ABSTRACT
Objetivo: identificar ocorrência de surto compatível com escorbuto e fatores de exposição associados aos sinais/sintomas típicos de hipovitaminose, em penitenciária masculina, Ceará, Brasil, 2019-2020. Métodos: estudo de caso-controle populacional; foram utilizados registros clínicos e entrevistas com casos compatíveis - sinais/sintomas iniciados no período - e com controles; realizou-se análise multivariável. Resultados: 62 casos; idade média de 40,6 anos (DP = 10,8); principais sinais/sintomas foram edema e dor em membros inferiores (100,0%), dificuldade para deambular (91,9%), hematoma/equimose em membros inferiores (90,3%), febre (88,7%); identificou-se, como fator de exposição, média de idade > 40 anos (ORa = 1,10; IC95% 1,05;1,17; p-valor = 0,001); e como fatores protetores, trabalho (ORa = 0,11; IC95% 0,03;0,36; p-valor < 0,001) e participação em aulas (ORa = 0,21; IC95% 0,08;0,59; p-valor = 0,003) dentro da penitenciária. Conclusão: surto da penitenciária compatível com escorbuto pelos sinais/sintomas característicos, associados aos fatores identificados; recomendou-se oferta regular de dieta rica em vitamina C para todos os internos e acompanhamento clínico dos casos.
Objective: to identify the occurrence of an outbreak compatible with scurvy and exposure factors associated with typical signs/symptoms of hypovitaminosis that occurred in a male penitentiary in Ceará, Brazil between 2019-2020. Methods: this was a population-based case-control study; we used clinical records and interviews with compatible cases - based on sign/symptom onset during the study period - and with controls; we carried out multivariate analysis. Results: out of 62 cases, mean age was 40.6 years (SD = 10.8); main signs/symptoms were edema and pain in the lower limbs (100.0%), difficulty in walking (91.9%), hematoma/ecchymosis in the lower limbs (90.3%) and fever (88.7%); we identified being over 40 years old as an associated factor (aOR = 1.10; 95%CI 1.05;1.17; p-value = 0.001); and as protective factors: working (aOR = 0.11; 95%CI 0.03;0.36; p-value < 0.001) and taking part in classes (aOR = 0.21; 95%CI 0.08;0.59; p-value = 0.003) in the prison. Conclusion: we considered the penitentiary outbreak to be compatible with scurvy due to characteristic signs/symptoms, associated with the identified factors; we recommended regular provision of a diet rich in vitamin C to all male inmates and clinical follow-up of cases.
Objetivo: identificar la ocurrencia del brote compatible con escorbuto y los factores de exposición asociados con signos/síntomas típicos de hipovitaminosis que ocurrieron en una penitenciaría masculina en Ceará, Brasil entre 2019-2020. Métodos: estudio poblacional de casos y controles; se utilizaron historias clínicas y entrevistas con casos compatibles, con inicio de signos/síntomas durante el período de estudio, y controles; se realizó análisis multivariable. Resultados: de los 62 casos, edad media fue 40,6 años (DE = 10,8); principales signos/síntomas fueron edema y dolor en miembros inferiores (100,0%), dificultad para caminar (91,9%), hematoma/equimosis en miembros inferiores (90,3%) y fiebre (88,7%); la edad mayor de 40 años se identificó como factor asociado (ORa = 1,10; IC95% 1,05;1,17; p-valor = 0,001); y como factores protectores: trabajo (ORa = 0,11; IC95% 0,03;0,36; p-valor< 0,001) y participación en clases (ORa = 0,21; IC95% 0,08;0,59; p-valor = 0,003) dentro del centro penitenciario. Conclusión: el brote en centro penitenciario fue considerado compatible con escorbuto debido a los signos/síntomas característicos, asociados a los factores identificados; se recomendó oferta regular de dieta rica en vitamina C a todos los internos y seguimiento clínico de los casos.
Subject(s)
Humans , Male , Adult , Middle Aged , Ascorbic Acid Deficiency/diagnosis , Scurvy/epidemiology , Disease Outbreaks , Prisoners , Avitaminosis/diagnosis , Brazil , Field EpidemiologyABSTRACT
Introduction@#Field epidemiology training (FET) was first established in 1951, named as Epidemics Intelligence Service, next to the Centres for Disease Control and Prevention of USA. At present, FET is conducted in over 50 countries in the world and the training is based on the main principle of promoting utilization of theories of epidemiology in public health practice and evidence-based decision making. Main goal of FET is to strengthen capacity and infrastructure of the public health system and to improve people’s health as a result of forming a core team of professionals, which will deliver public health services in a particular country, survey any country-specific public health issues, and provide evidence.</br> MFETPs have been implemented in Mongolia since 2009 with support from Ministry of Health (MOH) and World Health Organization (WHO). To ensure structural and organizational sustainability of the training, the programme has been integrated into the National Centre for Communicable Disease (NCCD) under the auspices of MOH and the trainings have been conducted nationwide. MFETPs last for one year, which includes 1-2 months of classroom training and 3-11 months of field internship by trainees. The training graduates should be skilled to use the science of epidemiology in studying public health issues and to deliver evidence-based conclusions and recommendations.@*Goal@#To evaluate of MFETP graduates’ knowledge, skills and their contribution to the public health system@*Method@#We conducted a cross-sectional online survey link between October 2019 and March 2020 through Mongolian field epidemiology alumni networks. Survey questions included demographic details of participants, along with their technical background, level of formal education, topics studied during epidemiology training, and years of experience as an epidemiologist. We specifically targeted FETP alumni, however the survey was open to all people who had studied MFETP.@*Results@#In total, 55 field epidemiologists (77% of all graduates) responded to the survey. Participants had a range of formal public health and epidemiology training backgrounds. Of the total graduates, 19 (30%) are currently working at NCCD, of whom 3 are head of department. A total of 7 (11%) graduates work in rural health centers and health centers, while 6 (10%) graduates work in the tertiary level. In addition, there are 2 graduates working in the Ministry of Health. 80.6% (25/31) were involved in outbreak-response activities and 93.9% (31/33) conducted operational research, 91.4% (32/35) said that the surveillance analysis was conducted and 81.5% (22/27) performed fundamental researches at least one times. One graduate had an average 3.7 study and analysis during the course of the study, and increased to 7.7±12.4 after graduation. Particularly, the operational study (4.1 ± 8.7) and the outbreak study (3.1 ± 4.5) have increased.@*Conclusion@#Our study has demonstrated that applied epidemiology workforce training must evolve to remain relevant to current and future public health challenges.
ABSTRACT
Introduction@#Field epidemiology training programmes (FETPs) emphasize competency-based training and learning by doing. Supervision of FETP trainees is critical for programmes to achieve learning outcomes. We sought to address a knowledge gap regarding what constitutes effective FETP supervision. @*Methods@#We investigated FETP supervision using a mixed-methods approach. Quantitative data were collected through a survey of FETP directors. Qualitative data included written feedback from the survey and a focus group discussion (FGD) conducted with FETP supervisors at the 8th South-East Asia and Western Pacific Bi-regional TEPHINET Conference. FGD questions focused on effective supervisory qualities and activities and challenges to effective supervision. We calculated descriptive statistics for quantitative data and analysed qualitative data using a deductive content analysis approach.@*Results@#Eleven FETP directors responded to the survey and 23 participated in the FGD. Overall, supervision was seen as very important for trainee outcomes. Participants identified the different roles of academic and field supervisors but emphasized the importance of an enabling and supporting attitude towards trainees. Soft skills and interpersonal abilities were among the most important qualities identified for effective supervision. Key challenges identified included a lack of consistency in supervisors’ technical knowledge and the difficulty of finding candidate supervisors with sufficient interest, availability and motivation for supervision. @*Discussion@#Several practical recommendations arose from this study for supervision in FETPs, including recruiting and training supervisors with a more holistic range of skills. Our findings also provide key points for current FETP supervisors to consider to improve their own practice.
ABSTRACT
Objective:To build a social aging scale for healthy people,and get the accuracy and feasibility of the scale to judge the aging of healthy people on the basis of the empirical research.Methods:Stratified random sampling was conducted according to the nine different age groups,and the age-related social function information was collected for healthy people by using the scale,which was made in our own plant;the distribution of the score,the correlations between the score and age or telomere length were analyzed by statistical software.Results:A total of 2 297 subjects were collected for the analysis.The ratio of male to female was 0.8:1.Social function of aging score was in the range of 3.00-12.90;aging score of personal ability was in the range of 1.00-4.45;aging score of social participation was in the range of 1.00-4.52;and aging score of organizational communication was in the range of 1.00-5.00.The correlation coefficient of aging scores with age was 0.696 (P＜0.001).The result of telomere length showed that the relative telomere length was 1.056±0.261.The telomere length in different groups were significantly different (F=35.803,P＜0.001).The telomere length was negatively correlated with aging (r=-0.964,P＜0.001) and social function of aging (r=-0.857,P＜0.001),respectively.Conclusion:The scores of age-related social function,personal ability,social participation,and organizational communication are increased with age.The telomere length is negatively correlated to aging score.The scale is applicable to measure social function of aging,which can provide reference for evaluation of the comprehensive of aging.
ABSTRACT
Objective To understand the current status,type,and effect of training programs conducted by Health Bureau and CDC in China.Methods One person of each province was selected from China field epidemiology training network and designated as contact person who was responsible for collecting information of field practical training lasting for at least 6 months for staff of public health emergency and infectious disease control in each province from October 2001 to October 2010.Questionnaire including basic condition,organization and management,training design,faculty condition,trainee condition and training outputs was designed and filled in by contact person.Results There were 35 training programs covering over 9 provinces in China.The first province and city FETP started in 2004,including Guangdong FETP,Zhejiang FETP,Hangzhou FETP,Ningbo FETP and Guizhou FETP.Thirty-five training programs had 355 mentors,22(6％)were CFETP graduates and 57 (16％)were local FETP graduates.All program funds were paid by local governments.The training programs included two parts,theoretical lectures and field practice,which occupying 10％-20％ and 80％-90％ of the whole training time,respectively.Among 6 evaluative items including emergency investigation,surveillance analysis,surveillance evaluation,planned investigation,investigation report and paper publication,most programs(50％-94％) had less than average one person per time.Conclusions Field epidemiology training program after several years of development in china achieves the certain scale.Some provincial programs are successful,but the effect and quality of training programs in different areas are uneven.We suggest optimizing of field epidemiology training resources and further expanding China field epidemiology training network.
ABSTRACT
Objective All news reports (NR) that were related to public health emergency (PHE) were collected from the Southern Metropolis Daily (SMD) to explore the characteristics of epidemiology in the fields.Methods Based on the theory of communication that including both case and text analysis,qualitative analysis on all the NR regarding PHE published in SMD from the years of 2008 to 2012,was carried out and input to database using the EpiData.Numbers of articles as indicators were compared to show the yearly change of different types of events.Various features of the NR including coverage,source of information,location of the incident,style and size of news,with or without editorials etc.were statistically analyzed by SPSS version 18.0.Results Among all the 998 reports related to PHE,higher proportion was found in the events of Infectious diseases (35.3％)and food safety (34.1％) respectively.Events on vaccines and drugs used for disease prevention and control (8.9％),environmental pollution caused incidents (8.0％) appeared to be less frequent.Events related to occupational disease,poisoning,bioterrorism and biochemical events were rare.Looking at the monthly distribution of reports,we noticed that the peaks occurred in 2008 and in 2009,which were caused by the Melamine-contamination events and the 2009 H1N1 pandemic.Between 2010 and 2012,figures of monthly reports were smooth,including some critical events from the interests of the media.Most events took place in Guangdong province (34.3％) and other provinces (50.9％),with some were from Hong Kong,Macao and Taiwan regions (9.5％).However,international events (5.2％) were less seen.Extensive coverage accounted for 17.6％ of all of reports,and 11.5％ allotted the editorials or other forms of in-depth reports.Most of the source of reports on infectious diseases and food safety were from the official release,however.The main sources of occupational diseases and poisoning,vaccines and drug incidents,environmental pollution related incidents were reported by active journalists through interview.Reports on hand,foot and mouth disease,influenza,milk safety,AIDS and lead pollution showed continued concern in the past five years by SMD.Conclusion NR on public health emergencies by SM had encompassed all 10 categories-related events formulated by the Ministry of Health.Sustained and in-depth coverage were more commonly seen.Fieldepidemiologists should learn interdisciplinary sciences on the theory and methodology of communication.They also need to interact with media people during the whole processes of public health emergency preparedness and responses.
ABSTRACT
O estudo objetivou descrever dois surtos de intoxicação por exposição à rapadura, ocorridos em três municípios do estado do Rio Grande do Norte, entre janeiro e fevereiro de 2008. Foi conduzida uma investigação epidemiológica com a realização de estudo de caso. Outras investigações, laboratorial e ambiental, complementaram o quadro de informações sobre os surtos. Foram oito casos prováveis por exposição à rapadura, dos quais cinco por consumo do produto (um evoluiu para óbito) e três por proximidade física. As manifestações clínicas foram compatíveis com intoxicação por organofosforados. Outros sintomas apresentados podem estar relacionados com a presença de SO2, como rouquidão, lacrimejamento, dor nos olhos e ulceração corneana. A acetilcolinesterase eritrocitária resultou alterada para um dos pacientes que consumiu rapadura. Ocorreram dois surtos de intoxicação exógena: um por circunstância acidental e o outro, em decorrência do primeiro, por intoxicação ocupacional, cujo alimento implicado foi a rapadura contaminada com metamidofós e sulfito (SO2). A quantidade de metamidofós presente na rapadura consumida por dois casos foi 3.000 vezes maior que a ingestão diária aceitável para essa substância em humanos. Recomendam-se a adoção de medidas de saúde pública com a finalidade de minimizar a incidência de casos de intoxicação exógena e problemas decorrentes e prevenir surtos ocasionados por substâncias químicas, como as investigadas neste estudo.
Subject(s)
Organophosphorus Compounds/poisoning , Sulfur Dioxide/poisoning , Foodborne Diseases , Epidemiology , Epidemiology, Descriptive , Rapadura , Disease OutbreaksABSTRACT
Objective To find out the relationship of ecological environment protection and the transmission of Lyme disease under economic development of western regions in China.Methods Both scene molecular and traditional epidemiological methods were used to assess the effects of environmental protection on the transmission of Lyme disease.Results Among areas as protected natural forests,semiprotected nursery forests and farmland,the vector tick species and reservoir rodents from protected natural forests area had the highest quantity of population and diversity index and followed by semi-protected nursery forests.Vector competence of reservoir hosts and value of natural foci from protected natural forests area were also remarkably higher than those areas of semi-protected nursery forests and farmland. Staff working in the areas who were bitten by ticks from protected natural forests areas had higher serological Dositive rate(66.7%)than those from semi-protected nursery forests areas(2.5%),and both showed remarkable difference(P=6.45,E-11＜0.01,df=1).The difference of genetic divergence among these subpoPulations from different habitats being surveyed showed that the biggest genetic divergence index (Fst)of 0.557 42 was between protected natural forests area and farmland area.The index between semiprotected nursery forests area and farmland area was also bigger than zero with statistical significance.The genetic divergence index of 0.108 02 between semi-protected nursery forests area and protected natural forests area was the lowest which showed that genetic divergence between the subpopulations of the two sampling areas was not obvious.The genetic distance among these subpopulations had similar change along with their habitats.Conclusion Under economic development of western regions in China,when programs as natural forests protections,recovery prairie and grassland from farmland were actively performed,vectors insects and reservoir hosts of Lyme disease might also be protected to some degree but the risk and value of natural foci on Lyme disease might increase.Data suggested that people entering these areas should be told to strengthen their awareness on individual protection against the disease.