Vigilancia epidemiológica en los últimos 4 años del Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea: situación actual y tendencias / Four-year Epidemiological Surveillance of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy: Current Situation and Trends

Antecedentes: El Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea tiene entre sus objetivos la vigilancia epidemiológica de la dermatitis de contacto. Para ello es importante conocer si se producen alteraciones en el tiempo de las prevalencias de las positividades a los distintos alérgenos. Objetivos: Describir las variaciones en las tendencias temporales en positividades a alérgenos en la serie estándar del GEIDAC en el periodo comprendido entre 2018 y el 31 de diciembre de 2022. Métodos: Estudio observacional multicéntrico de pacientes estudiados consecutivamente mediante pruebas epicutáneas dentro del estudio de un posible eczema alérgico de contacto recogidos de forma prospectiva en el seno del Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea. Se analizaron los datos mediante 2 pruebas estadísticas: una de homogeneidad (para ver si hay cambios en los diferentes años) y otra de tendencia (para ver si los cambios siguen una tendencia lineal). Resultados: Se incluyeron un total de 11.327 pacientes en el periodo de estudio. Los alérgenos en los que de forma global se detectó una sensibilización mayor fueron sulfato de níquel, metilisotiazolinona, cloruro de cobalto, metilcloroisotiazolinona/metilisotiazolinona y mezcla de fragancias i. Se detectó una disminución estadísticamente significativa en el porcentaje de positividades de metilisotiazolinona a lo largo de años de estudio con una tendencia ordenada. Conclusiones: Si bien se pueden apreciar diferentes cambios en las tendencias a sensibilizaciones a varios de los alérgenos de la batería estándar, se observa que persiste una alta sensibilización al níquel, a la metilcloroisotiazolinona/metilisotiazolinona y a la mezcla de fragancias i. Solo se aprecia una tendencia a disminuir de forma significativa en el caso de la metilisotiazolinona.(AU)

Background: The epidemiological surveillance of contact dermatitis is one of the objectives of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. Knowing whether the prevalence of positive tests to the different allergens changes over time is important for this monitoring process. Objectives: To describe the various temporary trends in allergen positivity in the GEIDAC standard series from 2018 through December 31, 2022. Methods: This was a multicenter, observational trial of consecutive patients analyzed via patch tests as part of the study of possible allergic contact dermatitises collected prospectively within the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. The data was analyzed using 2 statistical tests: one homogeneity test (to describe the changes seen over time) and one trend test (to see whether the changes described followed a linear trend). Results: A total of 11327 patients were included in the study. Overall, the allergens associated with a highest sensitization were nickel sulfate, methylisothiazolinone, cobalt chloride, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix i. A statistically significant decrease was found in the percentage of methylisothiazolinone positive tests across the study years with an orderly trend. Conclusions: Although various changes were seen in the sensitizations trends to several allergens of the standard testing, it became obvious that a high sensitization to nickel, methylchloroisothiazolinone/methylisothiazolinone and fragrances mix i remained. Only a significant downward trend was seen for methylisothiazolinone.(AU)

[Translated article] Four-year Epidemiological Surveillance of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy: Current Situation and Trends / Vigilancia epidemiológica en los últimos 4 años del Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea: situación actual y tendencias

Antecedentes: El Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea tiene entre sus objetivos la vigilancia epidemiológica de la dermatitis de contacto. Para ello es importante conocer si se producen alteraciones en el tiempo de las prevalencias de las positividades a los distintos alérgenos. Objetivos: Describir las variaciones en las tendencias temporales en positividades a alérgenos en la serie estándar del GEIDAC en el periodo comprendido entre 2018 y el 31 de diciembre de 2022. Métodos: Estudio observacional multicéntrico de pacientes estudiados consecutivamente mediante pruebas epicutáneas dentro del estudio de un posible eczema alérgico de contacto recogidos de forma prospectiva en el seno del Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea. Se analizaron los datos mediante 2 pruebas estadísticas: una de homogeneidad (para ver si hay cambios en los diferentes años) y otra de tendencia (para ver si los cambios siguen una tendencia lineal). Resultados: Se incluyeron un total de 11.327 pacientes en el periodo de estudio. Los alérgenos en los que de forma global se detectó una sensibilización mayor fueron sulfato de níquel, metilisotiazolinona, cloruro de cobalto, metilcloroisotiazolinona/metilisotiazolinona y mezcla de fragancias i. Se detectó una disminución estadísticamente significativa en el porcentaje de positividades de metilisotiazolinona a lo largo de años de estudio con una tendencia ordenada. Conclusiones: Si bien se pueden apreciar diferentes cambios en las tendencias a sensibilizaciones a varios de los alérgenos de la batería estándar, se observa que persiste una alta sensibilización al níquel, a la metilcloroisotiazolinona/metilisotiazolinona y a la mezcla de fragancias i. Solo se aprecia una tendencia a disminuir de forma significativa en el caso de la metilisotiazolinona.(AU)

Background: The epidemiological surveillance of contact dermatitis is one of the objectives of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. Knowing whether the prevalence of positive tests to the different allergens changes over time is important for this monitoring process. Objectives: To describe the various temporary trends in allergen positivity in the GEIDAC standard series from 2018 through December 31, 2022. Methods: This was a multicenter, observational trial of consecutive patients analyzed via patch tests as part of the study of possible allergic contact dermatitises collected prospectively within the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. The data was analyzed using 2 statistical tests: one homogeneity test (to describe the changes seen over time) and one trend test (to see whether the changes described followed a linear trend). Results: A total of 11327 patients were included in the study. Overall, the allergens associated with a highest sensitization were nickel sulfate, methylisothiazolinone, cobalt chloride, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix i. A statistically significant decrease was found in the percentage of methylisothiazolinone positive tests across the study years with an orderly trend. Conclusions: Although various changes were seen in the sensitizations trends to several allergens of the standard testing, it became obvious that a high sensitization to nickel, methylchloroisothiazolinone/methylisothiazolinone and fragrances mix i remained. Only a significant downward trend was seen for methylisothiazolinone.(AU)

[Translated article] Four-year Epidemiological Surveillance of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy: Current Situation and Trends.

BACKGROUND: The epidemiological surveillance of contact dermatitis is one of the objectives of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. Knowing whether the prevalence of positive tests to the different allergens changes over time is important for this monitoring process. OBJECTIVES: To describe the various temporary trends in allergen positivity in the GEIDAC standard series from 2018 through December 31, 2022. METHODS: This was a multicenter, observational trial of consecutive patients analyzed via patch tests as part of the study of possible allergic contact dermatitises collected prospectively within the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. The data was analyzed using 2 statistical tests: one homogeneity test (to describe the changes seen over time) and one trend test (to see whether the changes described followed a linear trend). RESULTS: A total of 11327 patients were included in the study. Overall, the allergens associated with a highest sensitization were nickel sulfate, methylisothiazolinone, cobalt chloride, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix i. A statistically significant decrease was found in the percentage of methylisothiazolinone positive tests across the study years with an orderly trend. CONCLUSIONS: Although various changes were seen in the sensitizations trends to several allergens of the standard testing, it became obvious that a high sensitization to nickel, methylchloroisothiazolinone/methylisothiazolinone and fragrances mix i remained. Only a significant downward trend was seen for methylisothiazolinone.

Open data for monitoring COVID-19 in Spain: Descriptive study.

BACKGROUND: The indicators of the pandemic have been based on the total number of diagnosed cases of COVID-19, the number of people hospitalized or in intensive care units, and deaths from the infection. The aim of this study is to describe the available data on diagnostic tests, health service used for the diagnosis of COVID-19, case detection and monitoring. METHOD: Descriptive study with review of official data available on the websites of the Spanish health councils corresponding to 17 Autonomous Communities, 2 Autonomous cities and the Ministry of Health. The variables collected refer to contact tracing, technics for diagnosis, use of health services and follow-up. RESULTS: All regions of Spain show data on diagnosed cases of COVID-19 and deaths. Hospitalized cases and intensive care admissions are shown in all regions except the Balearic Islands. Diagnostic tests for COVID-19 have been registered in all regions except Madrid region and Extremadura, with scarcely information on what type of test has been performed (present in 7 CCAA), requesting service and study of contacts. CONCLUSIONS: The information available on the official websites of the Health Departments of the different regions of Spain are heterogeneous. Data from the use of health service or workload in Primary Care, Emergency department or Out of hours services are almost non-existent.

Maternal health surveillance panel: a tool for expanding epidemiological surveillance of women's health and its determinants / Painel de vigilância da saúde materna: uma ferramenta para ampliação da vigilância epidemiológica da saúde das mulheres e seus determinantes

ABSTRACT Objective: To present the methodology used in the development of two products for maternal health surveillance and its determinants and discuss their possible uses. Methods: Based on a theoretical model of the determinants of maternal death and databases of Brazilian health information systems, two free products were developed: an interactive panel "surveillance of maternal health" and an educational material "Aparecida: a story about the vulnerability of Brazilian women to maternal death", both available on the website of the Brazilian Obstetric Observatory. Results: More than 30 indicators were calculated for the period 2012-2020, containing information on socioeconomic conditions and access to health services, reproductive planning, prenatal care, delivery care, conditions of birth and maternal mortality and morbidity. The indicators related to severe maternal morbidity in public hospitalizations stand out, calculated for the first time for the country. The panel allows analysis by municipality or aggregated by health region, state, macro-region and country; historical series analysis; and comparisons across locations and with benchmarks. Information quality data are presented and discussed in an integrated manner with the indicators. In the educational material, visualizations with national and international data are presented, aiming to help in the understanding of the determinants of maternal death and facilitate the interpretation of the indicators. Conclusion: It is expected that the two products have the potential to expand epidemiological surveillance of maternal health and its determinants, contributing to the formulation of health policies and actions that promote women's health and reduce maternal mortality.

RESUME Objetivo: Apresentar a metodologia utilizada no desenvolvimento de dois produtos para a vigilância da saúde materna e seus determinantes e discutir as suas possíveis utilizações. Métodos: A partir de modelo teórico dos determinantes do óbito materno e bases de dados dos sistemas de informação em saúde brasileiros, foram desenvolvidos dois produtos gratuitos: um painel interativo denominado "Vigilância da saúde materna" e um material educativo chamado "Aparecida: uma história sobre a vulnerabilidade da mulher brasileira à morte materna", ambos disponíveis no site do Observatório Obstétrico Brasileiro. Resultados: Foram calculados mais de 30 indicadores para o período 2012-2020, contendo informações sobre condições socioeconômicas e de acesso a serviços de saúde, planejamento reprodutivo, assistência pré-natal, assistência ao parto, condições de nascimento e mortalidade e morbidade materna. Destacam-se os indicadores relacionados à morbidade materna grave em internações públicas, calculados pela primeira vez para o país. O painel permite análises por município ou agregadas por região de saúde, unidade da federação, macrorregião e país; análises de série histórica; e comparações entre localidades e com padrões de referência. Dados de qualidade da informação são apresentados e discutidos de forma integrada aos indicadores. No material educativo, visualizações com dados nacionais e internacionais são apresentadas, visando auxiliar na compreensão dos determinantes do óbito materno e facilitar a interpretação dos indicadores. Conclusão: Espera-se que os produtos tenham o potencial de ampliar a vigilância epidemiológica da saúde materna e seus determinantes, contribuindo para a formulação de políticas e ações de saúde que promovam a saúde das mulheres e reduzam a mortalidade materna.

Machine learning in predicting severe acute respiratory infection outbreaks / Aprendizado de máquina na previsão de surtos de síndrome respiratória aguda grave / Aprendizaje automático en la predicción de brotes de síndrome respiratorio agudo grave

Abstract: Severe acute respiratory infection (SARI) outbreaks occur annually, with seasonal peaks varying among geographic regions. Case notification is important to prepare healthcare networks for patient attendance and hospitalization. Thus, health managers need adequate resource planning tools for SARI seasons. This study aims to predict SARI outbreaks based on models generated with machine learning using SARI hospitalization notification data. In this study, data from the reporting of SARI hospitalization cases in Brazil from 2013 to 2020 were used, excluding SARI cases caused by COVID-19. These data were prepared to feed a neural network configured to generate predictive models for time series. The neural network was implemented with a pipeline tool. Models were generated for the five Brazilian regions and validated for different years of SARI outbreaks. By using neural networks, it was possible to generate predictive models for SARI peaks, volume of cases per season, and for the beginning of the pre-epidemic period, with good weekly incidence correlation (R2 = 0.97; 95%CI: 0.95-0.98, for the 2019 season in the Southeastern Brazil). The predictive models achieved a good prediction of the volume of reported cases of SARI; accordingly, 9,936 cases were observed in 2019 in Southern Brazil, and the prediction made by the models showed a median of 9,405 (95%CI: 9,105-9,738). The identification of the period of occurrence of a SARI outbreak is possible using predictive models generated with neural networks and algorithms that employ time series.

Resumo: Surtos de síndrome respiratória aguda grave (SRAG) ocorrem anualmente, com picos sazonais variando entre regiões geográficas. A notificação dos casos é importante para preparar as redes de atenção à saúde para o atendimento e internação dos pacientes. Portanto, os gestores de saúde precisam ter ferramentas adequadas de planejamento de recursos para as temporadas de SRAG. Este estudo tem como objetivo prever surtos de SRAG com base em modelos gerados com aprendizado de máquina usando dados de internação por SRAG. Foram incluídos dados sobre casos de hospitalização por SRAG no Brasil de 2013 a 2020, excluindo os casos causados pela COVID-19. Estes dados foram preparados para alimentar uma rede neural configurada para gerar modelos preditivos para séries temporais. A rede neural foi implementada com uma ferramenta de pipeline. Os modelos foram gerados para as cinco regiões brasileiras e validados para diferentes anos de surtos de SRAG. Com o uso de redes neurais, foi possível gerar modelos preditivos para picos de SRAG, volume de casos por temporada e para o início do período pré-epidêmico, com boa correlação de incidência semanal (R2 = 0,97; IC95%: 0,95-0,98, para a temporada de 2019 na Região Sudeste). Os modelos preditivos obtiveram uma boa previsão do volume de casos notificados de SRAG; dessa forma, foram observados 9.936 casos em 2019 na Região Sul, e a previsão feita pelos modelos mostrou uma mediana de 9.405 (IC95%: 9.105-9.738). A identificação do período de ocorrência de um surto de SRAG é possível por meio de modelos preditivos gerados com o uso de redes neurais e algoritmos que aplicam séries temporais.

Resumen: Brotes de síndrome respiratorio agudo grave (SRAG) ocurren todos los años, con picos estacionales que varían entre regiones geográficas. La notificación de los casos es importante para preparar las redes de atención a la salud para el cuidado y hospitalización de los pacientes. Por lo tanto, los gestores de salud deben tener herramientas adecuadas de planificación de recursos para las temporadas de SRAG. Este estudio tiene el objetivo de predecir brotes de SRAG con base en modelos generados con aprendizaje automático utilizando datos de hospitalización por SRAG. Se incluyeron datos sobre casos de hospitalización por SRAG en Brasil desde 2013 hasta 2020, salvo los casos causados por la COVID-19. Se prepararon estos datos para alimentar una red neural configurada para generar modelos predictivos para series temporales. Se implementó la red neural con una herramienta de canalización. Se generaron los modelos para las cinco regiones brasileñas y se validaron para diferentes años de brotes de SRAG. Con el uso de redes neurales, se pudo generar modelos predictivos para los picos de SRAG, el volumen de casos por temporada y para el inicio del periodo pre-epidémico, con una buena correlación de incidencia semanal (R2 = 0,97; IC95%: 0,95-0,98, para la temporada de 2019 en la Región Sudeste). Los modelos predictivos tuvieron una buena predicción del volumen de casos notificados de SRAG; así, se observaron 9.936 casos en 2019 en la Región Sur, y la predicción de los modelos mostró una mediana de 9.405 (IC95%: 9.105-9.738). La identificación del periodo de ocurrencia de un brote de SRAG es posible a través de modelos predictivos generados con el uso de redes neurales y algoritmos que aplican series temporales.

Recognize the epidemiological and geospatial profile of the Mobile Emergency Care Service: a strategy to optimize response time

Epidemiological, cross-sectional, descriptive, retrospective study of a quantitative nature, to trace the epidemiological and geospatial profile of the occurrences assisted by the Mobile Emergency Care Service. For that purpose, secondary data from the documents of the Mobile Emergency Care Service of a city in the interior of Rio Grande do Norte were used, considering the frequency of the variables: sex, age group, nature of occurrences, days of the week, ambulance sent, removal inter-hospital care and patient destination. Of the 363 occurrences, most were due to clinical causes, followed by traumatic, psychiatric, and gynecological/obstetric causes, with an emphasis on cardiovascular diseases and transport accidents. aged 19 to 59 years and over 60 years, with the Basic Support Unit providing the majority of care. Among the calls for clinical causes, women stood out, while for traumatic and psychiatric causes, men. The information contributes to the organization and planning of the service and the understanding of the morbidity profile. The geographic distribution highlights the need for integration between health agencies, for the institution of preventive actions, and the redirection of human and financial resources.

Estudio epidemiológico, transversal, descriptivo, retrospectivo, de carácter cuantitativo que tiene como objetivo trazar el perfil epidemiológico y geoespacial de los incidentes atendidos por el Servicio Móvil de Atención de Urgencias. Para ello se utilizan datos secundarios de dos documentos del Servicio Móvil de Atención de Emergencias de un municipio del interior de Rio Grande do Norte; considera la frecuencia de las variables: sexo, edad, naturaleza de los eventos, días de la semana, ambulancia enviada, retiro interhospitalario y destino del paciente. De los 363 sucesos, la mayoría se debió a causas clínicas, seguidas de causas traumáticas, psiquiátricas y ginecológicas/obstétricas, incluidas las enfermedades cardiovasculares y los accidentes de transporte. La frecuencia de ocurrencia fue ligeramente mayor en individuos masculinos con predominio de mujeres y edades entre los 19 y 59 años y mayores de 60 años; la Unidad Básica de Apoyo fue la responsable de la mayoría de los servicios. Entre los lesionados por causas clínicas destacan las mujeres, mientras que los hombres tienen causas traumáticas y psiquiátricas. Esta información contribuye a la organización y planificación de los servicios y a la comprensión del perfil de morbilidad. La distribución geográfica resalta la necesidad de integración entre las organizaciones de salud para implementar acciones preventivas y redireccionar recursos humanos y financieros.

Evaluation of Severe Acute Respiratory Syndrome surveillance caused by respiratory viruses in a pediatric unit, 2013 to 2019 / Avaliação da vigilância da Síndrome Respiratória Aguda Grave causada por vírus respiratórios em uma unidade pediátrica, 2013 a 2019

ABSTRACT Objective: To evaluate severe acute respiratory syndrome surveillance in a pediatric unit. Methods: Descriptive study of reported severe acute respiratory syndrome cases with the detection of respiratory viruses in the nasopharyngeal sample of patients hospitalized between 2013 and 2019, in a reference hospital in the Federal District, Brazil. Results: A total of 269 children had one or more viruses detected, resulting in 280 viruses, of which 152 (54%) were respiratory syncytial virus. The detection of respiratory syncytial virus was higher during the autumn-winter period. Children´s median age was 6.9 months, 156 (58%) were male, 104 (39%) had comorbidity, 197 (73%) required mechanical ventilation, 241 (90%) received antibiotics, and 146 (54%) oseltamivir. There were 19 (7%) deaths. The median time from symptom onset to sample collection was 5 days and the median time from sample collection to final results was 6 days. Conclusions: The system needs to reduce the time to deliver results so that inappropriate use of antibiotics and antivirals can be avoided. Moreover, the burden of viral pneumonia was relevant and the system must be flexible enough to include emerging viruses in order to be useful in responding to public health emergencies caused by respiratory viruses.

RESUMO Objetivo: Avaliar a vigilância da síndrome respiratória aguda grave em uma unidade pediátrica. Métodos: Estudo descritivo dos casos de síndrome respiratória aguda grave, notificados e com a detecção de vírus respiratório em amostra de nasofaringe de pacientes internados entre 2013 e 2019, em um hospital de referência do Distrito Federal. Resultados: Um total de 269 crianças tiveram algum vírus detectado, resultando em 280 vírus, sendo 152 (54%) vírus sincicial respiratório. A detecção do vírus sincicial respiratório foi maior durante o período de outono-inverno. A mediana da idade das crianças foi de 6,9 meses, 156 (58%) eram do sexo masculino, 104 (39%) tinham comorbidade, 197 (73%) necessitaram de ventilação mecânica, 241 (90%) receberam antibióticos e 146 (54%) oseltamivir. Ocorreram 19 (7%) óbitos. A mediana do tempo desde o início dos sintomas até a coleta da amostra foi de 5 dias, e do tempo da coleta até o resultado foi de 6 dias. Conclusões: O sistema necessita reduzir o tempo do resultado final para que seja possível evitar o uso inadequado de antibióticos e antivirais. Ademais, o impacto das pneumonias virais foi relevante e o sistema deve ser flexível suficiente para incluir vírus emergentes, para ser útil na resposta às emergências de saúde pública causada por vírus respiratórios.

Panorama clínico, epidemiológico e espacial da ocorrência de Leishmaniose visceral no estado do Pará, Amazônia brasileira / Clinical, epidemiological and spatial overview of visceral Leishmaniasis in the state of Pará, brazilian amazonia / Panorama clínico, epidemiológico y espacial de la Leishmaniasis visceral en el estado de Pará, amazonia brasileña

Objetivo: Essa pesquisa teve como objetivo determinar o perfil clínico, epidemiológico e espacial daLeishmaniose Visceral, bem como, sua associação com o desmatamento nos municípios pertencentesao 12º centro regional de saúde no Sudeste do Estado do Pará, Brasil de 2016 a 2020. Método: Trata-se de um estudo analítico ecológico, realizado com dados provenientes de 15 municípios do 12º Centro Regional de Saúde, obtidos por meio do banco de dados do Data-SUS-TABNET, através do SINAN. Resultados: Para o período do estudo foram notificados 415 casos de LV nos municípios analisados, o que correspondeu a uma média anual de 83 casos. O ano com maior número de notifi- cações foi 2017, apresentando 34,7%, sendo o município de Redenção com o maior número de casos.Conclusões: Portanto, há necessidade de ampliação das medidas de controle e vigilância da LV, comfoco na notificação de casos, a fim de realizar a obtenção do panorama fidedigno da LV e elaborar estratégias mais assertivas para seu controle e mitigação.

Objective: This research aimed to determine the clinical, epidemiological and spatial profile of Vis- ceral Leishmaniasis, as well as its association with deforestation in the municipalities belonging to the 12th regional health center in the Southeast of Pará State, Brazil from 2016 to 2020. Method: Thisis an ecological analytical study, conducted with data from 15 municipalities of the 12th Regional Health Center, obtained through the Data-SUS-TABNET database, through SINAN. Results: For thestudy period, 415 cases of VL were reported in the analyzed municipalities, corresponding to an an-nual average of 83 cases. The year with the highest number of notifications was 2017, present- ing 34.7%, being the municipality of Redenção with the highest number of cases. Conclu- sion: Therefore,there is a need to expand VL control and surveillance measures, focusing on the notification of casesin order to obtain a reliable picture of VL and develop more assertive strategies for its control and mitigation.

Objetivo: Esta investigación tuvo como objetivo determinar el perfil clínico, epidemiológico y espacial de la Leishmaniasis Visceral, así como su asociación con la deforestación en municipios pertenecientes al 12º Centro Regional de Salud del Sudeste del Estado de Pará, Brasil, de 2016 a 2020. Método: Trata-se de um estudo analítico ecológico, realizado com dados provenientes de 15 municípios do 12º Centro Regional de Saúde, obtidos por meio do banco de dados do Data-SUS-TABNET, através do SINAN. Resultados: Durante el período de estudio, fueron notificados 415 casos de LV en los municipios analizados, correspondiendo a una media anual de 83 casos. El año con mayor número de notificaciones fue 2017, 34,7%, y el municipio de Redenção presentó el mayor número de casos. Conclusiones: Por lo tanto, es necesario ampliar las medidas de control y vigilancia de la LV, centrándose en la notificación de casos con el fin de obtener una imagen fiable de la LV y desarrollar estrategias más asertivas para su control y mitigación.

Four-year Epidemiological Surveillance of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy: Current Situation and Trends. / Vigilancia epidemiológica en los últimos 4 años del Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea: situación actual y tendencias.

BACKGROUND: The epidemiological surveillance of contact dermatitis is one of the objectives of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. Knowing whether the prevalence of positive tests to the different allergens changes over time is important for this monitoring process. OBJECTIVES: To describe the various temporary trends in allergen positivity in the GEIDAC standard series from 2018 through December 31, 2022. METHODS: This was a multicenter, observational trial of consecutive patients analyzed via patch tests as part of the study of possible allergic contact dermatitises collected prospectively within the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. The data was analyzed using 2 statistical tests: one homogeneity test (to describe the changes seen over time) and one trend test (to see whether the changes described followed a linear trend). RESULTS: A total of 11327 patients were included in the study. Overall, the allergens associated with a highest sensitization were nickel sulfate, methylisothiazolinone, cobalt chloride, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix i. A statistically significant decrease was found in the percentage of methylisothiazolinone positive tests across the study years with an orderly trend. CONCLUSIONS: Although various changes were seen in the sensitizations trends to several allergens of the standard testing, it became obvious that a high sensitization to nickel, methylchloroisothiazolinone/methylisothiazolinone and fragrances mix i remained. Only a significant downward trend was seen for methylisothiazolinone.

Effect of school reopening on pediatric morbidity and mortality during the third epidemiological wave of COVID-19 in a Mexican state / Efecto de la reapertura de escuelas en la morbimortalidad pediátrica durante la tercera ola epidemiológica por COVID-19 en un estado mexicano

Abstract Background: Determining the effect of reopening schools on pediatric SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection rates increased the need to share the experience of governments in many geographic regions for better future decision-making in similar health emergencies. Methods: Through a prospective study based on a population-based cohort, students from 18,988 schools in the State of Mexico who began returning to school were followed. Daily sanitation filters were implemented in each school and district liaisons were informed on a daily basis through a negative network. Identified cases were confirmed by reverse transcriptase-polymerase chain reaction. Simple case frequencies, percentages, and incidences of COVID-19 were estimated. State incidences were compared with the national incidence. Results: A total of 3,586 cases were confirmed; 2,048 (57.1%) were children. Twenty-four (0.6%) were hospitalized for moderate to severe COVID-19; nine (37.5%) died, and only one was a schoolchild. From week 36, an average infection rate of 0.36 was observed. The highest infection rate in schoolchildren was observed in epidemiologic week 40 (1.01); from this week on, a decrease in the number of cases was observed until week 50. Conclusions: The use of non-pharmaceutical interventions has more advantages than limitations, as long as the strategies are homogeneous and properly implemented to ensure adequate control of infections.

Resumen Introducción: La determinación del efecto de reabrir las escuelas sobre las tasas de infección pediátrica por SARS-CoV-2 (síndrome respiratorio agudo grave coronavirus 2) incrementó la necesidad de trasmitir la experiencia de los gobiernos de muchas regiones geográficas para mejores decisiones futuras en emergencias sanitarias similares. Métodos: Mediante un estudio prospectivo basado en una cohorte poblacional se dio seguimiento a los alumnos de 18,988 escuelas del Estado de México que iniciaron con el regreso a clases. Se implementaron filtros sanitarios diarios en cada escuela y cotidianamente se informaban a los enlaces jurisdiccionales a través de una red negativa. Los casos identificados eran confirmados a través de RT-PCR (reacción en cadena de la polimerasa con transcriptasa inversa). Se estimaron frecuencias simples de casos, porcentajes e incidencias de COVID-19. Las incidencias del estado se compararon con la incidencia nacional. Resultados: Un total de 3,586 casos fueron confirmados; 2,048 (57.1%) correspondieron a niños. Veinticuatro (0.6%) fueron hospitalizados por COVID-19 moderado a grave; nueve (37.5%) fallecieron, y solamente una correspondió a un escolar. A partir de la semana 36 se observó una tasa promedio de infecciones de 0.36. En la semana epidemiológica 40 se observó la mayor tasa de infección en escolares (1.01); a partir de esta semana se observa un declive de los casos hasta la semana 50. Conclusiones: La implementación de intervenciones no farmacéuticas tiene más ventajas que limitaciones, siempre y cuando las estrategias sean homogéneas y correctamente ejecutadas, lo que asegurará un adecuado control en los contagios.

Congenital syphilis in Roraima and Venezuelan migration: analysis of cases at the state maternity hospital in the 2017/2018 and 2020/2021 biennia / Sífilis congênita em Roraima e a migração venezuelana: análise de casos na maternidade estadual nos biênios 2017/2018 e 2020/2021 / Sífilis congénita en Roraima y migración venezolana: análisis de casos en la maternidad estatal en los bienios 2017/2018 y 2020/2021

Background and objectives: in 2017 and 2018, Roraima experienced the most significant increase in congenital syphilis incidence rates among all federal units. This phenomenon occurred in parallel with the significant Venezuelan migration to the region. The study aimed to analyze the relationship between the increase in cases of congenital syphilis registered at the Hospital Materno Infantil Nossa Senhora de Nazareth and the Venezuelan migratory crisis. Methods: this is a document-based, descriptive research, covering the 2017/2018 and 2020/2021 periods, developed from data collected in copies of congenital syphilis report/investigation forms from the hospital. Results: in the 2017/2018 biennium, the peak of Venezuelan migration in Roraima, fewer cases of syphilis occurred than when the migratory flow declined. In the 2020/2021 biennium, there was a decrease in the migratory flow due to the closing of the border and the acceleration of the interiorization process. Although it is the period with the highest number of reports of congenital syphilis among Venezuelan mothers, the percentage is considerably lower than that recorded among Brazilian women. The incidence rate was higher among the group of Brazilian mothers (7.5/1,000 live births, in the 2017/2018 period, and 11.5/1,000 live births, in the 2020/2021 period). Conclusion: Venezuelan migration, although it may have eventually exerted some influence on the total number of cases of congenital syphilis, cannot be considered the determining factor for the increase in cases of the disease in the hospital in the defined period, and other factors deserve to be assessed as decisive in this case.(AU)

Justificativa e objetivos: em 2017 e 2018, Roraima apresentou o aumento mais significativo nas taxas de incidência de sífilis congênita entre todas as unidades federativas. Este fenômeno ocorreu paralelamente à significativa migração venezuelana para a região. O estudo teve como objetivo analisar a relação entre o aumento de casos de sífilis congênita registrados no Hospital Materno Infantil Nossa Senhora de Nazareth e a crise migratória venezuelana. Métodos: trata-se de uma pesquisa documental, descritiva, abrangendo os períodos 2017/2018 e 2020/2021, desenvolvida a partir de dados coletados em cópias de fichas de notificação/investigação de sífilis congênita do hospital. Resultados: no biênio 2017/2018, pico da migração venezuelana em Roraima, ocorreram menos casos de sífilis do que quando o fluxo migratório diminuiu. No biénio 2020/2021, registou-se uma diminuição do fluxo migratório devido ao encerramento da fronteira e à aceleração do processo de interiorização. Embora seja o período com maior número de notificações de sífilis congênita entre mães venezuelanas, o percentual é consideravelmente inferior ao registrado entre as brasileiras. A taxa de incidência foi maior entre o grupo de mães brasileiras (7,5/1.000 nascidos vivos, no período 2017/2018, e 11,5/1.000 nascidos vivos, no período 2020/2021). Conclusão: A migração venezuelana, embora possa eventualmente ter exercido alguma influência no total de casos de sífilis congênita, não pode ser considerada o fator determinante para o aumento de casos da doença no hospital no período definido, e outros fatores merecem ser destacados. ser considerada decisiva neste caso.(AU)

Antecedentes y objetivos: en 2017 y 2018, Roraima experimentó el aumento más significativo en las tasas de incidencia de sífilis congénita entre todas las unidades federales. Este fenómeno se produjo en paralelo con la importante migración venezolana a la región. El estudio tuvo como objetivo analizar la relación entre el aumento de casos de sífilis congénita registrados en el Hospital Materno Infantil Nossa Senhora de Nazareth y la crisis migratoria venezolana. Métodos: se trata de una investigación descriptiva, documental, que abarca los períodos 2017/2018 y 2020/2021, desarrollada a partir de datos recolectados en copias de formularios de informe/investigación de sífilis congénita del hospital. Resultados: en el bienio 2017/2018, pico de migración venezolana en Roraima, ocurrieron menos casos de sífilis que cuando el flujo migratorio disminuyó. En el bienio 2020/2021 se produjo una disminución del flujo migratorio debido al cierre de fronteras y la aceleración del proceso de interiorización. Si bien es el período con mayor número de reportes de sífilis congénita entre madres venezolanas, el porcentaje es considerablemente menor que el registrado entre las mujeres brasileñas. La tasa de incidencia fue mayor entre el grupo de madres brasileñas (7,5/1.000 nacidos vivos, en el período 2017/2018, y 11,5/1.000 nacidos vivos, en el período 2020/2021). Conclusión: La migración venezolana, si bien eventualmente pudo haber ejercido alguna influencia en el número total de casos de sífilis congénita, no puede considerarse el factor determinante del aumento de casos de la enfermedad en el hospital en el período definido, y otros factores merecen ser considerados. considerarse decisivo en este caso.(AU)

Retos del Sistema Nacional de Salud en los tiempos pos-COVID / Challenges of the National Health System in post-COVID times

El Sistema Nacional de Salud de Cuba se fundó en el año 1961 y es una entidad dependiente del Ministerio de Salud Pública de Cuba. Este constituye una prioridad nacional, tiene carácter universal, gratuito y se basa en el modelo del médico de familia, con un enfoque clínico, epidemiológico y social de los problemas sanitarios. Se sustenta en siete principios que expresan el derecho del pueblo a la salud, con responsabilidad del Estado, y las prácticas de salud se sostienen sobre una base científica sólida con acciones preventivas. En el año 2019, una epidemia azotó a la mayoría de los países del mundo (la COVID-19), entre ellos, Cuba. Ello conllevó a que los profesionales de la salud asumieran retos importantes ante una situación de salud sin precedentes. Este trabajo se refiere a los retos asumidos, principalmente, después de la COVID-19.

The Cuban National Health System was founded in 1961 and is an entity dependent on the Cuban Ministry of Public Health. This constitutes a national priority, is universal, free and is based on the family doctor model, with a clinical, epidemiological and social approach to health problems. It is supported in seven principles that express the right of the people to health, with responsibility of the State and the health practices are sustained on a solid scientific basis with preventive actions. In 2019, an epidemic hit most of the countries in the world (COVID-19), including Cuba. This led health professionals to assume important challenges in order to face an unprecedented health situation. This work refers to the challenges assumed, mainly, after COVID-19.

Effect of school reopening on pediatric morbidity and mortality during the third epidemiological wave of COVID-19 in a Mexican state.

BACKGROUND: Determining the effect of reopening schools on pediatric SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection rates increased the need to share the experience of governments in many geographic regions for better future decision-making in similar health emergencies. METHODS: Through a prospective study based on a population-based cohort, students from 18,988 schools in the State of Mexico who began returning to school were followed. Daily sanitation filters were implemented in each school and district liaisons were informed on a daily basis through a negative network. Identified cases were confirmed by reverse transcriptase-polymerase chain reaction. Simple case frequencies, percentages, and incidences of COVID-19 were estimated. State incidences were compared with the national incidence. RESULTS: A total of 3,586 cases were confirmed; 2,048 (57.1%) were children. Twenty-four (0.6%) were hospitalized for moderate to severe COVID-19; nine (37.5%) died, and only one was a schoolchild. From week 36, an average infection rate of 0.36 was observed. The highest infection rate in schoolchildren was observed in epidemiologic week 40 (1.01); from this week on, a decrease in the number of cases was observed until week 50. CONCLUSIONS: The use of non-pharmaceutical interventions has more advantages than limitations, as long as the strategies are homogeneous and properly implemented to ensure adequate control of infections.

INTRODUCCIÓN: La determinación del efecto de reabrir las escuelas sobre las tasas de infección pediátrica por SARS-CoV-2 (síndrome respiratorio agudo grave coronavirus 2) incrementó la necesidad de trasmitir la experiencia de los gobiernos de muchas regiones geográficas para mejores decisiones futuras en emergencias sanitarias similares. MÉTODOS: Mediante un estudio prospectivo basado en una cohorte poblacional se dio seguimiento a los alumnos de 18,988 escuelas del Estado de México que iniciaron con el regreso a clases. Se implementaron filtros sanitarios diarios en cada escuela y cotidianamente se informaban a los enlaces jurisdiccionales a través de una red negativa. Los casos identificados eran confirmados a través de RT-PCR (reacción en cadena de la polimerasa con transcriptasa inversa). Se estimaron frecuencias simples de casos, porcentajes e incidencias de COVID-19. Las incidencias del estado se compararon con la incidencia nacional. RESULTADOS: Un total de 3,586 casos fueron confirmados; 2,048 (57.1%) correspondieron a niños. Veinticuatro (0.6%) fueron hospitalizados por COVID-19 moderado a grave; nueve (37.5%) fallecieron, y solamente una correspondió a un escolar. A partir de la semana 36 se observó una tasa promedio de infecciones de 0.36. En la semana epidemiológica 40 se observó la mayor tasa de infección en escolares (1.01); a partir de esta semana se observa un declive de los casos hasta la semana 50. CONCLUSIONES: La implementación de intervenciones no farmacéuticas tiene más ventajas que limitaciones, siempre y cuando las estrategias sean homogéneas y correctamente ejecutadas, lo que asegurará un adecuado control en los contagios.

Impacto psicosocial de la COVID-19 en los profesionales de los Servicios de Vigilancia Epidemiológica de Cataluña / Psychosocial impact of COVID-19 on the professionals of the Epidemiological Surveillance Services of Catalonia

Fundamentos: Los profesionales sanitarios estuvieron sometidos durante la pandemia de la COVID-19 a condiciones laborales muy exigentes. El objetivo de este artículo fue evaluar el nivel de riesgo de padecer algún trastorno psicosocial por parte de los profesionales de los Servicios de Vigilancia Epidemiológica de Cataluña (SVE) durante la sexta ola pandémica de la COVID-19. Métodos: Se realizó un estudio epidemiológico de prevalencia en trabajadores/as de los SVE de Cataluña. La información se recogió mediante un cuestionario de datos sociodemográficos, laborales y elCuestionario de Salud General de Goldberg (GHQ-28) de enero a marzo de 2022. Una puntuación igual o mayor de 7 en el GHQ-28 se consideró positiva e indicaba riesgo de padecer algún trastorno. Las variables dependientes fueron la puntuación y la positividad del test GHQ-28. La relación entre la puntuación del GHQ-28 con el resto de las variables independientes del estudio se estudió con laOdds Ratio (OR) y sus intervalos de confianza (IC) del 95%. Resultados: La edad media de la población estudiada fue de 37 años (DE=±11,4) y el 75% eran mujeres. El 53,8% de los participantes presentaron un resultado positivo en el GHQ-28. Los participantes con mayor riesgo psicosocial fueron los trabajadores con antecedentes de problemas psicológicos (OR 2,8; IC95% 1,2-6,7). El riesgo también fue superior en las mujeres (OR 1,8; IC95% 0,8-4,1), los participantes con profesiones sanitarias (OR 1,2: IC95% 0,6-2,5), los que estaban tomando tratamiento farmacológico (OR 2,4; IC95% 0,6-9,7) o los que estaban realizando terapia psicológica (OR 1,5; IC95% 0,6-3,6) en el momento de la recogida de datos y los trabajadores que no tuvieron una percepción de apoyo y reconocimiento laboral por parte de sus equipos de trabajo (OR 1,8; IC95% 0,9-3,8), aunque algunas diferencias no fueron estadísticamente significativas...(AU)

Background: Healthcare professionals were subjected to very demanding working conditions during the COVID-19 pandemic. The aim of this paper was to assess the level of risk of suffering a psychosocial disorder in the professionals of the Epidemiological Surveillance Services of Catalonia (EVS) during the sixth wave of the COVID-19 pandemic. Methods: An epidemiological study of prevalence was carried out in SVE workers in Catalonia. The information was collected through a questionnaire of sociodemographic and occupational data and the Goldberg General Health Questionnaire (GHQ-28) from January to March 2022. A score equal to or greater than 7 on the GHQ-28 was considered positive and indicated a risk of suffering some disorder. The dependent variables were the score and positivity of the GHQ-28 test. The relationship between the GHQ-28 score and the rest of the independent variables of the study was studied with the Odds Ratio (OR) and its 95% confidence intervals (IC). Results: The mean age of the population studied was 37 years (SD=±11.4) and 75% were women. 53.8% of the participants presented a positive result in the GHQ-28. The participants with the highest psychosocial risk were workers with a history of psychological problems (OR 2.8; IC95% 1.2-6.7). The risk was also higher in women (OR 1.8; IC95% 0.8-4.1), participants with health professions (OR 1.2: IC95% 0.6-2.5), those who were taking pharmacological treatment (OR 2.4; IC95% 0.6-9.7) or those who were undergoing psychological therapy (OR 1.5; IC95% 0.6-3.6) at the time of data collection and workers who did not had a perception of work support and recognition from their work teams (OR 1.8; IC95% 0.9-3.8), although some differences were not statistically significant. Conclusions: The professionals of the SVE professionals presented, during the sixth pandemic wave, a high risk of psychosocialdisorder...(AU)

Impacto de la pandemia de la COVID-19 en los sistemas de vigilancia epidemiologica de la infección por VIH en España / Impact of the COVID-19 pandemic on the epidemiological surveillance systems of HIV infection in Spain

Fundamentos: La pandemia de la COVID-19 afectó de forma indirecta a otras enfermedades transmisibles, como la infección por el virus de la inmunodeficiencia humana (VIH). El objetivo de este estudio fue evaluar el impacto de la pandemia de la COVID-19 en la vigilancia epidemiológica del VIH a través de indicadores epidemiológicos. Métodos: Se analizaron los datos recogidos en el Sistema de Información de Nuevos Diagnósticos de VIH (SINIVIH) en el periodo 2013-2021. Los indicadores epidemiológicos analizados fueron: 1) Retraso en la notificación de nuevos diagnósticos; 2) Infradiagnóstico de caso, calculado por mes y por cada año de diagnóstico; 3) Diagnóstico tardío, casos diagnosticados con menos de 350 células CD4/mm3.Resultados: Respecto al retraso en la notificación de nuevos diagnósticos, en 2022 se notificaron 2.770 casos diagnosticados en 2020, un 43,8% más respecto a los notificados en 2021 para ese año. Los casos diagnosticados por mes entre 2016 y 2019 seguían una tendencia constante. En 2020 se observó un descenso importante de diagnósticos entre marzo y mayo que no se recuperó al corregir por retraso en la notificación. Al comparar las tasas de casos diagnosticados en 2013 con los años sucesivos, se observó un descenso continuo que se interrumpía en el último año del periodo de estudio. El porcentaje de casos con diagnóstico tardío se mantuvo estable en el periodo de estudio (entre el 46% y el 50%), observándose un descenso al corregir por retraso en la notificación. Conclusiones: La vigilancia epidemiológica del VIH sufrió un importante retraso en la notificación. Se constata un descenso en los casos diagnosticados, en parte debido al confinamiento y la falta de acceso a pruebas diagnósticas. No se observan cambios en el diagnóstico tardío.(AU)

Background: The COVID-19 pandemic indirectly affected other communicable diseases, such as human immunodeficiency virus (HIV) infection. The aim of this paper was to evaluate the impact of the COVID-19 pandemic on the epidemiological surveillance of HIV through epidemiological indicators. Methods: Data collected in the New HIV Diagnosis Information System (SINIVIH, acronym in Spanish) in the period 2013-2021 was analyzed. The epidemiological indicators analyzed were: 1) Reporting delay of new diagnoses; 2) Under diagnosis of cases, calculated per month of diagnosis and for each year of diagnosis; 3) Late diagnosis, cases diagnosed with less than 350 CD4 cell/mm3. Results: Regarding the reporting delay of new diagnoses, in 2022 2,770 diagnoses were reported in 2020, 43.8% more than those reported in 2021 for that year. The cases diagnosed per month between 2016 and 2019 followed a constant trend. In 2020, a significant decrease in diagnoses was observed between March and May that was not recovered after correcting for reporting delay. When comparing the rates of cases diagnosed in 2013 with the successive years, a continuous decrease was interrupted in the last year of the study period. The percentage of cases with late diagnosis had remained stable in the study period (between 46% and 50%), and a decrease in this percentage was observed after correcting for reporting delay.Conclusions: The epidemiological surveillance of HIV suffered a significant reporting delay. A decrease in cases diagnosed is confirmed, partly due to lockdown and lack of access to the health system. Changes on late diagnosis is not observed.(AU)

Comparación de la vigilancia centinela de infecciones respiratorias agudas frente a la vigilancia universal en La Rioja en la temporada 2021-2022 / Comparison of sentinel surveillance of acute respiratory infections versus universal surveillance in La Rioja in the 2021-2022 season

Fundamentos: La vigilancia centinela se emplea para monitorizar problemas de salud. En laEstrategia de detección de COVID se lleva a cabo vigilancia universal de infección por SARS-CoV-2, que puede pasar a monitorización mediante sistemas centinela, a través de vigilancia de infección respiratoria aguda leve (IRA) o grave (IRAG). El objetivo del presente trabajo fue comparar datos de incidencia obtenidos mediante vigilancia centinela frente a vigilancia universal en las infecciones respiratorias agudas. Métodos: Se realizó un estudio descriptivo de las incidencias (casos por cada 100.000 habitantes) de infección respiratoria aguda (comienzo súbito de tos, dolor de garganta, disnea o rinorrea y juicio clínico de infección) en toda la población de La Rioja, registrados en la historia clínica de Atención Primaria, y en una cohorte centinela, por edad y sexo durante el periodo que incluye la semana 40-2021 hasta la 06-2022. Para IRAG se calcularon los casos hospitalizados totales por cada 100.000 habitantes con inicio de síntomas en los diez días previos, así como la incidencia en una selección sistemática de todos los IRAG hospitalizados un día a la semana. Se calcularon las tasas de incidencia semanales en cada cohorte desde la semana cuarenta del año 2021 a la semana seis del año 2022 por sexo y grupo de edad. Las características de la población se expresaron en su distribución por número y porcentaje. Resultados: Los datos observados para IRA fueron similares en ambos sistemas por sexo y edad, salvo para el grupo de cero a cuatro años y el de más de setenta y nueve años, donde se observaron diferencias, siendo las cifras de IRA más elevadas en el primer grupo de edad en la vigilancia centinela, mientras que en el grupo de mayores fueron superiores en la vigilancia universal. Las IRAG mostraron una incidencia similar, excepto en los grupos de edad de quince a cuarenta y cuatro años, que fue mayor en vigilancia universal que en el centinela.(AU)

Background: Sentinel surveillance is used to monitor health problems. The COVID detection strategy conducts universal surveillance of SARS-CoV-2 infection, which can be monitored by sentinel systems, through surveillance of mild acute respiratory infection (IRA) or severe respiratory infection (IRAG). The objective of this study was to compare incidence data obtained through sentinel surveillance against versus universal surveillance in acute respiratory infections. Methods: A descriptive study of the incidences (cases/100,000 inhabitants) of acute respiratory infection (sudden onset of cough, sore throat, dyspnea or runny nose and clinical judgment of infection) was carried out in the entire population of La Rioja recorded in the primary care medical record, and in a sentinel cohort, by age and sex during the period from weeks 40-2021 to 06-2022. For SARI, the total number of hospitalized cases per 100,000 inhabitants with onset of symptoms in the previous ten days was calculated, as well as the incidence in a systematic selection of all SARI hospitalized one day a week. Weekly incidence rates were calculated in each cohort from week forty of 2021 to week six of 2022 by sex and age group. The characteristics of the population were expressed in their distribution by number and percentage.Results: The data observed for ARI were similar in both systems by sex and age, except for the zero to four-year-old group and the group over seventy-nine years of age, where differences were observed, with the highest ARI figures in the first age group in sentinel surveillance, while in the older group they were superior in universal surveillance. SARIs showed a similar incidence, except in the fifteen/fourty-four age groups, which was higher in universal surveillance than in sentinel surveillance.(AU)

Infecciones, hospitalizaciones y mortalidad por COVID-19 en Navarra entre febrero de 2020 y septiembre de 2022 / COVID-19 infections, hospitalizations, and mortality in Navarre (Spain) between February 2020 and September 2022

Fundamento: El SARS-CoV-2 circuló ininterrumpidamente enEspaña durante el período comprendido entre febrero de 2020y septiembre de 2022. Este estudio analiza su repercusión en lasinfecciones, hospitalizaciones y defunciones en Navarra. Métodos: A partir de la vigilancia epidemiológica reforzada yde los resultados de encuestas sero-epidemiológicas, se hananalizado las infecciones, hospitalizaciones y defunciones porCOVID-19 en función de la cobertura vacunal y otras medidaspreventivas aplicadas durante el período del estudio.Resultados: Se confirmaron 295.424 personas con COVID-19(45% de la población navarra), 8.594 requirieron ingreso hospitalario (1,3%), 832 ingresaron en unidades de cuidados intensi-vos (1,3‰) y 1.725 fallecieron (2,6‰). Durante la primera ondapandémica, en pocas semanas se registraron 1.934 hospitalizaciones y 529 defunciones por COVID-19 confirmado; dicha cifrase redujo significativamente tras el confinamiento domiciliario. Hasta octubre de 2021, la circulación del SARS-CoV-2 estuvomodulada por las medidas preventivas no farmacológicas. Laposterior relajación de las mismas dio paso a una amplia circulación de la variante ómicron, triplicando el número de casosregistrados hasta entonces. La alta cobertura vacunal frente ala COVID-19 introdujo cambios decisivos en su epidemiología,reduciendo la proporción de casos que requirieron hospitalización, ingreso en unidades de cuidados intensivos y fallecimientos a menos del 2%, 0,1% y 0,5%, respectivamente. Conclusiones: El confinamiento domiciliario inicial y las medidas preventivas no farmacológicas contuvieron la circulación delSARS-CoV-2 hasta extenderse la vacunación, con la cual se logróuna reducción decisiva en la gravedad y letalidad de la COVID-19.(AU)

Background: Between February 2020 and September 2022,SARS-CoV-2 has circulated uninterruptedly throughout Spain.This study analyses COVID-19 infections, hospitalizations, anddeaths in Navarre. Methods: Enhanced epidemiological surveillance and results ofseroepidemiological surveys were used to analyze COVID-19 infections, hospitalizations, and deaths, based on the vaccinationcoverage and other preventive measures applied from February2020 to September 2022. Results: A total of 295,424 COVID-19 cases were confirmed (45%of the population in Navarre); 8,594 required hospital admission (1.3%), 832 were admitted to intensive care units (1.3‰)and 1,725 died (2.6‰). Over the first wave of the pandemic,there were 1,934 hospitalizations and 529 deaths from confirmed COVID-19 cases over a few weeks; these figures droppedrapidly following lockdown. Until October 2021, SARS-CoV-2circulation was modulated by non-pharmacological preventivemeasures. The subsequent relaxation of these measures led to awide circulation of the omicron variant, increasing the numberof cases by three-fold. The high vaccination coverage againstCOVID-19 introduced decisive changes in the epidemiology ofthe disease, reducing to less than 2%, 0.1%, and 0.5% the casesrequiring hospitalization, intensive care unit admission, or thatdied, respectively. Conclusions: Initial lockdown and non-pharmacological preventive measures helped control SARS-CoV-2 transmission untilvaccination was extended. Vaccination achieved a decisive reduction of the COVID-19 severity and lethality.(AU)

Vigilância epidemiológica dos diagnósticos de enfermagem: qual a realidade no agrupamento de centros de saúde do Alto Minho? / Epidemiological surveillance of nursing diagnoses: what is the reality in the Alto Minho cluster of health centres?

O presente trabalho surge no âmbito da Unidade Curricular: Estágio de Natureza Profissional com Relatório Final, inserido no plano curricular do II Curso de Mestrado em Enfermagem Comunitária, da Escola Superior de Saúde, do Instituto Politécnico de Viana do Castelo. Este tem como principal finalidade a análise critico-reflexiva da investigação e das atividades realizadas durante o estágio estruturantes do desenvolvimento simultaneamente de competências conducentes à obtenção ao grau de mestre em Enfermagem Comunitária e das competências comuns e especificas à obtenção posteriormente, do título profissional de Enfermeiro Especialista em Enfermagem Comunitária (EEEC), na área da Enfermagem de Saúde Comunitária e de Saúde Pública, atribuído pela Ordem dos Enfermeiros (OE). Decorreu no período de 1 de março a 31 de agosto de 2022. O desenvolvimento deste percurso, teve como problemática central a vigilância epidemiológica dos diagnósticos de enfermagem (VEDE), a partir de uma Unidade de Saúde Pública (USP), tendo como alvo o processo de cuidados prestados pelos enfermeiros do Agrupamento de Centros de Saúde (ACeS) da região norte. Para a compreensão desta realidade e do potencial de intervenção que lhe está inerente recorreu-se ao Modelo de Avaliação, Intervenção e Empoderamento Comunitário (MAIEC, Pedro Melo, 2016). Assim, tendo como objetivo principal conhecer a realidade da VEDE no ACeS, onde se realizou o estágio, realizou-se um estudo observacional, transversal e descritivo, num universo de 262 enfermeiros, sendo a amostra constituída por 77 enfermeiros. A partir da análise documental do Diagnóstico Local de Saúde e do Plano Local de Saúde do ACeS, foram identificados os principais fenómenos de enfermagem e determinadas as taxas de documentação dos mesmos por parte dos enfermeiros. Os resultados obtidos evidenciam um nível baixo de documentação dos diagnósticos de enfermagem e avaliação diagnóstica da gestão comunitária do ACeS sobre a VEDE está comprometida em todas as suas dimensões diagnósticas (liderança comunitária, participação comunitária e processo comunitário).

The present work comes within the scope of the Curricular Unit: Internship of a Professional Nature with Final Report, inserted in the curricular plan of the II Master's Course in Community Nursing, of the Superior School of Health, of the Polytechnic Institute of Viana do Castelo. This has as its main purpose the critical-reflexive analysis of the investigation and activities carried out during the structuring stage of the simultaneous development of skills leading to obtaining a master's degree in Community Nursing and common and specific skills to subsequently obtain the professional title of Nurse Specialist in Community Nursing (EEEC), in the area of Community Health Nursing and Public Health, awarded by the Order of Nurses (OE). It took place from March 1 to August 31, 2022. The development of this course had as its central problem the epidemiological surveillance of nursing diagnoses (VEDE), from a Public Health Unit (USP), having as its target the care process provided by nurses from the Grouping of Health Centers (ACeS) in the northern region. In order to understand this reality and the potential for intervention inherent to it, the Model of Evaluation, Intervention and Community Empowerment (MAIEC, Pedro Melo, 2016) was used. Thus, with the main objective of knowing the reality of VEDE in ACeS, where the internship took place, an observational, cross-sectional and descriptive study was carried out, in a universe of 262 nurses, with a sample consisting of 77 nurses. Based on the documental analysis of the Local Health Diagnosis and the Local Health Plan of ACeS, the main nursing phenomena were identified and the rates of documentation of these by nurses were determined. The results obtained show a low level of documentation of nursing diagnoses and diagnostic evaluation of the community management of ACeS on VEDE is compromised in all its diagnostic dimensions (community leadership, community participation and community process).

La prevención de riesgos laborales en el SNS-O: Protección frente a la COVID-19, vacunación y cuidado emocional de profesionales sanitarios / The prevention of occupational risks in the SNS-O: Protection against COVID-19, vaccination and emotional care of health professionals

La pandemia de SARS-CoV-2 supuso un importante reto para la gestión de la prevención deriesgos laborales en el Servicio Navarro de Salud-Osasunbidea (SNS-O). Las actuacionesdesarrolladas se agrupan en cinco líneas fundamentales: adopción de medidas preventivasy vigilancia de la salud, rastreo de casos y contactos, protección del profesional especial-mente sensible, gestión del impacto psicoemocional e intervención vacunal. A pesar deestos esfuerzos, la salud del personal del SNS-O se vio afectada, tanto por los contagios deSARS-CoV-2 producidos en el ámbito laboral, como por los cambios que se generaron en suscondiciones de trabajo. Es necesario disponer de planes de contingencia en previsión defuturas pandemias, que garanticen que se dispone de los medios materiales, la formacióny los sistemas de información necesarios para afrontarlas con las adecuadas condicionesde seguridad para el personal del ámbito sanitario. También es necesario continuar conla integración de la prevención de riesgos laborales como un aspecto transversal de laorganización.(AU)