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2.
Rev Bras Enferm ; 73(suppl 2): e20200350, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32965403

RESUMEN

OBJECTIVE: to report the experience of telemonitoring Brazilian nursing homes before coronavirus and COVID-19 infections. METHODS: a descriptive experience report that occurred between March 18 and April 25, 2020 through telemonitoring nursing homes in Salvador, Bahia, following a script previously prepared for first contact and follow-up. The telemonitoring was carried out by professors from the School of Nursing of Universidade Federal da Bahia and Graduate Program students for four weeks. RESULTS: thirty-two institutions were followed for four weeks. Some facilities and difficulties appeared during the monitoring. FINAL CONSIDERATIOS: as nursing homes are collective households, their residents are vulnerable to transmission of infections. In addition, the diversity of structures and economic, social and human resources needs of these locations reveal their fragility and urgency of public policies that address such diversities.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Hogares para Ancianos , Casas de Salud , Enfermedades Profesionales/epidemiología , Neumonía Viral/epidemiología , Teléfono , Anciano , Brasil/epidemiología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Personal de Salud/estadística & datos numéricos , Humanos , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/prevención & control , Pandemias/prevención & control , Equipo de Protección Personal/provisión & distribución , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Vigilancia de la Población/métodos , Habilidades Sociales , Teléfono/estadística & datos numéricos , Factores de Tiempo
3.
Rev Bras Epidemiol ; 23: e200096, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-32997083

RESUMEN

OBJECTIVE: To evaluate the factors associated with food insecurity in families living in the urban area of Tocantins/Brazil. METHODS: This is a population-based cross-sectional study conducted in the urban area of 22 municipalities in the 8 microregions of the state. A semi-structured questionnaire was applied to the head of household to obtain socioeconomic and demographic data, and the Brazilian Food Insecurity Scale (EBIA) was used to assess food insecurity at home. The anthropometric assessment of the residents was made by measuring weight, height/length and waist circumference. Multinomial logistic regression was performed to assess the association of food insecurity with individual/household variables, and Pearson's chi-square test was used to compare whether there was a difference in the prevalence of food insecurity between microregions and between families with and without individuals under 18 years. RESULTS: A total of 596 households were evaluated, of which 63.4% were in a food insecurity situation. The final model of the multivariate analysis showed that low head-of-household schooling, low per capita income, receiving social assistance benefits and lack of clean drinking water in the household were associated with food insecurity (p < 0.05). CONCLUSIONS: The findings of this study reveal the high prevalence of food insecurity in the families studied and their associated factors, showing the need for local actions and public policies to improve health conditions, education and income of the population, and consequently, improve the scenario of food and nutritional insecurity in the state.


Asunto(s)
Composición Familiar , Abastecimiento de Alimentos , Vigilancia de la Población/métodos , Adolescente , Brasil , Ciudades , Estudios Transversales , Humanos , Factores Socioeconómicos , Población Urbana
4.
BMC Med Res Methodol ; 20(1): 235, 2020 09 21.
Artículo en Inglés | MEDLINE | ID: mdl-32958001

RESUMEN

BACKGROUND: Data analysis and visualization is an essential tool for exploring and communicating findings in medical research, especially in epidemiological surveillance. RESULTS: Data on COVID-19 diagnosed cases and mortality, from January 1st, 2020, onwards is collected automatically from the European Centre for Disease Prevention and Control (ECDC). We have developed a Shiny application for data visualization and analysis of several indicators to follow the SARS-CoV-2 epidemic using ECDC data. A country-specific tool for basic epidemiological surveillance, in an interactive and user-friendly manner. The available analyses cover time trends and projections, attack rate, population fatality rate, case fatality rate, and basic reproduction number. CONCLUSIONS: The COVID19-World online web application systematically produces daily updated country-specific data visualization and analysis of the SARS-CoV-2 epidemic worldwide. The application may help for a better understanding of the SARS-CoV-2 epidemic worldwide.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Biología Computacional/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Visualización de Datos , Pandemias , Neumonía Viral/epidemiología , Algoritmos , Betacoronavirus/fisiología , Biología Computacional/métodos , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Europa (Continente)/epidemiología , Salud Global/estadística & datos numéricos , Humanos , Incidencia , Internet , Neumonía Viral/transmisión , Neumonía Viral/virología , Vigilancia de la Población/métodos
5.
Epidemiol Serv Saude ; 29(4): e2020499, 2020 09 04.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32901699

RESUMEN

This article presents an experience report about integration between public and private health services, health service managers and the academy, for surveillance and control of the COVID-19 epidemic, in the municipality of Tubarão, Santa Catarina, Brazil. The city is home to a university and has a large flow of people from different parts of the country, as well as being one of the first municipalities in the state of Santa Catarina to report cases of community transmission of SARS-CoV-2. The measures adopted included the implementation of the COVID-19 Monitoring Committee, the Municipal Health Emergency Operations Center, and the COVID-19 Contingency Plan. After 100 days of pandemic, 5,979 cases had been reported, 431 (7.2%) had been confirmed, of which five (1.2%) died. Early decisions, such as the immediate suspension of business activities and crowded events, may have reduced the spread of the virus. The partnerships put into place have provided innovation and supported public service management in decision-making based upon scientific evidence.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Relaciones Interinstitucionales , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Asociación entre el Sector Público-Privado/organización & administración , Comités Consultivos , Brasil/epidemiología , Comunicación , Infecciones por Coronavirus/transmisión , Implementación de Plan de Salud , Humanos , Neumonía Viral/transmisión , Vigilancia de la Población/métodos
6.
JMIR Public Health Surveill ; 6(3): e17242, 2020 09 10.
Artículo en Inglés | MEDLINE | ID: mdl-32909955

RESUMEN

BACKGROUND: A better understanding of the influenza epidemiology among primary care workers could guide future recommendations to prevent transmission in primary care practices. Therefore, we designed a pilot study to assess the feasibility of using a work-based online influenza surveillance system among primary care workers. Such an approach is of particular relevance in the context of the coronavirus disease (COVID-19) pandemic, as its findings could apply to other infectious diseases with similar mechanisms of transmission. OBJECTIVE: This study aims to determine the feasibility of using a work-based online influenza surveillance system for primary care workers in Switzerland. METHODS: Physicians and staff of one walk-in clinic and two selected primary care practices were enrolled in this observational prospective pilot study during the 2017-2018 influenza season. They were invited to record symptoms of influenza-like illness in a weekly online survey sent by email and to self-collect a nasopharyngeal swab in case any symptoms were recorded. Samples were tested by real-time polymerase chain reaction for influenza A, influenza B, and a panel of respiratory pathogens. RESULTS: Among 67 eligible staff members, 58% (n=39) consented to the study and 53% (n=36) provided data. From the time all participants were included, the weekly survey response rate stayed close to 100% until the end of the study. Of 79 symptomatic episodes (mean 2.2 episodes per participant), 10 episodes in 7 participants fitted the definition of an influenza-like illness case (attack rate: 7/36, 19%). One swab tested positive for influenza A H1N1 (attack rate: 3%, 95% CI 0%-18%). Swabbing was considered relatively easy. CONCLUSIONS: A work-based online influenza surveillance system is feasible for use among primary care workers. This promising methodology could be broadly used in future studies to improve the understanding of influenza epidemiology and other diseases such as COVID-19. This could prove to be highly useful in primary care settings and guide future recommendations to prevent transmission. A larger study will also help to assess asymptomatic infections.


Asunto(s)
Personal de Salud , Gripe Humana/epidemiología , Tamizaje Masivo/métodos , Sistemas en Línea , Vigilancia de la Población/métodos , Atención Primaria de Salud , Adulto , Betacoronavirus , Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Estudios de Factibilidad , Femenino , Encuestas Epidemiológicas , Humanos , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/diagnóstico , Gripe Humana/virología , Masculino , Persona de Mediana Edad , Pandemias , Proyectos Piloto , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/virología , Prevalencia , Estudios Prospectivos , Reacción en Cadena en Tiempo Real de la Polimerasa , Suiza
8.
Orv Hetil ; 161(38): 1619-1622, 2020 09.
Artículo en Húngaro | MEDLINE | ID: mdl-32924965

RESUMEN

INTRODUCTION: In Hungary, SARS-CoV-2 was first detected in the swab samples of two Iranian patients on March 4, 2020. After finding the first positive cases, the question arose whether the virus had entered Hungary and caused infections before this date. Before March 4, 2020, except for the two above-mentioned samples, none of the 224 swab samples received specifically for SARS-CoV-2 tested positive. AIM: The National Reference Laboratory for Respiratory Viruses of the National Public Health Center aimed to carry out a retrospective study of the swab and other samples taken for testing respiratory virus infections between January 1, and April 19, 2020 sent by sentinel physicians within the influenza surveillance for diagnostic purposes. METHOD: For the study, we used swab samples taken weekly by sentinel physicians of the influenza surveillance service, and other samples received for diagnostic purposes. Tests were performed using real-time PCR. RESULTS: All the 465 swab samples sent by sentinel physicians were found to be SARS-CoV-2 negative. Also, of the 551 samples collected for diagnostic reasons of other respiratory viruses, no SARS-CoV-2 positive was found among those taken before March 4. CONCLUSION: Based on our data, it is very likely that prior to the first cases diagnosed on March 4, 2020, SARS-CoV-2 did not cause clinically symptomatic infections in Hungary. Orv Hetil. 2020; 161(38): 1619-1622.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Pandemias , Neumonía Viral/diagnóstico , Vigilancia de la Población/métodos , Betacoronavirus/genética , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Humanos , Hungría/epidemiología , Irán , Neumonía Viral/epidemiología , Neumonía Viral/virología , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos
10.
Euro Surveill ; 25(38)2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32975186

RESUMEN

Mitigation of the coronavirus disease (COVID-19) pandemic in Germany included school closures in early March 2020. After reopening in April, preventive measures were taken in schools. We analysed national surveillance system data on COVID-19 school outbreaks during different time periods. After reopening, smaller outbreaks (average: 2.2/week) occurred despite low incidence in the general population. School closures might have a detrimental effect on children and should be applied only cautiously and in combination with other measures.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Coronavirus , Brotes de Enfermedades/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Vigilancia de la Población/métodos , Cuarentena , Adolescente , Niño , Preescolar , Infecciones por Coronavirus/epidemiología , Humanos , Neumonía Viral/epidemiología , Instituciones Académicas , Factores de Tiempo
11.
J Popul Ther Clin Pharmacol ; 27(S Pt 1): e53-e57, 2020 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-32757541

RESUMEN

During the COVID-19 pandemic, most citizens in North America receive daily updates, which highlight the number of new cases per day in a specified region. However, as this data metric is often presented alone on media and news platforms, the spread of the novel coronavirus may often be misinterpreted. Among these daily updates which are critical to informing the public, the authors emphasize the importance of controlling for variation attributed to changes in surveillance. The number of test results that have been analyzed each day along with the total number of tests being conducted in a region have a significant impact on capturing virus spread and should always be included in widespread data. Presenting these variables may help to differentiate increases or decreases of new cases attributed to the expansion of surveillance and testing, or rather other environmental and behavioral factors. Overall, to best inform politicians, healthcare workers, and all citizens of the progress against COVID-19, there is a need to constantly improve analyses and reporting of data.


Asunto(s)
Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/epidemiología , Difusión de la Información/métodos , Neumonía Viral/epidemiología , Infecciones por Coronavirus/diagnóstico , Humanos , América del Norte/epidemiología , Pandemias , Neumonía Viral/diagnóstico , Vigilancia de la Población/métodos
13.
Pan Afr Med J ; 36: 71, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32754298

RESUMEN

Introduction: polio eradication initiatives started in 1988, this is almost the past 32 years following the WHA resolution 41.8 of eradicating polio by the year 2000. As of 2019, only 3 countries remained to be polio endemic globally, Afghanistan, Pakistan and Nigeria. The east and southern sub-region countries had shown progressive achievement towards polio eradication and to start with the African regional certification. The availability of sensitive AFP surveillance performance is among important strategies in the achievement of polio eradication. We, therefore, decided to conduct this assessment of AFP performance from 2012 to 2019 in the ESA sub-region have evidence documentation and support the certification process of the WHO AFRO region. Methods: we reviewed all reported acute flaccid paralysis (AFP) cases from 19 countries in the ESA sub region with the date of onset of paralysis from 1 January 2012 to 31 December 2019. The data were run to descriptive analysis based on the personal characteristics and AFP surveillance performance indicators parameters. Results: a total of 46,014 AFP cases were reported from 19 countries in the ESA countries who were paralyzed from 1 January 2012 to 31 December 2019. The most affected age group was children aged 0 to 3 years old where 19,740 children with acute paralysis were reported representing 42.9% of the total reported AFP for the period. The overall assessment of the non-polio AFP rate, there is an increase from a rate of 2.7 in 2012 to 3.5 in 2019 per 100,000 population aged less than 15 years, reflects a significant change with a p-value of 0.040 (95% C.I. ranges from 0.035 to 1.564). Furthermore, the percentage of stool adequacy raised from 86.4% in 2012 to 88.5% in 2019, with an observed 2.1% difference and no significant change over the 8 years. Conclusion: we observed an overall increase in the sensitivity of the AFP surveillance performance for the ESA sub-region countries from 2012 to 2019 using the national performance indicators. The COVID-19 pandemic paused an operational challenge for AFP surveillance performances from 2020. A further subnational surveillance performance analysis is suggested.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Parálisis/epidemiología , Neumonía Viral/epidemiología , Poliomielitis/epidemiología , Vigilancia de la Población/métodos , Enfermedad Aguda , Adolescente , África Oriental/epidemiología , África Austral/epidemiología , Distribución por Edad , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Pandemias , Estudios Retrospectivos
14.
JMIR Public Health Surveill ; 6(3): e21653, 2020 09 21.
Artículo en Inglés | MEDLINE | ID: mdl-32845852

RESUMEN

BACKGROUND: Hospital workers have been the most frequently and severely affected professional group during the COVID-19 pandemic, and have a big impact on transmission. In this context, innovative tools are required to measure the symptoms compatible with COVID-19, the spread of infection, and testing capabilities within hospitals in real time. OBJECTIVE: We aimed to develop and test an effective and user-friendly tool to identify and track symptoms compatible with COVID-19 in hospital workers. METHODS: We developed and pilot tested Hospital Epidemics Tracker (HEpiTracker), a newly designed app to track the spread of COVID-19 among hospital workers. Hospital staff in 9 hospital centers across 5 Spanish regions (Andalusia, Balearics, Catalonia, Galicia, and Madrid) were invited to download the app on their phones and to register their daily body temperature, COVID-19-compatible symptoms, and general health score, as well as any polymerase chain reaction and serological test results. RESULTS: A total of 477 hospital staff participated in the study between April 8 and June 2, 2020. Of note, both health-related (n=329) and non-health-related (n=148) professionals participated in the study; over two-thirds of participants (68.8%) were health workers (43.4% physicians and 25.4% nurses), while the proportion of non-health-related workers by center ranged from 40% to 85%. Most participants were female (n=323, 67.5%), with a mean age of 45.4 years (SD 10.6). Regarding smoking habits, 13.0% and 34.2% of participants were current or former smokers, respectively. The daily reporting of symptoms was highly variable across participating hospitals; although we observed a decline in adherence after an initial participation peak in some hospitals, other sites were characterized by low participation rates throughout the study period. CONCLUSIONS: HEpiTracker is an already available tool to monitor COVID-19 and other infectious diseases in hospital workers. This tool has already been tested in real conditions. HEpiTracker is available in Spanish, Portuguese, and English. It has the potential to become a customized asset to be used in future COVID-19 pandemic waves and other environments. TRIAL REGISTRATION: ClinicalTrials.gov NCT04326400; https://clinicaltrials.gov/ct2/show/NCT04326400.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Epidemias , Hospitales , Tamizaje Masivo/métodos , Aplicaciones Móviles , Personal de Hospital , Neumonía Viral/epidemiología , Vigilancia de la Población/métodos , Adulto , Betacoronavirus , Temperatura Corporal , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/virología , Revelación , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Proyectos Piloto , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/virología , España/epidemiología , Telemedicina
15.
JMIR Public Health Surveill ; 6(3): e19446, 2020 09 11.
Artículo en Inglés | MEDLINE | ID: mdl-32784193

RESUMEN

BACKGROUND: The rapid spread of COVID-19 means that government and health services providers have little time to plan and design effective response policies. It is therefore important to quickly provide accurate predictions of how vulnerable geographic regions such as counties are to the spread of this virus. OBJECTIVE: The aim of this study is to develop county-level prediction around near future disease movement for COVID-19 occurrences using publicly available data. METHODS: We estimated county-level COVID-19 occurrences for the period March 14 to 31, 2020, based on data fused from multiple publicly available sources inclusive of health statistics, demographics, and geographical features. We developed a three-stage model using XGBoost, a machine learning algorithm, to quantify the probability of COVID-19 occurrence and estimate the number of potential occurrences for unaffected counties. Finally, these results were combined to predict the county-level risk. This risk was then used as an estimated after-five-day-vulnerability of the county. RESULTS: The model predictions showed a sensitivity over 71% and specificity over 94% for models built using data from March 14 to 31, 2020. We found that population, population density, percentage of people aged >70 years, and prevalence of comorbidities play an important role in predicting COVID-19 occurrences. We observed a positive association at the county level between urbanicity and vulnerability to COVID-19. CONCLUSIONS: The developed model can be used for identification of vulnerable counties and potential data discrepancies. Limited testing facilities and delayed results introduce significant variation in reported cases, which produces a bias in the model.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Modelos Estadísticos , Pandemias , Neumonía Viral/epidemiología , Vigilancia de la Población/métodos , Anciano , Algoritmos , Betacoronavirus , Comorbilidad , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Humanos , Aprendizaje Automático , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/virología , Densidad de Población , Medición de Riesgo , Estados Unidos , Población Urbana
16.
Lancet Diabetes Endocrinol ; 8(10): 823-833, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32798471

RESUMEN

BACKGROUND: Diabetes has been associated with increased COVID-19-related mortality, but the association between modifiable risk factors, including hyperglycaemia and obesity, and COVID-19-related mortality among people with diabetes is unclear. We assessed associations between risk factors and COVID-19-related mortality in people with type 1 and type 2 diabetes. METHODS: We did a population-based cohort study of people with diagnosed diabetes who were registered with a general practice in England. National population data on people with type 1 and type 2 diabetes collated by the National Diabetes Audit were linked to mortality records collated by the Office for National Statistics from Jan 2, 2017, to May 11, 2020. We identified the weekly number of deaths in people with type 1 and type 2 diabetes during the first 19 weeks of 2020 and calculated the percentage change from the mean number of deaths for the corresponding weeks in 2017, 2018, and 2019. The associations between risk factors (including sex, age, ethnicity, socioeconomic deprivation, HbA1c, renal impairment [from estimated glomerular filtration rate (eGFR)], BMI, tobacco smoking status, and cardiovascular comorbidities) and COVID-19-related mortality (defined as International Classification of Diseases, version 10, code U07.1 or U07.2 as a primary or secondary cause of death) between Feb 16 and May 11, 2020, were investigated by use of Cox proportional hazards models. FINDINGS: Weekly death registrations in the first 19 weeks of 2020 exceeded the corresponding 3-year weekly averages for 2017-19 by 672 (50·9%) in people with type 1 diabetes and 16 071 (64·3%) in people with type 2 diabetes. Between Feb 16 and May 11, 2020, among 264 390 people with type 1 diabetes and 2 874 020 people with type 2 diabetes, 1604 people with type 1 diabetes and 36 291 people with type 2 diabetes died from all causes. Of these total deaths, 464 in people with type 1 diabetes and 10 525 in people with type 2 diabetes were defined as COVID-19 related, of which 289 (62·3%) and 5833 (55·4%), respectively, occurred in people with a history of cardiovascular disease or with renal impairment (eGFR <60 mL/min per 1·73 m2). Male sex, older age, renal impairment, non-white ethnicity, socioeconomic deprivation, and previous stroke and heart failure were associated with increased COVID-19-related mortality in both type 1 and type 2 diabetes. Compared with people with an HbA1c of 48-53 mmol/mol (6·5-7·0%), people with an HbA1c of 86 mmol/mol (10·0%) or higher had increased COVID-19-related mortality (hazard ratio [HR] 2·23 [95% CI 1·50-3·30, p<0·0001] in type 1 diabetes and 1·61 [1·47-1·77, p<0·0001] in type 2 diabetes). In addition, in people with type 2 diabetes, COVID-19-related mortality was significantly higher in those with an HbA1c of 59 mmol/mol (7·6%) or higher than in those with an HbA1c of 48-53 mmol/mol (HR 1·22 [95% CI 1·15-1·30, p<0·0001] for 59-74 mmol/mol [7·6-8·9%] and 1·36 [1·24-1·50, p<0·0001] for 75-85 mmol/mol [9·0-9·9%]). The association between BMI and COVID-19-related mortality was U-shaped: in type 1 diabetes, compared with a BMI of 25·0-29·9 kg/m2, a BMI of less than 20·0 kg/m2 had an HR of 2·45 (95% CI 1·60-3·75, p<0·0001) and a BMI of 40·0 kg/m2 or higher had an HR of 2·33 (1·53-3·56, p<0·0001); the corresponding HRs for type 2 diabetes were 2·33 (2·11-2·56, p<0·0001) and 1·60 (1·47-1·75, p<0·0001). INTERPRETATION: Deaths in people with type 1 and type 2 diabetes rose sharply during the initial COVID-19 pandemic in England. Increased COVID-19-related mortality was associated not only with cardiovascular and renal complications of diabetes but, independently, also with glycaemic control and BMI. FUNDING: None.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Diabetes Mellitus Tipo 1/mortalidad , Diabetes Mellitus Tipo 2/mortalidad , Neumonía Viral/mortalidad , Vigilancia de la Población , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Infecciones por Coronavirus/diagnóstico , Bases de Datos Factuales/tendencias , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Programas Nacionales de Salud/tendencias , Pandemias , Neumonía Viral/diagnóstico , Vigilancia de la Población/métodos , Factores de Riesgo , Adulto Joven
17.
Lancet Diabetes Endocrinol ; 8(10): 813-822, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32798472

RESUMEN

BACKGROUND: Although diabetes has been associated with COVID-19-related mortality, the absolute and relative risks for type 1 and type 2 diabetes are unknown. We assessed the independent effects of diabetes status, by type, on in-hospital death in England in patients with COVID-19 during the period from March 1 to May 11, 2020. METHODS: We did a whole-population study assessing risks of in-hospital death with COVID-19 between March 1 and May 11, 2020. We included all individuals registered with a general practice in England who were alive on Feb 16, 2020. We used multivariable logistic regression to examine the effect of diabetes status, by type, on in-hospital death with COVID-19, adjusting for demographic factors and cardiovascular comorbidities. Because of the absence of data on total numbers of people infected with COVID-19 during the observation period, we calculated mortality rates for the population as a whole, rather than the population who were infected. FINDINGS: Of the 61 414 470 individuals who were alive and registered with a general practice on Feb 16, 2020, 263 830 (0·4%) had a recorded diagnosis of type 1 diabetes, 2 864 670 (4·7%) had a diagnosis of type 2 diabetes, 41 750 (0·1%) had other types of diabetes, and 58 244 220 (94·8%) had no diabetes. 23 698 in-hospital COVID-19-related deaths occurred during the study period. A third occurred in people with diabetes: 7434 (31·4%) in people with type 2 diabetes, 364 (1·5%) in those with type 1 diabetes, and 69 (0·3%) in people with other types of diabetes. Unadjusted mortality rates per 100 000 people over the 72-day period were 27 (95% CI 27-28) for those without diabetes, 138 (124-153) for those with type 1 diabetes, and 260 (254-265) for those with type 2 diabetes. Adjusted for age, sex, deprivation, ethnicity, and geographical region, compared with people without diabetes, the odds ratios (ORs) for in-hospital COVID-19-related death were 3·51 (95% CI 3·16-3·90) in people with type 1 diabetes and 2·03 (1·97-2·09) in people with type 2 diabetes. These effects were attenuated to ORs of 2·86 (2·58-3·18) for type 1 diabetes and 1·80 (1·75-1·86) for type 2 diabetes when also adjusted for previous hospital admissions with coronary heart disease, cerebrovascular disease, or heart failure. INTERPRETATION: The results of this nationwide analysis in England show that type 1 and type 2 diabetes were both independently associated with a significant increased odds of in-hospital death with COVID-19. FUNDING: None.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Diabetes Mellitus Tipo 1/mortalidad , Diabetes Mellitus Tipo 2/mortalidad , Mortalidad Hospitalaria/tendencias , Neumonía Viral/mortalidad , Vigilancia de la Población , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Comorbilidad , Infecciones por Coronavirus/diagnóstico , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Inglaterra/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Pandemias , Neumonía Viral/diagnóstico , Vigilancia de la Población/métodos , Adulto Joven
18.
PLoS Med ; 17(8): e1003235, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32760068

RESUMEN

BACKGROUND: Temporal patterns in the frequency and characteristics of self-harm episodes across the Australian asylum seeker population may have implications for self-harm prevention and public health policy. The aim of this study was to examine how the distribution of self-harm episodes and method(s) of self-harm used across the Australian asylum seeker population vary according to the 24-hour cycle, day, and month, and to establish a basis for further research. METHODS AND FINDINGS: We conducted an observational study of all 949 self-harm incidents reported across the Australian asylum seeker population (representing a monthly average of 28,992 adults) between 1 August 2014 and 31 July 2015, obtained by Freedom of Information (FOI) from the Department of Immigration. Time of self-harm, day, and month of occurrence were investigated across all five Australian asylum seeker populations (i.e., community-based arrangements, community detention, onshore immigration detention, offshore immigration detention [Nauru], and offshore immigration detention [Manus Island]). Significant variations in distributions over the 24-hour cycle were observed by processing arrangements. Compared with the average distribution across all other processing arrangements, self-harm more commonly occurred among community-based asylum seekers (36.3%) between 12:00 AM and 3:59 AM (p < 0.001), in asylum seekers on Manus Island (36.4%) between 4:00 PM and 7:59 PM (p = 0.02), and among asylum seekers in onshore detention (20.4%) between 8:00 PM and 11:59 PM (p < 0.001). Compared with the average distribution across all other methods, self-poisoning (by medication) (25%) was significantly more likely to occur between 12:00 AM and 3:59 AM (p = 0.009), and self-battery (42%) between 8:00 AM and 11:59 AM (p < 0.001). The highest and lowest monthly self-harm episode rates for the whole asylum seeker population were in August (2014) (5 episodes per 1,000 asylum seekers; 95% confidence interval [CI] 1-11) and in both January and February (2015) (2.1 episodes per 1,000 asylum seekers; 95% CI 0.6-7.2), respectively; however, the overlapping CIs indicate no statistically significant differences across the months. When examining monthly trends by processing arrangements, we observed that self-harm was significantly more likely to occur in August (2014) than other months of the year among asylum seekers in onshore detention (19%) (p < 0.001), in January (2015) on Manus Island (18%) (p = 0.002), and in October (2014) on Nauru (15%) (p < 0.001). The main study limitations were that we could not investigate certain characteristics associated with self-harm (e.g., gender, country of origin), as the Department of Immigration did not routinely collect such data. There was also the potential risk of making a type 1 error, given the exploratory nature of the comparisons we undertook; we minimised this by lowering our significance threshold from 0.05 to 0.01. CONCLUSIONS: Self-harm in the Australian asylum seeker population was found to vary according to time of day and month of the year, by processing arrangements. A series of procedure-related and detention-related factors were observed to be associated with the temporal variations in self-harm. These findings should form the basis for further investigation into temporal variations in self-harm among asylum seekers, which may in turn lead to effective self-harm prevention strategies.


Asunto(s)
Ritmo Circadiano , Vigilancia de la Población , Refugiados/psicología , Estaciones del Año , Conducta Autodestructiva/epidemiología , Conducta Autodestructiva/psicología , Adulto , Australia/epidemiología , Ritmo Circadiano/fisiología , Femenino , Humanos , Masculino , Vigilancia de la Población/métodos , Conducta Autodestructiva/diagnóstico , Factores de Tiempo , Adulto Joven
19.
Public Health Rep ; 135(5): 640-649, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32783780

RESUMEN

OBJECTIVE: The objective was to compare estimates of childhood influenza vaccination across 7 consecutive influenza seasons based on 2 survey systems. METHODS: We analyzed data from the National Health Interview Survey (NHIS) and the National Immunization Survey-Flu (NIS-Flu) using Kaplan-Meier survival analysis to estimate receipt, based on parental report, of at least 1 dose of influenza vaccine among children aged 6 months to 17 years. RESULTS: We found no significant increasing trend in influenza vaccination coverage among children overall from 2012 to 2018 based on the NHIS or from 2012 to 2019 based on the NIS-Flu. We found 4 seasons with a significant increase in influenza vaccination coverage compared with the previous season (2012-2013 [NHIS, NIS-Flu], 2013-2014 [NIS-Flu], 2017-2018 [NHIS], and 2018-2019 [NIS-Flu]). As of the 2018-2019 season, based on NIS-Flu, influenza vaccination coverage was only 62.6%. Children with health conditions that put them at increased risk for complications from influenza had higher influenza vaccination coverage than children without these health conditions for all the seasons studied except 2014-2015. For all seasons studied, influenza vaccination coverage estimates for children were higher based on NIS-Flu data compared with NHIS data. Trends across seasons and differences in vaccination coverage between age groups were similar between the 2 surveys. CONCLUSIONS: Influenza vaccination coverage among children appears to have plateaued. Only about half of the children in the United States were vaccinated against influenza. Improvements in measurement of influenza vaccination and development and review of strategies to increase childhood influenza vaccination coverage are needed.


Asunto(s)
Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Vigilancia de la Población/métodos , Análisis de Supervivencia , Cobertura de Vacunación/estadística & datos numéricos , Cobertura de Vacunación/tendencias , Adolescente , Niño , Preescolar , Femenino , Predicción , Humanos , Lactante , Gripe Humana/epidemiología , Masculino , Encuestas y Cuestionarios , Estados Unidos/epidemiología
20.
Public Health Rep ; 135(5): 676-684, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32795209

RESUMEN

OBJECTIVE: Infants born to women with hepatitis B virus (HBV) infection are at high risk for chronic HBV infection and premature death. We examined epidemiologic trends among women with HBV infection who gave birth in New York City (NYC) to inform public health prevention activities. METHODS: We obtained data on HBV-infected women residing and giving birth in NYC during 1998-2015 from the NYC Perinatal HBV Prevention Program. We obtained citywide birth data from the NYC Office of Vital Statistics. We calculated the incidence of births to HBV-infected women per 100 000 live births and stratified by maternal race, birthplace, and age. We calculated annual percentage change (APC) in incidence of births to HBV-infected women by using joinpoint regression. RESULTS: Of 29 896 HBV-infected women included in the study, 28 195 (94.3%) were non-US-born, of whom 16 600 (58.9%) were born in China. Overall incidence of births to HBV-infected women per 100 000 live births increased from 1156 in 1998 to 1573 in 2006 (APC = 3.1%; P < .001) but declined to 1329 in 2015 (APC = -1.4%; P = .02). Incidence among US-born women declined from 1998 to 2015 (330 to 84; APC = -7.3%; P < .001) and among non-US-born women increased from 1998 to 2007 (1877 to 2864; APC = 3.6%; P < .001) but not thereafter. Incidence among women born in China increased from 1998 to 2006 (13 275 to 16 480; APC = 1.8%; P = .02) but decreased to 12 631 through 2015 (APC = -3.3%; P < .001). CONCLUSIONS: The incidence of births to HBV-infected women in NYC declined significantly among US-born women but not among non-US-born women, highlighting the need for successful vaccination programs worldwide.


Asunto(s)
Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Emigrantes e Inmigrantes/estadística & datos numéricos , Hepatitis B Crónica/epidemiología , Hepatitis B Crónica/transmisión , Vigilancia de la Población/métodos , Complicaciones Infecciosas del Embarazo/epidemiología , Mujeres Embarazadas , Adolescente , Adulto , Femenino , Hepatitis B Crónica/prevención & control , Humanos , Incidencia , Recién Nacido , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Características de la Residencia/estadística & datos numéricos , Adulto Joven
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