Mortality due to COVID-19 in Spain and its association with environmental factors and determinants of health.

Background: The objective of this study was to identify which air pollutants, atmospheric variables and health determinants could influence COVID-19 mortality in Spain. This study used information from 41 of the 52 provinces in Spain (from Feb. 1, to May 31, 2021). Generalized Linear Models (GLM) with Poisson link were carried out for the provinces, using the Rate of Mortality due to COVID-19 (CM) per 1,000,000 inhabitants as dependent variables, and average daily concentrations of PM10 and NO2 as independent variables. Meteorological variables included maximum daily temperature (Tmax) and average daily absolute humidity (HA). The GLM model controlled for trend, seasonalities and the autoregressive character of the series. Days with lags were established. The relative risk (RR) was calculated by increases of 10 g/m3 in PM10 and NO2 and by 1 â„ƒ in the case of Tmax and 1 g/m3 in the case of HA. Later, a linear regression was carried out that included the social determinants of health. Results: Statistically significant associations were found between PM10, NO2 and the CM. These associations had a positive value. In the case of temperature and humidity, the associations had a negative value. PM10 being the variable that showed greater association, with the CM followed of NO2 in the majority of provinces. Anyone of the health determinants considered, could explain the differential geographic behavior. Conclusions: The role of PM10 is worth highlighting, as the chemical air pollutant for which there was a greater number of provinces in which it was associated with CM. The role of the meteorological variables-temperature and HA-was much less compared to that of the air pollutants. None of the social determinants we proposed could explain the heterogeneous geographical distribution identified in this study. Supplementary Information: The online version contains supplementary material available at 10.1186/s12302-022-00617-z.

Psychological distress in women and men living with HIV in Spain: a cross-sectional telephone survey.

BACKGROUND: Psychological distress includes a broader range of experiences, varying from less severe symptoms of depression and anxiety to severe psychiatric disease. Global estimates for depression and anxiety in 2017 were 3.4% and 3.8%, respectively. While for people living with HIV, global estimates were 16% and 33%, respectively. OBJECTIVE: We aimed to determine the prevalence of psychological distress by gender and associated characteristics in patients living with HIV. METHODS: A cross-sectional study was conducted within the Spanish HIV Research Network CoRIS. Participants were interviewed by telephone between 2010 and 2014 about their psychological distress, sociodemographics, drug consumption, self-perceived health and combined antiretroviral therapy (cART) adherence. Laboratory tests and medical history details were collected from CoRIS. Logistic regression was used to identify characteristics associated with psychological distress. FINDINGS: We interviewed 99 women and 464 men, both living with HIV. A greater proportion of women (51, 51.5%) reported psychological distress than men (179, 38.6%; p<0.01). Non-adherence to cART (OR 4.6 and 2.3, 95% CI 1.4‒15.1 and 1.3‒4.2) and non-use of cART (8.4 and 1.8, 2.2‒32.4 and 1.1‒2.8) were related to psychological distress in women and men, respectively. Spending little time in leisure-based physical activity was related to psychological distress in women (3.1, 1.1‒9.0). Living alone (2.0, 1.3‒3.0) and being unemployed (2.3, 1.4‒3.6) were related to psychological distress in men. CONCLUSIONS AND CLINICAL IMPLICATIONS: As people living with HIV have a high prevalence of psychological distress, their regular screening appointments should include psychological assessment. A gendered approach is needed to detect and manage psychological distress.

Analysis of extrapulmonary tuberculosis in Spain: 2007-2012 National Study / Análisis de la tuberculosis extrapulmonar en España: Estudio Nacional 2007-2012

INTRODUCTION: This study sought to study the epidemiological characteristics of the extrapulmonary tuberculosis (EPTB) in relation to pulmonary tuberculosis (PTB) from 2007 to 2012 in Spain, and plot its trend across the same period. METHODS: We conducted an analytical cross-sectional study in which the following variables were analysed: age; sex; disease site; history of antituberculosis treatment; country of birth; presence of HIV infection; and culture results. Age-related differences were ascertained using the test of comparison of proportions, and crude and adjusted ORs were calculated using linear regression models. RESULTS: Of the total of 44,050 cases of tuberculosis reported in the period 2007-2012 and included in the study, 31,508 (71.53%) were pulmonary tuberculosis and 12,542 (28.47%) were EPTB. EPTB rates decreased across all age groups. The main EPTB risk factor was presence of HIV infection (OR 1.39). Persons aged under 65 years had a lower risk of EPTB. CONCLUSIONS: Although persons aged over 65 years displayed the highest incidence, there was nevertheless a downward trend across all age groups. Whereas children showed a significant decrease in tuberculous meningitis, this was not so for all extrapulmonary forms. EPTB rates among persons born outside Spain were much higher than those among the Spanish population

INTRODUCCIÓN: Estudiamos las características epidemiológicas de la tuberculosis extrapulmonar (TBEP) en comparación con la tuberculosis pulmonar del 2007 al 2012 en España, y argumentamos las tendencias durante el mismo período. MÉTODOS: Realizamos un estudio transversal analítico en el cual analizamos las siguientes variables: edad, sexo, lugar de la tuberculosis, historia de tratamiento antituberculosis, país de nacimiento, presencia de infección por VIH y resultados de cultivo. Se realizó el test de comparación de proporciones para determinar los diferentes grupos de edad y calcular las OR brutas y ajustadas usando modelos de regresión lineal. RESULTADOS: De un total de 44,050 casos de tuberculosis reportados en el período 2007-2012 e incluidos en el estudio, 31,508 (71.53%) fueron tuberculosis pulmonar y 12,542 (28.47%) fueron TBEP. Las tasas de TBEP disminuyeron en todos los grupos de edad. El principal factor de riesgo para TBEP fue la presencia de infección por VIH (OR 1.39). El grupo de edad de menores de 65 años tuvo un menor riesgo de TBEP. CONCLUSIONES: Aunque las personas mayores de 65 años mostraron una mayor incidencia, en general en todos los grupos de edad hubo una tendencia al descenso. Mientras en los niños se observó un descenso significativo en la meningitis tuberculosa, dicha tendencia no se observó en el resto de las formas de tuberculosis extrapulmonar. La tasa de TBEP entre las personas nacidas fuera de España fue mucho mayor que entre las personas nacidas en España

Analysis of extrapulmonary tuberculosis in Spain: 2007-2012 National Study.

INTRODUCTION: This study sought to study the epidemiological characteristics of the extrapulmonary tuberculosis (EPTB) in relation to pulmonary tuberculosis (PTB) from 2007 to 2012 in Spain, and plot its trend across the same period. METHODS: We conducted an analytical cross-sectional study in which the following variables were analysed: age; sex; disease site; history of antituberculosis treatment; country of birth; presence of HIV infection; and culture results. Age-related differences were ascertained using the test of comparison of proportions, and crude and adjusted ORs were calculated using linear regression models. RESULTS: Of the total of 44,050 cases of tuberculosis reported in the period 2007-2012 and included in the study, 31,508 (71.53%) were pulmonary tuberculosis and 12,542 (28.47%) were EPTB. EPTB rates decreased across all age groups. The main EPTB risk factor was presence of HIV infection (OR 1.39). Persons aged under 65 years had a lower risk of EPTB. CONCLUSIONS: Although persons aged over 65 years displayed the highest incidence, there was nevertheless a downward trend across all age groups. Whereas children showed a significant decrease in tuberculous meningitis, this was not so for all extrapulmonary forms. EPTB rates among persons born outside Spain were much higher than those among the Spanish population.

[Prevalence of hepatitis B infection in children under 5 years old on indigenous communities of the Peruvian Amazonia after immunization interventions]. / Prevalencia de la infección por el virus de hepatitis B en niños menores de 5 años de comunidades indígenas de la Amazonía peruana posterior a intervenciones mediante inmunización.

OBJECTIVES: To determine the prevalence of hepatitis B virus (HVB) infection and seroprotection in indigenous children living in three draining basins of the Peruvian Amazon. MATERIALS AND METHODS: A cross sectional study was conducted in three draining basins (Pastaza, Morona and Lower Urubamba rivers), home to six indigenous populations: shapra, candoshi, machiguenga, yine, ashaninka and nanti. Children under 5 years were included. A survey and review of the vaccination card was applied, and a serum sample was processed with ELISA for HBsAg, total anti-HBc and anti-HBs was obtained, defining "seroprotected children" if they were reactive to anti-HBs and non-reactive to anti-HBc. RESULTS: A total of 742 children under 5 years old residents in six indigenous communities were included in the study. 380 (51.2%) were male and 169 (22.9%) one year old or younger. Regarding recorded HVB vaccination on the card, only 434 (58.5%) had received three doses; 208 (38.8%) received the first dose within 24 hours. No cases were detected with HBsAg. 88.8% of children had seroconverted, varying between 67-100% across the populations. CONCLUSIONS: No cases of chronic HBV infection were detected. The vaccination coverage by card revision is low, contrasting with high seroconversion rates.

Prevalencia de la infección por el virus de hepatitis B en niños menores de 5 años de comunidades indígenas de la Amazonía peruana posterior a intervenciones mediante inmunización / Prevalence of hepatitis B infection in children under 5 years old on indigenous communities of the peruvian Amazonia after immunization interventions

Objetivos. Determinar la prevalencia de infección y de sobreprotección para virus hepatitis B (HVB) en niños indígenas residentes en tres cuencas de la Amazonía peruana. Materiales y métodos. Se realizó un estudio transversal analítico en tres cuencas hidrográficas (ríos Pastaza, Morona y Bajo Urubamba), donde habitan seis pueblos indígenas: shapra, candoshi, machiguengas, yine, ashaninka y nanti. Se incluyeron niños menores de 5 años. Se aplicó una encuesta y revisión del carné de vacunación, y se obtuvo una muestra de suero que se procesó con la técnica de ELISA para detectar HBsAg, anti-HBc total y anti-HBs, definiendo “niños seroprotegidos” si fueron reactivos al anti-HBs y no reactivos al anti-HBc. Resultados. Se incluyó un total de 742 niños menores de 5 años residentes en seis comunidades indígenas, donde 380 (51,2%) eran varones y 169 (22,9%) de un año a menos. Sobre la vacunación contra HVB registrado por carné, solo 434 (58,5%) había recibido tres dosis; 208 (38,8%) recibieron la primera dosis en las primeras 24 h. No se detectaron casos con HBsAg. El 88,8% de los niños había seroconvertido, con variaciones según la población indígena entre 67 a 100% de seroconversión. Conclusiones. No se detectaron casos de infección crónica para HVB en la población evaluada. La cobertura de la vacunación mediante revisión del carné es baja en contraste el promedio de seroconversión que es alto.

Objectives. To determine the prevalence of hepatitis B virus (HVB) infection and seroprotection in indigenous children living in three draining basins of the Peruvian Amazon. Materials and methods. A cross sectional study was conducted in three draining basins (Pastaza, Morona and Lower Urubamba rivers), home to six indigenous populations: shapra, candoshi, machiguenga, yine, ashaninka and nanti. Children under 5 years were included. A survey and review of the vaccination card was applied, and a serum sample was processed with ELISA for HBsAg, total anti-HBc and anti-HBs was obtained, defining “seroprotected children” if they were reactive to anti-HBs and non-reactive to anti-HBc. Results. A total of 742 children under 5 years old residents in six indigenous communities were included in the study. 380 (51.2%) were male and 169 (22.9%) one year old or younger. Regarding recorded HVB vaccination on the card, only 434 (58.5%) had received three doses; 208 (38.8%) received the first dose within 24 hours. No cases were detected with HBsAg. 88.8% of children had seroconverted, varying between 67-100% across the populations. Conclusions. No cases of chronic HBV infection were detected. The vaccination coverage by card revision is low, contrasting with high seroconversion rates.