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1.
F1000Res ; 10: 88, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33680432

RESUMO

Background: The purpose of the study was to compare  trends in the progression of COVID-19 among South Asian countries with more developed Western countries. Methods: COVID-19 data from South Asian countries were used for this observational study. Data were taken up to April 21, 2020 from the outbreak of the COVID-19. Four of the seven countries met the inclusion criteria and were included in the analysis. Results: An exponential increase in the average number of weekly cases was reported after the fifth week following the first case. The correlation between reported cases and tests was found to be strong and significant (r=0.90, p=0.037). However, on average, 315.25 tests per million population were performed, which was at least 12 times lower than the number of tests performed in countries with a large number of COVID-19 cases. Conclusions: At present, the number of confirmed cases from South Asia was found to be significantly lower than in Western countries. However, this could be due to the smaller number of tests performed. Hence, an increase in the strength of performing diagnostic tests is highly recommended. Strict measures are required to make the people of these countries follow the instructions of social distancing and comply with preventive measures.


Assuntos
/epidemiologia , Notificação de Doenças/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Ásia/epidemiologia , Humanos
2.
Artigo em Inglês | MEDLINE | ID: mdl-33530563

RESUMO

BACKGROUND: Potential unreported infection might impair and mislead policymaking for COVID-19, and the contemporary spread of COVID-19 varies in different counties of the United States. It is necessary to estimate the cases that might be underestimated based on county-level data, to take better countermeasures against COVID-19. We suggested taking time-varying Susceptible-Infected-Recovered (SIR) models with unreported infection rates (UIR) to estimate factual COVID-19 cases in the United States. METHODS: Both the SIR model integrated with unreported infection rates (SIRu) of fixed-time effect and SIRu with time-varying parameters (tvSIRu) were applied to estimate and compare the values of transmission rate (TR), UIR, and infection fatality rate (IFR) based on US county-level COVID-19 data. RESULTS: Based on the US county-level COVID-19 data from 22 January (T1) to 20 August (T212) in 2020, SIRu was first tested and verified by Ordinary Least Squares (OLS) regression. Further regression of SIRu at the county-level showed that the average values of TR, UIR, and IFR were 0.034%, 19.5%, and 0.51% respectively. The ranges of TR, UIR, and IFR for all states ranged from 0.007-0.157 (mean = 0.048), 7.31-185.6 (mean = 38.89), and 0.04-2.22% (mean = 0.22%). Among the time-varying TR equations, the power function showed better fitness, which indicated a decline in TR decreasing from 227.58 (T1) to 0.022 (T212). The general equation of tvSIRu showed that both the UIR and IFR were gradually increasing, wherein, the estimated value of UIR was 9.1 (95%CI 5.7-14.0) and IFR was 0.70% (95%CI 0.52-0.95%) at T212. INTERPRETATION: Despite the declining trend in TR and IFR, the UIR of COVID-19 in the United States is still on the rise, which, it was assumed would decrease with sufficient tests or improved countersues. The US medical system might be largely affected by severe cases amidst a rapid spread of COVID-19.


Assuntos
Notificação de Doenças , /epidemiologia , Notificação de Doenças/estatística & dados numéricos , Humanos , Modelos Estatísticos , Análise de Regressão , Estados Unidos/epidemiologia
3.
Scand J Public Health ; 49(1): 48-56, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33406993

RESUMO

Aim: Research concerning COVID-19 among immigrants is limited. We present epidemiological data for all notified cases of COVID-19 among the 17 largest immigrant groups in Norway, and related hospitalizations and mortality. Methods: We used data on all notified COVID-19 cases in Norway up to 18 October 2020, and associated hospitalizations and mortality, from the emergency preparedness register (including Norwegian Surveillance System for Communicable Diseases) set up by The Norwegian Institute of Public Health to handle the pandemic. We report numbers and rates per 100,000 people for notified COVID-19 cases, and related hospitalizations and mortality in the 17 largest immigrant groups in Norway, crude and with age adjustment. Results: The notification, hospitalization and mortality rates per 100,000 were 251, 21 and five, respectively, for non-immigrants; 567, 62 and four among immigrants; 408, 27 and two, respectively, for immigrants from Europe, North-America and Oceania; and 773, 106 and six, respectively for immigrants from Africa, Asia and South America. The notification rate was highest among immigrants from Somalia (2057), Pakistan (1868) and Iraq (1616). Differences between immigrants and non-immigrants increased when adjusting for age, especially for mortality. Immigrants had a high number of hospitalizations relative to notified cases compared to non-immigrants. Although the overall COVID-19 notification rate was higher in Oslo than outside of Oslo, the notification rate among immigrants compared to non-immigrants was not higher in Oslo than outside. Conclusions: We observed a higher COVID-19 notification rate in immigrants compared to non-immigrants and much higher hospitalization rate, with major differences between different immigrant groups. Somali-, Pakistani- and Iraqi-born immigrants had especially high rates.


Assuntos
/epidemiologia , Notificação de Doenças/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Sistema de Registros , Adulto Jovem
4.
BMC Infect Dis ; 21(1): 91, 2021 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-33478414

RESUMO

BACKGROUND: Informed decision making is underlined by all tiers in the health system. Poor data record system coupled with under- (over)-reporting of malaria cases affects the country's malaria elimination activities. Thus, malaria data at health facilities and health offices are important particularly to monitor and evaluate the elimination progresses. This study was intended to assess overall reported malaria cases, reporting quality, spatiotemporal trends and factors associated in Gedeo zone, South Ethiopia. METHODS: Past 8 years retrospective data stored in 17 health centers and 5 district health offices in Gedeo Zone, South Ethiopia were extracted. Malaria cases data at each health center with sociodemographic information, between January 2012 and December 2019, were included. Meteorological data were obtained from the national meteorology agency of Ethiopia. The data were analyzed using Stata 13. RESULTS: A total of 485,414 suspected cases were examined for malaria during the previous 8 years at health centers. Of these suspects, 57,228 (11.79%) were confirmed malaria cases with an overall decline during the 8-year period. We noted that 3758 suspected cases and 467 confirmed malaria cases were not captured at the health offices. Based on the health centers records, the proportions of Plasmodium falciparum (49.74%) and P. vivax (47.59%) infection were nearly equivalent (p = 0.795). The former was higher at low altitudes while the latter was higher at higher altitudes. The over 15 years of age group accounted for 11.47% of confirmed malaria cases (p < 0.001). There was high spatiotemporal variation: the highest case record was during Belg (12.52%) and in Dilla town (18,150, 13.17%, p < 0.001) which is located at low altitude. Monthly rainfall and minimum temperature exhibited strong associations with confirmed malaria cases. CONCLUSION: A notable overall decline in malaria cases was observed during the eight-year period. Both P. falciparum and P. vivax were found at equivalent endemicity level; hence control measures should continue targeting both species. The noticed under reporting, the high malaria burden in urban settings, low altitudes and Belg season need spatiotemporal consideration by the elimination program.


Assuntos
Malária/epidemiologia , Altitude , Demografia , Notificação de Doenças/normas , Notificação de Doenças/estatística & dados numéricos , Etiópia/epidemiologia , Feminino , Humanos , Malária/diagnóstico , Malária/parasitologia , Malária/prevenção & controle , Masculino , Meteorologia , Análise Multivariada , Plasmodium falciparum/isolamento & purificação , Plasmodium vivax/isolamento & purificação , Prevalência , Estudos Retrospectivos , Estações do Ano
5.
Rev. enferm. UERJ ; 28: e50487, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1145487

RESUMO

Objetivo: analisar a ocorrência de sífilis gestacional e congênita à luz da vulnerabilidade, no período de 2008 a 2018, no Mato Grosso do Sul. Método: estudo transversal, retrospectivo, de caráter analítico e abordagem quantitativa, com base em dados secundários coletados no Sistema de Informações e Agravos de Notificação. Resultados: houve aumento progressivo de sífilis gestacional e congênita ao longo dos 11 anos, com predomínio em populações vulneráveis e associação (p< 0.05) da ocorrência de sífilis congênita com as variáveis "escolaridade", "faixa etária" e "cor da pele". Verificou-se a influência de fatores comportamentais e relacionados aos serviços de saúde, dentre eles o diagnóstico tardio da sífilis e a baixa adesão do tratamento entre estas gestantes e seus parceiros sexuais. Conclusão: a sífilis gestacional e congênita tiveram causas multifatoriais e podem ser combatidas com ações em saúde que considerem os aspectos que potencializam a vulnerabilidade social, individual e programática da população.


Objective: to examine the occurrence of gestational and congenital syphilis in the light of vulnerability in Mato Grosso do Sul, from 2008 to 2018. Method: this retrospective, analytical, quantitative, cross-sectional study was based on secondary data collected from Brazil's Notifiable Disease Information System. Results: gestational and congenital syphilis increased steadily over the eleven years, predominantly in vulnerable groups. The occurrence of congenital syphilis was found to associate (p < 0.05) with the variables "education", "age group" and "skin color". Behavioral and health service-related factors ­ among them, late diagnosis of syphilis and poor treatment adherence by pregnant women and their sexual partners ­ were found to influence the association. Conclusion: gestational and congenital syphilis had multifactorial causes and can be combated with health measures that address aspects that heighten this population's social, individual and programmatic vulnerability.


Objetivo: examinar la ocurrencia de sífilis gestacional y congénita a la luz de la vulnerabilidad en Mato Grosso do Sul, de 2008 a 2018. Método: este estudio retrospectivo, analítico, cuantitativo y transversal se basó en datos secundarios recopilados del Sistema de Información de Enfermedades Notificables de Brasil. Resultados: la sífilis gestacional y congénita aumentó de manera sostenida durante los once años, predominantemente en grupos vulnerables. Se encontró que la ocurrencia de sífilis congénita se asocia (p < 0.05) con las variables "educación", "grupo de edad" y "color de piel". Se encontró que factores relacionados con el comportamiento y los servicios de salud, entre ellos, el diagnóstico tardío de la sífilis y la mala adherencia al tratamiento por parte de las mujeres embarazadas y sus parejas sexuales, influyen en la asociación. Conclusión: la sífilis gestacional y congénita tuvo causas multifactoriales y se puede combatir con medidas de salud que aborden aspectos que aumentan la vulnerabilidad social, individual y programática de esta población.


Assuntos
Humanos , Feminino , Gravidez , Criança , Adolescente , Adulto , Adulto Jovem , Sífilis Congênita/epidemiologia , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Vulnerabilidade em Saúde , Cuidado Pré-Natal , Sífilis Congênita/prevenção & controle , Brasil/epidemiologia , Incidência , Prevalência , Estudos Transversais , Notificação de Doenças/estatística & dados numéricos , Saúde Materna , Serviços de Saúde Materna
6.
Euro Surveill ; 25(46)2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33213683

RESUMO

The COVID-19 pandemic negatively impacted the 2019/20 WHO European Region influenza surveillance. Compared with previous 4-year averages, antigenic and genetic characterisations decreased by 17% (3,140 vs 2,601) and 24% (4,474 vs 3,403). Of subtyped influenza A viruses, 56% (26,477/47,357) were A(H1)pdm09, 44% (20,880/47,357) A(H3). Of characterised B viruses, 98% (4,585/4,679) were B/Victoria. Considerable numbers of viruses antigenically differed from northern hemisphere vaccine components. In 2020/21, maintaining influenza virological surveillance, while supporting SARS-CoV-2 surveillance is crucial.


Assuntos
Infecções por Coronavirus/epidemiologia , Notificação de Doenças/estatística & dados numéricos , Monitoramento Epidemiológico , Vírus da Influenza A/isolamento & purificação , Vírus da Influenza B/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Antígenos Virais/genética , Betacoronavirus , Humanos , Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vírus da Influenza A Subtipo H3N2/genética , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Vírus da Influenza A/genética , Vírus da Influenza B/genética , Pandemias , Pneumonia Viral , Vigilância da População , RNA Viral/genética , Análise de Sequência de DNA
7.
PLoS One ; 15(10): e0239569, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33002036

RESUMO

We provide results on the level of COVID-19 excess mortality in the Italian region of Lombardy and in the province of Bergamo using official and original data sources. Since February 2020 Lombardy and in particular the province of Bergamo have been severely hit by the novel COVID-19 infectious disease. Combining official statistics, retrospective data and original data (i.e., obituaries and death notices) we provide a tentative estimate of the number of deaths either directly or indirectly, associated with COVID-19 as well as the total number of persons infected. Our findings suggest that the reported number of deaths attributable to COVID-19 identified by public authorities accounts only for one half of the observed excess mortality between March 2020 and previous years.


Assuntos
Infecções por Coronavirus/mortalidade , Notificação de Doenças/estatística & dados numéricos , Mortalidade/tendências , Pneumonia Viral/mortalidade , Adolescente , Adulto , Idoso , Betacoronavirus , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Adulto Jovem
8.
Rev Bras Epidemiol ; 23: e200103, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33053094

RESUMO

OBJECTIVE: To analyze how syphilis detection rates evolved from 2011 to 2017 according to sex, age and place of residence in the state of São Paulo. METHODS: A historical series was organized with data from the Notification Disease Information System. The acquired syphilis detection rates (ASDR) per 100,000 inhabitants and the acquired syphilis detection rates including pregnant women with syphilis (PASDR) per 100,000 inhabitants were described. For a trend analysis of the rates in the studied period, the Poisson Jointpoint (inflection point) model was performed, and the annual percentage change (APC) per segment and the average annual percentage change (AAPC) were estimated, with respective 95% confidence intervals (95%CI). RESULTS: A total of 205,424 cases of acquired syphilis and syphilis in pregnant women in the period were reported. The ASDR per 100,000 inhabitants ranged from 26.0 to 84.6 between 2011 and 2017 and the PASDR per 100,000 inhabitants ranged from 33.7 to 108.9; the trend was increasing in both, and an inflection point was identified dividing the ASDR and PASDR curve into two periods: 2011 to 2013 and 2013 to 2017: the AAPC found for ASDR was 21.0% (95%CI 15.5 ‒ 26.4) and the PASDR was 21.2% (95%CI 16.4 ‒ 26.1), in the age groups up to 24 years old, there was a significant growth in both sexes. A heterogeneity in the evolution of rates by region of the state was observed between 2011 and 2017. CONCLUSIONS: The increasing trend in acquired syphilis detection rates can be attributed to better adherence to notification and disproportionate involvement of young people.


Assuntos
Notificação de Doenças/estatística & dados numéricos , Sorodiagnóstico da Sífilis/estatística & dados numéricos , Sífilis/epidemiologia , Treponema pallidum/isolamento & purificação , Adolescente , Adulto , Brasil/epidemiologia , Feminino , Humanos , Masculino , Gravidez , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-33087023

RESUMO

Nationally, there was a continuing downward trend in notifications of COVID-19. The daily average number of cases for this reporting period was 14 compared to an average of 23 cases per day in the previous fortnight. There were 192 cases of COVID-19 and 23 deaths this fortnight, bringing the cumulative case count to 27,344 and 898 deaths. While the majority of cases in this reporting period were from Victoria (60%; 116/192), there continues to be a decrease in cases in this state resulting from public health interventions. During this fortnight, 66% (127/192) of all cases were reported as locally acquired, with the majority reported from Victoria (108/127). The highest proportion of overseas-acquired cases was reported in New South Wales (75%; 38/51), followed by Western Australia (22%; 11/51). Although testing rates declined, they remain high overall at 9.2 tests per week per 1,000 persons. There was variability in the testing rate by jurisdiction, with testing rates depending on the epidemic context. The overall positivity rate for the reporting period was 0.05%, with Victoria reporting a positivity rate of 0.08% for this reporting period. In all other jurisdictions the positivity rate was ≤ 0.06%.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/epidemiologia , Notificação de Doenças/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Vigilância da População/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Criança , Pré-Escolar , Feminino , Variação Genética , Genoma Viral , Genômica , Saúde Global , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores de Tempo , Adulto Jovem
11.
BMC Public Health ; 20(1): 1284, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32843011

RESUMO

BACKGROUND: China has always been one of the countries with the most serious Tuberculosis epidemic in the world. Our study was to observe the Spatial-temporal characteristics and the epidemiology of Tuberculosis in China from 2004 to 2017 with Joinpoint regression analysis, Seasonal Autoregressive integrated moving average (SARIMA) model, geographic cluster, and multivariate time series model. METHODS: The data of TB from January 2004 to December 2017 were obtained from the notifiable infectious disease reporting system supplied by the Chinese Center for Disease Control and Prevention. The incidence trend of TB was observed by the Joinpoint regression analysis. The Seasonal autoregressive integrated moving average (SARIMA) model was used to predict the monthly incidence. Geographic clusters was employed to analyze the spatial autocorrelation. The relative importance component of TB was detected by the multivariate time series model. RESULTS: We included 13,991,850 TB cases from January 2004 to December 2017, with a yearly average morbidity of 999,417 cases. The final selected model was the 0 Joinpoint model (P = 0.0001) with an annual average percent change (AAPC) of - 3.3 (95% CI: - 4.3 to - 2.2, P < 0.001). A seasonality was observed across the 14 years, and the seasonal peaks were in January and March every year. The best SARIMA model was (0, 1, 1) X (0, 1, 1)12 which can be written as (1-B) (1-B12) Xt = (1-0.42349B) (1-0.43338B12) εt, with a minimum AIC (880.5) and SBC (886.4). The predicted value and the original incidence data of 2017 were well matched. The MSE, RMSE, MAE, and MAPE of the modelling performance were 201.76, 14.2, 8.4 and 0.06, respectively. The provinces with a high incidence were located in the northwest (Xinjiang, Tibet) and south (Guangxi, Guizhou, Hainan) of China. The hotspot of TB transmission was mainly located at southern region of China from 2004 to 2008, including Hainan, Guangxi, Guizhou, and Chongqing, which disappeared in the later years. The autoregressive component had a leading role in the incidence of TB which accounted for 81.5-84.5% of the patients on average. The endemic component was about twice as large in the western provinces as the average while the spatial-temporal component was less important there. Most of the high incidences (> 70 cases per 100,000) were influenced by the autoregressive component for the past 14 years. CONCLUSION: In a word, China still has a high TB incidence. However, the incidence rate of TB was significantly decreasing from 2004 to 2017 in China. Seasonal peaks were in January and March every year. Obvious geographical clusters were observed in Tibet and Xinjiang Province. The relative importance component of TB driving transmission was distinguished from the multivariate time series model. For every provinces over the past 14 years, the autoregressive component played a leading role in the incidence of TB which need us to enhance the early protective implementation.


Assuntos
Notificação de Doenças/estatística & dados numéricos , Vigilância da População , Tuberculose/diagnóstico , Tuberculose/epidemiologia , China/epidemiologia , Feminino , Previsões , Humanos , Incidência , Masculino , Análise de Regressão , Análise Espaço-Temporal
12.
Emerg Infect Dis ; 26(10): 2506-2508, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32672531

RESUMO

After South Korea raised its infectious disease alert to the highest level in response to coronavirus disease emergence, tuberculosis notification during the first 18 weeks of 2020 decreased significantly from the same period for each year during 2015-2019. Adequate measures to diagnose, control, and prevent tuberculosis need to be maintained.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Betacoronavirus , Notificação de Doenças/estatística & dados numéricos , Humanos , Pandemias , República da Coreia/epidemiologia
13.
Rev Bras Ter Intensiva ; 32(2): 224-228, 2020 Jun.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32667439

RESUMO

OBJECTIVE: To estimate the reporting rates of coronavirus disease 2019 (COVID-19) cases for Brazil as a whole and states. METHODS: We estimated the actual number of COVID-19 cases using the reported number of deaths in Brazil and each state, and the expected case-fatality ratio from the World Health Organization. Brazil's expected case-fatality ratio was also adjusted by the population's age pyramid. Therefore, the notification rate can be defined as the number of confirmed cases (notified by the Ministry of Health) divided by the number of expected cases (estimated from the number of deaths). RESULTS: The reporting rate for COVID-19 in Brazil was estimated at 9.2% (95%CI 8.8% - 9.5%), with all the states presenting rates below 30%. São Paulo and Rio de Janeiro, the most populated states in Brazil, showed small reporting rates (8.9% and 7.2%, respectively). The highest reporting rate occurred in Roraima (31.7%) and the lowest in Paraiba (3.4%). CONCLUSION: The results indicated that the reporting of confirmed cases in Brazil is much lower as compared to other countries we analyzed. Therefore, decision-makers, including the government, fail to know the actual dimension of the pandemic, which may interfere with the determination of control measures.


Assuntos
Infecções por Coronavirus/epidemiologia , Notificação de Doenças/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Humanos , Pandemias
14.
Rev Bras Epidemiol ; 23 Suppl 1: e200004.SUPL.1, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32638987

RESUMO

INTRODUCTION: Violence experienced in adolescence results in serious damage and suffering to society. This study aims to characterize the profile of violence victims and likely perpetrators of violence against adolescents, as well as to describe the percentage of notifying municipalities according to the federation unit. METHODS: Cross-sectional study conducted with data on notification of violence against adolescents from the Information System for Notifiable Diseases, from 2011 to 2017. The chi-square test was used to assess the statistical significance of the differences between the proportions in the comparison between genders. Proportion ratios for the most frequent types of violence were estimated according to selected variables. RESULTS: The notifications came from 75.4% of all the Brazilian municipalities. Physical violence predominated among males, aged 15-19 years. Psychological violence was predominant among females, between 10 and 14 years old, when perpetrated repeatedly at home by family aggressors. Sexual violence prevailed among females, aged 10 to 14 years old, in the indigenous, black and yellow races/colors, when perpetrated repeatedly at home. Negligence was more common among males, between 10 and 14 years old, when perpetrated repeatedly by family aggressors. CONCLUSIONS: Sexual violence occurred predominantly against females and generated significant negative impacts on mental, physical, sexual and reproductive health. Community violence, perpetrated with sharp objects and firearms, were prominent among males and are important risk factors for male over-mortality. Because the problems are complex, addressing them requires intersectoral actions.


Assuntos
Violência/estatística & dados numéricos , Adolescente , Brasil/epidemiologia , Criança , Estudos Transversais , Notificação de Doenças/estatística & dados numéricos , Feminino , Setor de Assistência à Saúde , Humanos , Masculino , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/terapia , Adulto Jovem
15.
BMC Infect Dis ; 20(1): 490, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32650738

RESUMO

BACKGROUND: In order to effectively combat Tuberculosis, resources to diagnose and treat TB should be allocated effectively to the areas and population that need them. Although a wealth of subnational data on TB is routinely collected to support local planning, it is often underutilized. Therefore, this study uses spatial analytical techniques and profiling to understand and identify factors underlying spatial variation in TB case notification rates (CNR) in Bangladesh, Nepal and Pakistan for better TB program planning. METHODS: Spatial analytical techniques and profiling was used to identify subnational patterns of TB CNRs at the district level in Bangladesh (N = 64, 2015), Nepal (N = 75, 2014) and Pakistan (N = 142, 2015). A multivariable linear regression analysis was performed to assess the association between subnational CNR and demographic and health indicators associated with TB burden and indicators of TB programme efforts. To correct for spatial dependencies of the observations, the residuals of the multivariable models were tested for unexplained spatial autocorrelation. Spatial autocorrelation among the residuals was adjusted for by fitting a simultaneous autoregressive model (SAR). RESULTS: Spatial clustering of TB CNRs was observed in all three countries. In Bangladesh, TB CNR were found significantly associated with testing rate (0.06%, p < 0.001), test positivity rate (14.44%, p < 0.001), proportion of bacteriologically confirmed cases (- 1.33%, p < 0.001) and population density (4.5*10-3%, p < 0.01). In Nepal, TB CNR were associated with population sex ratio (1.54%, p < 0.01), facility density (- 0.19%, p < 0.05) and treatment success rate (- 3.68%, p < 0.001). Finally, TB CNR in Pakistan were found significantly associated with testing rate (0.08%, p < 0.001), positivity rate (4.29, p < 0.001), proportion of bacteriologically confirmed cases (- 1.45, p < 0.001), vaccination coverage (1.17%, p < 0.001) and facility density (20.41%, p < 0.001). CONCLUSION: Subnational TB CNRs are more likely reflective of TB programme efforts and access to healthcare than TB burden. TB CNRs are better used for monitoring and evaluation of TB control efforts than the TB epidemic. Using spatial analytical techniques and profiling can help identify areas where TB is underreported. Applying these techniques routinely in the surveillance facilitates the use of TB CNRs in program planning.


Assuntos
Notificação de Doenças/estatística & dados numéricos , Determinantes Sociais da Saúde/estatística & dados numéricos , Tuberculose/epidemiologia , Bangladesh/epidemiologia , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Mortalidade , Nepal/epidemiologia , Paquistão/epidemiologia , Densidade Demográfica , Razão de Masculinidade , Análise Espacial , Resultado do Tratamento , Tuberculose/tratamento farmacológico , Cobertura Vacinal/estatística & dados numéricos
16.
BMC Public Health ; 20(1): 1029, 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32600376

RESUMO

BACKGROUND: Several statistical methods of variable complexity have been developed to establish thresholds for influenza activity that may be used to inform public health guidance. We compared the results of two methods and explored how they worked to characterize the 2018 influenza season performance-2018 season. METHODS: Historical data from the 2005/2006 to 2016/2018 influenza season performance seasons were provided by a network of 412 primary health centers in charge of influenza like illness (ILI) sentinel surveillance. We used the WHO averages and the moving epidemic method (MEM) to evaluate the proportion of ILI visits among all outpatient consultations (ILI%) as a proxy for influenza activity. We also used the MEM method to evaluate three seasons of composite data (ILI% multiplied by percent of ILI with laboratory-confirmed influenza) as recommended by WHO. RESULTS: The WHO method estimated the seasonal ILI% threshold at 0.9%. The annual epidemic period began on average at week 46 and lasted an average of 18 weeks. The MEM model estimated the epidemic threshold (corresponding to the WHO seasonal threshold) at 1.5% of ILI visits among all outpatient consultations. The annual epidemic period began on week 49 and lasted on average 14 weeks. Intensity thresholds were similar using both methods. When using the composite measure, the MEM method showed a clearer estimate of the beginning of the influenza epidemic, which was coincident with a sharp increase in confirmed ILI cases. CONCLUSIONS: We found that the threshold methodology presented in the WHO manual is simple to implement and easy to adopt for use by the Moroccan influenza surveillance system. The MEM method is more statistically sophisticated and may allow a better detection of the start of seasonal epidemics. Incorporation of virologic data into the composite parameter as recommended by WHO has the potential to increase the accuracy of seasonal threshold estimation.


Assuntos
Epidemias/estatística & dados numéricos , Influenza Humana/epidemiologia , Vigilância de Evento Sentinela , Assistência Ambulatorial/estatística & dados numéricos , Confiabilidade dos Dados , Notificação de Doenças/estatística & dados numéricos , Humanos , Marrocos/epidemiologia , Saúde Pública , Encaminhamento e Consulta/estatística & dados numéricos , Estações do Ano , Organização Mundial da Saúde
17.
BMC Infect Dis ; 20(1): 433, 2020 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-32571231

RESUMO

BACKGROUND: The disease burden caused by pulmonary tuberculosis (TB) in Sichuan province still persisted at a high level, and large spatial variances were presented across regional distribution disparities. The socio-economic factors were suspected to affect the population of TB notification, we aimed to describe TB case notification rate (CNR) and identify which factors influence TB epidemic are necessary for the prevention and control of the disease in Sichuan province. METHODS: A retrospective cross-sectional study and an ecological spatial analysis was conducted to quantify the presence and location of spatial clusters of TB by the Moran's I index and examined these patterns with socio-economic risk factors by hierarchical Bayesian spatio-temporal model. RESULTS: A total of 630,009 pulmonary TB cases were notified from 2006 to 2015 in 181 counties of Sichuan province. The CNR decreased year by year since 2007, from 88.70 to 61.37 per 100,000 persons. The spatial heterogeneities of CNR were observed during the study periods. Global Moran's I index varied from 0.23 to 0.44 with all P-value < 0.001. The Bayesian spatio-temporal model with parametric spatio-temporal interactions was chosen as the best model according to the minimum of Deviance Information Criterion (DIC)(19,379.01), and in which the quadratic form of time was taken. The proportion of age group and education year were all associated with CNR after adjusting the spatial effect, temporal effect and spatio-temporal interactions. TB CNR increased by 10.2% [95% credible interval (CI): 6.7-13.7%] for every 1-standard-deviation increase in proportion of age group and decreased by 23% (95% CI: 13.7-32.7%) for every 1-standard-deviation increase in education year. CONCLUSIONS: There were spatial clusters of TB notification rate in Sichuan province from 2006 to 2015, and heavy TB burden was mainly attributed to aging and low socioeconomic status including poor education. Thus, it is more important to pay more attention to the elderly population and improve socioeconomic status including promoting education level in Sichuan province to reduce the TB burden.


Assuntos
Classe Social , Tuberculose Pulmonar/epidemiologia , Idoso , Envelhecimento , Teorema de Bayes , China/epidemiologia , Estudos Transversais , Notificação de Doenças/estatística & dados numéricos , Escolaridade , Epidemias , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Análise Espaço-Temporal
18.
Am J Trop Med Hyg ; 103(1): 120-131, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32394883

RESUMO

The incidence and geographical distribution of dengue fever has increased in recent decades. The actual disease burden is unknown owing to frequent underreporting and misclassification of cases. A well-functioning system for diagnosing, treating, and reporting cases is of prime importance as disease statistics is the foundation for decisions aiming to control the disease. This study aimed to explore the hospital-based disease surveillance system in Yogyakarta, a dengue-endemic region on Java, Indonesia. Semi-structured interviews were performed with 16 informants from four hospitals, including five general practitioners, three internists, four pediatricians, and four administrative staff working with administration relating to dengue diagnostics and reporting. Data were analyzed using content analysis. A theme arose from the analysis "Dengue surveillance stands and falls by the rigor of the health system." The theme, and underlying categories and subcategories, describes a surveillance system that in the best-case scenario works well and is likely to produce reliable dengue case data. However, there is a lack of synchronization between regulations and guidelines in different hospitals and some friction between regulatory bodies and the care provider. Knowledge among the staff appears to vary, and many clinical and financial decisions are made rather arbitrarily, which ultimately might lead to unequal health service delivery. In conclusion, the dengue surveillance system under study could improve further, particularly by ensuring that all regulations and recommended procedures are standardized and that all staff are given the best opportunity to stay updated on dengue-related matters, clinical as well as regulatory, on a regular basis.


Assuntos
Vírus da Dengue/patogenicidade , Dengue/epidemiologia , Monitoramento Epidemiológico , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Dengue/diagnóstico , Dengue/virologia , Notificação de Doenças/estatística & dados numéricos , Feminino , Hospitais , Humanos , Incidência , Indonésia/epidemiologia , Masculino , Guias de Prática Clínica como Assunto , Pesquisa Qualitativa , Inquéritos e Questionários
19.
Euro Surveill ; 25(18)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32400358

RESUMO

An exponential growth model was fitted to critical care admissions from two surveillance databases to determine likely coronavirus disease (COVID-19) case numbers, critical care admissions and epidemic growth in the United Kingdom before the national lockdown. We estimate, on 23 March, a median of 114,000 (95% credible interval (CrI): 78,000-173,000) new cases and 258 (95% CrI: 220-319) new critical care reports, with 527,000 (95% CrI: 362,000-797,000) cumulative cases since 16 February.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Coronavirus/isolamento & purificação , Cuidados Críticos/estatística & dados numéricos , Notificação de Doenças/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , Síndrome Respiratória Aguda Grave/transmissão , Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Surtos de Doenças , Monitoramento Epidemiológico , Feminino , Humanos , Incidência , Masculino , Modelos Teóricos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Vigilância da População , Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/epidemiologia , Síndrome Respiratória Aguda Grave/virologia , Reino Unido/epidemiologia
20.
Ann Epidemiol ; 44: 60-63, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32253059

RESUMO

PURPOSE: Psittacosis is a bacterial zoonosis caused by Chlamydia (Chlamydophila) psittaci that infects birds. Although potentially fatal, infections can be reduced by controlling the source of infection. We therefore described the epidemiology of psittacosis, focusing on the infection source. METHODS: We descriptively analyzed psittacosis cases reported through national surveillance in Japan from 2007 to 2016. We also analyzed Chlamydia psittaci prevalence among captive psittaciformes during the same period. RESULTS: One hundred eleven cases were reported, and the annual number and notification rate of psittacosis declined. While 58% were male and the median age was 61 years, the median age differed by gender (males: 63 years, females: 53 years), with more female cases in those aged <50 years. In addition, the most common infection source differed by gender (men: columbiformes; women: psittaciformes). The decline in notifications was associated with a decline in psittaciformes-associated cases, with a concomitant decline in female cases. The prevalence of C. psittaci among captive psittaciformes also decreased over the period. CONCLUSIONS: We found important differences in the epidemiology of psittacosis by gender, and the recent decrease in notifications correlated with decreasing C. psittaci prevalence in birds. Risk communications for psittacosis should consider the current epidemiology regarding gender, age, and infection source.


Assuntos
Aves/microbiologia , Chlamydophila psittaci/isolamento & purificação , Notificação de Doenças/estatística & dados numéricos , Psitacose/diagnóstico , Adulto , Distribuição por Idade , Idoso , Animais , Doenças das Aves/microbiologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Psitacose/epidemiologia , Psitacose/microbiologia , Psitacose/veterinária , Distribuição por Sexo , Zoonoses
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