[Reporting of birth defects from the Zika outbreak in Colombia, 2015-2017Notificação de defeitos congênitos associados ao surto de vírus zika na Colômbia, 2015-2017]. / Notificación de defectos congénitos por brote del virus del Zika en Colombia, 2015-2017.

OBJECTIVE: The Zika outbreak affected several tropical countries in 2015 and 2016, requiring the creation of intensified surveillance strategies for microcephaly and other neurological syndromes. The effect of the Zika outbreak on the reporting of birth defects in Colombia was evaluated from the perspective of the national surveillance system. METHODS: National reporting of newborns with different birth defects was analyzed; variations in reporting attributed to the epidemic were determined through difference in differences (DID), a semiparametric model. RESULTS: During the period of study, 18,234 cases of birth defects were reported in Colombia. The majority were congenital malformations (91.9%), and 82.3% was confirmed by clinical diagnosis or epidemiological link. In the case of microcephaly, eight new cases per epidemiological week were reported (coefficient of case reporting [D] = 8.8; P = 0.000) and 32 cases from other congenital anatomical malformations (D = 32.0; P = 0.000). The absolute value of the difference in differences estimator attributed to the Zika outbreak increased weekly case reporting of microcephaly (DID = |-5.0|; P = 0.008) and congenital malformations (DID = |-12.0|; P = 0.111). CONCLUSIONS: The Zika outbreak increased reporting of newborns with microcephaly, but caused no significant variation in reporting of other malformations and functional birth defects of sensory or metabolic origin in the surveillance system.

OBJETIVO: O surto de vírus zika afetou vários países tropicais de 2015 a 2016. Fez-se necessário elaborar estratégias de vigilância intensificada da microcefalia e outras síndromes neurológicas. O presente estudo avaliou o impacto do surto de vírus zika na notificação de defeitos congênitos no sistema nacional de vigilância da Colômbia. MÉTODOS: A notificação nacional de recém-nascidos com defeitos congênitos foi analisada e a variação na notificação atribuída à epidemia de zika foi determinada com o uso de um modelo semiparamétrico de diferença em diferenças (DD). RESULTADOS: Ao todo, 18.234 casos de defeitos congênitos foram notificados na Colômbia no período considerado. Os casos, na sua maioria, foram de malformações congênitas (91,9%), sendo 82,3% confirmados por diagnóstico clínico ou nexo epidemiológico. Foram notificados oito casos novos de microcefalia por semana epidemiológica (coeficiente de notificação de casos [D] = 8,8; P = 0,000) e 32 casos de outras malformações congênitas anatômicas (D = 32,0; P = 0,000). O valor absoluto do estimador do método de diferença em diferenças atribuído ao surto de vírus zika indicou um aumento na notificação semanal de casos de microcefalia (DD = |­5,0|; P = 0,008) e malformações congênitas (DD = |­12,0|; P = 0,111). CONCLUSÕES: O surto de vírus zika ocasionou um aumento na notificação de recém-nascidos com microcefalia, mas não houve variação significativa na notificação de outras malformações e defeitos congênitos funcionais de origem sensorial ou metabólica no sistema de vigilância.

Short report: serological evidence of West Nile virus activity in El Salvador.

Epizootics of encephalitis in El Salvador killed 203 equines between November 2001 and April 2003. During an investigation of the outbreaks, 18 (25%) of 73 serum samples collected from stablemates of deceased animals in 2003 had antibodies to West Nile virus. Ten of these infections were confirmed by plaque reduction neutralization tests, suggesting West Nile virus has extended its range and spread to Central America.

Strong and Flexible: Developing a Three-Tiered Curriculum for the Regional Central America Field Epidemiology Training Program.

Field Epidemiology Training Programs (FETPs) are recognized worldwide as an effective means to strengthen countries' capacity in epidemiology, surveillance, and outbreak response. FETPs are field-based, with minimum classroom time and maximum time in the field, providing public health services while participants achieve competency. The Central America FETP (CAFETP) uses a three-level pyramid model: basic, intermediate, and advanced. In 2006, a multidisciplinary team used a methodical process based on adult learning practices to construct a competency-based curriculum for the CAFETP. The curriculum was designed based on the tasks related to disease surveillance and field epidemiology that public health officers would conduct at multiple levels in the system. The team used a design process that engaged subject matter experts and considered the unique perspective of each country. The designers worked backwards from the competencies to define field activities, evaluation methods, and classroom components. The 2006 pyramid curriculum has been accredited for a master's of science in field epidemiology by the Universidad del Valle de Guatemala and has been adapted by programs around the world. The team found the time and effort spent to familiarize subject matter experts with key adult learning principles was worthwhile because it provided a common framework to approach curriculum design. Early results of the redesigned curriculum indicate that the CAFETP supports consistent quality while allowing for specific country needs.

Risk factors for infection during a severe dengue outbreak in El Salvador in 2000.

In 2000, El Salvador experienced a large dengue-2 virus epidemic with many severe cases. A seroepidemiologic survey was conducted in 106 randomly selected households (501 residents) in an affected community (Las Pampitas). The frequency of recent infection, documented by the presence of IgM antibodies or high-titer IgG antibodies to dengue virus, was estimated to be 9.8% (95% confidence interval [CI] = 5.8-13.7), of which at least 44% were secondary infections. The number of containers positive for Aedes mosquito larvae or pupae per 100 premises (Breteau Index) was 62 and the frequency of positive premises (House Index) was 36%; 33% (35 of 106) of the informants reported having taken action against mosquito larval habitats and 82% (87 of 106) reported having taken actions against adult mosquitoes. Recent infection was associated with the presence in the home environment of mosquito infested discarded cans (odds ratio [OR] = 4.30, 95% CI = 2.54-7.28), infested discarded plastic containers (OR = 3.98, 95% CI = 1.05-15.05), and discarded tire casings (OR = 2.57, 95% CI = 1.09-6.04). The population attributable fractions associated with these factors were 4%, 13%, and 31%, respectively. Our data suggest that targeted community cleanup campaigns, particularly those directed at discarded tires and solid waste, are likely to have the greatest impact on reducing the risk of dengue infection.

Notificación de defectos congénitos por brote del virus del Zika en Colombia, 2015-2017

[RESUMEN]. Objetivo. El brote por virus del Zika afectó a varios países tropicales durante 2015 y 2016. Esto obligó a crear estrategias de vigilancia intensificada de microcefalia y otros síndromes neurológicos. Se evaluó el efecto del brote por virus del Zika en la notificación de defectos congénitos en Colombia desde la perspectiva del sistema nacional de vigilancia. Métodos. Se analizó la notificación nacional de recién nacidos con diferentes defectos congénitos y se determinaron las variaciones en la notificación atribuidas a la epidemia mediante un modelo semiparamétrico denominado “diferencia en diferencias” (DID). Resultados. Un total de 18 234 casos por defectos congénitos fueron notificados en Colombia durante el período de estudio. La mayoría eran malformaciones congénitas (91,9%). El 82,3% se confirmó por diagnóstico clínico o nexo epidemiológico. En el caso de la microcefalia, se notificaron ocho casos nuevos por semana epidemiológica (coeficiente de notificación de casos [D] = 8,8; P = 0,000) y 32 casos por otras malformaciones congénitas anatómicas (D = 32,0; P = 0,000). El valor absoluto del estimador de diferencia en diferencias atribuido al brote por virus del Zika incrementó la notificación semanal de casos de microcefalia (DID = |-5,0|; P = 0,008) y malformaciones congénitas (DID = |-12,0|; P = 0,111). Conclusiones. El brote por virus del Zika incrementó la notificación de recién nacidos con microcefalia, pero sin ninguna variación significativa en la notificación de otras malformaciones y defectos congénitos funcionales de origen sensorial o metabólico en el sistema de vigilancia.

[ABSTRACT]. Objective. The Zika outbreak affected several tropical countries in 2015 and 2016, requiring the creation of intensified surveillance strategies for microcephaly and other neurological syndromes. The effect of the Zika outbreak on the reporting of birth defects in Colombia was evaluated from the perspective of the national surveillance system. Methods. National reporting of newborns with different birth defects was analyzed; variations in reporting attributed to the epidemic were determined through difference in differences (DID), a semiparametric model. Results. During the period of study, 18,234 cases of birth defects were reported in Colombia. The majority were congenital malformations (91.9%), and 82.3% was confirmed by clinical diagnosis or epidemiological link. In the case of microcephaly, eight new cases per epidemiological week were reported (coefficient of case reporting [D] = 8.8; P = 0.000) and 32 cases from other congenital anatomical malformations (D = 32.0; P = 0.000). The absolute value of the difference in differences estimator attributed to the Zika outbreak increased weekly case reporting of microcephaly (DID = |-5.0|; P = 0.008) and congenital malformations (DID = |-12.0|; P = 0.111). Conclusions. The Zika outbreak increased reporting of newborns with microcephaly, but caused no significant variation in reporting of other malformations and functional birth defects of sensory or metabolic origin in the surveillance system.

[RESUMO]. Objetivo. O surto de vírus zika afetou vários países tropicais de 2015 a 2016. Fez-se necessário elaborar estratégias de vigilância intensificada da microcefalia e outras síndromes neurológicas. O presente estudo avaliou o impacto do surto de vírus zika na notificação de defeitos congênitos no sistema nacional de vigilância da Colômbia. Métodos. A notificação nacional de recém-nascidos com defeitos congênitos foi analisada e a variação na notificação atribuída à epidemia de zika foi determinada com o uso de um modelo semiparamétrico de diferença em diferenças (DD). Resultados. Ao todo, 18.234 casos de defeitos congênitos foram notificados na Colômbia no período considerado. Os casos, na sua maioria, foram de malformações congênitas (91,9%), sendo 82,3% confirmados por diagnóstico clínico ou nexo epidemiológico. Foram notificados oito casos novos de microcefalia por semana epidemiológica (coeficiente de notificação de casos [D] = 8,8; P = 0,000) e 32 casos de outras malformações congênitas anatômicas (D = 32,0; P = 0,000). O valor absoluto do estimador do método de diferença em diferenças atribuído ao surto de vírus zika indicou um aumento na notificação semanal de casos de microcefalia (DD = |–5,0|; P = 0,008) e malformações congênitas (DD = |–12,0|; P = 0,111). Conclusões. O surto de vírus zika ocasionou um aumento na notificação de recém-nascidos com microcefalia, mas não houve variação significativa na notificação de outras malformações e defeitos congénitos funcionais de origem sensorial ou metabólica no sistema de vigilância.

Lesiones atendidas por la red de urgencias de Bogotá durante las festividades del fin de año, 1997-1998 / External causes of injury attended in the city network of emergency rooms during the Christmas holidays, 1997-1998: Bogota

Con el fin de ampliar el conocimiento en cuanto a la magnitud de las lesiones de causa externa atendidas por la Red Distrital de Urgencias y las características de las víctimas, y el luga, tiempo y circunstancias relacionadas con estos eventos, se implementó una vigilancia especial en los organismos de salud adscritos a la Red, durante la época de fin de año de 1997 y comienzos de 1998. Los datos recolectados muestran que, en promedio, se presentaron 430 lesionados diarios durante las tres semanas de vigilancia especial, la mayoría hombres entre los 15 y 29 años. Las dos terceras paertes de las lesiones correspondieron a lesiones accidentales, con predominio de las caídas y los accidentes de tránsito. La tercera parte correspondió a lesiones intencionales, con predominio de las ocasionadas por riñas.