Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.377
Filtrar
4.
Ann Glob Health ; 87(1): 23, 2021 02 25.
Artículo en Inglés | MEDLINE | ID: mdl-33665145

RESUMEN

Introduction: Rwanda has made significant advancements in medical and economic development over the last 20 years and has emerged as a leader in healthcare in the East African region. The COVID-19 pandemic, which reached Rwanda in March 2020, presented new and unique challenges for infectious disease control. The objective of this paper is to characterize Rwanda's domestic response to the first year of the COVID-19 pandemic and highlight effective strategies so that other countries, including high and middle-income countries, can learn from its innovative initiatives. Methods: Government publications describing Rwanda's healthcare capacity were first consulted to obtain the country's baseline context. Next, official government and healthcare system communications, including case counts, prevention and screening protocols, treatment facility practices, and behavioral guidelines for the public, were read thoroughly to understand the course of the pandemic in Rwanda and the specific measures in the response. Results: As of 31 December 2020, Rwanda has recorded 8,383 cumulative COVID-19 cases, 6,542 recoveries, and 92 deaths since the first case on 14 March 2020. The Ministry of Health, Rwanda Biomedical Centre, and the Epidemic and Surveillance Response division have collaborated on preparative measures since the pandemic began in January 2020. The formation of a Joint Task Force in early March led to the Coronavirus National Preparedness and Response Plan, an extensive six-month plan that established a national incident management system and detailed four phases of a comprehensive national response. Notable strategies have included disseminating public information through drones, robots for screening and inpatient care, and official communications through social media platforms to combat misinformation and mobilize a cohesive response from the population. Conclusion: Rwanda's government and healthcare system has responded to the COVID-19 pandemic with innovative interventions to prevent and contain the virus. Importantly, the response has utilized adaptive and innovative technology and robust risk communication and community engagement to deliver an effective response to the COVID-19 pandemic.


Asunto(s)
Control de Enfermedades Transmisibles , Prestación de Atención de Salud , Regulación Gubernamental , Gestión de Riesgos , /epidemiología , Gestión del Cambio , Control de Enfermedades Transmisibles/legislación & jurisprudencia , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Comunicación , Prestación de Atención de Salud/organización & administración , Prestación de Atención de Salud/tendencias , Transmisión de Enfermedad Infecciosa/prevención & control , Humanos , Innovación Organizacional , Gestión de Riesgos/métodos , Gestión de Riesgos/organización & administración , Rwanda/epidemiología
9.
Respirology ; 26(4): 322-333, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33690946

RESUMEN

COVID-19 has hit the world by surprise, causing substantial mortality and morbidity since 2020. This narrative review aims to provide an overview of the epidemiology, induced impact, viral kinetics and clinical spectrum of COVID-19 in the Asia-Pacific Region, focusing on regions previously exposed to outbreaks of coronavirus. COVID-19 progressed differently by regions, with some (such as China and Taiwan) featured by one to two epidemic waves and some (such as Hong Kong and South Korea) featured by multiple waves. There has been no consensus on the estimates of important epidemiological time intervals or proportions, such that using them for making inferences should be done with caution. Viral loads of patients with COVID-19 peak in the first week of illness around days 2 to 4 and hence there is very high transmission potential causing community outbreaks. Various strategies such as government-guided and suppress-and-lift strategies, trigger-based/suppression approaches and alert systems have been employed to guide the adoption and easing of control measures. Asymptomatic and pre-symptomatic transmission is a hallmark of COVID-19. Identification and isolation of symptomatic patients alone is not effective in controlling the ongoing outbreaks. However, early, prompt and coordinated enactment predisposed regions to successful disease containment. Mass COVID-19 vaccinations are likely to be the light at the end of the tunnel. There is a need to review what we have learnt in this pandemic and examine how to transfer and improve existing knowledge for ongoing and future epidemics.


Asunto(s)
Control de Enfermedades Transmisibles , Asia/epidemiología , Australasia/epidemiología , /fisiopatología , /virología , Defensa Civil/organización & administración , Control de Enfermedades Transmisibles/legislación & jurisprudencia , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/estadística & datos numéricos , Regulación Gubernamental , Humanos , Cooperación Internacional , /fisiología
11.
Mayo Clin Proc ; 96(4): 912-920, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33714601

RESUMEN

OBJECTIVE: To assess the prevalence and characteristics of coronavirus disease 2019 (COVID-19) cases during the reopening period in older adults, given that little is known about the prevalence of COVID-19 after the stay-at-home order was lifted in the United States, nor the actual effects of adherence to recommended public health measures (RPHM) on the risk of COVID-19. PATIENTS AND METHODS: This was a cross-sectional study nested in a parent prospective cohort study, which followed a population-based sample of 2325 adults 50 years and older residing in southeast Minnesota to assess the incidence of viral infections. Participants were instructed to self-collect both nasal and oropharyngeal swabs, which were tested by reverse transcription polymerase chain reaction-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assay between May 8, 2020, and June, 30, 2020. We assessed the prevalence of COVID-19 cases and characteristics of study subjects. RESULTS: A total of 1505 eligible subjects participated in the study whose mean age was 68 years, with 885 (59%) women, 32 (2%) racial/ethnic minorities, and 906 (60%) with high-risk conditions for influenza. The prevalence of other Coronaviridae (human coronavirus [HCoV]-229E, HCoV-NL63, and HCoV-OC43) during the 2019 to 2020 flu season was 109 (7%), and none tested positive for SARS-CoV-2. Almost all participants reported adhering to the RPHM (1,488 [99%] for social distancing, 1,438 [96%] for wearing mask in a public space, 1,476 [98%] for hand hygiene, and 1,441 (96%) for staying home mostly). Eighty-six percent of participants resided in a single-family home. CONCLUSION: We did not identify SARS-COV-2 infection in our study cohort. The combination of participants' behavior in following the RPHM and their living environment may considerably mitigate the risk of COVID-19.


Asunto(s)
Control de Enfermedades Transmisibles , Adhesión a Directriz/estadística & datos numéricos , Salud Pública , Anciano , /epidemiología , /psicología , /estadística & datos numéricos , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/estadística & datos numéricos , Estudios Transversales , Transmisión de Enfermedad Infecciosa/prevención & control , Femenino , Humanos , Masculino , Minnesota/epidemiología , Prevalencia , Salud Pública/métodos , Salud Pública/estadística & datos numéricos , Conducta de Reducción del Riesgo , Precauciones Universales/métodos , Precauciones Universales/estadística & datos numéricos , Virología/métodos
12.
Curr Opin Pulm Med ; 27(3): 146-154, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33660619

RESUMEN

PURPOSE OF REVIEW: Severe acute respiratory syndrome-coronaviruses-2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), emerged as a new zoonotic pathogen of humans at the end of 2019 and rapidly developed into a global pandemic. Over 106 million COVID-19 cases including 2.3 million deaths have been reported to the WHO as of February 9, 2021. This review examines the epidemiology, transmission, clinical features, and phylogenetics of three lethal zoonotic coronavirus infections of humans: SARS-CoV-1, SARS-CoV-2, and The Middle East respiratory syndrome coronavirus (MERS-COV). RECENT FINDINGS: Bats appear to be the common natural source of SARS-like CoV including SARS-CoV-1 but their role in SARS-CoV-2 and MERS-CoV remains unclear. Civet cats and dromedary camels are the intermediary animal sources for SARS-CoV-1 and MERS-CoV infection, respectively whereas that of SARS-CoV-2 remains unclear. SARS-CoV-2 viral loads peak early on days 2-4 of symptom onset and thus high transmission occurs in the community, and asymptomatic and presymptomatic transmission occurs commonly. Nosocomial outbreaks are hallmarks of SARS-CoV-1 and MERS-CoV infections whereas these are less common in COVID-19. Several COVID-19 vaccines are now available. SUMMARY: Of the three lethal zoonotic coronavirus infections of humans, SARS-CoV-2 has caused a devastating global pandemic with over a million deaths. The emergence of genetic variants, such as D614G, N501Y (variants 1 and 2), has led to an increase in transmissibility and raises concern about the possibility of re-infection and impaired vaccine response. Continued global surveillance is essential for both SARS-CoV-2 and MERS-CoV, to monitor changing epidemiology due to viral variants.


Asunto(s)
Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Síndrome Respiratorio Agudo Grave , Animales , /prevención & control , Quirópteros/virología , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Humanos , Filogenia , /patogenicidad , Síndrome Respiratorio Agudo Grave/epidemiología , Síndrome Respiratorio Agudo Grave/prevención & control , Síndrome Respiratorio Agudo Grave/transmisión , /prevención & control , /transmisión
13.
BMJ Glob Health ; 6(3)2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33762253

RESUMEN

Early on in the COVID-19 pandemic, the WHO Eastern Mediterranean Regional Office recognised the importance of epidemiological modelling to forecast the progression of the COVID-19 pandemic to support decisions guiding the implementation of response measures. We established a modelling support team to facilitate the application of epidemiological modelling analyses in the Eastern Mediterranean Region (EMR) countries. Here, we present an innovative, stepwise approach to participatory modelling of the COVID-19 pandemic that engaged decision-makers and public health professionals from countries throughout all stages of the modelling process. Our approach consisted of first identifying the relevant policy questions, collecting country-specific data and interpreting model findings from a decision-maker's perspective, as well as communicating model uncertainty. We used a simple modelling methodology that was adaptable to the shortage of epidemiological data, and the limited modelling capacity, in our region. We discuss the benefits of using models to produce rapid decision-making guidance for COVID-19 control in the WHO EMR, as well as challenges that we have experienced regarding conveying uncertainty associated with model results, synthesising and comparing results across multiple modelling approaches, and modelling fragile and conflict-affected states.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/organización & administración , Toma de Decisiones , Métodos Epidemiológicos , Salud Pública , Humanos , Región Mediterránea/epidemiología , Pandemias
14.
BMC Infect Dis ; 21(1): 242, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33673819

RESUMEN

BACKGROUND: Previous studies have indicated that the risk of infectious disease spread is greatest in locations where a population has massive and convenient access to the epicenter of an outbreak. However, the spatiotemporal variations and risk determinants of COVID-19 in typical labor export regions of China remain unclear. Understanding the geographical distribution of the disease and the socio-economic factors affecting its transmission is critical for disease prevention and control. METHODS: A total of 2152 COVID-19 cases were reported from January 21 to February 24, 2020 across the 34 cities in Henan and Anhui. A Bayesian spatiotemporal hierarchy model was used to detect the spatiotemporal variations of the risk posed by COVID-19, and the GeoDetector q statistic was used to evaluate the determinant power of the potential influence factors. RESULTS: The risk posed by COVID-19 showed geographical spatiotemporal heterogeneity. Temporally, there was an outbreak period and control period. Spatially, there were high-risk regions and low-risk regions. The high-risk regions were mainly in the southwest areas adjacent to Hubei and cities that served as economic and traffic hubs, while the low-risk regions were mainly in western Henan and eastern Anhui, far away from the epicenter. The accessibility, local economic conditions, and medical infrastructure of Wuhan in Hubei province all played an important role in the spatiotemporal heterogeneity of COVID-19 transmission. The results indicated that the q statistics of the per capita GDP and the proportion of primary industry GDP were 0.47 and 0.47, respectively. The q statistic of the population flow from Wuhan was 0.33. In particular, the results showed that the q statistics for the interaction effects between population density and urbanization, population flow from Wuhan, per capita GDP, and the number of doctors were all greater than 0.8. CONCLUSIONS: COVID-19 showed significant spatiotemporal heterogeneity in the labor export regions of China. The high-risk regions were mainly located in areas adjacent to the epicenter as well as in big cities that served as traffic hubs. Population access to the epicenter, as well as local economic and medical conditions, played an important role in the interactive effects of the disease transmission.


Asunto(s)
Control de Enfermedades Transmisibles/organización & administración , Transmisión de Enfermedad Infecciosa , Medición de Riesgo , /epidemiología , /transmisión , China/epidemiología , Transmisión de Enfermedad Infecciosa/prevención & control , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Humanos , Medición de Riesgo/métodos , Medición de Riesgo/estadística & datos numéricos , Factores de Riesgo , Determinantes Sociales de la Salud , Factores Socioeconómicos , Análisis Espacio-Temporal , Migrantes , Urbanización
15.
BMC Infect Dis ; 21(1): 245, 2021 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-33676420

RESUMEN

BACKGROUND: Based on differences in populations and prevention and control measures, the spread of new coronary pneumonia in different countries and regions also differs. This study aimed to calculate the transmissibility of coronavirus disease 2019 (COVID-19), and to evaluate the effectiveness of measures to control the disease in Jilin Province, China. METHODS: The data of reported COVID-19 cases were collected, including imported and local cases from Jilin Province as of March 14, 2019. A Susceptible-Exposed-Infectious-Asymptomatic-Recovered/Removed (SEIAR) model was developed to fit the data, and the effective reproduction number (Reff) was calculated at different stages in the province. Finally, the effectiveness of the measures was assessed. RESULTS: A total of 97 COVID-19 infections were reported in Jilin Province, among which 45 were imported infections (including one asymptomatic infection) and 52 were local infections (including three asymptomatic infections). The model fit the reported data well (R2 = 0.593, P < 0.001). The Reff of COVID-19 before and after February 1, 2020 was 1.64 and 0.05, respectively. Without the intervention taken on February 1, 2020, the predicted cases would have reached a peak of 177,011 on October 22, 2020 (284 days from the first case). The projected number of cases until the end of the outbreak (on October 9, 2021) would have been 17,129,367, with a total attack rate of 63.66%. Based on the comparison between the predicted incidence of the model and the actual incidence, the comprehensive intervention measures implemented in Jilin Province on February 1 reduced the incidence of cases by 99.99%. Therefore, according to the current measures and implementation efforts, Jilin Province can achieve good control of the virus's spread. CONCLUSIONS: COVID-19 has a moderate transmissibility in Jilin Province, China. The interventions implemented in the province had proven effective; increasing social distancing and a rapid response by the prevention and control system will help control the spread of the disease.


Asunto(s)
Número Básico de Reproducción , Control de Enfermedades Transmisibles , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , /epidemiología , /transmisión , China/epidemiología , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/normas , Humanos , Incidencia , /aislamiento & purificación
16.
Med J (Ft Sam Houst Tex) ; (PB 8-21-01/02/03): 20-21, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33666907

RESUMEN

The Installation Management Command (IMCOM) delivers quality base support from the strategic support area, enabling readiness for a globally responsive Army. IMCOM has more than 75 installations, covering more than 13 million acres, in 17 time zones, 12 countries and 58 services. In early March 2020, the COVID-19 pandemic required IMCOM to shift focus in ensuring health protection measures were implemented early and quickly, which relied on medical expertise. The IMCOM Surgeon and the Deputy Surgeon serve as the command's key advisors for all matters related to health care and medical readiness. During the COVID-19 pandemic, the IMCOM Surgeon and the Deputy Surgeon were critical in the consolidation of various information from multiple organizations. They promoted the integration of force health protection principles during COVID-19 operations. All of the military members at IMCOM headquarters (HQ) were considered mission essential while other personnel were identified on a phasing structure in the early stages of the pandemic, which meant civilian personnel were instructed to telework.


Asunto(s)
/prevención & control , Control de Enfermedades Transmisibles/organización & administración , Colaboración Intersectorial , Medicina Militar/organización & administración , /epidemiología , Gestión de Recursos de Personal en Salud/organización & administración , Humanos , Asociación entre el Sector Público-Privado/organización & administración , Estados Unidos
17.
Med J (Ft Sam Houst Tex) ; (PB 8-21-01/02/03): 22-27, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33666908

RESUMEN

While grappling with the implications of the current COVID-19 pandemic, we have perhaps overlooked recent history dealing with previous outbreaks. In the spring of 1993, America was presented with an outbreak of Hantavirus Pulmonary Syndrome caused by the Sin Nombre virus. This article recounts the investigation into this disease and discusses the spectrum of issues that medical communities must face as it deals with a mysterious outbreak.


Asunto(s)
/prevención & control , Control de Enfermedades Transmisibles/organización & administración , Brotes de Enfermedades/prevención & control , Síndrome Pulmonar por Hantavirus/epidemiología , Síndrome Pulmonar por Hantavirus/prevención & control , /epidemiología , Síndrome Pulmonar por Hantavirus/transmisión , Humanos , Estados Unidos/epidemiología
18.
Med J (Ft Sam Houst Tex) ; (PB 8-21-01/02/03): 90-96, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33666918

RESUMEN

As SARS-CoV-2 spread throughout the world military units had to develop ways of combatting risk to ensure force health protection and deployability of their soldiers. Medical functions were impacted and solutions needed to be found in order to incorporate these items as functioning medical platforms. In the following article, we address one unit's individual response to the difficulties faced as a Military Police Brigade in Europe. Lessons learned from the initial wave of COVID-19 across medical operations, medical readiness, virtual health, and behavioral health initiatives can be utilized for better planning and response in the future.


Asunto(s)
/diagnóstico , Control de Enfermedades Transmisibles/organización & administración , Medicina Militar/organización & administración , Personal Militar , Policia , /epidemiología , Europa (Continente) , Humanos , Estados Unidos
19.
Med J (Ft Sam Houst Tex) ; (PB 8-21-01/02/03): 104-107, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33666920

RESUMEN

Since the onset of the COVID-19 pandemic in late 2019, the world community has responded with ever-evolving measures to reduce the spread of SARS CoV-2, the virus that causes COVID-19 (Coronavirus Disease 2019)1. One particular area of interest is understanding the risk of the in-person classroom setting and if any mitigation efforts are effective in preventing the spread of disease in that setting. In this paper, we present a case study of a US Army Advanced Individual Training (AIT) course/classroom wherein a student was diagnosed with COVID-19, and there was no apparent spread to others in his classroom. We discuss the mitigation efforts put in place that appear to be, in this case, effective in preventive onward spread of the virus. These are social distancing, face coverings/masks, and hygiene practices including hand washing and sanitation of surfaces.


Asunto(s)
/prevención & control , Control de Enfermedades Transmisibles/organización & administración , Medicina Militar/educación , Personal Militar , Adulto , /transmisión , Desinfección de las Manos , Humanos , Masculino , Máscaras , Facultades de Enfermería/organización & administración
20.
Med J (Ft Sam Houst Tex) ; (PB 8-21-01/02/03): 144-149, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33666928

RESUMEN

The 1st Cavalry Division Forward (1CD FWD) along with Polish ally, subordinate brigades, adjacent supporting commands, and the 7th Army Training Command successfully executed large scale combat operations training in the Defender Europe 2020 Plus (DE20P) exercise in a biologically compromised environment. The coronavirus 2019 (COVID-19) presented many unique challenges and opportunities across all warfighting functions. Still, it proved that it is possible to train in a large-scale multinational exercise while effectively mitigating the contraction and contamination of COVID-19. Through behavioral policies, screening, and testing, the 1CD FWD was able to conduct a high-quality multinational training event, while preserving force health protection and preventing the spread of COVID-19 within the host nation. The 1CD FWD executed a qualitative focus group study and learned that fighting in a pandemic is challenging but manageable and sustainable. The overall protective measures associated with the training exercise did have shortfalls; there were populations that had the potential to bring outside vectors in the training area. Units must create their codified policies, communicate, train, and resource their behavioral and movement systems. Leadership and individual involvement with accountability enforced. COVID-19 tests must be comprehensive, continuous, focused, and targeted as described in the 1CD FWD's ready to fight guide and concept. Recommend one point of restriction of movement and coronavirus test upon reception, staging, on-ward movement, and integration (RSOI) into the European theater.


Asunto(s)
/prevención & control , Control de Enfermedades Transmisibles/organización & administración , Personal Militar , /diagnóstico , Europa (Continente) , Grupos Focales , Humanos , Políticas , Investigación Cualitativa , Encuestas y Cuestionarios , Estados Unidos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...