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2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1191-1196, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658515

RESUMO

The number of people living with HIV/AIDS (PLHIV), new HIV infections, and deaths due to HIV in China were estimated. These data provided evidences for the analysis on current HIV/AIDS epidemic in China, development of AIDS prevention and control strategies and public health education. However, whether the estimation results could be fully used in practice depends on appropriate interpretation. Since the differences in estimation methods and data to produce the estimates for each year, it is not suitable to directly use the estimation results of different years to conclude the HIV/AIDS epidemic trends. The 2018 estimation results indicated that the number of PLHIV is already beyond one million by the end of 2018 and would keep growing, causing much pressure of for HIV/AIDS prevention and control. With the increased burden of case management, innovative strategies are needed to reduce secondary transmission of HIV and control the aggravating spread to general population. Less than 70%, which is significantly lower than the goal of China's 13th Five-year Action plan for AIDS prevention and control. All local governments have the necessity of analyzing percentage of PLHIV who know their status, to conduct targeted strategies and measures for the improvement of HIV case finding. New HIV infection is the core indicator for HIV epidemic evaluation. The number of estimated new HIV infections is around 80 000 in 2018. It is necessary to further improve the strategy and increase the intensity to effectively reduce the new infection of HIV.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Epidemias , Infecções por HIV/epidemiologia , Síndrome de Imunodeficiência Adquirida/prevenção & controle , China/epidemiologia , Infecções por HIV/prevenção & controle , Humanos
3.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(10): 1007-1011, 2019 Oct 06.
Artigo em Chinês | MEDLINE | ID: mdl-31607046

RESUMO

Objective: We planned to evaluate the effectiveness of moving epidemic method (MEM) in calculating influenza epidemic threshold of 7 climatic zones in China mainland. Methods: The positive rate of influenza virus was obtained from the National Influenza Surveillance Network System from 2010/2011 to 2017/2018. We divided the 31 provinces into 7 climatic zones according to previous literatures and applied MEM to calculate the influenza epidemic threshold of 2018/2019 influenza season for these climatic zones. Sensitivity, specificity, positive predictive value and negative predictive value were calculated to evaluate the effectiveness of MEM. Results: Pre-epidemic threshold (the positive rate of influenza virus) varied from 9.66% (temperate zone) to 16.36% (subtropical zone) for 2018/2019 influenza season. The gap between pre-epidemic and post-epidemic thresholds was less than 5% except for plateau zone. The sensitivity was 86.16% (95CI:66.81%-98.23%), the specificity was 94.92% (95CI: 91.13%-98.41%), the positive predictive value was 89.87% (95%CI: 84.39%-94.38%), the negative predictive value was 92.96% (95%CI: 84.46%-99.17%). Conclusion: Overall, moving epidemic Method performs well in calculating influenza epidemic threshold in China, much better than the previous study.


Assuntos
Epidemias , Influenza Humana/epidemiologia , Orthomyxoviridae , China/epidemiologia , Clima , Humanos , Sensibilidade e Especificidade
4.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(10): 1066-1070, 2019 Oct 06.
Artigo em Chinês | MEDLINE | ID: mdl-31607058

RESUMO

Influenza is an acute respiratory infection that seriously harms the world and public health. Because influenza viruses are prone to mutations and difficult to predict, the World Health Organization has been promoting global continuous strengthening of influenza surveillance to monitor the level of influenza activity and epidemic trends in real time. Establishing baselines and thresholds for influenza epidemic helps to gauge the start and severity of influenza seasons. At present, there are various methods for calculating baseline and threshold, such as annual median value, percentile approach, moving epidemic method, and control chart method. This paper will summarize the methods of establishing influenza baseline or threshold at home and abroad, and hope to provide reference for the establishment of baseline or threshold of influenza in China.


Assuntos
Epidemias , Influenza Humana/epidemiologia , China/epidemiologia , Humanos , Estações do Ano , Organização Mundial da Saúde
5.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1164-1167, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31594166

RESUMO

Objective: To construct Bayes discriminant function for clinical classification of common and severe Japanese encephalitis (JE) cases, and to identify cases accurately with quantitative indicators. Methods: Samples of confirmed common and severe JE cases reported by the epidemic surveillance system of Gansu Provincial Center for Disease Control and Prevention from 2005 to 2017 were collected. Non-conditional logistic regression analysis and Bayes stepwise discriminant analysis were used to screen meaningful clinical indicators, so as to construct and evaluate Bayes discriminant function. Results: There were 256 common JE cases and 257 severe JE cases. There were no significant differences in sex, age and occupation distributions between the two groups (P>0.05) and there was significant difference in case fatality rate (P<0.05). Non-conditional logistic regression analysis and Bayes stepwise discriminant analysis, combined with using related literature, to screen 11 clinical indicators for the construction of Bayes discriminant function. Interactive validation showed that the sensitivity of discriminant function was 71.48% (95%CI: 65.53%-76.93%) and the specificity was 73.93% (95%CI: 68.11%-79.19%). The area under ROC curve was 0.761 (95%CI: 0.720-0.803) and the total accuracy rate was 72.71%. Conclusion: Bayes discriminant function can be used to identify common and severe JE cases more accurately, which is helpful for the reasonable treatment and good prognosis of JE patients.


Assuntos
Análise Discriminante , Encefalite Japonesa/diagnóstico , Epidemias , Teorema de Bayes , Encefalite Japonesa/epidemiologia , Humanos , Curva ROC
6.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(4): 393-399, 2019 Sep 25.
Artigo em Chinês | MEDLINE | ID: mdl-31612674

RESUMO

OBJECTIVE: To explore the spatial and temporal distribution characteristics of cases with newly diagnosed echinococcosis in Sichuan Province from 2007 to 2017, so as to provide reference for the formulation of echinococcosis prevention and control strategies and for the identification of key areas. METHODS: The spatial distribution maps of detection of cases with newly diagnosed echinococcosis were plotted in Sichuan Province from 2007 to 2017, and the spatial distribution characteristics and epidemic trends were analyzed. RESULTS: From 2007 to 2017, the detection rate of cases with newly diagnosed echinococcosis appeared a decline in Sichuan Province year by year, and the areas with a high detection rate of cases with newly diagnosed echinococcosis were mainly located in western, northwestern and northern parts of Sichuan Province, while the areas with a low detection rate were predominantly found in the southern and eastern parts of the province. The global Moran's I values were 0.19, 0.22, 0.17, 0.44, 0.48, 0.31 and 0.16 for the detection rate of cases with newly diagnosed echinococcosis in Sichuan Province from 2010 to 2016 (all Z scores > 1.96, all P values < 0.05), suggesting spatial aggregation distribution during this period. Local spatial autocorrelation analysis revealed that the"high-high"areas and"low-low"areas for the detection rate of cases with newly diagnosed echinococcosis all showed an aggregation tendency. CONCLUSIONS: The detection rate of cases with newly diagnosed echinococcosis decreases in Sichuan Province from 2007 to 2017 year by year, and shows a spatial aggregation. The echinococcosis control activities should be intensified in Shiqu, Seda, Dege, Ganzi and Baiyu counties.


Assuntos
Equinococose , Análise Espaço-Temporal , China/epidemiologia , Equinococose/diagnóstico , Equinococose/epidemiologia , Equinococose/prevenção & controle , Epidemias , Humanos , Fatores de Tempo
7.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(4): 418-422, 2019 Jul 24.
Artigo em Chinês | MEDLINE | ID: mdl-31612679

RESUMO

OBJECTIVE: To understand Leishmania infections among employees of China Petroleum First Construction Corporation returning from Uzbekistan, and take timely actions to prevent the spread of the epidemic. METHODS: Questionnaire survey was conducted to collect screening subjects'information. Palpation of the liver, spleen and superficial lymph nodes was performed by a physician, and the lesions on the frequently exposed skin were detected by a dermatologist. In addition, the liver and spleen sizes were measured using B-mode ultrasonography, and serum samples were collected to be subjected to an rK39-based rapid diagnostic test for detection of visceral leishmaniasis. Leishmania was detected using microscopy in the specimens sampled from the lesioned skin, and the parasites species was identified using molecular assays in parasitologically positive specimens. RESULTS: Among the 181 employees screened, enlarged cervical lymph nodes were palpable in 6 subjects, and skin lesions were found in 12 cases. B-mode ultrasonography displayed hepatosplenomegaly in 5 cases, and rK39 test were positive in 3 serum samples. Two classical lesioned skin specimens were sampled, and Leishmania was detected in one specimen. The promastigote DNA was extracted and two fragments of 120 bp and 350 bp in sizes were amplified using PCR assay with K13A/K13B and L5.8S/LITSR primers specific to Leishmania. The two amplification products were 90% and 98% homologous to the corresponding sequences of L. major (GenBank accession numbers: EU370906.1 and FN677342.1). CONCLUSIONS: Six patients with cutaneous leishmaniasis were screened, including 2 uncured cases. One uncured case was diagnosed as imported cutaneous leishmaniasis caused by L. major infection.


Assuntos
Doenças Transmissíveis Importadas , Leishmania , Leishmaniose Cutânea , China/epidemiologia , Doenças Transmissíveis Importadas/diagnóstico , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/parasitologia , DNA de Protozoário , Epidemias , Humanos , Leishmania/genética , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/epidemiologia , Fígado/diagnóstico por imagem , Linfonodos/patologia , Reação em Cadeia da Polimerase , Baço/diagnóstico por imagem , Inquéritos e Questionários , Ultrassonografia , Uzbequistão
8.
Vet Clin North Am Food Anim Pract ; 35(3): 593-604, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31590904

RESUMO

Herd immunity is an important concept of epidemic theory regarding the population-level effect of individual immunity to prevent transmission of pathogens. Herd immunity exists when sufficient numbers of animals in a group or population have immunity against an agent such that the likelihood of an effective contact between diseased and susceptible individuals is reduced. Understanding herd immunity requires consideration of infection dynamics, modes of transmission, as well as the acquisition of immunity by individuals in the population. Loss of herd immunity may also explain age-associated epidemics of disease related to loss of passively acquired maternal immunity.


Assuntos
Imunidade Coletiva , Animais , Epidemias/prevenção & controle , Humanos , Vacinação/métodos , Vacinação/veterinária
9.
Rev Soc Bras Med Trop ; 52: e20190167, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31596350

RESUMO

INTRODUCTION: The aim of this study was to characterize the clinical-epidemiological profile of Chikungunya virus infection and the factors associated with hospitalization during the peak of the most recent epidemic period in Brazil (2016-2017). METHODS: Two official databases of the State Health Secretariat of Ceará were used, and a total of 182,731 notifications were analyzed. RESULTS: Independent factors associated with hospital admission were chronic kidney disease (OR 4.56, 95% CI 3.36-6.17), hypertension (OR 1.90, 95% CI 1.69-2.14), leukopenia (OR 1.89, 95% CI 1.56-2.30) and diabetes mellitus (OR 1.70, 95% CI 1.44-1.99). CONCLUSIONS: The pre-existing comorbidities have shown the potential to destabilize the patients' clinical status.


Assuntos
Febre de Chikungunya/epidemiologia , Epidemias , Adolescente , Adulto , Brasil/epidemiologia , Febre de Chikungunya/complicações , Comorbidade , Estudos Transversais , Escolaridade , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
10.
J Opioid Manag ; 15(4): 295-306, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31637682

RESUMO

OBJECTIVE: To understand the needs of Emergency Medical Service (EMS) providers caring for substance users in an urban setting. DESIGN: Qualitative interviews with EMS providers regarding perceptions of substance users and treatment programs. SETTING: Baltimore City. PARTICIPANTS: Twenty-two Baltimore City Fire Department EMS providers. INTERVENTIONS: Semistructured in-depth interviews were conducted with 22 EMS providers. Topics included experiences caring for substance-using patients and attitudes about local harm reduction approaches. MAIN OUTCOME MEASURE: Providers were asked their views on receiving training to deliver a brief motivational intervention to encourage patients to enter drug treatment. Interviews were transcribed and analyzed using constant comparison. RESULTS: Participants were mostly Male (68.2 percent), White (66.6 percent), and had Advanced Life Skills training (90.9 percent). Mean experience was 8.7 years. Many providers described EMS misusers as mostly male and middle-aged, although there were variations in substance use patterns among all races and income levels. Most stated that repeated care provision to a small number of substance-users negatively impacted care quality. Provider demands included departmental policies and resource limitations. Many expressed willingness to deliver motivational messages to substance-using patients to consider drug treatment. Other stated that behavioral interventions were beyond their job duties and most reported having little-to-no knowledge of local treatment programs. CONCLUSIONS: EMS providers may be uniquely positioned to deliver substance use treatment messages to substance users. This could be a life- and cost-saving improvement to EMS in Baltimore City with incentivized training. More research is needed to inform opioid use preparedness in urban settings, which remain at the center of the opioid epidemic.


Assuntos
Analgésicos Opioides , Serviços Médicos de Emergência , Auxiliares de Emergência/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias , Adulto , Baltimore , Serviços Médicos de Emergência/estatística & dados numéricos , Epidemias , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
15.
BMJ ; 366: l5021, 2019 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-31506273

RESUMO

Human respiratory syncytial virus (RSV) belongs to the recently defined Pneumoviridae family, Orthopneumovirus genus. It is a negative sense, single stranded RNA virus that results in epidemics of respiratory infections that typically peak in the winter in temperate climates and during the rainy season in tropical climates. Generally, one of the two genotypes (A and B) predominates in a single season, alternating annually, although regional variation occurs. RSV is a cause of disease and death in children, older people, and immunocompromised patients, and its clinical effect on adults admitted to hospital is clarified with expanded use of multiplex molecular assays. Among adults, RSV produces a wide range of clinical symptoms including upper respiratory tract infections, severe lower respiratory tract infections, and exacerbations of underlying disease. Here we discuss the latest evidence on the burden of RSV related disease in adults, especially in those with immunocompromise or other comorbidities. We review current therapeutic and prevention options, as well as those in development.


Assuntos
Carga Global da Doença , Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sinciciais Respiratórios/genética , Infecções Respiratórias/epidemiologia , Adulto , Antivirais/uso terapêutico , Epidemias , Genótipo , Humanos , Hospedeiro Imunocomprometido , Imunoglobulinas Intravenosas/uso terapêutico , Infecções por Vírus Respiratório Sincicial/imunologia , Infecções por Vírus Respiratório Sincicial/terapia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sinciciais Respiratórios/patogenicidade , Infecções Respiratórias/imunologia , Infecções Respiratórias/terapia , Infecções Respiratórias/virologia , Ribavirina/uso terapêutico , Estações do Ano
17.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46770

RESUMO

O sarampo é uma doença viral aguda, infecto-contagiosa, altamente transmissível que atinge com mais severidade populações de baixo nível sócio-econômico.


Assuntos
Sarampo , Epidemias , Programas de Imunização , Vacina contra Sarampo , Vacina contra Sarampo-Caxumba-Rubéola
18.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46761

RESUMO

Sarampo é uma doença infecciosa grave, causada por um vírus, que pode ser fatal. Sua transmissão ocorre quando o doente tosse, fala, espirra ou respira próximo de outras pessoas. A única maneira de evitar o sarampo é pela vacina.


Assuntos
Sarampo , Vacina contra Sarampo , Epidemias , Sistema Único de Saúde
19.
MMWR Morb Mortal Wkly Rep ; 68(31): 679-686, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31393863

RESUMO

BACKGROUND: The CDC Guideline for Prescribing Opioids for Chronic Pain recommends considering prescribing naloxone when factors that increase risk for overdose are present (e.g., history of overdose or substance use disorder, opioid dosages ≥50 morphine milligram equivalents per day [high-dose], and concurrent use of benzodiazepines). In light of the high numbers of drug overdose deaths involving opioids, 36% of which in 2017 involved prescription opioids, improving access to naloxone is a public health priority. CDC examined trends and characteristics of naloxone dispensing from retail pharmacies at the national and county levels in the United States. METHODS: CDC analyzed 2012-2018 retail pharmacy data from IQVIA, a health care, data science, and technology company, to assess U.S. naloxone dispensing by U.S. Census region, urban/rural status, prescriber specialty, and recipient characteristics, including age group, sex, out-of-pocket costs, and method of payment. Factors associated with naloxone dispensing at the county level also were examined. RESULTS: The number of naloxone prescriptions dispensed from retail pharmacies increased substantially from 2012 to 2018, including a 106% increase from 2017 to 2018 alone. Nationally, in 2018, one naloxone prescription was dispensed for every 69 high-dose opioid prescriptions. Substantial regional variation in naloxone dispensing was found, including a twenty-fivefold variation across counties, with lowest rates in the most rural counties. A wide variation was also noted by prescriber specialty. Compared with naloxone prescriptions paid for with Medicaid and commercial insurance, a larger percentage of prescriptions paid for with Medicare required out-of-pocket costs. CONCLUSION: Despite substantial increases in naloxone dispensing, the rate of naloxone prescriptions dispensed per high-dose opioid prescription remains low, and overall naloxone dispensing varies substantially across the country. Naloxone distribution is an important component of the public health response to the opioid overdose epidemic. Health care providers can prescribe or dispense naloxone when overdose risk factors are present and counsel patients on how to use it. Efforts to improve naloxone access and distribution work most effectively with efforts to improve opioid prescribing, implement other harm-reduction strategies, promote linkage to medications for opioid use disorder treatment, and enhance public health and public safety partnerships.


Assuntos
Naloxona/uso terapêutico , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Farmácias/estatística & dados numéricos , Prescrições/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Overdose de Drogas/mortalidade , Overdose de Drogas/prevenção & controle , Epidemias/prevenção & controle , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
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