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Antecedentes:Las infecciones asociadas a la Atención en salud (IAAS) son un flagelo que azota a las instituciones prestadoras de servicio de salud aescala Mundial, se considera uno de los mayores problemas para la seguridad del paciente, afectando directamente la calidad en la prestación de servicios. Objetivo:Profundizar en los principales aspectosepidemiológicos de la IAAS, los factores de riesgorelacionados, el impacto que tiene este problema a nivel mundial y local y la importancia de un programa devigilancia epidemiológica hospitalaria comouna de las medidas para su prevención y control. Metodología:El presente documento es el resultadode una revisión bibliográfica de artículos científicos consultados enbases de datos Pubmed, Scielo, Proquest, Ovid, Google Académico, de los últimos 10 años, publicados en español y en inglés. Para la selección de la bibliografía se consideró el siguiente grupo de palabras claves: infección Asociada a la atención de la salud; infección intrahospitalaria; control de infecciones, vigilancia epidemiológica, sistema nacional de vigilancia hospitalaria.Conclusión:Con la revisión actual se evidenció que la prevalencia de IAAS se mantiene a través de los años, e incluso ha aumentado en instituciones de nivel intermedio de atención en salud, resaltando la importancia de incrementar las unidades notificadoras de IAAS y resistencia bacteriana, así como la creaciónde programas de vigilancia epidemiológica o Sistema Nacional de información de estos eventosde manera más eficiente, considerándose un componente clave de cualquier sistema de salud para mejorar los indicadores de la calidad en los servicios prestados en beneficio del paciente. La Vigilancia Epidemiológica es importante no solo por contribuir de manera significativa en el control y prevención de las IAAS sino para determinar los pasos a seguir en el momento de registrar y difundir debidamente, a las autoridades encargadas del análisis de dicha problemáticaen sus diferentes esferas de acción, apoyandode esta manera la toma de decisiones, la ejecución y evaluación de dichas enfermedades.
Background:The infections associated to the Attention in health (IAAS) they are an I lash that it whips to the institutions prestoredof service of health to World scale, it is considered one of the biggest problems for patient safety, directly affecting the quality in the provision of services. Objective:To deepen the knowledge in the main aspects of the IAAS, analysis of the factors of risk, mechanisms of prevention and the importance of the hospital epidemic surveillance as one of the measures for their control. Methodology: The present document is the result of a bibliographical revision of scientific articles consulted in the databases PubMed, Scielo, ProQuest, Ovid, Academic Google, of the last 10 years, published in Spanish and in English. For the selection of the bibliography it was considered the following group of key words: infection Associated to the attention of the health; infection intrahospital; control of infections, epidemic surveillance, national system of hospital surveillance. Conclusion:With the current review it was shown that the prevalence ofIAASis maintained over the years, and has even increased in intermediate level health care institutions, highlighting the importance of increasing the reporting units of IAASand bacterial resistance, as well as the creation of epidemiological surveillance programs or a more efficient National Information System for these events, considered a key component of any health system to improve the indicators of quality in the services provided for the benefit of the patient. The Epidemiological Surveillance is important not only for contributing in a significant way in the control and prevention of the IAAS, but also in determining the steps to be takenat the time of registering and disseminating, to the authorities in charge of the analysis of said problem in its different spheres of activity. action, supporting in this way the decision making, execution and evaluation of these diseases
Subject(s)
Humans , Health Services Accessibility , Health Services Administration , Epidemiology , AraucariaABSTRACT
Resumen Los mosquitos del genero Aedes, han provocado importantes epidemias de enfermedades como dengue, chikungunya, fiebre amarilla y zika en las Américas. La vigilancia epidemiológica de tales enfermedades, a través de los sistemas de información geográfica y la cartografía digital se han convertido en aliados para la Salud Pública. El objetivo de este estudio es describir el uso práctico de una herramienta geoespacial de acceso gratuito, en la vigilancia de enfermedades transmitidas por Aedes spp., en un sector endémico de Costa Rica para la presencia de este vector. Metodología: Se trata de un estudio de caso sobre la implementación de Herramientas Cartográficas digitales en un Área Rectora de Salud local del Ministerio de Salud, y su uso exitoso para la geo-localización de los casos sospechosos de dengue, zika y chikungunya notificados en esa área entre 2013 y 2016. Resultados: Se logró implementar el mapeo digital de los casos a través de marcas de posición. Con ventajas en la vigilancia epidemiológica, gracias al programa que permitió la identificación rápida de las viviendas, identificación de conglomerados, y selección de zonas prioritarias para intervenir. Además, fue un apoyo en la ejecución de los planes operativos, y en la conducción de actividades de movilización social. Discusión: Por su calidad de visualización topográfica y la interfaz intuitiva, las Herramientas Cartográficas digitales fueron útiles útil para la vigilancia epidemiológica de la transmisión de virus por el vector Aedes spp en Nandayure de Guanacaste, Costa Rica.
Abstract Aedes mosquito, because of it´s capability for spreading several virus, and it´s wide distribution at the American Continent, has generated epidemics of dengue, chikungunya, yellow fever and zika. Epidemic surveillance of these vector transmitted diseases, using free Geographic Information Systems and digital programs, has become into a great partner of Public Health departments. Objective: This study describes the practical use of free software of satellite image and free Geographic Information Systems, for the surveillance of Aedes spp transmitted diseases, in a Costa Rican Aedes endemic location. Methods: It is a case study developed at one local office, of Ministry of health in Costa Rica, geo locating the reported cases of dengue, zika, chikungunya from 2013 to 2016. Results: the achievement of position marks representing the house of all the cases reported, in a digital database of points and layers. Improvement in epidemic surveillance, thanks to the use of the selected programs that permitted to identify the conglomerates of cases at the neighborhoods, and the higher priority intervention zones. Discussion: the programs used, helped to visualize planned routes for the execution of social movement actions, and operational plans. Thanks to the image quality and the easy interactive interface, free Software selected, resulted into a useful tool for the surveillance of Aedes spp. transmitted diseases in the case of the public health department of Nandayure, from Guanacaste province of Costa Rica.
Subject(s)
Humans , Software/statistics & numerical data , Communicable Diseases , Aedes , Dengue/epidemiology , Geographic Information Systems , Disease Vectors , Epidemiological Monitoring , Geographic Mapping , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Analog-Digital Conversion , Costa RicaABSTRACT
Objective@#To analyze the epidemiological characteristics and distribution characteristics of tick-borne encephalitis in China in 2014, and to provide scientific basis for formulating specific prevention and control measures.@*Methods@#The epidemic data were obtained from the "infectious disease report information management system" , using Excel 2016, GIS and other software to summarize and analyze the cases of tick borne encephalitis (TBE) reported, using the number of cases, incidence, composition ratio and other indicators to analyze and describe the TBE epidemiological characteristics in China in 2014.@*Results@#In 2014, a total of 322 cases of TBE were reported in 9 provinces in China, with an annual incidence of 0.024/100, 000 and 1 death of patient. The provinces with high number of cases were Jilin province, Inner mongolia autonomous region and Heilongjiang province, and the number of cases in the other six provinces is no more than two. TBE was distributed in spring and summer, and it is concentrated in May to July. The age of the affected population was mostly concentrated in 40-49 years old, the male-female ratio was 1.6∶1 (198/124), and the patients were dominantly farmers, household and unemployed workers, and forestry workers, they accounted for 49.40% (159/322), 26.40% (85/322) and 18.60% (60/322) of the national TBE cases respectively. The three hospitals that reported the most TBE cases in 2014 were Inner mongolia forestry general hospital, Jiangyuan People′s hospital of Baishan city, Jilin province and Mudanjiang forestry central hospital of Heilongjiang province. The number of reported cases in these three hospitals accounted for 68.6% of the whole country. The laboratory diagnosis rate of Inner mongolia forestry general hospital was the highest (91.9%).@*Conclusions@#In 2014, the incidence of TBE in China has continued to rise compared with the previous two years. The geographical focus is mainly on the forest areas of Daxing′anling, Xiaoxing′anling and Changbai Mountain.
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Epidemic surveillance is critical to infectious disease prevention and control .This article describes the evolution and current situation of epidemic surveillance in PLA , systematically analyzes major problems with epidemic surveillance , including incomplete surveillance , simplistic surveillance methods , outdated surveillance technology , inefficient disease diagnosis , poor epidemic prediction , and administrative interference in epidemic reporting .Ways to enhance epidemic surveillance are described here , such as carrying out comprehensive surveillance , and expanding the contents of surveillance , strengthening active surveillance , optimizing surveillance methods , speeding up informatization construction , innovating surveillance technology ,improving disease diagnosis technology , enhancing the ability of epidemic recognition,carrying out the prediction research ,improving the ability of early warning ,perfecting the system construction , and strengthening the awareness of infectious disease reporting .
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Analisar a completude dos dados das notificações de gestante HIV positivo e de Aids em menores de 13 anos registradas no SINAN. Foi realizado estudo transversal descritivo. Os dados foram obtidos junto à Secretaria Municipal de Saúde, utilizando o banco de dados do Sistemade Informação de Agravos de Notificação de gestante HIV positivo e criança exposta, e o de Aids em menores de treze anos contaminados por Transmissão vertical (TV), residentes em Vitória, notificados entre 2000 e 2006. Foi realizada avaliação da completude dos dados, classificados como: Excelente, Regular ou Ruim. Foram notificadas 137 gestantes infectadas pelo HIV e 14 crianças por TV. Observou-se subnotificação de casos de gestante infectada, visto que7 mães não foram localizadas na base de dados. Verificou-se que variáveis do banco de gestante apresentaram grau de preenchimento variando entre 73,7% e 88,3%. As variáveis: momento de evidência laboratorial do HIV, escolaridade e uso de ARV na gestação apresentaramcompletude abaixo de 70%. Verificou-se que variáveis de importância epidemiológica apresentaram completude deficiente. Constatou-se a necessidade de capacitação para profissionais envolvidos com a Vigilância Epidemiológica da Aids, principalmente em relação ao preenchimento da ficha de notificação/investigação, visto a baixa completude verificada das variáveis estudadas.
To analyze the data notifications completeness of HIV positive pregnant woman and Aids in smaller than 13 years registered in SINAN. Seccional study. The data were obtained from SEMUS. SINAN database of HIV positive pregnant and exposed child and the database of Aids in smallerthan 13 years infected by Vertical Transmission (VT), residents in Vitória, notified from 2000 to 2006 were used. The evaluation of data completeness was made and classified as Excellent, Regular or Bad. 137 pregnant women were notified infected by HIV and 14 children with VT.The sub notification of infected pregnant woman cases was observed, because 7 mothers were not located into database. The variable related to the HIV pregnant woman database presented completion varying from 73.7% to 88.3%. The variables: laboratorial evidence of HIV moment, education and ARV use in pregnant presented completeness below 70%. The variables of epidemic importance presented deficient completeness. It is necessary to make training for professionals involved with Epidemic Surveillance of Aids, mainly in what concerns the record completeness, due to the low variables completeness.
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A partir del sistema de vigilancia para la metahemoglobinemia en niños menores de un año por ingestión de agua subterránea con altos contenidos de nitratos y nitritos creado en 1987 en la provincia de Camaguey, se rediseña el perfeccionamiento del mismo aprovechando la actual interrelación existente entre a comunidad, la atención primaria de salud, la Higiene y la Epidemiología y aquellos organismos estrechamente ligados al problema.
Departing from the surveillance system for the methemoglobinemia in children smaller than one year by underground water ingestion with high contents of nitrates and nitrites created in 1987 in Camagüey province, its improvement is redrawn, taking advantage of the existent current interrelation among the community, the primary health attention, Hygiene and Epidemiology and those more closely related organisms to the problem.
Subject(s)
Humans , Child , Infant , MethemoglobinemiaABSTRACT
Durante el desarrollo de diversos cursos de Bacteriología, tanto presenciales como a distancia, del Programa de Educación Continua (PROECO) de la Fundación Bioquímica Argentina, se solicitó a los colegas la notificación voluntaria de los resultados de los urocultivos y antibiogramas pertenecientes a pacientes ambulatorios, realizados entre el 1º de mayo y el 31 de julio de 2004 en los laboratorios en donde se desempeñaban. Del presente trabajo participaron ochenta y seis bioquímicos de treinta ciudades correspondientes a cuatro provincias argentinas. El objetivo general fue evaluar la importancia de las actividades de educación continua basadas en el análisis del trabajo cotidiano, a través de la notificación de los resultados de laboratorio de los urocultivos y antibiogramas, utilizando el papel didáctico del error como estrategia para aproximar la teoría y la práctica, con el objeto de implementar acciones que permitan normatizar los procedimientos de laboratorio y mejorar la calidad de los mismos. Con los resultados se confeccionó una base de datos en los programas de computación Excel 6.1 y SPSS 10.0 para procesarlos estadísticamente. De 1.260 datos, el 80% fueron aportados por los laboratorios privados y los restantes por los hospitales públicos y centros de atención primaria de salud municipales. El 80,6% de las muestras pertenecieron a mujeres y el 89% de los aislamientos correspondieron a bacilos gramnegativos. El agente más frecuente fue Escherichia coli 835 (66,3%); seguido por Proteus spp. 104 (8,3%); Klebsiella spp. 83 (6,6%); Staphylococcus spp. 79 (6,2%); Enterococcus spp. 43 (3,4%) y otros 116 (9,2%). Al analizar comparativamente las resistencias a antibióticos en los laboratorios privados y hospitalarios respecto de las publicadas por centros de referencia nacionales se encontraron similitudes y diferencias. Los errores de procedimiento detectados, tanto en la identificación de gérmenes como en los antibióticos ensayados, permitieron avanzar en la normatización de las técnicas. Desde el PROECO se dirigió una tarea de capacitación entre pares con supervisión docente, dentro de los talleres participativos nominales, enfatizando el valor del trabajo en el proceso de aprendizaje y favoreciendo la accesibilidad a los conocimientos. Esto también mostró la potencialidad del impacto indirecto de un programa de educación sobre actividades de vigilancia epidemiológica y la importancia que tiene la notificación de resultados de distintas patologías por parte de los laboratorios privados que aportaron cuatro veces más datos que el sector público, lo cual resulta interesante al momento de tomar medidas de prevención y la actualización de guías de tratamiento, incidiendo tanto sobre la prescripción médica como en la aún persistente venta directa de antibióticos en las farmacias. Esta publicación pretende ser un aporte preliminar para hacer notar la importancia de instalar una actividad de notificación de resultados con continuidad por parte del sector bioquímico privado y público, basada en el análisis de datos reales de la atención primaria de la salud, que contribuya a la toma de medidas sanitarias pertinentes en relación con diversas patologías.
During the development of diverse courses on Bacteriology such as in site classes or Distance learn-ing classes, of the Program of Continuous Education (PROECO) of the Fundación Bioquímica Argentina, colleagues were requested the voluntary notification of the results of urine cultures and disk diffusion tests from outpatients, carried out from May 1 to July 31, 2004 in the laboratories where they worked. Eighty-six biochemists from thirty cities from four Argentine provinces participated in this work. The general objective was to evaluate the importance of the activities of continuous education based on the analysis of daily work, through the notification of the laboratory results of urine cultures and disk diffusion tests using the didactic error as a strategy to approach theory to practice, in order to achieve actions that make it possible to standardize the laboratory procedures and to improve their quality. With the results a database was made using Excel 6.1 and SPSS 10.0 for statistical processing. A total of 1008 out of 1260 (80%) data were provided given by private laboratories and the 20% remaining by public hospitals and municipal centers of primary health attention. 80.6% of the samples belonged to women and in 89% of the cases gramnegative bacilli were isolated. The most frequent agent was Escherichia coli 835 out of 1260 (66.3%); followed by Proteus spp. 104 out of 1260 (8.3%); Klebsiella spp. 83 out of 1260 (6.6%); Staphylococcus spp. 79 out of 1260 (6.2%); Enterococcus spp. 43 out of 1260 (3.4%) and other 116 out of 1260 (9.2%). There were similarities and differences in the comparison of the resistances to antibiotics in private and public hospital laboratories with those published by the national reference center. The procedure errors detected both in the identification of germs and in the rehearsed antibiotics enabled the improvement of the standardization of the techniques. PROECO ran a training task among colleagues with educational supervision, inside the nominal participatory workshops, emphasizing the value of work in the learning process improving the accessibility to knowledge. This also showed the potentiality of the indirect impact of an educational program about epidemic surveillance, and the importance of the notification of results of different diseases from private laboratories, which contributed with four times more data than the public sector, which is interesting at the moment of taking prevention and treatment measures, impacting both on the medical prescription and on the dispensation of antibiotics by pharmacists. This article tries to be a preliminary contribution to highlight the importance of achieving an activity of notification of the results with continuity by the private biochemical sector that contributes to take pertinent sanitary measures in relation to different diseases.