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1.
BMJ ; 372: n534, 2021 03 24.
Artículo en Inglés | MEDLINE | ID: mdl-33762259

RESUMEN

OBJECTIVE: To evaluate the short term associations between nitrogen dioxide (NO2) and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide, using a uniform analytical protocol. DESIGN: Two stage, time series approach, with overdispersed generalised linear models and multilevel meta-analysis. SETTING: 398 cities in 22 low to high income countries/regions. MAIN OUTCOME MEASURES: Daily deaths from total (62.8 million), cardiovascular (19.7 million), and respiratory (5.5 million) causes between 1973 and 2018. RESULTS: On average, a 10 µg/m3 increase in NO2 concentration on lag 1 day (previous day) was associated with 0.46% (95% confidence interval 0.36% to 0.57%), 0.37% (0.22% to 0.51%), and 0.47% (0.21% to 0.72%) increases in total, cardiovascular, and respiratory mortality, respectively. These associations remained robust after adjusting for co-pollutants (particulate matter with aerodynamic diameter ≤10 µm or ≤2.5 µm (PM10 and PM2.5, respectively), ozone, sulfur dioxide, and carbon monoxide). The pooled concentration-response curves for all three causes were almost linear without discernible thresholds. The proportion of deaths attributable to NO2 concentration above the counterfactual zero level was 1.23% (95% confidence interval 0.96% to 1.51%) across the 398 cities. CONCLUSIONS: This multilocation study provides key evidence on the independent and linear associations between short term exposure to NO2 and increased risk of total, cardiovascular, and respiratory mortality, suggesting that health benefits would be achieved by tightening the guidelines and regulatory limits of NO2.


Asunto(s)
Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/efectos adversos , Enfermedades Cardiovasculares/mortalidad , Salud Global/estadística & datos numéricos , Dióxido de Nitrógeno/toxicidad , Enfermedades Respiratorias/mortalidad , Salud Urbana/estadística & datos numéricos , Enfermedades Cardiovasculares/inducido químicamente , Ciudades , Países Desarrollados/estadística & datos numéricos , Países en Desarrollo/estadística & datos numéricos , Exposición a Riesgos Ambientales/efectos adversos , Humanos , Modelos Lineales , Enfermedades Respiratorias/inducido químicamente
3.
Chron Respir Dis ; 18: 1479973120986806, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33550849

RESUMEN

We examined the relative contribution of pulmonary diseases (chronic obstructive pulmonary disease, asthma and sleep apnea) to mortality risks associated with Coronavirus Disease (COVID-19) independent of other medical conditions, health risks, and sociodemographic factors. Data were derived from a large US-based case series of patients with COVID-19, captured from a quaternary academic health network covering New York City and Long Island. From March 2 to May 24, 2020, 11,512 patients who were hospitalized were tested for COVID-19, with 4,446 (38.62%) receiving a positive diagnosis for COVID-19. Among those who tested positive, 959 (21.57%) died of COVID-19-related complications at the hospital. Multivariate-adjusted Cox proportional hazards modeling showed mortality risks were strongly associated with greater age (HR = 1.05; 95% CI: 1.04-1.05), ethnic minority (Asians, Non-Hispanic blacks, and Hispanics) (HR = 1.26; 95% CI, 1.10-1.44), low household income (HR = 1.29; 95% CI: 1.11, 1.49), and male sex (HR = 0.85; 95% CI: 0.74, 0.97). Higher mortality risks were also associated with a history of COPD (HR = 1.27; 95% CI: 1.02-1.58), obesity (HR = 1.19; 95% CI: 1.04-1.37), and peripheral artery disease (HR = 1.33; 95% CI: 1.05-1.69). Findings indicate patients with COPD had the highest odds of COVID-19 mortality compared with patients with pre-existing metabolic conditions, such as obesity, diabetes and hypertension. Sociodemographic factors including increased age, male sex, low household income, ethnic minority status were also independently associated with greater mortality risks.


Asunto(s)
Asma/complicaciones , Mortalidad Hospitalaria , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Síndromes de la Apnea del Sueño/complicaciones , Salud Urbana/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , /diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Modelos de Riesgos Proporcionales , Factores de Riesgo , Factores Socioeconómicos
4.
Aten Primaria ; 53(2): 101957, 2021 02.
Artículo en Español | MEDLINE | ID: mdl-33423880

RESUMEN

OBJETIVE: To evaluate SAR-COV-2 pacients' features. To analyse de diferences between those who required hospital care and those who didn't. DESIGN: Observational, descriptive and retrospective study. SETTING: Twomedical practices of an urban health center in Salamanca (Spain). PARTICIPANTS: ≥18 years diagnosed with SAR-CoV-2 between March 11th and April 20th. MAIN MEASUREMENTS: clinical-epidemiological chatacteristics, diagnosis, treatment and outcome at the end of study RESULTS: 122 patients (63.9% female), 19.7% social and health care workers y 4.9% from nursing homes. Predominant age group: 46-60 years. 67.2% without comorbility. Predomint symptoms: low-grade fever (73.5%), cough (65.2%) y fever (43%). Average age of the patients requiring hospital care was higher: 59.85 (DE16.22) versus 50.78 (DE17.88) P=.013. 63.6% of all the patients monitored by Primary Health Care and 14.1% of patients that required assistance did not present dyspnea P=.001. Only 2.5% of the hospital-assisted patients, compared to 61.5% of Primary Health Care, were not tested P=.0001. 26 patients were attendedn at an emergency room: 11(9%) stayed and 2 (1.6%) passed away. No antibiotic or inhaler treatment for 52.5% and 70.5% respectively. The most used antipyretic treatment was paracetamol (78.7%). CONCLUSIONS: Prevalence in females, comorbility-free patients and in age range: 46-60 years. Complementary and confirmatory test were performed mainly in hospital care. Predominance of mild symptoms and favourable evolution. Highliting the role played by Primary Health Care in detection, early intervention and monitoring of severe cases.


Asunto(s)
Servicios Urbanos de Salud/estadística & datos numéricos , Salud Urbana/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , /epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Estudios Retrospectivos , España/epidemiología , Resultado del Tratamiento , Adulto Joven
5.
Am J Physiol Heart Circ Physiol ; 320(3): H1102-H1111, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33416460

RESUMEN

Residential proximity to greenness is associated with a lower risk of cardiovascular disease (CVD) and all-cause mortality. However, it is unclear whether the beneficial effects of greenness are linked to a reduction in the effects of ambient air pollutants. We measured arterial stiffness in 73 participants with moderate to high CVD risk. Average levels of ambient PM2.5 and ozone were calculated from local monitoring stations. Residential greenness was estimated using satellite-derived normalized difference vegetation index (NDVI) for a 200-m and 1-km radius around each participant's home. Participants were 51% female, average age of 52 yr, and 79% had diagnosed hypertension. In multiple linear regression models, residential NDVI was negatively associated with augmentation index (-3.8% per 0.1 NDVI). Ambient levels of PM2.5 [per interquartile range (IQR) of 6.9 µg/m3] were positively associated with augmentation pressure (3.1 mmHg), pulse pressure (5.9 mmHg), and aortic systolic pressure (8.1 mmHg). Ozone (per IQR of 0.03 ppm) was positively associated with augmentation index (5.5%), augmentation pressure (3.1 mmHg), and aortic systolic pressure (10 mmHg). In areas of low greenness, both PM2.5 and ozone were positively associated with pulse pressure. Additionally, ozone was positively associated with augmentation pressure and systolic blood pressure. However, in areas of high greenness, there was no significant association between indices of arterial stiffness with either PM2.5 or ozone. Residential proximity to greenness is associated with lower values of arterial stiffness. Residential greenness may mitigate the adverse effects of PM2.5 and ozone on arterial stiffness.NEW & NOTEWORTHY Previous studies have linked proximity to green spaces with lower cardiovascular disease risk. However, the mechanisms underlying the salutary effects of green areas are not known. In our study of participants at risk of cardiovascular disease, we found that arterial stiffness was positively associated with short-term exposure to PM2.5, PM10, and ozone and inversely associated with greenness. The association between pollution and arterial stiffness was attenuated in areas of high greenness, suggesting that living green neighborhoods can lessen the adverse cardiovascular effects of air pollution.


Asunto(s)
Contaminantes Atmosféricos/efectos adversos , Contaminación del Aire/efectos adversos , Enfermedades Cardiovasculares/prevención & control , Exposición a Riesgos Ambientales/efectos adversos , Hemodinámica , Salud Urbana , Urbanización , Rigidez Vascular , Adulto , Anciano , Anciano de 80 o más Años , Presión Arterial , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/fisiopatología , Planificación de Ciudades , Femenino , Humanos , Kentucky , Masculino , Persona de Mediana Edad , Ozono/efectos adversos , Material Particulado/efectos adversos , Factores Protectores , Características de la Residencia , Medición de Riesgo , Factores de Riesgo , Adulto Joven
6.
Nat Commun ; 12(1): 418, 2021 01 18.
Artículo en Inglés | MEDLINE | ID: mdl-33462211

RESUMEN

With COVID-19 surging across the world, understanding the effectiveness of intervention strategies on transmission dynamics is of primary global health importance. Here, we develop and analyze an epidemiological compartmental model using multi-objective genetic algorithm design optimization to compare scenarios related to strategy type, the extent of social distancing, time window, and personal protection levels on the transmission dynamics of COVID-19 in São Paulo, Brazil. The results indicate that the optimal strategy for São Paulo is to reduce social distancing over time with a stepping-down reduction in the magnitude of social distancing every 80-days. Our results also indicate that the ability to reduce social distancing depends on a 5-10% increase in the current percentage of people strictly following protective guidelines, highlighting the importance of protective behavior in controlling the pandemic. Our framework can be extended to model transmission dynamics for other countries, regions, states, cities, and organizations.


Asunto(s)
Algoritmos , Modelos Teóricos , /aislamiento & purificación , Brasil/epidemiología , /virología , Ciudades , Salud Global , Humanos , Pandemias , Salud Urbana/estadística & datos numéricos
7.
Nat Commun ; 12(1): 595, 2021 01 26.
Artículo en Inglés | MEDLINE | ID: mdl-33500409

RESUMEN

Zika virus (ZIKV) emerged from obscurity in 2013 to spread from Asia to the South Pacific and the Americas, where millions of people were infected, accompanied by severe disease including microcephaly following congenital infections. Phylogenetic studies have shown that ZIKV evolved in Africa and later spread to Asia, and that the Asian lineage is responsible for the recent epidemics in the South Pacific and Americas. However, the reasons for the sudden emergence of ZIKV remain enigmatic. Here we report evolutionary analyses that revealed four mutations, which occurred just before ZIKV introduction to the Americas, represent direct reversions of previous mutations that accompanied earlier spread from Africa to Asia and early circulation there. Our experimental infections of Aedes aegypti mosquitoes, human cells, and mice using ZIKV strains with and without these mutations demonstrate that the original mutations reduced fitness for urban, human-amplifed transmission, while the reversions restored fitness, increasing epidemic risk. These findings include characterization of three transmission-adaptive ZIKV mutations, and demonstration that these and one identified previously restored fitness for epidemic transmission soon before introduction into the Americas. The initial mutations may have followed founder effects and/or drift when the virus was introduced decades ago into Asia.


Asunto(s)
Epidemias , Evolución Molecular , Aptitud Genética , Infección por el Virus Zika/epidemiología , Virus Zika/genética , Aedes/virología , África/epidemiología , Américas/epidemiología , Sustitución de Aminoácidos , Animales , Asia/epidemiología , Línea Celular , Modelos Animales de Enfermedad , Femenino , Fibroblastos , Humanos , Queratinocitos , Ratones , Mutación , Filogenia , Cultivo Primario de Células , Salud Urbana/estadística & datos numéricos , Virus Zika/patogenicidad , Infección por el Virus Zika/transmisión , Infección por el Virus Zika/virología
8.
Artículo en Español | IBECS | ID: ibc-196559

RESUMEN

OBJETIVO: Conocer el número y el porcentaje de radiografías de tórax (RxT) derivadas a un centro de diagnóstico por imagen de Atención Primaria y al Centro de Urgencias de Atención Primaria para descartar afectación pulmonar por SARS-CoV-2 desde el 16 de marzo al 15 de mayo de 2020, en un área de salud urbana de unos 400.000 habitantes de población de referencia. Determinar el porcentaje de casos indicativos de afectación pulmonar por RxT por SARS-CoV-2 y el porcentaje de casos sin afectación pulmonar del total de RxT derivadas en la población de referencia desde el 16 de marzo al 15 de mayo de 2020. MATERIAL Y MÉTODOS: Diseño: estudio descriptivo observacional. Los criterios radiológicos para catalogar de probable infección pulmonar por SARS-CoV-2 (RxT[+]) son: 1) opacidad focal; 2) tenue opacidad focal; 3) tenue aumento de densidad difuso; 4) patrón intersticial focal o difuso, y 5) patrón alveolointersticial focal o difuso. RESULTADOS Y CONCLUSIONES: Mantener la RxT como método útil de cribado en las etapas medias de la enfermedad, cuando la RxT es más sensible para detectar afectación pulmonar por SARS-CoV-2. Nuestra gráfica de afectación por SARS-CoV-2 no presenta diferencias valorables con la curva esperada en una epidemia


OBJECTIVE: Know the number and percentage of chest X-rays (CXR) referred to a Primary Care Imaging Center and Primary Care Emergency Center to rule out lung involvement due to SARS-CoV-2 from March 16 to May 15, 2020, in an urban health area of about 400,000 reference population inhabitants. To determine the percentage of cases suggestive of pulmonary involvement due to SARS-CoV-2 CXR and the percentage of cases without pulmonary involvement of the total CXR derived in the reference population from March 16 to May 15, 2020. MATERIAL AND METHODS: Design observational descriptive study. The radiological criteria to classify probable pulmonary infection by SARS-CoV-2 (RxT[+]) are: 1) focal opacity; 2) faint focal opacity; 3) faint diffuse increase in density; 4) focal or diffuse interstitial pattern, and 5) focal or diffuse interstitial alveolus pattern. RESULTS AND CONCLUSIONS: Maintain CXR as a useful screening method in the middle stages of the disease, when CXR is more sensitive to detect lung involvement due to SARS-CoV-2. Our graph of affectation by SARS-CoV-2 does not present assessable differences with the expected curve in an epidemic


Asunto(s)
Humanos , Infecciones por Coronavirus/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Pandemias , Radiografía Torácica/estadística & datos numéricos , Estudios Longitudinales , Salud Urbana
9.
Nature ; 589(7842): 415-419, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33328634

RESUMEN

The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)1-4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5-8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children.


Asunto(s)
Países Desarrollados/estadística & datos numéricos , Mapeo Geográfico , Sarampión/epidemiología , Sarampión/prevención & control , Vacunación/estadística & datos numéricos , Niño , Preescolar , Disparidades en Atención de Salud/estadística & datos numéricos , Humanos , Internacionalidad , Sarampión/inmunología , Salud Rural/estadística & datos numéricos , Incertidumbre , Salud Urbana/estadística & datos numéricos , Negativa a la Vacunación/estadística & datos numéricos
10.
High Blood Press Cardiovasc Prev ; 28(1): 63-68, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33337531

RESUMEN

INTRODUCTION: Hypertension (SBP/DBP > 130/80 mmHg) is a leading risk factor for cardiovascular disease worldwide. AIM: To determine the prevalence of hypertension in a homeless community during an interprofessional education (IPE)-based health fair. METHODS: Homeless participants were recruited between August 2019-September 2019. Faculty, nursing, and pharmacist students, educated 477 participants, aged 18-80 years, on the risk factors associated with untreated hypertension. Then, participants self-completed the consented demographic survey questionnaire. Finally, the sitting blood pressure (BP) was recorded three times based on a standardized procedure, using Omron BPN monitor with cuff. RESULTS: Seven pharmacy students, nine nursing students, two registered nurses, five registered pharmacists, and two medical doctors collaboratively provided health education to the homeless community and screened their sitting BP. 390/477 (81.8%) of participants satisfied the inclusion criteria. Participants (54.7%) of the reported education level was at the high School level or less. More than the half of the participants (average age of 51 ± 13 years) had hypertension (median SBP/DBP ≥ 130/82.7 mmHg), respectively. The prevalence of hypertension for the overall cohort was 61.52% (95% CI, 56.59-66.35). Age (p value = 0.000) was significantly associated with hypertension based on the binary logistic analysis. CONCLUSION: This study demonstrated a high prevalence of hypertension in the homeless community in Long Beach, California with high risk of cardio-vascular events or strokes. This works sheds new light on an issue of major public health significance and points to the need for fostering IPE community-based health fairs intervention program for the US homeless population.


Asunto(s)
Presión Sanguínea , Servicios de Salud Comunitaria , Exposiciones Educacionales en Salud , Personas sin Hogar , Hipertensión/epidemiología , Educación Interprofesional , Salud Urbana , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , California/epidemiología , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Prevalencia , Adulto Joven
11.
J Environ Public Health ; 2020: 9793425, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33376494

RESUMEN

Environmental influence is one of the attributing factors for health status. Chronic interaction with electronic display technology and lack of outdoor activities might lead to health issues. Given the concerns about the digital impact on lifestyle and health challenges, we aimed to investigate the daily activity inclination and health complaints among the Malaysian youth. A self-administered questionnaire covering lifestyle and health challenges was completed by 220 youths aged between 16 and 25. There were a total of 22 questions. Seven questions inspected the patterns of indoor and outdoor activities. Fifteen questions focused on the visual and musculoskeletal symptoms linked to both mental and physical health. The total time spent indoors (15.0 ± 5.4 hours/day) was significantly higher than that spent outdoors (2.5 ± 2.6 hours/day) (t = 39.01, p < 0.05). Total time engrossed in sedentary activities (13.0 ± 4.5 hours/day) was significantly higher than that in nonsedentary activities (4.5 ± 3.8 hours/day) comprised of indoor sports and any outdoor engagements (t = 27.10, p < 0.05). The total time spent on electronic related activities (9.5 ± 3.7 hours/day) was were higher than time spent on printed materials (3.4 ± 1.6 hours/day) (t = 26.01, p < 0.05). The association of sedentary activities was positive in relation to tired eyes (χ 2 = 17.58, p < 0.05), sensitivity to bright light (χ 2 = 12.10, p < 0.05), and neck pain (χ 2 = 17.27, p < 0.05) but negative in relation to lower back pain (χ 2 = 8.81, p < 0.05). Our youth spent more time in building and engaged in sedentary activities, predominantly electronic usage. The health-related symptoms, both visual and musculoskeletal symptoms, displayed a positive association with a sedentary lifestyle and a negative association with in-building time.


Asunto(s)
Estilo de Vida , Salud Urbana/estadística & datos numéricos , Adolescente , Femenino , Humanos , Malasia/epidemiología , Masculino , Enfermedades Musculoesqueléticas/epidemiología , Tiempo de Pantalla , Conducta Sedentaria , Trastornos de la Visión/epidemiología , Adulto Joven
12.
Rev. enferm. UERJ ; 28: e51838, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1145843

RESUMEN

Objetivo: descrever e comparar as características sociodemográficas e clínicas dos idosos, e o acesso e a utilização dos serviços de saúde, segundo três microrregionais de saúde de Minas Gerais. Método: inquérito domiciliar transversal realizado com 1.635 idosos residentes nas Microrregionais de Saúde do Triângulo Sul, em Minas Gerais. Procederam-se às análises descritivas e teste qui-quadrado (p<0,05). Resultados: na comparação entre os grupos obteve-se diferença significativa em relação à faixa etária (p<0,001), número de morbidades (p<0,001), uso contínuo de medicamentos (p<0,001) e não realizar consulta com dentista no último ano (p=0,005). Conclusão: as políticas públicas devem considerar os fatores sociodemográficos e as condições clínicas dos idosos, mediante o contexto da territorialização e regionalização em saúde, para proposição de estratégias de ação que favoreçam o acesso e uso dos serviços por essa população.


Objective: to describe and compare the older adults' sociodemographic and clinical characteristics, and their access to, and use of, health services, by three health micro-regions in Minas Gerais. Method: this cross-sectional household survey interviewed 1,635 older adults living in the Health Micro-regions of the Southern Triangle of Minas Gerais. Descriptive analyses and chisquare test were performed (p<0.05). Results: comparisons among the groups revealed significant differences by age group (p < 0.001), number of morbiditie (p<0.001), continuous medication use (p<0.001) and no dental appointment in the prior year (p = 0.005). Conclusion: in the context of health care territorialization and regionalization, public policies should consider older adults' sociodemographic characteristics and clinical conditions, in order to propose action strategies to favor service access and use by this population.


Objetivo: describir y comparar las características sociodemográficas y clínicas de los adultos mayores y su acceso y uso de los servicios de salud por parte de tres microrregiones de salud en Minas Gerais. Método: esta encuesta de hogares de corte transversal entrevistó a 1.635 adultos mayores residentes en las Microrregiones de Salud del Triángulo Sur de Minas Gerais. Se realizaron análisis descriptivos y prueba de chi-cuadrado (p<0.05). Resultados: as comparaciones entre los grupos revelaron diferencias significativas por grupo de edad (p<0.001), número de morbilidades (p<0.001), uso continuo de medicación (p<0.001) y ausencia de consulta dental en el año anterior (p = 0,005). Conclusión: en el contexto de territorialización y regionalización asistencial, las políticas públicas deben considerar las características sociodemográficas y las condiciones clínicas de los adultos mayores, con el fin de proponer estrategias de acción que favorezcan el acceso y uso de los servicios por parte de esta población.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Salud del Anciano , Accesibilidad a los Servicios de Salud , Factores Socioeconómicos , Brasil , Salud Urbana , Estudios Transversales , Encuestas y Cuestionarios , Accesibilidad a los Servicios de Salud/estadística & datos numéricos
13.
J Acoust Soc Am ; 148(4): 1824, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33138499

RESUMEN

Peru declared a state of emergency on March 16 in order to prevent SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) transmissions; thus, the International Airport was closed and the soundscape of urban zones under the flight tracks have been changed in view of the fact that airplane traffic was suspended. The authors have been conducting noise monitoring since February and because of that sufficient noise data for knowing the soundscape before and during the lockdown were obtained. This article presents a case of aircraft annoyance noise in one of Lima's city districts, which is near the aircraft climbing curve, toward the ocean on departure from Lima.


Asunto(s)
Viaje en Avión , Infecciones por Coronavirus/transmisión , Exposición a Riesgos Ambientales/prevención & control , Genio Irritable , Ruido del Transporte/prevención & control , Neumonía Viral/transmisión , Aislamiento Social , Salud Urbana , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Monitoreo del Ambiente , Humanos , Pandemias/prevención & control , Perú , Neumonía Viral/prevención & control , Neumonía Viral/virología , Espectrografía del Sonido , Factores de Tiempo
14.
BMC Infect Dis ; 20(1): 722, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33008314

RESUMEN

BACKGROUND: Ross River virus (RRV) is responsible for the most common vector-borne disease of humans reported in Australia. The virus circulates in enzootic cycles between multiple species of mosquitoes, wildlife reservoir hosts and humans. Public health concern about RRV is increasing due to rising incidence rates in Australian urban centres, along with increased circulation in Pacific Island countries. Australia experienced its largest recorded outbreak of 9544 cases in 2015, with the majority reported from south east Queensland (SEQ). This study examined potential links between disease patterns and transmission pathways of RRV. METHODS: The spatial and temporal distribution of notified RRV cases, and associated epidemiological features in SEQ, were analysed for the period 2001-2016. This included fine-scale analysis of disease patterns across the suburbs of the capital city of Brisbane, and those of 8 adjacent Local Government Areas, and host spot analyses to identify locations with significantly high incidence. RESULTS: The mean annual incidence rate for the region was 41/100,000 with a consistent seasonal peak in cases between February and May. The highest RRV incidence was in adults aged from 30 to 64 years (mean incidence rate: 59/100,000), and females had higher incidence rates than males (mean incidence rates: 44/100,000 and 34/100,000, respectively). Spatial patterns of disease were heterogeneous between years, and there was a wide distribution of disease across both urban and rural areas of SEQ. Overall, the highest incidence rates were reported from predominantly rural suburbs to the north of Brisbane City, with significant hot spots located in peri-urban suburbs where residential, agricultural and conserved natural land use types intersect. CONCLUSIONS: Although RRV is endemic across all of SEQ, transmission is most concentrated in areas where urban and peri-urban environments intersect. The drivers of RRV transmission across rural-urban landscapes should be prioritised for further investigation, including identification of specific vectors and hosts that mediate human spillover.


Asunto(s)
Infecciones por Alphavirus/epidemiología , Virus del Río Ross , Adulto , Infecciones por Alphavirus/transmisión , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Queensland/epidemiología , Salud Rural , Salud Urbana
15.
PLoS One ; 15(10): e0238782, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33021973

RESUMEN

In 2015, UN member states committed to eliminate female genital mutilation (FGM) by 2030 as part of the Sustainable Development Agenda. To reach this goal, interventions need to be targeted and guided by the best available evidence. To date, however, estimates of the number of girls and women affected by FGM and their trends over time and geographic space have been limited by the availability, specificity and quality of population-level data. We present new estimates based on all publicly available nationally representative surveys collected since the 1990s that contain both information on FGM status and on the age at which FGM occurred. Using survival analysis, we generate estimates of FGM risk by single year of age for all countries with available data, and for rural and urban areas separately. The likelihood of experiencing FGM has decreased at the global level, but progress has been starkly uneven between countries. The available data indicate no progress in reducing FGM risk in Gambia, Guinea-Bissau, Mali and Guinea. In addition, rural and urban areas have diverged over the last two decades, with FGM declining more rapidly in urban areas. We describe limitations in the availability and quality of data on FGM occurrence and age-at-FGM. Based on current trends, the SDG goal of eliminating FGM by 2030 is out of reach, and the pace at which the practice is being abandoned would need to accelerate to eliminate FGM by 2030. The heterogeneity in trends between countries and rural vs urban areas offers an opportunity to contrast countries where FGM is in rapid decline and explore potential policy lessons and programmatic implications for countries where the practice of FGM appears to remain entrenched.


Asunto(s)
Circuncisión Femenina , Adolescente , Adulto , Niño , Preescolar , Circuncisión Femenina/legislación & jurisprudencia , Circuncisión Femenina/estadística & datos numéricos , Circuncisión Femenina/tendencias , Estudios de Cohortes , Estudios Transversales , Femenino , Salud Global/legislación & jurisprudencia , Salud Global/estadística & datos numéricos , Salud Global/tendencias , Humanos , Lactante , Recién Nacido , Estimación de Kaplan-Meier , Persona de Mediana Edad , Estudios Retrospectivos , Salud Rural , Encuestas y Cuestionarios , Naciones Unidas , Salud Urbana , Salud de la Mujer/legislación & jurisprudencia , Salud de la Mujer/estadística & datos numéricos , Salud de la Mujer/tendencias , Adulto Joven
16.
mSphere ; 5(5)2020 10 07.
Artículo en Inglés | MEDLINE | ID: mdl-33028688

RESUMEN

The objective was to analyze the longitudinal distribution, epidemiological characteristics, and local prevention and control measures of coronavirus disease 2019 (COVID-19) in six cities in Henan Province, China, from 21 January 2020 to 17 June 2020: Xinyang City (including Gushi County), Nanyang City (including Dengzhou City), Zhumadian City (including Xincai County), Zhengzhou City (including Gongyi City), Puyang City, and Anyang City (including Hua County). Data were collected and analyzed through the COVID-19 information published on the official websites of the health commissions in the six selected cities of Henan Province. As of 17 June 2020, the cumulative incidence rate of COVID-19 in Henan Province was 1.33/100,000, the cumulative cure rate was 98.27%, the cumulative mortality rate was 1.73%, the age range of diagnosed cases was 5 days to 85 years old, and the male-to-female ratio was 1.09:1. The confirmed cases of COVID-19 in Henan Province were mainly imported cases from Hubei, accounting for 87.74% of all cases, of which the highest proportion was 70.50% in Zhumadian. The contact cases and local cases increased in a fluctuating manner over time. In this paper, epidemiological characteristics of COVID-19 in Henan Province were analyzed from the onset of the outbreak to the effective control within 60 days, and effective and distinctive prevention and control measures in various cities were summarized to provide a favorable useful reference for the further formulation and implementation of epidemic prevention and control and a valuable theoretical basis for effectively avoiding a second outbreak.IMPORTANCE Epidemic prevention and control in China have entered a new stage of normalization. This article analyzes the epidemiological characteristics of COVID-19 in Henan Province and summarizes the effective disease prevention and control means and measures at the prefecture level; the normalized private data provide a theoretical reference for the formulation and conduct of future prevention and control work. At the same time, these epidemic prevention and control findings can also be used for reference in other countries and regions.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Betacoronavirus/aislamiento & purificación , Niño , Preescolar , China/epidemiología , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Neumonía Viral/diagnóstico , Salud Urbana/tendencias , Adulto Joven
17.
PLoS One ; 15(9): e0239175, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32941485

RESUMEN

The COVID-19 outbreak has forced most of the global population to lock-down and has put in check the health services all over the world. Current predictive models are complex, region-dependent, and might not be generalized to other countries. However, a 150-year old epidemics law promulgated by William Farr might be useful as a simple arithmetical model (percent increase [R1] and acceleration [R2] of new cases and deaths) to provide a first sight of the epidemic behavior and to detect regions with high predicted dynamics. Thus, this study tested Farr's Law assumptions by modeling COVID-19 data of new cases and deaths. COVID-19 data until April 10, 2020, was extracted from available countries, including income, urban index, and population characteristics. Farr's law first (R1) and second ratio (R2) were calculated. We constructed epidemic curves and predictive models for the available countries and performed ecological correlation analysis between R1 and R2 with demographic data. We extracted data from 210 countries, and it was possible to estimate the ratios of 170 of them. Around 42·94% of the countries were in an initial acceleration phase, while 23·5% already crossed the peak. We predicted a reduction close to zero with wide confidence intervals for 56 countries until June 10 (high-income countries from Asia and Oceania, with strict political actions). There was a significant association between high R1 of deaths and high urban index. Farr's law seems to be a useful model to give an overview of COVID-19 pandemic dynamics. The countries with high dynamics are from Africa and Latin America. Thus, this is a call to urgently prioritize actions in those countries to intensify surveillance, to re-allocate resources, and to build healthcare capacities based on multi-nation collaboration to limit onward transmission and to reduce the future impact on these regions in an eventual second wave.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Modelos Biológicos , Pandemias/legislación & jurisprudencia , Neumonía Viral/prevención & control , África/epidemiología , Asia/epidemiología , Infecciones por Coronavirus/epidemiología , Predicción , Geografía Médica , Humanos , Incidencia , América Latina/epidemiología , Morbilidad/tendencias , Mortalidad/tendencias , Pandemias/prevención & control , Neumonía Viral/epidemiología , Dinámica Poblacional , Salud Urbana
18.
Artículo en Inglés | MEDLINE | ID: mdl-32942626

RESUMEN

Wuhan encountered a serious attack in the first round of the coronavirus disease 2019 (COVID-19) pandemic, which has resulted in a public health social impact, including public mental health. Based on the Weibo help data, we inferred the spatial distribution pattern of the epidemic situation and its impacts. Seven urban factors, i.e., urban growth, general hospital, commercial facilities, subway station, land-use mixture, aging ratio, and road density, were selected for validation with the ordinary linear model, in which the former six factors presented a globally significant association with epidemic severity. Then, the geographically weighted regression model (GWR) was adopted to identify their unevenly distributed effects in the urban space. Among the six factors, the distribution and density of major hospitals exerted significant effects on epidemic situation. Commercial facilities appear to be the most prevalently distributed significant factor on epidemic situation over the city. Urban growth, in particular the newly developed residential quarters with high-rise buildings around the waterfront area of Hanyang and Wuchang, face greater risk of the distribution. The influence of subway stations concentrates at the adjacency place where the three towns meet and some near-terminal locations. The aging ratio of the community dominantly affects the hinterland of Hankou to a broader extent than other areas in the city. Upon discovering the result, a series of managerial implications that coordinate various urban factors were proposed. This research may contribute toward developing specific planning and design responses for different areas in the city based on a better understanding of the occurrence, transmission, and diffusion of the COVID-19 epidemic in the metropolitan area.


Asunto(s)
Entorno Construido , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Salud Urbana , Betacoronavirus , China , Ciudades , Planificación Ambiental , Humanos , Pandemias
20.
J UOEH ; 42(3): 237-249, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32879188

RESUMEN

Access to water and sanitation remain a challenge in many developing countries, especially in pro-poor urban informal settlements where socioeconomic livelihoods are generally low. The aim of this study was to characterise the water and sanitation facilities in the informal settlements of Kisumu City and to evaluate their effect on community hygiene and health. The study focussed on the five urban informal settlements of Nyalenda A, Nyalenda B, Manyatta A, Manyatta B and Obunga, and the three Peri-urban informal settlements of Kogony, Usoma and Otonglo. Using descriptive techniques, the researcher surveyed 114 water sources and all sanitation facilities within 0-15 m and 15-30 m radii of the water sources. The findings revealed dominance of shallow wells and traditional pit latrines as the primary water sources and sanitation facilities, respectively. Out of the water sources studied, 87.7% (100) were shallow wells (mean depth 1.5 m), 9.6% (11) springs and 2.6% (3) boreholes. Most of these shallow wells (83%) were within the urban informal settlements where uses range from washing and cleaning, cooking, and even drinking (13.5%), despite the majority being unprotected. The analysis of the density of sanitation facilities near the water points showed that 32.3% existed within a 15 m radius of the nearest water sources, in violation of the recommended safe distance of 30 m. With an increased density of toilets near critical water sources and other sanitary practices, public health is highly compromised.


Asunto(s)
Planificación en Salud , Pobreza , Saneamiento , Clase Social , Cuartos de Baño , Salud Urbana , Abastecimiento de Agua , Humanos , Kenia
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