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Objective: Describe good practices in epidemiological surveillance implemented in El Salvador between 2019 and 2023 to sustain the elimination of measles, rubella, and congenital rubella syndrome. Methods: Special descriptive report on the implementation of good epidemiological and laboratory surveillance practices for measles, rubella, and congenital rubella syndrome from 2019 to 2023. Results: During the period 2019 to 2023, El Salvador reported no confirmed cases of measles, rubella, or congenital rubella syndrome. The national measles and rubella notification rate was 8.4 per 100 000 population in 2023; 9 in 2022; 5.6 in 2021; 2.9 in 2020; and 8.2 in 2019. Between the report of the first confirmed case of COVID-19 in the country and the declaration of the end of the international health emergency by the World Health Organization on 5 May 2023, the rate of reported suspected cases of measles and rubella remained above the indicator. Conclusions: The implementation of permanent and mandatory epidemiological surveillance strategies allowed the sustainability of measles and rubella elimination in El Salvador during the COVID-19 pandemic.
Objetivo: Descrever as boas práticas de vigilância epidemiológica implementadas em El Salvador entre 2019 e 2023 para manter a eliminação do sarampo, da rubéola e da síndrome da rubéola congênita. Método: Relatório especial descrevendo a implementação de boas práticas de vigilância epidemiológica e laboratorial de sarampo, rubéola e síndrome da rubéola congênita entre os anos de 2019 e 2023. Resultados: No período de 2019 a 2023, El Salvador não registrou nenhum caso confirmado de sarampo, rubéola ou síndrome da rubéola congênita. A taxa nacional de notificação de sarampo e rubéola foi de 8,4 por 100 mil habitantes em 2023, 9 em 2022, 5,6 em 2021, 2,9 em 2020 e 8,2 por 100 mil habitantes em 2019. No período entre a notificação do primeiro caso confirmado de COVID-19 no país até a declaração do fim da emergência de saúde pública de importância internacional pela Organização Mundial da Saúde, em 5 de maio de 2023, a taxa de notificação de casos suspeitos de sarampo e rubéola manteve-se acima do indicador. Conclusões: A implementação de estratégias de vigilância epidemiológica de forma permanente e obrigatória permitiu manter a eliminação do sarampo e da rubéola em El Salvador durante a pandemia de COVID-19.
RESUMEN
Introducción. La enfermedad renal crónica es responsable de aproximadamente 2,4 millones de defunciones a nivel mundial. La supervivencia a los cinco años después de iniciar diálisis se encuentra entre un 39 a 60 % dependiendo del país. Objetivo. Describir la situación epidemiológica de los pacientes con diálisis y analizar los factores que influyen en la supervivencia de pacientes a cinco años de iniciar tratamiento sustitutivo renal en El Salvador. Metodología. Estudio de cohorte retrospectivo de los pacientes incluidos en el Registro Nacional de Diálisis y Trasplante Renal desde enero de 2016 hasta febrero de 2023. El seguimiento se comenzó al inicio de la diálisis, el evento de interés fue la muerte del paciente. Se utilizó el método de Kaplan-Meier para determinar la supervivencia al año y a los cinco años y la regresión de Cox con el modelo de Royston-Parmar para analizar los factores que influyen sobre la supervivencia a los cinco años. Resultados. El estudio incluyó 7088 pacientes, la supervivencia a uno y cinco años fue del 79,5 % (IC 95 %: 78,6-80,5) y 50,6 % (IC 95 %: 49,1-52,1) respectivamente. La regresión de Cox para la edad de inicio de tratamiento resultó en un hazard ratio de 1,02 (IC 95 %: 1,01-1,02), mientras que para el oficio de ser agricultor el hazard ratio fue 1,1 (IC 95 %: 1,01-1,18) y para la etiología hipertensiva el hazard ratio fue de 0,7 (IC 95 %: 0,64-0,78). Conclusión. La edad de inicio de tratamiento y el ser agricultor están asociados con una menor supervivencia a cinco años en pacientes con diálisis
Introduction. The chronic kidney disease is responsible for approximately 2.4 million deaths worldwide, in El Salvador during 2019 death rate was 72.9 for 100 000 habitants, five year survival in patients after starting dialysis was between 39 and 60 % depending on the country. Objective. Analyze the factors that influence the five years survival in patients after starting renal replacement therapy in El Salvador. Methodology. It is a retrospective cohort study from patients included in dialysis and renal replacement therapy national registry from January 2016 to February 2023, the start point for the following was the initiation of dialysis, the event of interest was patient Ìs death, the Kaplan-Meier method was used to determine one year and five year survival; and Cox regression with Royston-Parmar model was used to analyze the factors that influence survival. Results. The study included 7088 patients, one and five-years survival was 79.5 % (CI 95 %: 78.6-80.5) and 50.6 % (CI 95 %: 49.1-52.1) respectively. The Cox regression for age of treatment initiation resulted in a hazard ratio of 1.02 (CI 95 %: 1.01-1.02), while for farmers, the hazard ratio was 1.09 (CI 95 %: 1.00-1.18), for hypertensive etiology the hazard ratio was 0.7 (CI 95 %: 0.64-0.78). Conclusion. Data suggest that age of treatment initiation, and jobs related to agriculture were associated with less five year survival in dialysis patients.