World Outbreak Trend of Infectious Diseases with Surveillance

The diverse infectious diseases can occur everywhere in the world, but high-risk infectious diseases should be monitored immediately after the occurrence, and be controlled not to spread to the public. Other highly contagious ones also should be screened with the surveillance system and made to be prevented from a serious effect on public health. The outbreak information, articles and news reports concerning global infectious disease outbreaks were collected from known web-based resources and deposited in Global Center for Infectious Diseases since 2016. The number of reports collected from various sources was analyzed on the respect of Blueprint priority diseases and vaccine-preventable diseases, and the characteristic outbreak trend was shown in the geographic distribution and the so-called socio-economic level of countries. The WHO R&D Blueprint priority diseases are being reported especially in the region of Africa and Asia. The vaccine-preventable and other infectious diseases also are reported continuously and world-widely. They threaten the safety of life continuously in public. Therefore, keeping close observation and strengthening infectious disease surveillance is needed, and more effort to expand the collecting resources to get more outbreak information is warranted.

Barriers and facilitators of implementing child injury surveillance system / 中华创伤杂志(英文版)

PURPOSE@#Child injuries are a global public health problem and injury surveillance systems (ISS) can be beneficial by providing timely data. However, ISS implementation has challenges. Opinions of stakeholders of ISS implementation barriers and facilitators are a good source to understand this phenomenon. The aim of this study is to investigate barriers and facilitators of implementing ISS in Iran.@*METHODS@#This is a qualitative study. Data were gathered through interviews with 14 experts in the field of child injury and prevention from Iranian Ministry of Health and Medical Education (MOHME), medical universities, pediatrics hospitals, general hospitals and health houses during January 2017 to September 2017. Data collection and analysis continued until data saturation. Data were analyzed using content analysis through identifying meaning units.@*RESULTS@#Barriers were classified in three main categories and nine subcategories including management barriers (including performance, coordination and cooperation, supervision and attitude), weakness in data capture and usage (including data collection, data recording and data dissemination) and resource limitation (including human and financial resources). Facilitators identified in three areas of policy making (including empowerment and attitude), management (including organization, function and cooperation and coordination) and data recording and usage (including data collection/distribution and data recording).@*CONCLUSION@#The most important barrier is lack of national policy in child injury prevention. The most important facilitator is improving MOHME function through passing supportive regulations. Effective data usage and dissemination of information to those requiring data for policy making can help reduce child injuries. Coalition of stakeholders helps overcome existing barriers.

Ocorrência de brucelose e tuberculose bovinas no Rio Grande do Sul com base em dados secundários / Occurrence of bovine brucellosis and tuberculosis in Rio Grande do Sul, Brazil, based on secondary data

Avaliaram-se os resultados de testes para diagnóstico da brucelose e tuberculose bovinas objetivando analisar a distribuição de positividade e características de performance do programa de controle. A análise utilizou como dados secundários todos os resultados de testes para diagnóstico realizados em bovinos no ano de 2008 no estado do Rio Grande do Sul (RS) por médicos veterinários habilitados para atuação no âmbito do Programa Nacional de Controle e Erradicação de Brucelose e Tuberculose Animal. Os dados foram estatisticamente ajustados para minimizar os efeitos de valores extremos e de dados faltantes. Os testes alcançaram 66,80% dos 497 municípios do RS e incluíram a participação de 165 médicos veterinários habilitados. 40,21% dos testes foram realizados nos meses de abril, setembro e outubro, sendo que em 73,90% dos estabelecimentos foram realizados testes para ambas as enfermidades. No caso da brucelose verificou-se que foram testados 35.289 animais, com uma frequência de positivos de 0,25%, enquanto a frequência de estabelecimentos positivos entre os 3.406 testados foi 0,94%. Fêmeas apresentaram frequência de positividade mais elevada (0,29%, de 26.724 testadas) do que machos (0,13%, de 5.235 testados). Animais entre 48-60 meses de idade apresentaram chance de positividade superior às demais faixas etárias (Razão de Chances (RC) =2,63; IC 95%=1,63-4,26). Animais de aptidão leiteira representaram 62,66% dos animais testados, e apresentaram maior chance de positividade do que animais de corte (RC=2,32; IC 95%=1,38-3,90). Adicionalmente, 73,74% dos estabelecimentos testados eram dedicados à produção de leite. Já no caso da tuberculose foram testados 62.149 animais distribuídos em 5.151 propriedades, com frequência de positivos de 0,87% e 3,13%, respectivamente. A chance de positividade aumentou com a idade, sendo que animais com idade acima de 48 meses de idades apresentaram valores superiores aqueles verificados em animais mais jovens (RC=2,07; IC 95%=1,73-2,48). 59,74% dos animais testados eram de aptidão leiteira, os quais apresentaram mais chance de serem positivos do que aqueles de corte (RC=5,03; IC 95%=4,09-6,94). Propriedades leiteiras representaram 78,50% da totalidade dos testes para tuberculose. A análise comparativa do presente trabalho com estudos precedentes de prevalência da brucelose sugere que as ações de controle em curso têm sido efetivas na redução da prevalência da enfermidade no RS. Por outro lado, as informações obtidas no âmbito da tuberculose podem ser indicadoras da condição desta enfermidade, especialmente pela inexistência de estudos de prevalência realizados há menos de 30 anos. Adicionalmente, conclui-se que a utilização de dados secundários, desde que devidamente ajustados, pode ser uma ferramenta eficaz na gestão de programas de saúde animal e em sistemas de monitoramento e vigilância.(AU)

Results of tests for the diagnosis of bovine brucellosis and tuberculosis were evaluated aiming to analyze the distribution of positivity and characteristics of performance of the control program. The analysis used as secondary data the results of all diagnostic tests of bovines executed in 2008 in the state of Rio Grande do Sul (RS) by veterinarians authorized to operate under the National Program for Control and Eradication of Animal Brucellosis and Tuberculosis. The data were statistically adjusted to minimize the effect of outliers and missing data. The tests achieved 66.80% of the 497 municipalities in the RS and included the participation of 165 authorized veterinarians. 40.21% of tests were carried out in the months of April, September and October, and in 73.90% of establishments had tests performed for both diseases. In the case of brucellosis it appeared that 35,289 animals were tested, with positivity of 0.25%, while the frequency of positive holdings among the 3,406 tested was 0.94%. Females had higher positivity rate (0.29% of 26,724 tested) than males (0.13% of 5,235 tested). Animals between 48-60 months of age presented higher chance of positivity compared to other age groups (Odds Ratio (OR) = 2.63; CI 95% = 1.63 - 4.26). Dairy cattle represented 62.66% of tested animals, which were more likely to appear as positive than beef animals (OR = 2.32; CI 95% = 1.38 - 3.90). In addition, 73.74% of the tested holdings were dairy ones. In the case of tuberculosis, 62,149 animals were tested, distributed in 5,151 holdings, with positivity of 0.87% and 3.13%, respectively. The chance of positivity increased with age, being that animals older than 48 months presented higher values compared to ​​those found in younger animals (OR = 2.07; CI 95% = 1.73 - 2.48). Dairy cattle represented 59.74% of tested animals, which were more likely to be positive than beef ones (OR = 5.03; CI 95% = 4.09 - 6.94). Dairy holdings were 78.50% of all the tests for tuberculosis. The comparative analysis of this study with previous studies on brucellosis prevalence suggested that current control measures have been effective in reducing the prevalence of this disease in RS. On the other hand, information obtained on tuberculosis can be indicators of the condition of this disease, especially in the lack of prevalence studies carried out in the last 30 years. Finally, it is concluded that the use of secondary data, if properly adjusted, can be an effective tool in the management of animal health programs and monitoring and surveillance systems.(AU)

Elementos distintivos de los sistemas de vigilancia tecnológica en el contexto cubano e internacional / Distinctive features of technological surveillance systems in the Cuban and international contexts / Elementos distintivos dos Sistemas de Vigilância Tecnológica no contexto cubano e internacional

La propuesta de sistemas de vigilancia tecnológica en diversos sectores, tanto en Cuba como en el ámbito internacional, ha sido un área de conocimiento que ha evolucionado. Esta investigación tiene la intención de profundizar en las particularidades que distinguen a los sistemas de vigilancia tecnológica, con la finalidad de que las organizaciones que tienen entre sus proyecciones diseñar este tipo de sistema conozcan cuáles son los aspectos que deben tener en cuenta. Se identificaron un total de 21 sistemas de vigilancia tecnológica. Los elementos que se utilizaron para describirlos fueron: institución a la que pertenecen, diagnóstico de la vigilancia tecnológica, procesos de vigilancia tecnológica, norma o modelo de vigilancia tecnológica, roles del sistema, productos/servicios, difusión de los resultados de vigilancia tecnológica, plataformas para la gestión de la vigilancia tecnológica y evaluación del funcionamiento del sistema. Se utilizó el análisis documental para la identificación y el análisis de las diversas fuentes de información para analizar los aspectos teóricos y los elementos distintivos de los sistemas de vigilancia tecnológica objeto de estudio. Los principales resultados arrojaron que los elementos que coinciden en la estructura de este tipo de sistema son: etapas del proceso de vigilancia tecnológica, finalidad del sistemas de vigilancia tecnológica, fuentes de información que utilizan, definición de roles, productos/servicios de información y plataformas para la gestión de la sistemas de vigilancia tecnológica. La mayoría de las experiencias estudiadas define el sistema de vigilancia tecnológica a través de las normas de vigilancia AFNOR XP X 50-053-FRE y UNE 166006: 2006 Ex Sistema de Vigilancia Tecnológica.

Proposal of technological surveillance systems is a field of knowledge in permanent evolution, both in Cuba and internationally. The purpose of the present study is todeeply analyze the features distinguishing technological surveillance systems with a view to informing organizations in charge of designing such systems about the aspects they should bear in mind. A total 21 technological surveillance systems were identified. The following features were used for their description: institution they belong to, technological surveillance diagnosis, technological surveillance processes, technological surveillance standard or model, system roles, products / services, dissemination of technological surveillance results, technological surveillance management platforms, and system performance evaluation. Document analysis was performed to identify and analyze the various information sources as well as to examine the theoretical aspects and distinctive features of the technological surveillance systems under study. According to the main results obtained, the elements present in the structure of this type of system are the following: stages in the technological surveillance process, purpose of the technological surveillance system, sources of information used, role definition, information products / services, and platforms for technological surveillance systems management. Most of the experiences examined base their definition of technological surveillance system on surveillance standards AFNOR XP X 50-053-FRE and UNE 166006: 2006 Ex.

A proposta de sistemas de vigilância tecnológica em diversos sectores, tanto em Cuba como no âmbito internacional, tem sido uma área de conhecimento que tem evolucionado. Esta investigação tem a intenção de aprofundar nas particularidades que distinguem os sistemas de vigilância tecnológica, com a finalidade de que as organizações que têm entre suas projeções desenhar este tipo de sistema conheçam quais são os aspectos que devem ter em conta. Identificaram-se um total de 21 sistemas de vigilância tecnológica. Os elementos que se utilizaram para descrevê-los foram: instituição à que pertencem, diagnóstico da vigilância tecnológica, processos de vigilância tecnológica, norma ou modelo de vigilância tecnológica, roles do sistema, productos/serviços, difusão dos resultados de vigilância tecnológica, plataformas para a gestão da vigilância tecnológica e avaliação do funcionamento do sistema. Utilizou-se a análise documental para a identificação e a análise das diversas fontes de informação para analisar os aspectos teóricos e os elementos distintivos dos sistemas de vigilância tecnológica objeto de estudo. Os principais resultados fizeram com que os elementos que coincidem na estructura deste tipo de sistema são: etapas do processo de vigilância tecnológica, finalidade dos sistemas de vigilância tecnológica, fontes de informação que utilizam, definição de roles, produtos/serviços de informação e plataformas para a gestão dos sistemas de vigilância tecnológica. A maioria das experiências estudadas define o sistema de vigilância tecnológica a través das normas de vigilância AFNOR XP X 50-053-FRE e UNE 166006: 2006 Ex Sistema de Vigilância Tecnológica.

Construction plan of the military infectious diseases syndromic surveillance system / 军事医学

Combining theory and practice at home and abroad in recent years ,construction plan of the military infectious diseases syndromic surveillance system was discussed from aspects of data collection and transmission , data analysis and early warning , incident response based on the core business requirements of syndromic surveillance for infectious diseases . The study provides the demand traction for the system construction .

Magnitude, Distribution, and Estimated Level of Underreporting of Acute Gastroenteritis in Jamaica.

Jamaica is the third largest island in the Caribbean. The epidemiology of acute gastroenteritis (AGE) is important to Jamaica, particularly in the areas of health, tourism, and because of the potential impact on the local workforce and the economy. Data collected by the National Surveillance Unit on the prevalence of AGE transmitted by food are not accurate. To determine the true magnitude, risk factors, and the extent of underreporting of AGE in Jamaica, we conducted a cross-sectional, population-based retrospective survey during the periods of 21 February–7 March and 14-27 June 2009, corresponding to high- and low-AGE season respectively. Of the total 1,920 persons selected randomly by a multistage cluster-sampling process, 1,264 responded (response rate 65.8%). Trained interviewers administered a standardized, validated questionnaire during face-to-face interviews. The overall prevalence of self-reported AGE was 4.0% (95% CI 2.9-5.1) at a rate of 0.5 episodes/per person-year. The highest monthly prevalence of AGE (14.6%) was found among the 1-4 year(s) age-group and the lowest (2.1%) among the 25-44 years age-group. Of the 18 cases (36%) who sought medical care, 11% were hospitalized, 33% were treated with antibiotics, and 66.7% received oral rehydration fluids. Only 2 cases who sought medical care reportedly submitted stool specimens. The mean duration of diarrhoea was 3.1 days, which resulted in a mean loss of 4 productive days, with over half of the cases requiring someone to care for them. The burden of syndromic AGE for 2009 was extrapolated to be 122,711 cases, showing an underreporting factor of 58.9. For every laboratory-confirmed AGE case, it was estimated that 383 more cases were occurring in the population. This research confirms that the prevalence of AGE is underreported in Jamaica and not being adequately detected by the current surveillance system. The components of the integrated surveillance system for AGE in Jamaica, particularly the laboratory aspect, need to be strengthened.

Burden and Impact of Acute Gastroenteritis and Foodborne Pathogens in Trinidad and Tobago.

Objectives of this study were to determine the burden and impact of acute gastroenteritis (AGE) and foodborne pathogens in Trinidad and Tobago. A retrospective, cross-sectional population survey, based on selfreported cases of AGE, was conducted in November-December 2008 and May-June 2009 (high- and low- AGE season respectively) by face-to-face interviews. From 2,145 households selected to be interviewed, the response rate was 99.9%. Of those interviewed, 5.1% (n=110; 95% CI 4.3-6.2) reported having AGE (3 or more loose watery stools in 24 hours) in the 28 days prior to the interview (0.67 episodes/person-year). Monthly prevalence of AGE was the highest among children aged <5 years (1.3 episodes/year). Eighteen (16%) persons with AGE sought medical care (4 treated with oral rehydration salts and 6 with antibiotics), and 66% reported restricted activity [range 1-16 day(s)]. The mean duration of diarrhoea was 2.3 days (range 2-10 days). One case submitted a stool sample, and another was hospitalized. Overall, 56 (10%) AGE specimens tested positive for foodborne pathogens. It was estimated that 135,820 AGE cases occurred in 2009 (84% underreporting), and for every 1 AGE case reported, an additional 6.17 cases occurred in the community. The estimated economic cost of AGE ranged from US$ 27,331 to 19,736,344. Acute gastroenteritis, thus, poses a huge health and economic burden on Trinidad and Tobago.

Diseño de un sistema de vigilancia para infecciones transmitidas por transfusión de sangre en Cienfuegos / Design of a surveillance system for blood transfusion-borne infections in Cienfuegos province

Las infecciones víricas constituyen una de las complicaciones más temidas de la transfusión de sangre. A pesar de los esfuerzos para reducir o eliminar este riesgo, hoy es un problema no resuelto. En Cuba, la selección médica del donante, la pesquisa de infecciones y la vigilancia postransfusión, son actividades que están debidamente documentadas, sin embargo, existen brechas en su realización desde el punto de vista gerencial, epidemiológico y de atención médica. Por las razones anteriores se desarrolló esta investigación, para organizar con enfoque sistémico la vigilancia de las infecciones transmitidas por transfusión, que permitirá mejor control de los donantes y mayor seguridad de la sangre. Se realizó un estudio de desarrollo dividido en tres etapas: diagnóstico, planificación y diseño. Se utilizaron técnicas cualitativas individuales y grupales. Se presenta el diseño del Sistema de Vigilancia. Se explican los cinco subsistemas básicos: diagnóstico clínico, laboratorio, estadístico, epidemiológico, técnico material y comunitario. Con el sistema propuesto, la provincia de Cienfuegos está contribuyendo al logro de uno de los objetivos inmediatos del Programa de Medicina Transfusional de Cuba, que es el establecimiento de un sistema de hemovigilancia en todo el país

The viral infections are one of the most feared complications from blood transfusions. Despite the efforts directed at reducing or eliminating this risk, this is an unsolved problem at present. The medical selection of the donor, the infection screening and the post-transfusion surveillance are some activities to be performed to prevent this situation. These activities are duly documented in Cuba; however, there are difficulties in carrying them out from the managerial, epidemiological and medical care viewpoints. For the above-mentioned reasons, this research study was aimed at organizing the surveillance of transfusion-borne infections with systemic approach, for the better control of donors and greater blood safety. A developmental study was conducted in three phases: diagnosis, planning and design. Individual qualitative techniques and group qualitative techniques were used. The final design of the surveillance system was presented. It comprised the five basic surveillance subsystems, that is, clinical diagnosis, laboratory, statistical, epidemiological, technical-material and community. With this system, Cienfuegos province contributes to the attainment of one of the immediate objectives of the Cuban Transfusional Medicine Program - the setting up of a hemosurveillance system throughout the country

A discussion on the strategy of evaluating the communicable disease surveillance systems in US Center for Disease Control and Prevention and World Health Organization / 中华流行病学杂志

Objective To compare the different surveillance system evaluation guidelines proposed by US Center for Disease Control and Prevention (CDC) and WHO, so as to develop an evaluation strategy suitable for communicable disease surveillance systems in China. Methods Systematic collection and review on the guidelines that were proposed by US CDC and WHO.Situation analysis together with feasibility analysis were linked to the analysis of evaluation strategy used in China. Results US CDC guidelines were more appropriate for evaluating those single or appropriate for evaluating the multi-system or complicated system which focusing on data related to moment to start to evaluate the functions. Conclusion More flexible and comprehensive strategy based on national conditions is needed when constitute the national communicable disease surveillance evaluation guidelines. The multi-step strategy described in this article could be used as reference.

Avances y puntos pendientes en la agenda latinoamericana para el control del tabaco / Progress and pending issues in the Latin American agenda for tobacco control

El estudio de la Carga Mundial de la Enfermedad proyecta que el incremento en la prevalencia de fumadores en países de ingresos medios y bajos contribuirá a incrementar las muertes cardiovasculares, por enfermedad pulmonar obstructiva crónica y algunos cánceres. Para reducir estas consecuencias del tabaquismo, la Organización Mundial de la Salud (OMS) recomienda un conjunto de acciones reunidas en el Convenio Marco para el Control del Tabaco (CMCT) y los informes MPOWER. En este artículo se revisó el más reciente de estos informes y sintetizamos las principales intervenciones que estaban vigentes en los países latinoamericanos y también revisamos algunas medidas implementadas durante 2009 y 2010. En los últimos años se ha avanzado considerablemente en materia de control del tabaco. Sin embargo, todavía queda por avanzar para acercarnos a lo sugerido por la OMS. De mantenerse el nivel de consumo entre los adolescentes de la región actualmente, observaremos en las décadas futuras un incremento en el número de muertes prematuras y evitables causadas por el tabaco.

Projections based on the most recent report on the Global Burden of Disease show that the observed increase in smoking prevalence in middle and low income countries will contribute to the increase of the number of deaths due to cardiovascular diseases, chronic obstructive pulmonary diseases, and some cancers. The World Health Organization (WHO) Framework Convention on Tobacco Control recommends a group of actions to curb the tobacco epidemic. This is a review paper based on the most recent MPOWER report and also included in this review are some of the most recent tobacco control measures implemented during 2009 and 2010. We conclude that most Latin American countries have achieved significant progress in tobacco control in recent years. However, when comparing the current situation against the WHO recommendations we realized that for most countries there is still work to be done. If current smoking prevalence among teenagers remains unchanged, there will be a significant increase in the number of premature deaths attributable to tobacco consumption in future decades.