Dried blood spots: a robust tool for malaria surveillance in countries targeting elimination

With the advancements in analytical and molecular techniques, Dried Blood Spots (DBS) are re-emerging as attractive and cost-effective alternatives for global health surveillance. The use of DBS has been well-characterized in the neonatal screening of metabolic diseases, therapeutic screening as well as in epidemiological studies for biomonitoring. Malaria is one such infectious disease where DBS use can expedite molecular surveillance for assessing drug resistance and for refining drug usage policies. In India, malaria cases have reduced significantly over the past decade but to achieve malaria elimination by 2030, country-wide DBS-based screening should be conducted to identify the presence of molecular markers of artemisinin resistance and to study parasite reservoirs in asymptomatic populations. DBS has wide applications in genomics, proteomics, and metabolomic studies concerning both host and pathogen factors. Hence, it is a comprehensive tool for malaria surveillance that can capture both host and parasite information. In this review, we elucidate the current and prospective role of DBS in malaria surveillance and its applications in studies ranging from genetic epidemiology, parasite and vector surveillance, drug development and polymorphisms to ultimately how they can pave the roadmap for countries aiming malaria elimination

Analysis of monitoring results of Kashin-Beck disease in Shandong Province from 2016 to 2020 / 中华地方病学杂志

Objective:To analyze the surveillance data of Kashin-Beck disease (KBD) in Shandong Province, master the changes of KBD, and provide scientific basis for formulating prevention and control strategies of KBD and adjustment of the prevention and control focus of KBD.Methods:According to the requirements of the "National KBD Monitoring Plan" and the "Shandong KBD Monitoring Plan", from 2016 to 2020, the disease monitoring was carried out in the villages of KBD areas in Shandong Province, including the number of clinical positive cases, the number of X-ray positive cases, and the number of metaphyseal positive cases. The detection rate was calculated, and the dynamic changes of the disease was analyzed macroscopically.Results:From 2016 to 2020, a total of 1 816 children aged 7 - 12 years were clinically examined in Shandong Province, and no child with KBD was found. A total of 1 224 children were examined by X-ray, among which 1 positive patient was found in 2016 and 2017, respectively, both of whom were metaphyseal changes, with a total detection rate of 0.16%. There were 367 adult patients with KBD in Shandong Province, including 304 patients with grade Ⅰ, 47 patients with grade Ⅱ and 16 patients with grade Ⅲ. All villages in the KBD areas in Shandong Province had reached the elimination standard, with the elimination rate of 100%.Conclusion:No clinical case of KBD is detected in children aged 7 - 12 years in Shandong Province from 2016 to 2020, which has reached the elimination standard and is in a continuous elimination state.

Quality evaluation of infectious disease surveillance data in Lianyungang City in 2017 - 2021 / 公共卫生与预防医学

Objective To evaluate the quality of infectious disease surveillance data and provide scientific basis for improving data quality and health decision-making. Methods The comprehensive index of infectious disease monitoring system evaluation and the integrity, accuracy and reliability of infectious disease report data were used to evaluate the quality of infectious disease monitoring data in multiple dimensions. Results In 2021, The comprehensive evaluation index of infectious disease surveillance system was 98.40%. In terms of data integrity, 1 105 data were missing, and the incomplete rate was 1.46%; In terms of data accuracy, 1978 cases were not accurately, rate of accuracy was 26.72%; In terms of data reliability, the card reporting rate of tertiary medical institutions accounted for 67.05%, the diagnosis rate of confirmed cases was 27.74%, and the correction rate of report card was 28.48%. Conclusion The accuracy and reliability of infectious disease data are insufficient, and new methods for infectious disease monitoring data quality are expanded to make up for the lack of data quality evaluation of the current national epidemic system.

Surveillance of foodborne diseases in sentinel hospitals in Changzhou in 2016-2020 / 公共卫生与预防医学

Objective To understand and analyze the epidemiological and pathogenic characteristics of foodborne diseases in Changzhou in the past five years, so as to provide evidence for prevention and control measures. Methods All foodborne disease surveillance information reported by Changzhou foodborne disease sentinel hospital from 2016 to 2020 was collected through the “Foodborne Disease Surveillance and Reporting System”. The distribution of reported cases and etiological results was described, and the possible factors affecting pathogen detection results were analyzed. Results A total of 14 931 cases of foodborne diseases were reported, mainly distributed in summer and autumn, and peaked in July and August. The age group of reported cases was 25-34 years old, and the occupations were mainly workers, and farmers and migrant workers, accounting for 23.2% and 36.9%, respectively. Among the reported cases of 3 120 anal swabs were collected and tested for etiology , of which 291 specimens were positive, with a positive detection rate of 9.32%. Among the 291 positive results of 118 cases of norovirus were detected, with a detection rate of 6.03% . 66 cases of salmonella were detected, with a detection rate of 2.12% . 25 cases of vibrio parahaemolyticus were detected, with a detection rate of 0.80% . 7 cases of diarrhea-causing Escherichia coli was detected, with a detection rate of 0.22% ; and 5 cases of shigella was detected, with a detection rate of 0.16% . Single factor analysis of the results of pathogen detection showed that there were no statistical differences in the distribution of positive pathogen detection rate between males and females, and between different suspicious exposed foods (all P>0.05). There were statistical differences in different age groups, occupations, seasons and eating places (all P<0.05). Multivariate Logistic regression analysis showed that age and season were correlated with the detection rates of pathogenic microorganisms (all P<0.05) , and age was negatively correlated with the positive rate of pathogenic microorganisms (OR=0.863). The detection rates in the first and fourth quarters were higher than those in the second and third quarters. Conclusion Summer and autumn are the seasons with high incidence of foodborne diseases in Changzhou. Norovirus is the main pathogen. Age and season are closely related to the detection results of pathogenic microorganisms. Comprehensive prevention and control measures should be implemented for key population in summer and autumn to reduce the occurrence and outbreak of foodborne diseases.

Online capacity building for the health workforce: the case of the Integrated Disease Surveillance and Response for the African region

Background: The World Health Organisation (WHO) Regional Office for Africa (AFRO) has developed a comprehensive capacity development programme to support the successful implementation of the Integrated Disease Surveillance and Response 3 rd edition Technical Guidelines (IDSR). As part of the learning program, a series of asynchronous online courses are offered on Open WHO in English, French and Portuguese. This paper describes the use of five IDSR online courses and reports on feedback received from learners on Course 1 in the English series. Methods: An online learner survey was developed, and a descriptive analysis was conducted. This paper also reports on use related empirical metadata from the Open WHO platform. Results: Overall, learners (97%-n/N) of Course 1 IDSR English series indicated a positive perception toward their online learning experience because of the quality of course content, its organization, ease of use and relevance to their workplace needs. In addition, 88% (n/N) of learners reported that they had used their acquired knowledge at least sometimes and 54.4% (n/N) had shared their learning with others. Lastly, the quiz analyses showed an average of right answers of 78.97% for quiz 1 and 69.94% for quiz 2. Conclusion: Online learning is an essential component of a blended capacity development programme and provides cost effective, equitable and impactful learning. Learners who have a learning goal and find their needs met in courses tend to show more satisfaction and motivation to share their learning.

Avaliação do perfil epidemiológico das hepatites virais no Brasil - 2010 A 2021 / Evaluation of the epidemiological profile of viral hepatitis in Brazil - 2010 to 2021

As hepatites virais são doenças que apresentam elevado impacto de morbimortalidade no mundo, sendo assim, consideradas um grave problema para a saúde pública. Nos últimos anos o enfrentamento das hepatites virais tem sido um grande desafio, principalmente para os países com alta prevalência de vulnerabilidades sociais. Medidas de controle e prevenção da doença devem ser tomadas, por isso torna-se necessário a realização de estudos que contemplem conhecimentos sobre a dinâmica epidemiológica das hepatites para demonstrar sua importância em relação a saúde pública. Objetivo: O objetivo nesta pesquisa foi analisar o perfil epidemiológico das hepatites virais no Brasil, no período de 2010 a 2021. Método: Realizou-se um estudo transversal, descritivo, retrospectivo e qualiquantitativo que utilizou como unidades de análise as unidades federativas brasileiras. Os dados foram coletados a partir das informações disponíveis no site TABNET/DATASUS, DCCI, e a estimativa da população anual absoluta foi obtida no Instituto Brasileiro de Geografia e Estatística (IBGE). Resultados: No período analisado foram registrados 476.981 casos de hepatites virais no Brasil, destacando-se a notificação de casos de hepatite C, seguida pela hepatite B, A e D. Com relação a taxa de incidência, a Região Norte destacou-se para hepatite A e D, e a Região Sudeste para hepatite B e C. O sexo do indivíduo acometido em todos os tipos de hepatite virais analisados que se destacou foi o masculino, mas com pouca diferença do feminino. Foram registrados 25.553 óbitos, sendo 78,3% devido à hepatite C. A presente pesquisa nos permitiu concluir que o tipo de hepatite mais relatada no Brasil é a tipo C, assim como a que mais provoca óbitos. Todas as hepatites virais apresentaram queda nas notificações no ano de 2020 e 2021 e por isso este fato deve ser analisado pelos setores de vigilância pois pode se tratar de subnotificações, principalmente devido a situação do país neste período, que enfrentava a pandemia de COVID-19

Viral hepatitis is a disease with a high impact on morbidity and mortality worldwide and hence considered a serious problem for public health. Fighting viral hepatitis has been a major challenge in recent years, especially for countries with a high prevalence of social vulnerabilities. Measures to control and prevent the disease must therefore be taken, so studies that include knowledge about the epidemiological dynamics of hepatitis are warranted to demonstrate its importance to public health. In the objective of the present study was to analyze the epidemiological profile of viral hepatitis in Brazil in the period from 2010 to 2021. A cross-sectional, descriptive, retrospective, and qualitative-quantitative investigation was carried out using the federative units of Brazil as units of analysis. Data were collected from information available on the TABNET/DATASUS, DCCI website, and the absolute annual population estimate was obtained from the Brazilian Institute of Geography and Statistics (IBGE). In the analyzed period, 476,981 cases of viral hepatitis were recorded in Brazil, the majority of which referred to hepatitis C, followed by hepatitis B, A, and D. As regards the incidence rate, the north region stood out with hepatitis A and D; and the southeast region with hepatitis B and C. Males prevailed between the genders of individuals affected, considering all types of viral hepatitis analyzed, but with little difference from females. A total of 25,553 deaths were recorded, 78.3% of which were due to hepatitis C. Conclusions: The present study allowed us to conclude that the most reported type of hepatitis in Brazil is type C, which is also the most death-causing. There was a drop in notifications of all viral hepatitis in 2020 and 2021, and this fact should be analyzed by surveillance sectors as it may be a situation of underreporting, due mainly to the COVID-19 pandemic crisis the country was facing in the period

A summary on surveillance system of occupational disease under the framework of National Health Insurance Informatization Project / 中华劳动卫生职业病杂志

The surveillance of occupational disease has entered a new stage ofdevelopment, with the implementation of the national health informatization project. To improve the efficiency and quality of occupational disease monitoring information reporting in this paper, the system architecture and related management regulations, as long as the major changes and achievement of "surveillance system of occupational disease and health hazards information" under the framework of National Health Insurance Informatization Project were elaborated. The deficiencies existing in the system were analyzed, and expectation for the construction of the occupational disease surveillance system was addressed.

Carrying out occupational injury surveillance and assessment, and protecting workers’ occupational health / 环境与职业医学

Occupational injuries cause a large number of personal injuries, illnesses, or deaths, resulting in a huge burden of disease, and has become an important global occupational safety and health problem. Developed countries in Europe and the United States have provided strong support for occupational injury prevention and control by establishing continuous and stable occupational injury surveillance systems. The occupational injury problem has not attracted enough attention and concern in China, with few relevant research reports, and the current occupational injury surveillance system is far from perfection. From the perspective of protecting workers' occupational health, this paper analyzed and compared the classification and scope of occupational injuries at home and abroad, as well as the status quo of occupational injury surveillance and assessment, and proposed to set up an occupational injury surveillance system with multiple surveillance methods and multiple data sources that complement with each other, so as to strengthen the continuity of surveillance activities, consistency of data formats, and comparability of assessment indicators. Step by step, we can set up a surveillance system covering the whole process of surveillance, assessment, intervention, and evaluation of intervention effects.

Use of oral fluids for efficient monitoring of influenza viruses in swine herds in Colombia

Background: Influenza A virus (IAV) surveillance in swine is critical not only due to the direct impact of the disease in the pork industry but also because IAV are prone to interspecies transmission (from human to pigs and vice versa); therefore, its monitoring is fundamental from a public and animal health perspective. Several diagnostic techniques have been used to detect IAV infection from nasal samples in swine, while samples of oral fluids (OF) are in use as novel alternatives for pathogen detection. The OF allow for efficient and feasible low-cost disease detection at the herd level, with low risk of stress for the animals. Objective: To describe a surveillance strategy of IAV at the herd level during respiratory disease outbreaks in swine farms at tropical settings using porcine oral fluids. Methods: An active surveillance strategy was conducted in several farms with past records of respiratory disease. The IAV detection was conducted in five purposively selected swine farms from years 2014 to 2017. We investigated a total of 18 respiratory outbreaks of the disease. Swine OF were collected for IAV testing. An OF sample is described as a pen-based specimen collected from a group of >20 pigs per pen and/or per barn (stall-housed individually with close contact among them). The IAV infection was investigated in OF by rRT-PCR testing and confirmed by viral isolation in cell culture Results: We found 107 (7.4%) positives to IAV by rRT-PCR from a total of 1,444 OF samples tested. Additionally, 9 IAV isolates were all further identified as H1 subtype. Conclusions: Our results demonstrate that OF can be easily implemented as a novel, user-friendly, welfare-friendly, accurate and cost-effective sampling method for active surveillance and monitoring of IAV infections in swine farms in tropical settings.

Antecedentes: La vigilancia del Virus Influenza A (IAV) en los cerdos es fundamental debido al impacto directo de la enfermedad en la industria porcina, pero también porque los IAV son propensos de transmisión entre especies (humanos a cerdos y viceversa), y por lo tanto su monitoreo es crítico desde las perspectivas de salud pública y animal. Actualmente existen varias técnicas de diagnóstico disponibles para detectar la infección por IAV a partir de muestras nasales en cerdos, sin embargo, se han implementado otras muestras como los fluidos orales (OF) como nuevas alternativas para la detección de patógenos. El OF permite una detección eficiente y factible de enfermedades a menor costo a nivel de rebaño, con menor riesgo de estrés para los animales. Objetivo: Describir una estrategia de vigilancia de IAV a nivel de hato por medio de fluidos orales porcinos durante brotes de enfermedades respiratorias en granjas porcinas en entornos tropicales. Métodos: Se llevó a cabo una estrategia de vigilancia activa en cinco granjas porcinas seleccionadas con antecedentes de enfermedades respiratorias. Se recolectaron OF porcinos para la prueba de IAV. Una muestra de OF se describió como una muestra grupal recolectada de un grupo de >20 cerdos por corral y/o por establo (si estaban alojados individualmente, pero tenían un contacto cercano entre ellos). La infección por IAV se investigó probando OF mediante rRT-PCR y la confirmación mediante aislamiento viral en cultivo celular. Resultados: La detección de IAV se llevó a cabo en cinco granjas seleccionadas intencionalmente entre 2014- 2017. Investigamos un total de 18 eventos de brotes de enfermedades respiratorias. Del total de 1.444 OF muestras analizadas, encontramos 107 (7,4%) positivos a IAV mediante rRT-PCR. Además, solo se obtuvieron 9 aislamientos de IAV y todos se identificaron además como subtipo H1. Conclusiones: Los resultados de nuestro estudio demostraron cómo la OF puede implementarse fácilmente como un método de muestreo novedoso, fácil de usar, amigable con el bienestar animal, preciso y rentable para la vigilancia activa y el monitoreo de infecciones por IAV en granjas porcinas en entornos tropicales.

Antecedentes: A vigilância do vírus Influenza A (IAV) em suínos é crítica devido ao impacto direto da doença na indústria de suínos, mas também porque os IAV são propensos a transmissão interespécies (de humanos para porcos e vice-versa) e, portanto, seu monitoramento é crítico do ponto de vista da saúde pública e animal. Atualmente, existem várias técnicas de diagnóstico disponíveis para detectar a infecção por IAV em amostras nasais de suínos, no entanto, outras amostras, como fluidos orais (OF), têm sido implementadas como novas alternativas para a detecção de patógenos. O OF permite uma detecção eficiente e viável de doenças com menor custo em nível de rebanho, com menor risco de estresse para os animais. Objetivo: Descrever uma estratégia de vigilância de IAV em nível de rebanho durante surtos de doenças respiratórias em granjas de suínos em ambientes tropicais por meio de fluidos orais suínos. Métodos: A estratégia de vigilância ativa foi conduzida em cinco granjas de suínos selecionadas com histórico de doenças respiratórias. Suínos OF foram coletados para teste de IAV. Uma amostra OF foi descrita como um espécime baseado em curral coletado de um grupo de >20 porcos por curral e/ou por celeiro (se eles foram alojados individualmente, mas tendo contato próximo entre eles). A infecção IAV foi investigada testando OF por rRT-PCR e confirmada por isolamento em cultura de células. Resultados: A detecção do IAV foi realizada em cinco fazendas selecionadas propositalmente entre 2014-2017. Nós investigamos um total de 18 eventos de surto de doença respiratória. Do total de 1.444 amostras de OF testadas, encontramos 107 (7,4%) positivas para IAV por rRT-PCR. Além disso, apenas 9 isolados de IAV foram obtidos, e todos foram posteriormente identificados como subtipo H1. Conclusão: Os resultados de nosso estudo demonstraram como o OF pode ser facilmente implementado como um método de amostragem novo, amigável, amigável com o bem-estar, preciso e de baixo custo para vigilância ativa e monitoramento de infecções IAV em fazendas de suínos em ambientes tropicais.

Epidemiological characteristics of notifiable infectious diseasesin Zhejiang Province, 2021 / 预防医学

Objective@#To investigate the epidemiological features of notifiable infectious diseases in Zhejiang Province in 2021, so as to provide the evidence for formulating infectious disease control measures.@*Methods@#The data pertaining to notifiable infectious diseases reported in Zhejiang Province in 2021 were retrieved from the Infectious Disease Surveillance System of China Information System for Disease Control and Prevention. The incidence and mortality of notifiable infectious diseases in Zhejiang Province in 2021 were descriptively analyzed.@*Results@#Totally 29 types of notifiable infectious diseases with 396 623 cases and 391 deaths were reported in Zhejiang Province in 2021, with a reported incidence of 614.28/105 and a reported mortality of 0.605 6/105, respectively. There were 93 204 cases with class B notifiable infectious diseases, with a reported incidence rate of 144.35/105 and 303 419 cases with class C notifiable infectious diseases, with a reported incidence rate of 469.92/105; while no cases with class A notifiable infectious diseases were reported. Syphilis (39.45/105), tuberculosis (37.12/105), viral hepatitis (31.90/105) and gonorrhea (26.34/105) were the four most common class B notifiable infectious diseases, and AIDS (0.477 0/105) and pulmonary tuberculosis (0.116 2/105) were the two most deadly class B notifiable infectious diseases, while hand, foot and mouth disease (192.00/105), other infectious diarrhea (184.24/105) and influenza (86.45/105) were the three most common class C notifiable infectious diseases. According to the transmission route, intestinal and respiratory infectious diseases were the two most common infectious diseases, with reported incidence rates of 384.10/105 and 133.73/105, respectively; and according to the reported region, the highest incidence of class B notifiable infectious diseases was reported in Zhoushan and Ningbo cities, and the highest incidence of class C notifiable infectious diseases was reported in Ningbo City. Totally 1 101 COVID-19 cases were reported in Zhejiang Province in 2021, including 712 confirmed cases and 389 asymptomatic cases, and no deaths occurred.@*Conclusions@#The reported incidence of notifiable infectious diseases declined in Zhejiang Province in 2021 as compared to that prior to COVID-19 epidemics, with remarkable reductions in the incidence of respiratory and intestinal infectious diseases. The management of pulmonary tuberculosis, viral hepatitis and AIDS requires to be reinforced during the containment of COVID-19, to prevent the seasonable epidemic of influenza, hand, foot and mouth disease and other infectious diarrhea in Zhejiang Province.

Utilizing prospective space-time scan statistics to discover the dynamics of coronavirus disease 2019 clusters in the State of São Paulo, Brazil

ABSTRACT Background: The number of deaths and people infected with coronavirus disease 2019 (COVID-19) in Brazil has steadily increased in the first few months of the pandemic. Despite the underreporting of coronavirus cases by government agencies across the country, São Paulo has the highest rate among all Brazilian states. Methods: To identify the highest-risk municipalities during the initial outbreak, we utilized daily confirmed case data from official reports between February 25 and May 5, 2020, which were aggregated to the municipality level. A prospective space-time scan statistic was conducted to detect active clusters in three different time periods. Results: Our findings suggest that approximately 4.6 times more municipalities belong to a significant space-time cluster with a relative risk (RR) > 1 on May 5, 2020. Conclusions: Our study demonstrated the applicability of the space-time scan statistic for the detection of emerging clusters of COVID-19. In particular, we identified the clusters and RR of municipalities in the initial months of the pandemic, explaining the spatiotemporal patterns of COVID-19 transmission in the state of São Paulo. These results can be used to improve disease monitoring and facilitate targeted interventions.

Interactive web-based tool for evaluating the spread of bovine tuberculosis and brucellosis in Colombia / Herramienta interactiva basada en la web para evaluar la propagación de la tuberculosis bovina y la brucelosis en Colombia / Ferramenta interativa baseada na web para avaliar a disseminação da tuberculose e brucelose bovina na Colômbia

Abstract Background: Bovine tuberculosis (BTB) and brucellosis are associated with devastating losses in the livestock sector in Colombia and even in developed countries. Real-time disease surveillance is a key strategy to control and eradicate infectious disease outbreaks. Objective: To design an epidemiological tool for monitoring BTB and brucellosis in Colombia. Methods: An interactive platform for disease mapping of BTB and brucellosis during an observation period between years 2004 and 2019 was designed. Results: Our analysis showed that the provinces of Cundinamarca and Valle del Cauca are regions affected by BTB and brucellosis epidemics, respectively (p<0.001). Furthermore, increased case detection of BTB was reported in 2012 and brucellosis in 2019 (p<0.001). Conclusions: This epidemiological platform allows tracking BTB and tuberculosis hotspots, identifying trends over time, and provides useful information to animal health authorities for designing new strategies in control programs.

Resumen Antecedentes: La tuberculosis bovina (TBB) y la brucelosis están asociadas con problemas persistentes en la ganadería Colombiana e incluso en los países desarrollados. La vigilancia de enfermedades en tiempo real es una estrategia clave para controlar y erradicar brotes de enfermedades infecciosas. Objetivo: Diseñar una herramienta epidemiológica para monitorear TBB y brucelosis en Colombia. Métodos: Se diseñó un panel de control interactivo para el mapeo de ambas enfermedades durante el periodo de observación entre los años 2004 y 2019. Resultados: El análisis de la herramienta mostró que las Provincias de Cundinamarca y Valle del Cauca han sido áreas epidémicas para TBB y brucelosis, respectivamente (p<0,001). Además, se encontró un aumento de la detección de casos de TBB en 2012 y de brucelosis durante 2019 (p<0,001). Conclusiones: Este panel epidemiológico permite el seguimiento de puntos críticos de TBB y tuberculosis, identificando sus tendencias a lo largo del tiempo, y proporciona información útil para las autoridades de sanidad animal que diseñan nuevas estrategias para los programas de control.

Resumo Antecedentes: A tuberculose bovina (TBB) e a brucelose estão associadas a problemas persistentes no campo da pecuária na Colômbia e até em países desenvolvidos. Portanto, a vigilância de doenças em tempo real é uma estratégia essencial para controlar e erradicar surtos de doenças infecciosas. Objetivo: Projetar uma ferramenta epidemiológica para monitorar a TB e a brucelose na Colômbia. Métodos: Um painel de controle interativo foi projetado para o mapeamento de ambas as doenças entre 2004 e 2019 como período de observação. Resultados: A análise da ferramenta mostrou que as Províncias de Cundinamarca e Valle del Cauca foram áreas epidêmicas para TBB e brucelose, respectivamente (p<0,001). Além disso, foi encontrado um aumento na detecção de casos em 2012 para TBB e brucelose durante 2019 (p<0,001). Conclusões: Esse painel epidemiológico poderia permitir o monitoramento de pontos críticos dessas doenças, identificando tendências ao longo do tempo, fornecendo informações úteis para as autoridades de saúde animal que elaboram novas estratégias para programas de controle.

Summary report of a national survey of Kashin-Beck disease prevalence in 2019 / 中华地方病学杂志

Objective:To master the status of Kashin-Beck disease (KBD) in 2019, to provide the basis for assessment of KBD control and elimination.Methods:Data of endemic areas basic information collection and children KBD examination were executed in all endemic villages from every endemic county (city, district, banner) of 13 endemic provinces. All children aged 7 - 12 years in endemic villages underwent clinical examination, and X-ray examination was performed for clinically positive children. When both the clinical examination and X-ray reexamination were positive, the diagnosis was KBD.Results:In monitoring of 823 365 7 - 12 years old children, a total of 3 057 children with similar clinical signs of KBD were suspected positive cases. The results of X-ray reexamination showed that the X-ray manifestations of 3 057 children were normal, and no X-ray positive changes were found, that is, there was no case of KBD in children. A total of 16 559 endemic villages in 13 endemic provinces were monitored, and all reached the criteria for KBD elimination. Surveillance of all endemic villages was completed except Tibet Autonomous Region, the KBD elimination rates of endemic villages were 100.00% in 12 endemic provinces and 99.01% (16 559/16 725) in all 13 endemic provinces.Conclusions:No children KBD case is detected in 2019, children KBD stays at its eliminating level throughout the country. And 100.00% endemic villages meet the criteria for KBD elimination in the remaining 12 endemic provinces except Tibet Autonomous Region.

Analysis of the local dengue fever outbreak in the north of Henan Province in 2019 / 中华微生物学和免疫学杂志

Objective:To provide data support for the prevention and control of dengue fever in Henan Province by analyzing the molecular epidemiological and etiological characteristics of dengue fever outbreaks in Puyang in 2019.Methods:Blood samples were collected from all suspected cases of dengue fever. The antigen, antibody and nucleic acid of dengue virus (DENV) were detected. The E gene was amplified by viral nucleic acid extraction and sequenced. Phylogenetic tree was constructed to trace the source of infection. Results:A total of 61 local cases of dengue fever were reported, and no deaths were reported. Among them, 4 cases (72.13%) were positive for DENV NS1 antigen; 16(26.23%) cases were positive for specific IgM; 38(62.30%) cases were positive for specific IgG; 34 cases (54.10%) were positive for dengue nucleic acid testing. Ten dengue virus strains were isolated, all of which were dengue virus type 1(DENV-1). Sequence analysis of E gene suggested it belonged to the same clade as Henan201903 strain imported from Cambodia to Zhumadian, Henan in 2019, with the highest homology. Conclusions:The dengue fever epidemic in Henan Province was caused by DENV-1, which might be improted from Cambodia, Singapore, Myanmar and other Southeast Asian countries. Therefore, the surveillance of DENV in people returning from Southeast Asia should be strengthened.

A situation model of integrated health information platform in India: an anticipated review

Supportive supervision is one of the most important tasks in health systems management. A baseline assessment conducted by the primary health care transformation initiative had shown that the Gurage Zone health department had been conducting regular supportive supervision every quarter for the last five years in Gurage Zone. The study proposed establishing a feedback auditing system as an intervention to routinely assess the progress of previous visit actions included in the written feedback. The finding showed the culture of working on previous supportive supervision action items by woreda (district) health offices were significantly improved

Surveillance of the first cases of COVID-19 in Sergipe using a prospective spatiotemporal analysis: the spatial dispersion and its public health implications

Abstract INTRODUCTION: Coronavirus disease 2019 (COVID-19) has become a global public health emergency with lethality ranging from 1% to 5%. This study aimed to identify active high-risk transmission clusters of COVID-19 in Sergipe. METHODS: We performed a prospective space-time analysis using confirmed cases of COVID-19 during the first 7 weeks of the outbreak in Sergipe. RESULTS: The prospective space-time statistic detected "active" and emerging spatio-temporal clusters comprising six municipalities in the south-central region of the state. CONCLUSIONS: The Geographic Information System (GIS) associated with spatio-temporal scan statistics can provide timely support for surveillance and assist in decision-making.

Screening of Workers with Presumed Occupational Methanol Poisoning: The Applicablility of a National Active Occupational Disease Surveillance System

BACKGROUND: Methyl alcohol poisoning in mobile phone–manufacturing factories during 2015–2016 was caused by methyl alcohol use for cleaning in computerized numerical control (CNC) processes. To determine whether there were health complications in other workers involved in similar processes, the Occupational Safety and Health Research Institute conducted a survey. METHODS: We established a national active surveillance system by collaborating with the Ministry of Employment and Labor and National Health Insurance Service. Employment and national health insurance data were used. Overall, 12,048 employees of major domestic mobile phone companies and CNC process dispatch workers were surveyed from 2016 to 2017. We investigated methyl alcohol poisoning by using the national health insurance data. Questionnaires were used to investigate diseases due to methyl alcohol poisoning. RESULTS: Overall, 24.9% of dispatched workers were employed in at least five companies, and 23.9% of dispatched workers had missing employment insurance history data. The prevalence of blindness including visual impairment, optic neuritis, visual disturbances, and alcohol toxicity in the study participants was higher than that reported in the national health insurance database (0.02%, 0.07%, 0.23%, and 0.03% versus 0.01%, 0.07%, 0.13%, and 0.01%, respectively, in 2015). Moreover, 430 suspicious workers were identified; 415 of these provided an address and phone number, of whom 48 responded (response rate, 11.6%). Among the 48 workers, 10 had diseases at the time of the survey, of whom 3 workers were believed to have diseases related to methyl alcohol exposure. CONCLUSION: This study revealed that active surveillance data can be used to assess health problems related to methyl alcohol poisoning in CNC processes and dispatch workers.

Acute Chagas disease in the state of Pará, Amazon Region: is it increasing?

Acute Chagas disease (ACD) has a distinct epidemiological profile in the Amazon Region, with cases and outbreaks of Trypanosoma cruzi infection being possibly related to the ingestion of contaminated food. Data on ACD in the state of Pará retrieved from 2000 to 2016 from the Brazilian Notifiable Diseases Information System (SINAN) were evaluated. During this period, 2,030 of the 16,807 reported cases were confirmed, with a higher incidence between the months of August and December, thus characterising a seasonal pattern of acute infection, and coinciding with the higher production of "açaí", one fruit likely involved in the oral transmission of the disease. Evaluation of the absolute numbers of confirmed ACD cases secondary to oral infection suggests that infection through this route increased during the 2010-2016 period, differing from what was recorded in terms of vectorial or other infection routes. These findings point to the need of intensifying strategies to prevent or substantially reduce oral transmission.

An analysis on the reasons for the delay in discovering dengue fever outbreak in Zhejiang Province / 预防医学

Objective To learn the timeliness and reasons for the delay in discovering outbreaks via a dengue fever outbreak in Zhejiang Province,and try to improve our disease monitoring system.Methods Epidemic and clinic data were collected by searching cases and epidemiological investigation,and clinic behavior of cases in dengue fever outbreak were described,then the risk factors involved in the delay in discovering outbreak were analyzed.Results Totally 46 cases were found in this outbreak,among which 36 (78.28％) cases were infected before.The onset date of the first case we found was on July 15 th,57 day before the outbreak confirmation.According to the results,95.65％ of cases see a doctor after their sickness,and the rate of three day hospital visiting was 93.36％ (42/46),among which the rate of three day hospital visiting before pathogen confirmation was 91.67％ (33/36),and there was no statistic significance in diagnostic rate before and after pathogen confirmation(P =1.00).Conclusion Cases in this dengue outbreak presented high and timely outpatient rate.Thus,the delay confirmation of dengue fever outbreak was caused by the low sensitivity of doctors in all levels of hospital.More training on dengue fever diagnosis for doctors should be carried out in the future to control and prevent dengue fever more efficiently.

Epidemiologic analysis of other-infectious diarrhea in Shaanxi Province from 2006 to 2015 / 西安交通大学学报(医学版)

Objective To analyze the epidemiological characteristics of other-infectious diarrhea (OID) in Shaanxi Province from 2006 to 2015 to further clarify the prevention and control strategies.Methods We collected data from the Infectious Disease Report Information System in China for Disease Prevention and Control and made a statistical description of the epidemiological characteristics of incidence distribution in Shaanxi from 2006 to 2015.Results Totally 207 437 cases of other-infectious diarrhea were reported in Shaanxi Province during 2006 -2015,with the average yearly incidence rate of 52.43/105.The incidence number was higher in males (126 673 cases) than in females (80 764 cases),with male-female ratio of 1.57 ∶ 1.The diseases were most serious in age groups 0-and 1-4 years,accounting for 72.48％.The top-three careers of reported cases were scattered children (74.88 ％),farmers (10.75 ％) and students (5.75 ％),respectively.The cities with the highest incidence in Shaanxi Province were Baoji,Yan'an and Ankang.Two high-incidence seasons were summer (July to August) and winter (November to December).The main pathogen of viral diarrhea was rotavirus,but laboratory-confirmed proportion was low (4.60％).Conclusion Other-infectious diarrhea,especially infection caused by rotavirus in autumn and winter,mainly occurred in children younger than 5 years old.Etiological diagnosis should be strengthened because of the poor laboratory diagnosis reporting rate.