Feasibility of very short-term forecast models for COVID-19 hospital-based surveillance

Abstract INTRODUCTION: We evaluated the performance of Bayesian vector autoregressive (BVAR) and Holt's models to forecast the weekly COVID-19 reported cases in six units of a large hospital. METHODS: Cases reported from epidemiologic weeks (EW) 12-37 were selected as the training period, and from EW 38-41 as the test period. RESULTS: The models performed well in forecasting cases within one or two weeks following the end of the time-series, but forecasts for a more distant period were inaccurate. CONCLUSIONS: Both models offered reasonable performance in very short-term forecasts for confirmed cases of COVID-19.

Clinical and microbiological implications of invasive pneumococcal disease in hospitalized patients (1998-2013)

Abstract Introduction Infections caused by Streptococcus pneumoniae (pneumococcus) still represent a challenge for health systems around the world. Objective The objective of this study was to assess microbiological and clinical aspects in hospitalized patients with invasive pneumococcus disease between 1998 and 2013. Materials and methods This was a retrospective study that analyzed the results of pneumococcus identification, serotyping, and susceptibility testing found in the Adolfo Lutz Institute databank. Personal variables, medical history and clinical outcome of patients admitted with invasive pneumococcal disease were analyzed. These were obtained from records of a public teaching hospital – Hospital das Clínicas Faculdade de Medicina Ribeirão Preto. Results The sample comprised 332 patients. Patient age ranged from less than one month to 89 years old (mean 20.3 years) and the sample was predominately male. Pneumonia (67.8%) was the most common disease, accounting for 18.2% of deaths. Serotypes 14, 1, 3, 9V, 6B, 6A, 23F, 19A, 18C, 19F, 12F, and 4 were the most common (75.3%). Most patients, or 67.5%, were cured without any complication (success), 6.9% had some type of sequela (failure), and 25.6% died (failure). In the case of deaths due to meningitis, strains of fully penicillin resistant pneumococcus were isolated. Furthermore, 68.2% of patients who died presented some type of comorbidity. The 60 and older age group presented the most significant association (Odds Ratio = 4.2), with outcome failure regardless of the presence of comorbidity. Serotype 18C was the most significant risk factor both in raw analysis (Odds Ratio = 3.8) and when adjusted for comorbidity (Odds Ratio = 5.0) or age (Odds Ratio = 5.4). The same occurred with serotype 12F (respectively, Odds Ratio = 5.1, Odds Ratio = 5.0, and Odds Ratio = 4.7) Conclusion The present findings highlight the importance of IPD among young adults and older adults. In the era of conjugate vaccines, monitoring serotypes in different age groups is essential to assess the impact and adequacy of immunization.

Epizootia de raiva na área urbana de Ribeiräo Preto, SP, Brasil / Rabies epizootic in the urban area of Ribeiräo Preto, Säo Paulo, Brazil

Objetiva descrever uma epizootia de raiva iniciada em 1995 na área urbana de Ribeiräo Preto e estudar os fatores que propiciaram o seu aparecimento. Foram revistos e estudados todos os casos laboratorialmente confirmados de raiva animal ocorridos a partir de janeiro de 1995. Paralelamente, foram levantadas informaçöes relativas à cobertura vacinal e às atividades de vigilância. Em 1995, além de um caso humano, ocorreram 58 casos de raiva animal (54 cäes, três gatos e um morcego). Em 1996 foram observados vinte casos (18 cäes e dois gatos). A concentraçäo de casos de casos foi diferente conforme as áreas distritais, com maiores valores sendo observados nas regiöes mais pobres da cidade. A distribuiçäo de casos näo variou conforme os meses do ano. Baixas coberturas vacinais e quase ausência de atividades de vigilância, traduzida pelo näo-envio sistemático de amostras para exames laboratoriais nos anos imediatamente anteriores a 1995, foram os fatores determinantes do aparecimento da epizootia. Ilustra os riscos de se negligenciar a profilaxia permanente da raiva, mesmo numa cidade com razoável estrutura dos serviços de saúde e localizada numa das áreas de maior desenvolvimento econômico do País.