[Climate change and vector-borne diseases. From knowledge to action]. / Cambio climático y enfermedades transmitidas por vectores. Convertir el conocimiento en acción.

Andalusia is particularly sensitive to climate change, not only because of extreme weather events, but also because of the impact on the population dynamics of vectors, pathogens, reservoirs and hosts, which has led to a change in the epidemiological patterns of vector-borne diseases. In order to achieve an integrated vector management for disease control, public action is necessary. This study describes the design of the initial phase of a strategy for knowledge translation about climate change and vector-borne diseases to the public, using transdisciplinary co-creation and the World Café participatory method with three discussion rounds to address strategies for three age groups (adults, adolescents and schoolchildren). The aim is to drive knowledge into action and for this purpose the underlying messages for action (strategic and instrumental) have been identified, as well as the formats of the knowledge products and the potential implementers of the strategies.

Cambio climático y enfermedades transmitidas por vectores. Convertir el conocimiento en acción / Climate change and vector-borne diseases. From knowledge to action

Andalucía es un territorio especialmente sensible al cambio climático, por el impacto de los fenómenos meteorológicos extremos, así como por la dinámica poblacional de vectores, patógenos, reservorios y hospedadores, que ha ocasionado ya una modificación en los patrones epidemiológicos de enfermedades de transmisión por vectores. Para conseguir una gestión integral de los vectores y el control de las enfermedades que transmiten es necesaria la acción de la ciudadanía. Se describe el diseño de la fase inicial de una estrategia de transferencia de conocimientos sobre cambio climático y enfermedades de transmisión por vectores a la ciudadanía, mediante cocreación transdisciplinaria con la técnica de World café en tres rondas para la definición de estrategias dirigidas a diferentes audiencias (adultos, adolescentes y escolares). El objetivo es convertir el conocimiento en acción, y para ello se han identificado los mensajes de acción de fondo (estratégicos e instrumentales), así como los formatos de los productos de conocimiento y los posibles implementadores de las estrategias. (AU)

Andalusia is particularly sensitive to climate change, not only because of extreme weather events, but also because of the impact on the population dynamics of vectors, pathogens, reservoirs and hosts, which has led to a change in the epidemiological patterns of vector-borne diseases. In order to achieve an integrated vector management for disease control, public action is necessary. This study describes the design of the initial phase of a strategy for knowledge translation about climate change and vector-borne diseases to the public, using transdisciplinary co-creation and the World Café participatory method with three discussion rounds to address strategies for three age groups (adults, adolescents and schoolchildren). The aim is to drive knowledge into action and for this purpose the underlying messages for action (strategic and instrumental) have been identified, as well as the formats of the knowledge products and the potential implementers of the strategies. (AU)

Antibody Response 3 Months after 2 Doses of BNT162b2 mRNA COVID-19 Vaccine in Residents of Long-Term Care Facilities.

BACKGROUND: Older adults living in long-term care facilities (LTCFs) are at increased risk for severe outcomes from COVID-19 and were identified as a priority group in COVID-19 vaccination strategies. Emerging evidence suggests vaccine effectiveness in LTCF populations, but data about median and long-term durability of immune response after vaccination are still limited. OBJECTIVES: In this study, we assessed the humoral response to BNT162b2 mRNA COVID-19 vaccine 3 months after the second dose, in a cohort of 495 residents aged ≥65 years from 11 LTCF in Granada, Spain. METHOD: Between April 19 and April 30, 2021, we measured anti-SARS-CoV-2 Spike IgG to evaluate the humoral vaccination response. Antibody titers were reported in binding antibody units (BAU/mL). Bivariate and multivariate logistic regression models were performed to investigate the impact of age, sex, underlying health conditions, and prior COVID-19 infection on the antibody levels. RESULTS: Over 96% of the participants developed an adequate humoral response. We detected higher antibody titers in previously infected individuals, compared with those previously uninfected (B: 1,150.059 BAU/mL, p < 0.001). Moreover, we found a significant inverse association between age and antibody levels (B: -7.943 BAU/mL, p < 0.05). This negative age-dependent response was more noticeable among residents over 85 years old. In contrast, baseline health conditions and cognitive status were not associated with different antibody levels. CONCLUSIONS: These findings support monitoring COVID-19 vaccination response trend in older adults, in order to optimize future disease prevention and control strategies in this vulnerable population.

El uso de las mascarillas en la protección de las infecciones respiratorias: una revisión de revisiones / The use of masks to protect against respiratory infections: an umbrella review

Introducción: La emergencia sanitaria global causada por la actual pandemia de COVID-19 está suponiendo un enorme desafío a todos los niveles. El uso de la mascarilla puede reducir la propagación de la infección al minimizar la excreción de las gotitas de Flügge. Así, el objetivo de este trabajo es realizar una recopilación de la evidencia disponible sobre el uso de mascarillas en relación con las infecciones respiratorias. Metodología: Se realizó una revisión de revisiones sistemáticas (umbrella review). Dos revisores realizaron de forma independiente el proceso de cribado, la extracción y el análisis de datos. Las discrepancias fueron solventadas con un tercer revisor, y la evaluación del riesgo de sesgo de los trabajos se realizó mediante la herramienta AMSTAR-2. Para el proceso de cribado se utilizó el programa Rayyan QCRI. Resultados: Se incluyeron un total de 8 revisiones sistemáticas. Los estudios analizaron el uso en población general, en centros de cuidados de larga duración, centros hospitalarios, eventos masivos y compararon la efectividad para evitar las infecciones. Los resultados de esta revisión ponen de manifiesto que el uso de las mascarillas se asocia a un efecto protector frente a las infecciones respiratorias, tanto en los centros sanitarios como en los centros de cuidados de larga duración y en los eventos masivos. Conclusiones: A la luz de los resultados parece razonable recomendar el uso de las mascarillas a la población general, pero este uso debe venir acompañado de un plan de formación para mejorar el cumplimiento, ya que su uso inadecuado puede favorecer la infección.(AU)

Introduction: The global health emergency caused by the current COVID-19 pandemic is resulting in a huge challenge at all levels. The use of masks may reduce the spread of the infection by minimising the excretion of Flügge droplets. The objective of this study was to compile the evidence available on the use of masks in relation to respiratory infections. Methodology: An umbrella review (review of systematic reviews) was conducted. Two reviewers independently carried out the screening process, data extraction and data analysis. Discrepancies were resolved with a third reviewer, and the assessment of the risk of bias of the studies was carried out using the AMSTAR 2 tool. The Rayyan QCRI program was used for the screening process. Results: A total of eight systematic reviews were included. The studies analysed the use of masks in the general population, in long-term care facilities, in hospitals and at mass gatherings, and compared the effectiveness thereof in preventing infection. The results of this review revealed that the use of masks is associated with a protective effect against respiratory infections in healthcare facilities, in long-term care facilities and at mass gatherings. Conclusions: In light of the results, it seems reasonable to recommend the use of masks to the general population, but this use should be accompanied by a training programme to improve compliance, as not using them properly may increase the risk of infection.(AU)

The use of masks to protect against respiratory infections: An umbrella review.

INTRODUCTION: The global health emergency caused by the current COVID-19 pandemic is resulting in a huge challenge at all levels. The use of masks may reduce the spread of the infection by minimising the excretion of Flügge droplets. The objective of this study was to compile the evidence available on the use of masks in relation to respiratory infections. METHODOLOGY: An umbrella review (review of systematic reviews) was conducted. Two reviewers independently carried out the screening process, data extraction and data analysis. Discrepancies were resolved with a third reviewer, and the assessment of the risk of bias of the studies was carried out using the AMSTAR 2 tool. The Rayyan QCRI program was used for the screening process. RESULTS: A total of eight systematic reviews were included. The studies analysed the use of masks in the general population, in long-term care facilities, in hospitals and at mass gatherings, and compared the effectiveness thereof in preventing infection. The results of this review revealed that the use of masks is associated with a protective effect against respiratory infections in healthcare facilities, in long-term care facilities and at mass gatherings. CONCLUSIONS: In light of the results, it seems reasonable to recommend the use of masks to the general population, but this use should be accompanied by a training programme to improve compliance, as not using them properly may increase the risk of infection.

[COVID-19 and functional dependence: cohort study of an outbreak in a nursing home for elderly.] / COVID-19 y dependencia funcional: análisis de un brote en un centro sociosanitario de personas mayores.

OBJECTIVE: Older people have been severely affected by the COVID-19 pandemic. The aim of this study was to describe the main epidemiological findings of a COVID-19 outbreak occurred in March 2020 at a nursing home for elderly in Granada. Risk factors associated with the spread of the virus in the center were investigated. METHODS: A retrospective cohort study was conducted, collecting the most relevant clinical and epidemiological findings, occurred during the outbreak follow-up period (from 03/13/2020 to 06/20/2020). The association between the residents' health conditions (underlying diseases, level of physical dependence, level of cognitive impairment) and the risk of infection was estimated using multivariate Cox regression. RESULTS: 52 PCR-confirmed COVID-19 cases were identified among the residents and 50 cases among the employees of the nursing home. The epidemic curve was characteristic of a person to person transmission. Among residents with a higher level of physical dependence, according to the Barthel index score, a higher incidence of infection was detected, adjusting for age, sex and health conditions. At 55 days of exposure, moderately (RR 2.82), severely (RR 4.71) and completely (RR 3.49) dependent residents had between 2-4 times greater risk of infection than the minimally dependent residents (p<0.05). CONCLUSIONS: The epidemic curve supports the hypothesis of a cross-transmission of infections between residents and staff members of the nursing home. In the context of sustained transmission of the virus, physical dependence of the residents increases the risk of exposure to the virus, facilitating its spreading.

OBJETIVO: Los mayores institucionalizados han sido el grupo más afectado por la pandemia de COVID-19. El objetivo del presente estudio fue describir las principales características epidemiológicas de un brote de COVID-19, detectado en marzo 2020 en una residencia para mayores de Granada, e identificar los factores de riesgo asociados a la propagación del virus en el centro. METODOS: Estudio observacional de cohorte retrospectivo. Se describieron los principales aspectos clínicos y epidemiológicos registrados durante el período de seguimiento del brote (13/03/2020-20/06/2020). Mediante regresión de Cox multivariante se estimó la asociación entre las condiciones de salud de los residentes (enfermedades de base, nivel de dependencia física y deterioro cognitivo) y el riesgo de contraer la infección. RESULTADOS: Se encontraron 52 casos, confirmados mediante PCR, entre los residentes y 50 casos entre los trabajadores del centro. La curva epidémica fue compatible con un tipo de transmisión persona-persona. Se detectó una mayor incidencia de infección entre los residentes más dependientes, de acuerdo con la puntuación del Índice de Barthel, ajustando por edad, sexo y condiciones de salud. Los residentes con nivel de dependencia moderada (RR 2.82), grave (RR 4.71) y total (RR 3.49) tuvieron de 2 a 4 veces más riesgo de contraer la infección que aquellos con dependencia leve, a los 55 días de exposición (p<0,05). CONCLUSIONES: La curva epidémica orienta hacia la hipótesis de un fenómeno de transmisión cruzada trabajadores-residentes al origen del brote. En un contexto de elevada circulación del virus, el nivel de dependencia funcional de las personas institucionalizadas multiplica el riesgo de exposición al virus, facilitando su transmisión.

The use of masks to protect against respiratory infections: an umbrella review. / El uso de las mascarillas en la protección de las infecciones respiratorias: una revisión de revisiones.

INTRODUCTION: The global health emergency caused by the current COVID-19 pandemic is resulting in a huge challenge at all levels. The use of masks may reduce the spread of the infection by minimising the excretion of Flügge droplets. The objective of this study was to compile the evidence available on the use of masks in relation to respiratory infections. METHODOLOGY: An umbrella review (review of systematic reviews) was conducted. Two reviewers independently carried out the screening process, data extraction and data analysis. Discrepancies were resolved with a third reviewer, and the assessment of the risk of bias of the studies was carried out using the AMSTAR 2 tool. The Rayyan QCRI program was used for the screening process. RESULTS: A total of eight systematic reviews were included. The studies analysed the use of masks in the general population, in long-term care facilities, in hospitals and at mass gatherings, and compared the effectiveness thereof in preventing infection. The results of this review revealed that the use of masks is associated with a protective effect against respiratory infections in healthcare facilities, in long-term care facilities and at mass gatherings. CONCLUSIONS: In light of the results, it seems reasonable to recommend the use of masks to the general population, but this use should be accompanied by a training programme to improve compliance, as not using them properly may increase the risk of infection.

Vídeos como herramientas de diseminación y transferencia de conocimiento / Videos as tools for scientific dissemination and knowledge transfer

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La respuesta de Gaceta Sanitaria a la pandemia de COVID-19. Gestión rápida y transferencia / Gaceta Sanitaria’s response to the COVID-19 pandemic. Rapid management and transfer

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