates of HIV antigen/antibody combination assay （HIV-comb）， TP antibody （anti-TP）， HCV antibody （anti-HCV） and hepatitis B surface antigen （HBsAg） among the outpatients and inpatients who underwent the screening tests in 2022. Then we examined the percentage of those patients with seropositivity for further confirmation. ResultsIn patients who underwent the screening tests， the positive rate， percentage of patients for further confirmation test and overall prevalence for HIV-comb were were 0.07%， 100% and 0.06%， respectively； for Anti-PT 1.99%， 100% and 0.51%， respectively. Positive rate of anti-HCV was 0.90% and 26.61% of patients completed further HCV RNA quantitative assay， in 26.44% of whom， HCV RNA levels were above the detection limit. Positive rate of HBsAg was 21.06% and 54.40% of patients completed further HBV DNA quantitative assay， in 51.60% of whom， HBV DNA levels were above the detection limit. As for the nucleic acid testing among the suspected hepatitis patients， we found smaller coverage in outpatients than in inpatients and larger coverage in liver cancer patients than in other patients. ConclusionsCompared with general population， patients in this specialized cancer hospital had similar infection levels of HIV and syphilis， and 100% of them completed further confirmation testing. Hepatitis C and hepatitis B infections were at a relatively high level， but which could not accurately reflect the level of virus replication due to insufficient coverage of nucleic acid testing. Specialized cancer hospitals should prompt medical staff to attach more importance to screening and further confirmation of common infectious diseases among tumor patients. While offering anti-cancer treatment， hospitals should also actively refer the confirmed cases with infectious diseases to designated or general hospitals for a better outcome and quality of medical services.

On Prevention and Treatment of Infectious Diseases in Summer Based on TCM Theory of Heat Epidemic / 浙江中医药大学学报

[Objective]To provide insights into the clinical diagnosis and treatment of infectious diseases in summer through probing into the theory of heat epidemic and its characteristics formulated by famous doctors in the past dynasties.[Methods]The etiology,pathogenesis and treatment of heat epidemic were analyzed by summarizing the discussions of various doctors from different angles and at different levels,and the differentiation and treatment rules of several common summer infectious diseases were explored on the basis of the application of heat epidemic theory.[Results]The etiology and pathogenesis of heat epidemic can be classified as excessive main Qi,evil abundance and Yin deficiency,transpiration of summer heat and diffuse ptomaine.Its treatment can be roughly divided into interior-clearing and exterior-harmonizing,blood-cooling and orifice-unblocking.On the basis,the article explored the etiology,pathogenesis and treatment of summer infectious diseases,such as hand-foot-and-mouth disease,dengue and Corona Virus Disease 2019(COVID-19),which have certain similarities with heat epidemic.[Conclusion]The theory of heat epidemic,closely related to the syndrome and treatment rules of three types of summer infectious diseases,can be the tentative basis for clinical diagnosis and treatment of summer infectious diseases with traditional Chinese medicine.

Progress test as an assessment for learning approach in an Infectious Diseases Residency Program: a case study

ABSTRACT Assessment is an essential component for all educational programs and must check competence acquirement while foster and promote learning. Progress Test (PT) is well recognized to assess cognitive knowledge, clinical reasoning and decision making in the clinical context, offering important information about the individual performance and program quality. It is widely used in Brazilian and international medical schools; however, it still has little role in assessing medical residents in Brazil. We present the experience of a PT pilot implementation in an Infectious Diseases residency program over two years. The first, second and third-year residents did four serial exams with 40 multiple choice questions (item)/each. Preceptors were trained on best practices on item writing. All the items were reviewed by a panel of experts and, after approval, included in the item bank. All participants answered a survey on their perceptions about the experience. The final score was higher for the third-year residents in all exam applications. The level of satisfaction was high among the participants, who mentioned the learning opportunity with the exam and the feedback. PT can improve residents' assessment along the training period and residents' performance should guide review and improvement of the programs.

Overview of extracellular vesicles in pathogens with special focus on human extracellular protozoan parasites

Extracellular vesicles (EVs) are lipid-bilayered membrane-delimited particles secreted by almost any cell type, involved in different functions according to the cell of origin and its state. From these, cell to cell communication, pathogen-host interactions and modulation of the immune response have been widely studied. Moreover, these vesicles could be employed for diagnostic and therapeutic purposes, including infections produced by pathogens of diverse types; regarding parasites, the secretion, characterisation, and roles of EVs have been studied in particular cases. Moreover, the heterogeneity of EVs presents challenges at every stage of studies, which motivates research in this area. In this review, we summarise some aspects related to the secretion and roles of EVs from several groups of pathogens, with special focus on the most recent research regarding EVs secreted by extracellular protozoan parasites.

Transmissão vertical do HIV na rede de saúde: reflexões bioéticas sobre gênero e cuidado a partir de um caso emblemático / Vertical transmission of HIV in the health network: bioethics reflections on gender and care based on an emblematic case

Resumo Num cenário epidêmico ainda preocupante, a prevenção da Transmissão Vertical (TV) do HIV impõe problemas complexos, devido as vulnerabilidades individual, social e moral das mulheres vivendo com o vírus, somadas às fragilidades da rede de saúde. A partir de um caso emblemático, este estudo buscou compreender os desafios bioéticos do cuidado para a prevenção da TV do HIV no âmbito do Comitê de Porto Alegre/RS. Os eixos analíticos desenvolvidos refletem sobre como a produção do cuidado se articula, por um lado, com discursos e práticas relacionais pautadas no gênero e interseccionadas por raça e classe social e, por outro, com vulnerabilidades programáticas das políticas de saúde. Vislumbrou-se um processo de extrema estigmatização, em que as poucas ofertas para as mulheres cisgênero se dirigiam à regulação reprodutiva e perpetuavam dinâmicas de violência estrutural. Discute-se caminhos para a construção de um cuidado que incorpore a perspectiva decolonial e busque produzir equidade e justiça social ao reconhecer as trajetórias das mulheres.

Abstract In a still worrying epidemic scenario, the prevention of Vertical Transmission (VT) of HIV poses complex problems, due to the individual, social, and moral vulnerabilities of women living with the virus, in addition to the weaknesses of the health network. Based on an emblematic case, this study sought to understand the bioethical challenges of HIV VT prevention in the scope of the Porto Alegre/RS Committee. The analytical categories developed reflect on how the production of care is articulated, on the one hand, with relational discourses and practices based on gender and intersected by race and social class and, on the other, with programmatic vulnerabilities of health policies. A process of extreme stigmatization was revealed, in which the few offers for cisgender women were aimed toward reproductive regulation and perpetuated dynamics of structural violence. We discuss ways of building care that incorporates a decolonial perspective and seeks to produce equity and social justice by recognizing women's trajectories.

Detection of gestational and congenital syphilis in Paraná state, Brazil, 2007-2021: a time series analysis / Detección de sífilis gestacional y congénita en Paraná, Brasil, 2007-2021: análisis de series temporales / Detecção de sífilis gestacional e congênita no Paraná, 2007-2021: análise de séries temporais

Abstract Objective: To describe temporal trends in the detection rates of gestational and congenital syphilis, by maternal age and health macro-region of the state of Paraná, Brazil, 2007-2021. Methods: This was a time-series study using surveillance data; the trend analysis was performed by means of joinpoint regression, and average annual percent change (AAPC) and 95% confidence intervals (95%CI) were estimated. Results: An increase in statewide detection of gestational syphilis (AAPC = 21.7; 95%CI 17.7; 32.8) and congenital syphilis (AAPC = 14.8; 95%CI 13.0; 19.7) was found; an increase was also found in the health macro-regions, with the Northwest (gestational, AAPC = 26.1; 95%CI 23.4; 31.6) and North (congenital, AAPC = 23.8; 95%CI 18.8; 48.9) macro-regions standing out; statewide rising trends were observed for young women [gestational, AAPC = 26.2 (95%CI 22.4; 40.6); congenital, AAPC = 19.4 (95%CI 17.6; 21.8)] and adult women [gestational, AAPC = 21.3 (95%CI 16.9; 31.9); congenital, AAPC = 13.7 (95%CI 11.9; 19.3)]. Conclusion: Maternal and child syphilis detection rates increased in the state, regardless of maternal age and health macro-region.

Resumen Objetivo: Describir las tendencias temporales en las tasas de detección de sífilis gestacional y congénita, por grupo de edad materna y macrorregión de salud de Paraná, 2007-2021. Métodos: Estudio de series temporales utilizando datos de vigilancia; se realizó análisis de tendencia mediante regresión segmentada, estimando cambios porcentuales anuales promedio (CPAP) e intervalos de confianza del 95% (IC95%). Resultados: Se identificaron aumentos en la detección estatal de sífilis gestacional (CPAP = 21,7; IC95% 17,7;32,8) y congénita (CPAP = 14,8; IC95% 13,0;19,7); las macrorregiones mostraron incrementos, destacándose la Noroeste (gestacional, CPAP = 26,1; IC95% 23,4;31,6) y la Norte (congénita, CPAP = 23,8; IC95% 18,8;48,9); las tendencias estatales fueron crecientes para mujeres jóvenes [gestacional, CPAP = 26,2 (IC95% 22,4;40,6); congénita, CPAP = 19,4 (IC95% 17,6;21,8)] y adultas [gestacional, CPAP = 21,3 (IC95% 16,9;31,9); congénita, CPAP = 13,7 (IC95% 11,9;19,3)]. Conclusión: Las tasas de detección de sífilis materno-infantil estuvieron en aumento en el estado, independientemente de la edad materna y la macrorregión de salud.

Resumo Objetivo: Descrever as tendências temporais nas taxas de detecção de sífilis gestacional e congênita, por faixa etária materna e macrorregião de saúde do Paraná, Brasil, 2007-2021. Métodos: Estudo de séries temporais, utilizando-se dados de vigilância; realizou-se análise de tendência por regressão segmentada, sendo estimadas variações percentuais anuais médias (VPAM) e intervalos de confiança de 95% (IC95%). Resultados: Foram identificados acréscimos na detecção estadual de sífilis gestacional (VPAM = 21,7; IC95% 17,7;32,8) e congênita (VPAM = 14,8; IC95% 13,0;19,7); as macrorregiões de saúde registraram incrementos, destacando-se as macrorregiões Noroeste (gestacional, VPAM = 26,1; IC95% 23,4;31,6) e Norte (congênita, VPAM = 23,8; IC95% 18,8;48,9); as tendências estaduais foram crescentes para mulheres jovens [gestacional, VPAM = 26,2 (IC95% 22,4;40,6); congênita, VPAM = 19,4 (IC95% 17,6;21,8)] e mulheres adultas [gestacional, VPAM = 21,3 (IC95% 16,9;31,9); congênita, VPAM = 13,7 (IC95% 11,9;19,3)]. Conclusão: As taxas de detecção de sífilis materno-infantil foram ascendentes no estado, independentemente da idade materna e da macrorregião de saúde.

Caracterización clínica-epidemiológica de COVID-19

Las epidemias y las pandemias son eventos de ocurrencia natural. La aparición de una nueva enfermedad infecciosa supone siempre una situación compleja, sobre todo si lo hace como una epidemia de extensión o gravedad significativa, con el objetivo de describir las características clínico-epidemiológicas en pacientes confirmados con COVID-19. Se realizó un estudio descriptivo y retrospectivo sobre las características clínico-epidemiológicas de los 161 pacientes diagnosticados con esta enfermedad, en el municipio Yara, de la provincia Granma durante el período comprendido de junio de 2020-2021. Se estudiaron las variables: edad, sexo, lugar de infección, presencia o no de síntomas y signos, antecedentes patológicos personales, área de salud y consejo popular. El 60,8% de los afectados fueron del sexo femenino con 98 pacientes y el grupo de 30-44 años de edad quedó representado por 50 pacientes (31.0%); en 150 casos, la transmisión fue mayormente autóctona (93,1%) y asintomática en 86 casos para el 53,4%. De los pacientes sintomáticos fueron las manifestaciones respiratorias, los principales síntomas con 70 casos para el 93,3%, 63 pacientes tenían antecedentes personales de hipertensión arterial (39,1%). El área de salud que más casos notificó fue "Luis Enrique de la Paz" con 106 pacientes para el 65,8% y Yara el consejo popular más afectado con 72 casos (44,7%), la mayoría de los pacientes fueron del sexo femenino, predominó la transmisión autóctona y la presentación asintomática. La epidemia en el municipio Yara se comportó similar al resto del país.

Epidemics and pandemics are naturally occurring events. The emergence of a new infectious disease is always a complex situation, especially when it occurs as an epidemic of significant spread or severity. The aim of this study was to describe the clinical-epidemiologic characteristics of patients confirmed with COVID-19. A descriptive and retrospective study was carried out on the clinical-epidemiological characteristics of 161 patients diagnosed with this disease, in the municipality of Yara, province of Granma. The following variables were studied: age, sex, site of infection, presence or not of symptoms and signs, personal pathological antecedents, health area and locality. Out of the total, 98 patients were female (60.8%), and the age group 30-44 years was represented by 50 patients (31.0%). Transmission was generally autochthonous in 150 cases (93.1%), and asymptomatic in 86 cases (53.4%). Among the symptomatic patients, respiratory manifestations were the main symptom in 70 cases (93.3%). Also, 63 patients had a personal medical history of hypertension (39.1%). Luis Enrique de la Paz was the health area that reported the most cases with 106 patients (65.8%), and Yara was the most affected locality with 72 cases (44.7%). The majority of patients were female; and autochthonous transmission and asymptomatic presentation predominated. The epidemic in Yara municipality behaved alike in the whole country.

Epidemias e pandemias são eventos naturais. O surgimento de uma nova doença infecciosa é sempre uma situação complexa, especialmente se for uma epidemia de extensão ou gravidade significativa, com o objetivo de descrever as características clínico-epidemiológicas em pacientes confirmados com COVID-19. Foi realizado um estudo descritivo e retrospectivo sobre as características clínico-epidemiológicas dos 161 pacientes diagnosticados com essa doença, no município de Yara, província de Granma, no período de junho de 2020 a 2021, as variáveis foram estudadas: idade, sexo, local de infecção, presença ou não de sintomas e sinais, história patológica pessoal, área de saúde e conselho popular. O 60,8% dos acometidos eram do sexo feminino com 98 pacientes e a faixa etária de 30 a 44 anos foi representada por 50 pacientes (31,0%); Em 150 casos, a transmissão foi predominantemente autóctone (93,1%) e assintomática em 86 casos para 53,4%, entre os sintomáticos foram manifestações respiratórias, sendo os principais sintomas 70 casos para 93,3%, 63 pacientes tinham história pessoal de hipertensão arterial (39,1%). A área de saúde que mais registrou casos foi "Luis Enrique de la Paz" com 106 pacientes para 65,8% e Yara o município popular mais afetado com 72 casos (44,7%), a maioria dos pacientes era do sexo feminino, de transmissão autóctone e apresentação assintomática. A epidemia no município de Yara se comportou de forma semelhante ao resto do país.

Morphometry of the wings of Anopheles aquasalis in simulated scenarios of climate change

ABSTRACT Background: Climate change has significant implications on ecosystems. We verified the effects of climate change on the malaria vector Anopheles aquasalis using simulated climate change scenarios (SSCCs). Methods: An experimental model was designed for SSCCs, which composed of air-conditioned 25 m3 rooms. Results: The wing size was significantly different between SSCCs. A colony of Anopheles aquasalis could not be established in extreme scenarios. Conclusions: Increases in temperature and CO2 in the atmosphere may modify the global epidemiology of malaria, marking its emergence in currently malaria-free areas.

The influence of growth time on the identification of Bartonella henselae strains by MALDI-TOF mass spectrometry

ABSTRACT Bartonella spp. are bacteria responsible for neglected diseases worldwide. Bartonella henselae is the species most associated with human infections. It is associated with a large spectrum of clinical manifestations and is potentially fatal. The identification of Bartonella spp. is considered a challenge in clinical routine. These bacteria are fastidious, and the time required to isolate them varies from one to six weeks. MALDI-TOF mass spectrometry has emerged as an application for research on Bartonella spp. , and has still been little explored. We investigated whether three different B. henselae strains with different growth times—14 and 28 days—could be correctly identified by MALDI-TOF mass spectra fingerprint comparison and matching. We found that the spectra from strains with different growth times do not match each other, leading to misidentification. We suggest creating database entries with multiple spectra from strains with different growth times to increase the chances of accurate identification of Bartonella spp. by MALD-TOF MS.

Transtornos relacionados ao uso de álcool entre pessoas com doenças infecciosas, crônicas e mentais: Brasil, 2015 / Alcohol use disorder in people with infectious and chronic diseases and mental disorders: Brazil, 2015

Resumo O objetivo do artigo é estimar a prevalência de transtornos relacionados ao uso de álcool (TRA) e fatores associados entre indivíduos da população brasileira que reportaram doenças crônicas não-transmissíveis (DCNT), transtornos mentais (TM) e doenças infeciosas (DI). Análise secundária do III Levantamento Nacional sobre o Uso de Drogas pela População Brasileira, cujo desfecho principal foi a presença de TRA. A prevalência de TRA foi estimada para três subgrupos: indivíduos que reportaram DCNT, TM e DI. Os fatores associados a TRA dentro de cada grupo foram analisados utilizando modelos de regressão logística. Dos 15.645 adultos entrevistados, 30,5% (IC95%: 29,4-31,5) reportaram DCNT, 17,6% (IC95%: 16,5-18,7) TM e 1,6% (IC95%: 1,2-1,9) DI. Considerando as comorbidades, a amostra analítica foi de 6.612. Não foi encontrada diferença estatisticamente significativa na prevalência de TRA entre indivíduos com DCNT (7,5% [IC95% 6,1-8,7]), TM (8,4% [IC95% 6,7-10,2]) e DI (12,4% [IC95% 7,0-17,8]). Os principais fatores associados a TRA, em todos os grupos, foram ser do sexo masculino e jovem. Considerando a alta prevalência de TRA em todos os grupos é necessário seu rastreio sistemático em serviços de saúde que atendam DCNT, TM e DI.

Abstract The study aimed to estimate the prevalence of alcohol use disorder (AUD) and associated factors in Brazilian adults that reported chronic noncommunicable diseases (NCDs), mental disorders (MDs), and infectious diseases (IDs). This was a secondary analysis of the 3rd National Survey on Drug Use by the Brazilian Population in which the principal outcome was presence of AUD. Prevalence of AUD was estimated for three subgroups: individuals that reported NCDs, MDs, and IDs. Factors associated with AUD in each group were analyzed using logistic regression models. Of the 15,645 adults interviewed, 30.5% (95%CI: 29.4-31.5) reported NCDs, 17.6% (95%CI: 16.5-18.7) MDs, and 1.6% (95%CI: 1.2-1.9) IDs. Considering comorbidities, the analytical sample was 6,612. No statistically significant difference was found in the prevalence of AUD between individuals with NCDs (7.5% [95%CI: 6.1- 8.7]), MDs (8.4% [95%CI: 6.7-10.2]), and IDs (12.4% [95%CI: 7.0-17.8]). The main factors associated with AUD in all the groups were male sex and young adult age. Considering the high prevalence of AUD in all the groups, systematic screening of AUD is necessary in health services that treat NCDs, MDs, and IDs.

Unveiling microbial worlds: exploring viral metagenomics among waste pickers at Latin America's largest dumpsite

ABSTRACT Waste pickers constitute a marginalized demographic engaged in the collection of refuse, facing considerable occupational hazards that heighten their susceptibility to contract infectious diseases. Moreover, waste pickers contend with societal stigmatization and encounter barriers to accessing healthcare services. To explore the viral profile of waste pickers potentially linked to their occupational environment, we conducted a metagenomic analysis on 120 plasma specimens sampled from individuals employed at the Cidade Estrutural dumpsite in Brasilia city, Brazil. In total, 60 blood donors served as a comparative control group. Specimens were pooled and subjected to Illumina NextSeq 2000 sequencing. Viral abundance among waste pickers revealed the presence of significant pathogens, including HIV, HCV, and Chikungunya, which were not detected in the control group. Additionally, elevated levels of anelloviruses and Human pegivirus-1 were noted, with a comparable incidence in the control group. These findings underscore the utility of metagenomics in identifying clinically relevant viral agents within underserved populations. The implications of this study extend to informing public health policies aimed at surveilling infectious diseases among individuals facing socioeconomic disparities and limited access to healthcare resources.

Estudio de segmentación: intención de vacunación contra COVID-19 en seguidores de la Sociedad Venezolana de Infectología / Segmentation Study: Vaccination Intention Against COVID-19 in Venezuelan Society of Infectious diseases Followers

El mercadeo social delimita estrategias específicas para influir en las personas con un fin positivo para los individuos y la sociedad, siendo la segmentación un paso fundamental en donde se define los segmentos de individuos más susceptibles al cambio conductual deseado. Dentro de los seguidores de las principales redes sociales de la Sociedad Venezolana de Infectología (SVI), se realizó este estudio exploratorio que delimitó por técnicas de segmentación los grupos con mayor reticencia a las vacunas, y que pueden ser susceptibles a ser influenciados para mejorar la percepción hacia las vacunas contra la enfermedad por Coronavirus 2019 (COVID-19). Se encuestaron a 2 179 seguidores, por vía digital y bajo un muestreo no probabilístico de conveniencia. Las principales variables estudiadas eran sobre conocimientos, actitudes y prácticas, variables demográficas, y aspectos relacionados con las vacunas contra COVID-19 y la vacunación en general. Se realizó análisis descriptivo de los datos, estudios de correlación, análisis factorial y de segmentación bietápico. Sobre los resultados de segmentación se delimitaron 4 grupos, 2 de los cuales son favorables a la v acunación, y otros 2 que son reticentes a la misma. De estos dos últimos segmentos, el grupo que se denominó "reticentes" prefieren las redes sociales para buscar información referente a salud, mientras que el grupo de "legos" busca su información en profesionales de salud. Este hallazgo resulta relevante al momento de avanzar en las estrategias de mercadeo social, y buscar promover de un modo más efectivo la vacunación en estos segmentos.

Social marketing delimits specific strategies to influence people with a positive purpose for individuals and society. Segmentation is a fundamental step where the groups of individuals most susceptible to the desired behavioral change are defined. This exploratory study was carried out within the followers of the main social networks of the "Sociedad Venezolana de Infectología" (SVI). The purpose was to identified by segmentation techniques the groups more reluctance to vaccines and to be susceptible to improve their perception towards vaccines against Coronavirus disease 2019 (COVID-19). 2 179 followers were surveyed, digitally and using non-probabilistic convenience sampling. The main variables studied were knowledge, attitudes and practices, demographic variables, and aspects related to COVID-19 vaccines and vaccination in general. Descriptive analysis of the data, correlation studies, factor analysis and two-stage segmentation were carried out. Based on the segmentation results, 4 groups were delimited, 2 of which are favorable to vaccination, and another 2 that are reluctant. Of these last two segments, the group called "reluctant" prefers social networks to search for information related to health, while the group of "unawareness" seeks their information from health professionals. This finding is relevant for advancing using social marketing strategies and seeking to more effectively ways to promote vaccination in these segments.

Prevalencia de enfermedades infecciosas y parasitarias en el servicio de pacientes con necesidades especiales de la Facultad de Estomatología de la Universidad Peruana Cayetano Heredia / Prevalence of infectious and parasitic diseases in the service of patients with special needs of the Faculty of Stomatology of the Universidad Peruana Cayetano Heredia / Prevalência de doenças infecciosas e parasitárias no serviço de pacientes com necessidades especiais da Faculdade de Estomatologia da Universidad Peruana Cayetano Heredia

RESUMEN Objetivo: Determinar la prevalencia de diagnósticos médicos de las enfermedades infecciosas y/o parasitarias de pacientes que acudieron al servicio de Estomatología en Pacientes Especiales (EPE) de la Universidad Peruana Cayetano Heredia. Material y métodos: La población (n = 38) estuvo conformada por el número de diagnósticos médicos de pacientes con enfermedades infecciosas y/o parasitarias que acudieron al servicio de EPE durante los años 2015 y 2016. La información se trasladó a una base de datos en el programa Excel 2017, para posteriormente ser procesada y analizada de acuerdo con lo requerido por el programa Stata 12. Resultados: De un total de 1718 diagnósticos médicos, las enfermedades infecciosas y/o parasitarias tuvieron una prevalencia de 2,21 % (n = 38). Dentro de este grupo de enfermedades, el virus de inmunodeficiencia humana (VIH) fue el más prevalente con 63,2 % (n = 24), siendo el sexo masculino el más prevalente con 79 % (n = 19); y dentro del grupo etario de 21 a 40 años de edad, el segundo diagnóstico específico más prevalente fue la hepatitis A con un 15,8 % (n = 6), en donde el sexo femenino fue el más prevalente con 83 % (n = 5). Conclusiones: El diagnóstico específico, dentro del grupo de las enfermedades infecciosas y/o parasitarias, con mayor prevalencia fue el VIH con un 63,2 % (n = 24).

ABSTRACT Objective: To determine the prevalence of medical diagnoses of infectious and/or parasitic diseases in patients who attended the Special Patients Stomatology Service (EPE) of the Cayetano Heredia Peruvian University. Material and methods: The population (n = 38) comprised the number of medical diagnoses of patients with infectious and/or parasitic diseases who attended the EPE service during 2015 and 2016. The information was transferred to a database in the Excel 2017 program to be processed and analyzed as required by the Stata 12 program. Results: Of 1718 medical diagnoses, infectious and/or parasitic diseases had a prevalence of 2.21% (n = 38). Within this group of diseases, human immunodeficiency virus (HIV) was the most prevalent, with 63.2 % (n = 24), with the male sex being the most prevalent with 79 % (n = 19). Within the age group of 21 to 40 years of age, the second most prevalent specific diagnosis was hepatitis A with 15.8 % (n = 6), whereas the female sex was the most prevalent with 83 % (n = 5). Conclusions: The specific diagnosis within the group of infectious and/or parasitic diseases with the highest prevalence was HIV, with 63.2% (n = 24).

RESUMO Objetivo: Determinar a prevalência de diagnósticos médicos de doenças infecciosas e/ou parasitárias em pacientes que frequentaram o Serviço de Estomatologia para Pacientes Especiais (EPE) da Universidad Peruana Cayetano Heredia. Material e métodos: A população (n = 38) consistiu no número de diagnósticos médicos de pacientes com doenças infecciosas e/ou parasitárias que frequentaram o serviço EPE durante 2015 e 2016. A informação foi transferida para uma base de dados em Excel 2017, para posteriormente ser processada e analisada conforme requerido pelo programa Stata 12. Resultados: De um total de 1718 diagnósticos médicos, as doenças infeciosas e/ou parasitárias tiveram uma prevalência de 2,21 % (n = 38). Dentro deste grupo de doenças, o vírus da imunodeficiência humana (VIH) foi o mais prevalente com 63,2 % (n = 24), sendo o sexo masculino o mais prevalente com 79 % (n = 19); e dentro do grupo etário dos 21-40 anos, o segundo diagnóstico específico mais prevalente foi a hepatite A com 15,8 % (n = 6), sendo o sexo feminino o mais prevalente com 83 % (n = 5). Conclusões: O diagnóstico específico mais prevalente no grupo das doenças infecciosas e/ou parasitárias foi o VIH com 63,2 % (n = 24).

Conocimiento ancestral sobre el uso de plantas silvestres medicinales en el tratamiento de enfermedades en alpacas / Ancestral knowledge on the use of wild plants for the treatment of diseases in alpacas

In the high Andean areas, the main economic activity is alpaca raising, which is affected by various infectious and parasitic diseases. Rural populations often resort to wild plants that have diverse properties and help control various diseases. The objective was to document the uses of wild plants in the control of alpaca diseases in the high Andean areas of the Puno and Arequipa regions. Fifty alpaca-breeding families were interviewed in five localities. Thirty-two species belonging to 16 families were reported, with the Asteraceae and Fabaceae families having the highest number of species. The most frequently treated pathologies were diarrhea, pneumonia, fever and enteric parasitosis. For diarrhea treatment, the most used plants were M. mollis, S. nutans and T. filifolia, for pneumonia were G. prostrata and G. viravira, for enteric parasitosis were B. tricuneata and L. daucifolia and for the elimination of ectoparasites (lice) was A. compacta. For all diseases, the treatment dose was higher in adults than in neonates and its application is in the rainy season. In acute disease conditions, rural families choice to drugs. Wild plants are a viable and sustainable alternative for the treatment of various diseases in alpacas.

En las zonas altoandinas la principal actividad económica es la crianza de alpacas, las mismas que son afectadas por diversas enfermedades infecciosas y parasitarias. Las poblaciones rurales frecuentemente recurren a las plantas silvestres que tienen diversas propiedades y ayudan al control de diversas enfermedades. El objetivo fue documentar los usos de las plantas silvestres en el control de enfermedades de alpacas en las zonas altoandinas de la región Puno y Arequipa. Se entrevistó a 50 familias criadoras de alpacas en cinco localidades. Se reportaron 32 especies, pertenecientes a 16 familias, siendo la familia Asteraceae y Fabaceae con mayor número de especies. Las patologías que con mayor frecuencia se tratan fueron la diarrea, neumonía, fiebre y parasitosis entérica. Para el tratamiento de diarrea, las plantas más utilizadas fueron M. mollis, S. nutans y T. filifolia, para la nuemonía fueron G. prostrata y G. viravira, para parasitosis entérica fueron B. tricuneata y L. daucifolia y para la eliminación de ectoparásitos (piojos) fue A. compacta. Para todas las enfermedades, las dosis de tratamiento fueron superior en las adultas que en las crías y su aplicación es en la época de lluvias. En condiciones agudas de las enfermedades las familias rurales recurren a los fármacos. Las plantas silvestres, son una alternativa viable y sostenible para el tratamiento de diversas enfermedades en alpacas.

Infectious human diseases: Regions, habitats, threats, and mitigation strategies: The issues—Part II

Globally, vaccines against 47 infectious etiologic agents are approved by at least one regulatory authority as of December 2022. The numbers of viral diseases, infections caused by mycoplasma, bacterial and protozoal diseases, mycoses, diseases caused by parasitic worms, and other infectious diseases of unknown etiology run into thousands. Therefore, more vaccines are required to be developed to keep more populations disease free. Climate change and global increase in temperature may promote sea level rises and an increase in the intensity of rains, causing an upsurge in certain infectious diseases in regions of the human population and even causing movement of habitats. In societies where the expenditure on health as a percentage of gross domestic product is higher, people are more capacitated to tackle the treatment and spread of infectious diseases. As several of such conditions are zoonotic, well-planned strategies for controlling the spread would go a long way in the proper direction. Poverty and contagious diseases are infallibly linked. Major infectious diseases of poverty include tuberculosis, human immunodeficiency virus (HIV)/ acquired immuno deficiency syndrome (AIDS), malaria, measles, pneumonia, diarrheal diseases, and several neglected tropical diseases. The world is not yet unified in action to jointly work to contain the global problem of infectious diseases in every human habitat. There was a visible divide between and among the rich countries versus the developing countries regarding accessibility and deployment of vaccines against COVID-19 flu. To contain the spread of infectious diseases in the future, the whole world would have to work together, raising funds, strengthening epidemiological surveys, inventing effective vaccines, and vaccinating the eligible population, as also treating the infected with therapy in time, besides resorting to other preventive measures for overall human progress. The developmental efforts are to be pursued jointly and together to benefit all people, respecting the world as one.