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Recurso de Internet en Español | LIS - Localizador de Información en Salud, LIS-ES-CIUD, LIS-ES-PROF | ID: lis-LISBR1.1-47002


Contiene: situación epidemiológica, evaluación de riesgo y medidas de salud pública en España, actuaciones y recomendaciones de salud pública de la República Popular China, la Organización Mundial de la Salud (OMS) y el Centro Europeo de Control de Enfermedades (ECDC).

Infecciones por Coronavirus , Betacoronavirus , Medición de Riesgo , Vigilancia en Salud Pública , España , China , Organización Mundial de la Salud
MMWR Morb Mortal Wkly Rep ; 69(1): 14-19, 2020 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-31917783


On August 1, 2018, the Democratic Republic of the Congo (DRC) declared its 10th Ebola virus disease (Ebola) outbreak in an area with a high volume of cross-border population movement to and from neighboring countries. The World Health Organization (WHO) designated Rwanda, South Sudan, and Uganda as the highest priority countries for Ebola preparedness because of the high risk for cross-border spread from DRC (1). Countries might base their disease case definitions on global standards; however, historical context and perceived risk often affect why countries modify and adapt definitions over time, moving toward or away from regional harmonization. Discordance in case definitions among countries might reduce the effectiveness of cross-border initiatives during outbreaks with high risk for regional spread. CDC worked with the ministries of health (MOHs) in DRC, Rwanda, South Sudan, and Uganda to collect MOH-approved Ebola case definitions used during the first 6 months of the outbreak to assess concordance (i.e., commonality in category case definitions) among countries. Changes in MOH-approved Ebola case definitions were analyzed, referencing the WHO standard case definition, and concordance among the four countries for Ebola case categories (i.e., community alert, suspected, probable, confirmed, and case contact) was assessed at three dates (2). The number of country-level revisions ranged from two to four, with all countries revising Ebola definitions by February 2019 after a December 2018 peak in incidence in DRC. Case definition complexity increased over time; all countries included more criteria per category than the WHO standard definition did, except for the "case contact" and "confirmed" categories. Low case definition concordance and lack of awareness of regional differences by national-level health officials could reduce effectiveness of cross-border communication and collaboration. Working toward regional harmonization or considering systematic approaches to addressing country-level differences might increase efficiency in cross-border information sharing.

Brotes de Enfermedades , Fiebre Hemorrágica Ebola/diagnóstico , Fiebre Hemorrágica Ebola/epidemiología , Vigilancia en Salud Pública/métodos , República Democrática del Congo/epidemiología , Humanos , Rwanda/epidemiología , Sudán del Sur/epidemiología , Factores de Tiempo , Uganda/epidemiología
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 42-46, 2020 Jan 06.
Artículo en Chino | MEDLINE | ID: mdl-31914568


Focusing on the current challenges and opportunities of China National Infectious Disease Surveillance Network (CNIDS), the exploration and development of pathogen detecting and tracing technologies, and the key issues in vaccine development, 48 experts from the disease control and prevention centers; research institutes, universities and hospitals launched an in-depth discussion on October 24-27, 2019, and reached the following consensus. (1) CNIDS needs to coordinate operational activities and to integrate data across governmental departments in order to build a human-centered and life-cycle based disease monitoring and health managing system. (2) In addition to standardize and further strengthen pathogen culturing and isolating techniques, it is desired to develop multi-targeted, ultra-sensitive, high-specific, high-throughput, digitalized and easy-to-use techniques for pathogen detections and pathobionts analyses. (3) The rapid development of pathogen tracing technologies calls to facilitate the formulation of a more efficient pathogen-tracing system by integrating technologies from genomics, bioinformatics and microbiology.(4) To strengthen the basic researches to support new vaccine developments, to explore vaccination strategies and to unfold the post-marketing evaluation on vaccines. Finally, experts proposed and discussed possiblecountermeasures and suggestions tackling with those challenges.

Investigación Biomédica , Consenso , Vigilancia en Salud Pública , Vacunas , China , Congresos como Asunto , Humanos
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 20-27, jan.-dez. 2020. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1047828


Objetivo: descrever a ocorrência de acidentes e óbitos provocados por animais peçonhentos, na região Sudeste, Brasil. Método: estudo epidemiológico, ecológico e analítico. Efetuou-se busca no Sistema de Informação de Agravos de Notificação-NET sobre acidentes e óbitos ocorridos no período de 2005 a 2015. Efetuaram-se análises descritivas, seguidas de análise bivariada para comparar as médias entre estados do Sudeste (p<0,05). Resultados: observou-se um total de 471.403 acidentes e de 684 óbitos causados por animais peçonhentos na região Sudeste, com a maior parte dos acidentes registrada em 2014 (58.544) e de óbitos em 2015 (99). Houve maior média de acidentes e óbitos por escorpião: 5.694,14 e 7,45. Minas Gerais concentrou a maior quantidade de acidentes e óbitos, comparada aos demais estados (p<0,05). Conclusão: evidenciou-se elevada frequência de acidentes e óbitos provocados por animais peçonhentos, delineando uma realidade preocupante que deve ser efetivamente gerenciada

Objective: to describe the occurrence of accidents and deaths caused by venomous animals in the Southeast region of Brazil. Method: epidemiological, ecological and analytical study. The NET-Notification of Injury Information System was searched for accidents and deaths occurring in the period from 2005 to 2015. Descriptive analyzes were carried out, followed by a bivariate analysis to compare the averages between states in the Southeast (p<0.05). Results: a total of 471,403 accidents and 684 deaths caused by venomous animals in the Southeast region were observed, with most accidents recorded in 2014 (58,544) and deaths in 2015 (99). There was a greater average of accidents and deaths by scorpion: 5.694,14 and 7.45. Minas Gerais concentrated the largest number of accidents and deaths, compared to the other states (p<0.05). Conclusion: a high frequency of accidents and deaths caused by venomous animals was evidenced, delineating a worrisome reality that must be effectively managed

Objetivo: describir la ocurrencia de accidentes y muertes provocadas por animales venenosos, en la región Sudeste, Brasil. Método: estúdio epidemiológico, ecológico y analítico. Se realizó una búsqueda en El Sistema de Información de Agravios de Notificación-NET sobre accidentes y muertes ocurridos en el período de 2005 a 2015. Se realizaron análisis descriptivos, seguidos de análisis bivariado para comparar las medias entre estados del Sudeste (p<0,05). Resultados: se observó un total de 471.403 accidentes y de 684 muertes causadas por animales venenosos en la región Sudeste, con la mayor parte de los accidentes registrados em 2014 (58.544) y de muertes en 2015 (99). Se observó un mayor promedio de accidentes y muertes por escorpión: 5.694,14 y 7,45. Minas Gerais concentró la mayor cantidad de accidentes y muertes, comparada a lós demás estados (p<0,05). Conclusión: se evidenció una elevada frecuencia de accidentes y muertes provocadas por animales venenosos, delineando una realidad preocupante que debe ser efectivamente administrada

Humanos , Epidemiología , Vigilancia en Salud Pública , Animales Venenosos , Brasil , Indicadores de Morbimortalidad
BMC Infect Dis ; 19(1): 1016, 2019 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-31783799


BACKGROUND: Leprosy is a neglected disease that poses a significant challenge to public health in Uganda. The disease is endemic in Uganda, with 40% of the districts in the country affected in 2016, when 42 out of 112 districts notified the National Tuberculosis and Leprosy Program (NTLP) of at least one case of leprosy. We determined the spatial and temporal trends of leprosy in Uganda during 2012-2016 to inform control measures. METHODS: We analyzed quarterly leprosy case-finding data, reported from districts to the Uganda National Leprosy Surveillance system (managed by NTLP) during 2012-2016. We calculated new case detection by reporting district and administrative regions of treatment during this period. New case detection was defined as new leprosy cases diagnosed by the Uganda health services divided by regional population; population estimates were based on 2014 census data. We used logistic regression analysis in Epi-Info version 7.2.0 to determine temporal trends. Population estimates were based on 2014 census data. We used QGIS software to draw choropleth maps showing leprosy case detection rates, assumed to approximate the new case detection rates, per 100,000 population. RESULTS: During 2012-2016, there was 7% annual decrease in reported leprosy cases in Uganda each year (p = 0.0001), largely driven by declines in the eastern (14%/year, p = 0.0008) and central (11%/year, p = 0.03) regions. Declines in reported cases in the western (9%/year, p = 0.12) and northern (4%/year, p = 0.16) regions were not significant. The combined new case detection rates from 2012 to 2016 for the ten most-affected districts showed that 70% were from the northern region, 20% from the eastern, 10% from the western and 10% from the central regions. CONCLUSION: There was a decreasing trend in leprosy new case detection in Uganda during 2012-2016; however, the declining trends were not consistent in all regions. The Northern region consistently identified more leprosy cases compared to the other regions. We recommend evaluation of the leprosy surveillance system to ascertain the leprosy situation.

Lepra/diagnóstico , Bases de Datos Factuales , Humanos , Lepra/epidemiología , Modelos Logísticos , Vigilancia en Salud Pública , Estudios Retrospectivos , Análisis Espacio-Temporal , Uganda/epidemiología
RECIIS (Online) ; 13(4): 831-842, out.-dez. 2019. tab, ilus
Artículo en Inglés | LILACS | ID: biblio-1047577


The objective of this study was to compare intra-domiciliary contacts (IDCs) in the Health Information System (SIS) with records of people diagnosed with leprosy. This was a cross-sectional, retrospective, and quantitative study based on the physical information collected in medical records and the SIS records in 2015 and 2016, in a municipality in the countryside of the State of São Paulo. We used an instrument with variables related to IDCs such as gender, age, relationship, disease, BCG-ID vaccine, SIS records, and descriptive analysis. Out of the 81 IDCs from 40 diagnosed patients, 72 were evaluated, and 71 were included in the SIS. One IDC became ill after the end of treatment of the index case. The prevalent gender among IDCs was female, young adults, and children. A difference of 12.4% as observed between the physical and SIS records; a difference of 11.1% was observed when correlating 81 records with the frequency of the 72 evaluated IDCs. It is concluded that the IDC and SIS records are in disagreement.

O objetivo deste estudo foi comparar os contatos intradomiciliares (CIs) do Sistema de Informação em Saúde (SIS) com os registros de pessoas diagnosticadas com hanseníase. Estudo transversal, retrospectivo e quantitativo, baseado nas informações coletadas em registros físicos e do SIS em 2015 e 2016, em um município do interior do Estado de São Paulo. Foi utilizado um instrumento com variáveis relacionadas aos CIs: sexo, idade, relacionamento, doença, vacina BCG-ID, registros SIS e análise descritiva. Dos 81 CIs de 40 pacientes diagnosticados, 72 foram avaliados e 71 foram incluídos no SIS. 01 CIs adoeceu após o término do tratamento do caso índice. O sexo prevalente dos CIs é feminino, adulto jovem e filho. Entre os registros físicos e do SIS, houve uma diferença de 12,4%; e correlacionando os mesmos registros (81) com a frequência dos CIs avaliados (72), há uma diferença de 11,1%. Conclui-se que existe discordância entre os registos de CIs nos registos com o SIS.

El estudio tiene el objetivo de comparar las anotaciones de comunicantes intradomiciliares (CI) del Sistema de Información en Salud (SIS), con las de los prontuarios de las personas diagnosticadas con leprae. En el presente trabajo se analizaron los resultados obtenidos en el análisis de los resultados obtenidos en el análisis de los resultados obtenidos, evaluados en los registros del SIS. De los 81 CI de 40 pacientes diagnosticados, 72 fueron evaluados y 71 fueron incluidos en el SIS. Y en el caso de las mujeres, El grado de parentesco frecuente fue infantil, mujeres y adultos jóvenes. Entre las anotaciones del SIS y los prontuarios, hay diferencia del 12,4%; y correlacionando los mismos registros (81) con la frecuencia de los CI evaluados (72), hay una diferencia del 11,1%. Se concluye que hay discordancia entre los registros de CI en los prontuarios con el SIS.

Humanos , Epidemiología , Comunicación en Salud , Vigilancia en Salud Pública , Sistemas de Información en Salud , Lepra , Sistema Único de Salud , Registros Médicos , Epidemiología Descriptiva , Estudios Transversales , Lepra/diagnóstico
ABCS health sci ; 44(3): 195-202, 20 dez 2019. tab
Artículo en Inglés, Portugués | LILACS | ID: biblio-1047753


A acumulação de animais é considerada um fenômeno complexo que, apesar de já ser reconhecido no universo acadêmico, ainda é de difícil solução para a gestão da saúde. Os estudos a respeito de acumulação, principalmente de animais, são incipientes no Brasil. Este artigo de revisão da literatura tem por objetivo alertar a respeito desta complexa morbidade, cada vez mais comum às aglomerações urbanas, indicando ações de promoção e de vigilância em saúde que permitam garantir a saúde dos animais, do acumulador e da coletividade a qual ele pertença. Sugere-se que uma nova abordagem em relação ao distúrbio de acumulação de animais possa combater a pouca visibilidade - inclusive acadêmica - demonstrada na revisão da literatura, ampliando o investimento em intervenções específicas que possam explicitar esse importante problema de saúde pública no Brasil.

Animal accumulation is considered a complex phenomenon that, although recognized in the academic universe, is still difficult to solve for health management. Studies on accumulation, mainly of animals, are incipient in Brazil. This literature review article aims to warn about this complex morbidity, which is increasingly common to urban agglomerations, indicating health promotion and surveillance actions to ensure the health of animals, the accumulator and the community to which it belongs. It is suggested that a new approach to animal accumulation disorder may counteract the poor - including academic - visibility demonstrated in the literature review, increasing investment in specific interventions that may explain this important public health problem in Brazil.

Humanos , Mascotas , Vigilancia en Salud Pública , Trastorno de Acumulación , Salud Pública
Hematol Oncol ; 37(5): 578-585, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31702065


Event free survival at 24 months (EFS24) has been described as a powerful predictor for outcome in several subtypes of B cell lymphoma. However, it was limitedly described in T cell lymphoma. We explored the implication of EFS24 as a predictor marker for peripheral T cell lymphoma (PTCL). We reviewed 293 systemic PTCL patients at 13 nationwide major university hospitals in Thailand from 2007 to 2014. The median event free survival (EFS) and overall survival (OS) of PTCL patients in our cohort was 16.3 and 27.7 months with corresponding 2-year EFS and 2-year OS of 45.8% and 51.9%, respectively. A total of 118 patients achieved EFS24 (no events during the first 24 mo). Patients who achieved EFS24 had better OS than patients who did not (2-y OS 92% vs 18.8%; HR, 0.1; P < .001). The standardized mortality ratio of patients achieving EFS24 was 18.7 (95% CI, 14.6-22.8). Multivariable analysis demonstrated performance status, histologic subtype, remission status, and EFS24 achievement as independent predictors for OS. Our study affirmed the value of EFS24 as a powerful prognostic factor for PTCL. Further validation in prospective study setting is warranted.

Linfoma de Células T Periférico/mortalidad , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Supervivencia sin Enfermedad , Femenino , Humanos , Estimación de Kaplan-Meier , Linfoma de Células T Periférico/epidemiología , Linfoma de Células T Periférico/terapia , Masculino , Persona de Mediana Edad , Pronóstico , Supervivencia sin Progresión , Vigilancia en Salud Pública , Tailandia/epidemiología , Resultado del Tratamiento
Medicine (Baltimore) ; 98(44): e17679, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31689786


To introduce the National Maternal Near Miss Surveillance System (NMNMSS) in detail and to report the composition of maternal near miss (MNM) in China.The NMNMSS was established by the National Health Commission at the end of 2010, covered over 400 health facilities from 30 provinces in China. The NMNMSS was designed to collect individual information for every pregnant woman admitted to obstetric department in the sampled health facilities. Cross tabulations and correlations were used to describe the distribution of population and sampled facilities in the NMNMSS, and to calculate the MNM mortality ratio for different complications and organ dysfunctions.The individual survey forms of 9,051,638 pregnant women were collected in the NMNMSS between 2012 and 2017. Compared with urban areas, there are very few well-quality medical resources in rural areas. Most women with pregnancy complications in rural areas can only be treated in Level 2 and lower hospitals. MNM in women with indirect obstetric complications received treatment more frequently in Level 3 hospital. The most common maternal complications in severe maternal outcomes (including maternal near miss and maternal death) are obstetrics hemorrhage (58.7%), hypertension disorder (28.0%), and severe anemia (20.6%). The overall MNM mortality ratio is 38:1. The MNM mortality ratios are lowest in amniotic fluid embolism, HIV/AIDS, heart disease, thrombophlebitis, and sepsis. For different organ dysfunctions, the ranks of the MNM mortality ratio from low to high are renal dysfunction, respiratory dysfunction, cardiovascular dysfunction, hepatic dysfunction, neurologic dysfunction, uterine dysfunction, coagulation dysfunction.The NMNMSS is a well-established hospital-based surveillance system for maternal complications in China. It can identify the maternal complications that need to improve health care immediately in China through a powerful longitudinal real-world evidence.

Near Miss Salud/estadística & datos numéricos , Complicaciones del Embarazo/epidemiología , Vigilancia en Salud Pública/métodos , China/epidemiología , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Complicaciones del Trabajo de Parto/epidemiología , Embarazo , Características de la Residencia/estadística & datos numéricos , Factores Socioeconómicos
Semin Oncol ; 46(4-5): 362-371, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31727344


The correlation between clinical outcomes and treatment-related adverse events (AEs) has always been a debated topic in clinical oncology. Despite toxicities pharmacodynamics effects, the misunderstanding has always been around the corner: AEs themselves could lead to morbidity and mortality; on the other hand, the choice of the clinical outcomes to measure is not univocal. After the advent of immune checkpoint inhibitors (ICIs), such as anti-cytotoxic T-lymphocyte-associated protein 4 and anti-programmed death-1/programmed death ligand-1, new class-specific AEs have emerged, called immune-related AEs (irAEs). With irAEs, the correlation between toxicity and clinical outcomes has suddenly been suggested, but it is still to be proven. We conducted a systematic literature review regarding this emerging association, pointing out all the available data and speculating on the possible underlying mechanisms. Thirty-six studies were included in the analysis, involving different malignancies (mostly melanoma and lung cancer), with different measured clinical outcomes. The most of them were retrospective. Despite the high heterogeneity, and the enormous biases of the revised studies, we can assume that irAEs occurrence is linked to the therapeutic activity of immune checkpoint inhibitors, with a (certain) direct proportionality, maybe subtending the likelihood of an immunogenic phenotype. This phenomenon seems to occur with both anti-cytotoxic T-lymphocyte-associated protein 4 and anti-programmed death-1/programmed death ligand-1, and across different solid malignancies.

Antineoplásicos Inmunológicos/efectos adversos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/etiología , Neoplasias/complicaciones , Neoplasias/epidemiología , Antineoplásicos Inmunológicos/uso terapéutico , Biomarcadores de Tumor/antagonistas & inhibidores , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/diagnóstico , Humanos , Terapia Molecular Dirigida/efectos adversos , Metástasis de la Neoplasia , Estadificación de Neoplasias , Neoplasias/diagnóstico , Neoplasias/tratamiento farmacológico , Evaluación del Resultado de la Atención al Paciente , Vigilancia en Salud Pública
BMC Public Health ; 19(1): 1340, 2019 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-31640646


BACKGROUND: Diarrhea is a major cause of morbidity and mortality, yet incidence and etiology data are limited. We conducted laboratory-based diarrhea surveillance in Guatemala. METHODS: A diarrhea case was defined as ≥3 loose stools in a 24-h period in a person presenting to the surveillance facilities. Epidemiologic data and stool specimens were collected. Specimens were tested for bacterial, parasitic, and viral pathogens. Yearly incidence was adjusted for healthcare seeking behaviors determined from a household survey conducted in the surveillance catchment area. RESULTS: From November 2008 to December 2012, the surveillance system captured 5331 diarrhea cases; among these 1381 (26%) had specimens tested for all enteric pathogens of interest. The adjusted incidence averaged 659 diarrhea cases per 10,000 persons per year, and was highest among children aged < 5 years, averaging 1584 cases per 10,000 children per year. Among 1381 (26%) specimens tested for all the pathogens of interest, 235 (17%) had a viral etiology, 275 (20%) had a bacterial, 50 (4%) had parasites, and 86 (6%) had co-infections. Among 827 (60%) specimens from children aged < 5 years, a virus was identified in 196 (23%) patients; 165 (20%) had norovirus and 99 (12%) rotavirus, including co-infections. Among 554 patients aged ≥5 years, 103 (19%) had a bacterial etiology, including diarrheagenic Escherichia coli in 94 (17%) cases, Shigella spp. in 31 (6%), Campylobacter spp. in 5 (1%), and Salmonella spp. in 4 (1%) cases. Detection of Giardia and Cryptosporidium was infrequent (73 cases; 5%). CONCLUSIONS: There was a substantial burden of viral and bacterial diarrheal diseases in Guatemala, highlighting the importance of strengthening laboratory capacity for rapid detection and control and for evaluation of public health interventions.

Disentería/epidemiología , Disentería/etiología , Vigilancia en Salud Pública/métodos , Adolescente , Adulto , Niño , Preescolar , Heces/microbiología , Heces/parasitología , Heces/virología , Femenino , Guatemala/epidemiología , Humanos , Incidencia , Lactante , Laboratorios , Masculino , Persona de Mediana Edad , Adulto Joven
BMC Public Health ; 19(1): 1343, 2019 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-31640662


BACKGROUND: Evaluation of a surveillance system should be conducted on regular bases to ensure that the system is working as envisioned or not. Therefore, we evaluated Dangila district's public health surveillance system performance in line with its objectives. METHODS: In August 2017, a concurrent embedded mixed quantitative/qualitative, facility-based cross-sectional study was conducted in Dangila district among 12 health facilities/sites. The qualitative part involved 12 purposively selected key stakeholders interview. A semi-structured questionnaire adapted from updated CDC guideline for evaluating public health surveillance system was used for data collection through face to face interview and record review. The major qualitative findings were narrated and summarized based on thematic areas to supplement the quantitative findings. The quantitative findings were analyzed using Microsoft Excel 2007. RESULTS: All necessary surveillance guidelines, registers and reporting formats were distributed adequately to health facilities. Only the district health office has Emergency Preparedness and Response Plan (EPRP), but not supported by the budget required to respond in case an emergency occurred. There were no regular data analysis and interpretations in terms of time, place and person. Weekly report completeness and timeliness were 100 and 94.6% respectively. The information collected was considered relevant by its users to detect outbreaks early with high acceptability. All stakeholders agreed that the system is simple, easy to understand, representative and can accommodate modifications. Written feedbacks were not obtained in all health facilities. The supervision checklist obtained in the district was not adequate to assess surveillance activities in detail. The calculated positive predictive value for malaria was 11%. CONCLUSIONS: The surveillance system was simple, useful, flexible, acceptable and representative. Report completeness and timelines were above the national and international targets. However, the overall implementation of the system in the district was not satisfactory to achieve the intended objective of surveillance for public health action due to the lack of regular data analysis and feedback dissemination. To create a well-performing surveillance system, regular supervision and epidemiologically analyzed and interpreted feedback system is mandatory.

Brotes de Enfermedades , Instituciones de Salud , Vigilancia en Salud Pública , Estudios Transversales , Etiopía/epidemiología , Humanos , Investigación Cualitativa , Reproducibilidad de los Resultados , Encuestas y Cuestionarios