Surveillance on pinworm infection among rural children in Anhui Province from 2017 to 2021 / 中国学校卫生

Objective@#To understand the status of pinworm infection in rural children aged 3-9 years in Anhui Province, and to provide scientific basis for the prevention and control strategy of pinworm disease.@*Methods@#According to the National Surveillance Program of Liver Fluke Disease and Soil Transmitted Nematodiasis(Trial), no less than 10% counties(cities and districts) in Anhui Province were selected as mobile surveillance sites every year. Each surveillance site was divided into 5 areas on the basis of geographical location(east, west, south, north and middle), from each of the areas, one administrative village was selected from one township(town, community) for conducting surveillance. Children at age 3-9 years from each site were examined for pinworm infection with the modified Kato-Katz thick smear method and the adhesive cellophane tape perianal swab method. Chi square test was used to compare the infection rate.@*Results@#From 2017 to 2021, the 5 year average infection rate of pinworm in rural Anhui was 1.34%(128/9 557), and there was no significant difference in the infection rate over the years( P >0.05). The detection rates of the modified Kato-Katz thick smear method and the adhesive cellophane tape perianal swab method were 0.28% and 1.23%, respectively, the difference was statistically significant( χ 2=72.97, P <0.01). In different regions, the 5 year average infection rate of Fuyang City was the highest(4.27%), and the rate of each city was positively correlated with the number of local resident population( r =0.54, P <0.05). There was no significant sex difference in the 5 year average infection rates( P >0.05). The 5 year average infection rate of children aged 3 to 9 years in rural areas were 0.62%, 1.10%, 1.44%, 1.57%, 0.94%, 2.09% and 1.57%, respectively, showed an increasing trend with the increase of age( χ 2=14.41, χ 2 trend =6.70, P <0.05). There was no significant difference in the average infection rate between scattered children and collectively living children( P >0.05).@*Conclusion@#From 2017 to 2021, the infection rate of pinworm among children in rural Anhui province remains at a low level. In the future, health education and monitoring should be strengthened.

Changes in HIV prevalence and intervention service utilization among MSM under sentinel monitoring in Taizhou of Zhejiang Province / 上海预防医学

ObjectiveTo analyze the changes in HIV， syphilis and hepatitis C prevalence among men who have sex with men （MSM） in Taizhou City， Zhejiang Province from 2017 to 2022， and the utilization of HIV intervention services and its influencing factors. MethodsMSM participants were recruited from HIV sentinel surveillance in Taizhou through snowball sampling method. Participants’ socio-demographic characteristics， sexual behavior characteristics， knowledge of HIV and utilization of HIV intervention services were collected and statistically described by questionnaire survey. Blood samples from MSM sentinel population were also collected for HIV， syphilis， and HCV antibody testing. Multivariate logistic regression analysis was used to analyze the influencing factors for utilizing HIV intervention services among MSM. ResultsA total of 2 499 MSM were included in the analysis from 2017 to 2022， with HIV prevalence of 5.8%， syphilis prevalence of 4.0%， and HCV prevalence of 0.6%. The infection rate， proportion of homosexual anal sex and heterosexual sex showed a decreasing trend， while the proportion of condom use during homosexual anal sex， condom publicity and distribution， AIDS consultation and testing， acceptance of peer education， and online temporary homosexual sex showed an increasing trend. All these differences were statistically significant. Multivariate logistic regression analysis showed that COVID-19 epidemic （aOR=1.66， 95%CI：1.04‒2.64） and HIV knowledge awareness （aOR=2.57， 95%CI：1.22‒5.40） were positively correlated with increased acceptance of condom publicity and distribution， and utilization of AIDS counseling and testing. Those who sought male sexual partners through offline route （aOR=3.44， 95%CI： 1.16‒10.21）， and had a history of sexually transmitted diseases within one year （aOR=5.47， 95%CI： 1.04‒28.76） were positively correlated with community-based methadone maintenance therapy， clean needle provision and exchange services， while COVID-19 epidemic （aOR=0.35， 95%CI： 0.14‒0.88） was negatively correlated with the utilization of these services. COVID-19 epidemic （aOR=2.11， 95%CI： 1.54‒2.89）， HIV knowledge awareness （aOR=2.09， 95%CI： 1.08‒4.02）， offline search for male sexual partners （aOR=1.47， 95%CI： 1.03‒2.11）， and awareness of HIV infection of sexual partners （aOR=2.09， 95%CI： 1.62‒2.69） were positively correlated with the increased use of peer education service， while married or cohabited （aOR=0.73， 95%CI： 0.55‒0.98） and VCT （aOR=0.61， 95%CI： 0.46‒0.82） were negatively correlated with utilization of peer education service. ConclusionHIV infection rate of sentinel MSM population in Taizhou decreases， while the utilization of HIV intervention services increases in general. Targeted measures should be developed according to the changes in sexual behavior and HIV intervention services among MSM populations in Taizhou to improve the HIV intervention services for the MSM population.

Comparison of prevention of parent-to-child HIV transmission programme & national biennial HIV sentinel surveillance data for tracking HIV epidemic in India

Background & objectives: HIV sentinel surveillance (HSS) among antenatal women in India has been used to track the epidemic for many years. However, reliable tracking at the local level is not possible as ANC sentinel sites are limited in number and cover a smaller sample size at each site. Prevention of parent-to-child-transmission (PPTCT) programme data has a potential advantage due to better geographical coverage, which could provide more precise HIV case estimates; therefore, we compared HSS ANC data with PPTCT programme data for HIV tracking. Methods: Out of the 499 surveillance sites, where HSS and PPTCT programme was being conducted in 2015, 210 sites (140 urban and 70 rural) were selected using a stratified random sampling method. HSS (n=72,981) and PPTCT (n=112,832) data records were linked confidentially. The sociodemographic characteristics of HSS and PPTCT attendees were compared. HIV prevalence from HSS ANC was compared with the PPTCT programme data using Chi-square test. State- and site-level correlation of HIV prevalence was also done. Concordance between HSS and PPTCT HIV positivity was estimated using kappa statistics. Results: The age distribution of HSS and PPTCT attendees was similar (range: 23 to 27 yr); however, HSS ANC participants were better educated, whereas PPTCT recorded a higher proportion of homemakers. The correlation of HIV prevalence between HSS and PPTCT was high (r=0.9) at the State level and moderate at the site level (r=0.7). The HIV positivity agreement between HSS ANC and PPTCT was good (kappa=0.633). A similar prevalence was reported across 26 States, whereas PPTCT had a significantly lower prevalence than HSS in three States where PPTCT coverage was low. Overall HIV prevalence was 0.31 per cent in HSS and 0.22 per cent in PPTCT (P<0.001). Interpretation & conclusions: High-quality PPTCT programme data can provide reliable HIV trends in India. An operational framework for PPTCT-based surveillance should be pilot-tested in a phased manner before replacing HSS with PPTCT.

Detección y cuantificación de SARS-CoV-2 en plantas de tratamiento de aguas residuales de diferentes ciudades de Chile: hacia la implementación de una vigilancia centinela permanente

Introducción: La cuantificación de SARS-CoV-2 en aguas residuales es una herramienta que permite determinar la tendencia de la circulación viral en un área geográfica determinada. Objetivo: Cuantificar el virus SARS-CoV-2 en 15 plantas de tratamiento de aguas residuales en diferentes ciudades de Chile para establecer una comparación con las variables de: i) casos activos por cada 100.000 habs.; ii) positividad diaria (casos nuevos); y iii) fases del plan de confinamiento. Metodología: SARS-CoV-2 se concentró a partir de muestras de aguas residuales. Para obtener el número de genomas del virus por litro se realizó una cuantificación absoluta utilizando qRT-PCR. Resultados: Entre enero y junio de 2021 se procesaron 253 muestras, siendo todas positivas para la presencia del virus. Asimismo, se logró determinar que la tasa de casos activos por cada 100.000 habs. es la variable que mejor se ajusta a las tendencias obtenidas con la cuantificación de la carga viral en las aguas residuales. Conclusiones: La cuantificación de SARS-CoV-2 en las aguas residuales de manera permanente es una herramienta eficiente para determinar la tendencia del virus en un área geográfica determinada y, en conjunto con una vigilancia genómica, puede constituirse en una vigilancia centinela ideal generando alertas sobre futuros brotes.

Background: The quantification of SARS-CoV-2 in wastewater is a tool that allows determining the trend of viral circulation in a particular geographical area. Aim: To quantify the SARS-CoV-2 virus in 15 wastewater treatment plants in different Chilean cities to establish a comparison with the variables of: i) Active cases per 100,000 inhabitants; ii) daily positivity (novel cases); and iii) phases of the lockdown strategy. Methods: SARS-CoV-2 was concentrated from wastewater samples. To obtain the number of virus genomes per liter, absolute quantification was performed using qRT-PCR. Results: Between January and June 2021, 253 samples were processed, all of which were positive for the presence of the virus. Likewise, it will be determined that the rate of active cases per 100,000 inhabitants is the variable that best fits the trends obtained with the quantification of the viral load in wastewater. Conclusions: The quantification of SARS-CoV-2 in wastewater as a continuous strategy is an efficient tool to determine the trend of the viral circulation in a delimited geographical area and, combined with genomic surveillance, it can constitute an ideal sentinel surveillance alert on future outbreaks.

Spatiotemporal heterogeneity of schistosomiasis in mainland China: Evidence from a multi-stage continuous downscaling sentinel monitoring

Objective: To determine the spatiotemporal distribution of Schistosoma (S.) japonicum infections in humans, livestock, and Oncomelania (O.) hupensis across the endemic foci of China. Methods: Based on multi-stage continuous downscaling of sentinel monitoring, county-based schistosomiasis surveillance data were captured from the national schistosomiasis surveillance sites of China from 2005 to 2019. The data included S. japonicum infections in humans, livestock, and O. hupensis. The spatiotemporal trends for schistosomiasis were detected using a Joinpoint regression model, with a standard deviational ellipse (SDE) tool, which determined the central tendency and dispersion in the spatial distribution of schistosomiasis. Further, more spatiotemporal clusters of S. japonicum infections in humans, livestock, and O. hupensis were evaluated by the Poisson model. Results: The prevalence of S. japonicum human infections decreased from 2.06% to zero based on data of the national schistosomiasis surveillance sites of China from 2005 to 2019, with a reduction from 9.42% to zero for the prevalence of S. japonicum infections in livestock, and from 0.26% to zero for the prevalence of S. japonicum infections in O. hupensis. Analysis using an SDE tool showed that schistosomiasis-affected regions were reduced yearly from 2005 to 2014 in the endemic provinces of Hunan, Hubei, Jiangxi, and Anhui, as well as in the Poyang and Dongting Lake regions. Poisson model revealed 11 clusters of S. japonicum human infections, six clusters of S. japonicum infections in livestock, and nine clusters of S. japonicum infections in O. hupensis. The clusters of human infection were highly consistent with clusters of S. japonicum infections in livestock and O. hupensis. They were in the 5 provinces of Hunan, Hubei, Jiangxi, Anhui, and Jiangsu, as well as along the middle and lower reaches of the Yangtze River. Humans, livestock, and O. hupensis infections with S. japonicum were mainly concentrated in the north of the Hunan Province, south of the Hubei Province, north of the Jiangxi Province, and southwestern portion of Anhui Province. In the 2 mountainous provinces of Sichuan and Yunnan, human, livestock, and O. hupensis infections with S. japonicum were mainly concentrated in the northwestern portion of the Yunnan Province, the Daliangshan area in the south of Sichuan Province, and the hilly regions in the middle of Sichuan Province. Conclusions: A remarkable decline in the disease prevalence of S. japonicum infection was observed in endemic schistosomiasis in China between 2005 and 2019. However, there remains a long-term risk of transmission in local areas, with the highest-risk areas primarily in Poyang Lake and Dongting Lake regions, requiring to focus on vigilance against the rebound of the epidemic. Development of high-sensitivity detection methods and integrating the transmission links such as human and livestock infection, wild animal infection, and O. hupensis into the surveillance-response system will ensure the elimination of schistosomiasis in China by 2030.

Self-reported questionnaire on periodontal condition validated for use in Brazil

Abstract: There is a current expectation of instruments for periodontal condition surveillance worldwide. The present study aimed to validate the Oral Health Questions Set B (OHQB) for the Brazilian Portuguese and evaluate its temporal stability. This is a sequential mixed-method investigation. After the forward-backward translation process to the Brazilian Portuguese, the OHQB Brazil (OHQB-Br) was applied to 156 participants (39.5 ± 14.14 years; 51.9% males). In sequence, through a full-mouth six-sites/teeth examination and in accordance with the original instrument, the periodontal diagnosis was obtained (March 2020). In January 2021, the OHB-BR was reapplied (n = 71). Ordinal alpha and McDonald's omega tested the internal consistency of the OHQB-Br. Temporal stability was investigated [Spearman correlation, intraclass correlation coefficient (ICC), and the Bland-Altman]. The concurrent validity was also verified, considering the periodontal clinical diagnosis (Kruskal Wallis). The ordinal alpha (0.69) and McDonald's omega (0.73) coefficients showed an adequate internal consistency of the OHQB-Br. The OHQB-Br temporal stability was high, as demonstrated by the Spearman coefficient (0.80) and ICC (0.79) and by the Bland-Altman plot. A concurrent validity showed a direct relationship between the OHQB-Br and the clinical condition of no periodontitis, mild, moderate, and severe periodontitis (p < 0.05). Because the OHQB-Br shows internal validity, temporal stability, and adequately identifies periodontal health and moderate/severe periodontitis, the instrument might represent an important tool, at the public level or other settings, for periodontal surveillance in Brazil.

Surveillance of hepatitis C among five high-risk populations in Inner Mongolia Autonomous Region from 2013 to 2021 / 预防医学

Objective@#To investigate the prevalence of hepatitis C virus (HCV) infections among five high-risk populations in Inner Mongolia Autonomous Region, so as to provide insights into improvements in the control strategy for hepatitis C. @*Methods@#The detection of anti-HCV antibody was collected from patients receiving renal dialysis, patients receiving invasive diagnosis and treatment in hospitals, physical examination populations, unpaid blood donors and subjects admitted to family planning clinics in national hepatitis C surveillance sentinels in Inner Mongolia Autonomous Region from 2013 to 2021, and the year-, gender- and age-specific prevalence of anti-HCV antibody was analyzed. @*Results@#The mean prevalence of anti-HCV antibody was 2.19%, 1.81%, 0.05%, 0.10% and 0.03% among 3 600 patients receiving renal dialysis, 3 600 patients receiving invasive diagnosis and treatment in hospitals, 18 000 physical examination populations, 18 000 volunteer blood donors and 3 600 subjects admitted to family planning clinics, respectively. The prevalence of anti-HCV antibody appeared a tendency towards a decline among patients receiving renal dialysis (χ2trend=49.065, P<0.001) and volunteer blood donors (χ2trend=11.419, P=0.001). The prevalence of anti-HCV antibody was higher among male patients receiving invasive diagnosis and treatment in hospitals than among females (2.34% vs. 1.36%; χ2=4.826, P=0.028), and no gender-specific prevalence of anti-HCV antibody was seen among other four high-risk populations (all P>0.05). The highest prevalence of anti-HCV antibody was detected among patients receiving renal dialysis (3.30%) and patients receiving invasive diagnosis and treatment in hospitals at ages of 50 to 59 years (3.35%), while the highest prevalence was found among physical examination populations at ages of 60 years and greater (0.18%). @*Conclusion@#The prevalence of anti-HCV antibody was high among patients receiving renal dialysis and patients receiving invasive diagnosis and treatment in hospitals and low among physical examination populations, volunteer blood donors and subjects admitted to family planning clinics in Inner Mongolia Autonomous Region from 2013 to 2021. Periodical monitoring of anti-HCV antibody is recommended among the elderly.

Sentinel surveillance for bacterial pneumonia and meningitis in children under the age of 5 in a tertiary pediatric hospital in Colombia - 2016 / Vigilancia centinela de neumonías y meningitis bacterianas en menores de 5 años en un hospital pediátrico de tercer nivel en Colombia - 2016

Abstract | Introduction: Bacterial pneumonia and meningitis are vaccine-preventable diseases. Sentinel surveillance provides relevant information about their behavior. Objective: To present the data from sentinel surveillance carried out at the Fundación HOMI, Fundación Hospital Pediátrico La Misericordia in 2016. Materials and methods: We conducted a descriptive study from January 1 to December 31, 2016, on the daily surveillance of patients under 5 years of age diagnosed with pneumonia or bacterial meningitis according to PAHO's definitions. We identified the microorganisms using the automated VITEKTM 2 system. Bacterial isolates were sent to the Microbiology Group at the Colombian Instituto Nacional de Salud for confirmation, serotyping, phenotypic, and genotypic characterization. Antimicrobial susceptibility profiles were established. Results: From 1,343 suspected cases of bacterial pneumonia, 654 (48.7%) were probable, 84% had complete Hib vaccination schedules, and 87% had complete pneumococcal vaccination schedules for age. Blood culture was taken in 619 (94.6%) and 41 (6.6%) were positive while S. pneumoniae was isolated in 17 (41%) of them. The most frequent serotype was 19A in five cases (29.4%), and four 19A serotypes were associated with the reference isolate ST320. The incidence rate of probable bacterial pneumonia was 7.3 cases/100 hospitalized patients, and lethality was 2.1%. As for bacterial meningitis, 22 suspected cases were reported, 12 (54%) were probable, four (33%) were confirmed: two by Escherichia coli and two by group C N. meningitidis. The incidence of probable bacterial meningitis was 0.14 cases/100 hospitalized patients. Conclusion: Streptococcus pneumoniae serotypes 19A and 3 were the most frequent cause of pneumonia. Spn19A is related to the multi-resistant clone ST320. Strengthening and continuing this strategy will allow understanding the impact of vaccination.

Resumen | Introducción. La neumonía y la meningitis bacterianas son enfermedades inmunoprevenibles; la vigilancia centinela aporta información relevante acerca de su comportamiento. Objetivo. Presentar los resultados de la vigilancia centinela de neumonía y meningitis llevada a cabo en la HOMI, Fundación Hospital Pediátrico La Misericordia. Materiales y métodos. Se hizo un estudio descriptivo entre el 1 de enero y el 31 diciembre del 2016, de la vigilancia diaria de pacientes menores de 5 años con diagnóstico de neumonía o meningitis bacteriana, según las definiciones de la Organización Panamericana de la Salud (OPS). Los microorganismos fueron identificados usando el sistema automatizado VITEK TM2. Los aislamientos se enviaron al grupo de microbiología del Instituto Nacional de Salud para confirmación, serotipificación, y caracterización genotípica y fenotípica. Asimismo, se establecieron los perfiles de sensibilidad antimicrobiana. Resultados. De 1.343 casos sospechosos de neumonía bacteriana, 654 (48,7 %) fueron probables, el 84 % tenía el esquema de vacunación completo para la edad contra Haemophilus influenzae de tipo b, y el 87 %, contra neumococo. En 619 (94,6 %) pacientes se hizo hemocultivo y 41 (6,6 %) fueron positivos. S. pneumoniae se aisló en 17 (41 %) casos. El serotipo más frecuente fue el 19A, en cinco pacientes (29,4 %), en tanto que cuatro aislamientos de spn19A fueron relacionados con el clon ST320. La tasa de incidencia de neumonía bacteriana probable fue de 7,3 casos/100 pacientes hospitalizados. La letalidad fue de 2,1 %. Hubo 22 casos sospechosos de meningitis bacteriana, 12 (54 %) probables, y cuatro (33 %) confirmados: dos por Escherichia coli y dos por Neisseria meningitidis del grupo C. La incidencia de meningitis bacteriana probable fue de 0,14/100 pacientes hospitalizados. Conclusión. Los serotipos 19A y 3 de S. pneumoniae fueron la causa más frecuente de neumonía. El Spn19A se relacionó con el clon ST320 mulitirresistente. El fortalecimiento continuo de la vigilancia centinela permitirá entender el impacto de la vacunación.

Estudio clínico-epidemiológico de invaginación intestinal en el Hospital Pediátrico Docente Centro Habana, previo a la introducción de la vacuna contra rotavirus / Clinical and epidemiology characterization of intussusception at the Centro Habana Paediatric Hospital before rotavirus vaccine introduction

Contar con datos confiables de la incidencia de la invaginación intestinal en la población infantil cubana es un paso necesario previo a la introducción de la vacuna contra el rotavirus. Con el objetivo de profundizar en el conocimiento de los hallazgos clínicos y epidemiológicos de la invaginación intestinal en niños menores de 1 año, se realizó un estudio epidemiológico en el servicio de cirugía pediátrica del Hospital Pediátrico Docente Centro Habana entre noviembre de 2017 a abril de 2018. El estudio constituye el precursor de un sistema de vigilancia centinela de base hospitalaria que será parte del proyecto Vacuna contra rotavirus promovido por el Instituto Finlay de Vacunas. Los datos de todos los casos notificados se recolectaron por los cirujanos a través de la Ficha de vigilancia centinela de la invaginación intestina. Se notificaron un total de nueve casos con diagnóstico de invaginación intestinal, principalmente a los 5 meses de edad (44,4 por ciento), todos confirmados por ecografía de abdomen. La incidencia de invaginación intestinal en este período fue estimada de 1,41 por ciento. Los síntomas y signos más frecuentes fueron las deposiciones con sangre (77,8 por ciento), la irritabilidad (66,7 por ciento) y el vómito (55,6 por ciento). La desinvaginación por técnicas no quirúrgicas fue empleada en ocho casos y de ellas, el enema con aire fue la más usada (62,5 por ciento). Los resultados presentados aportan información necesaria para la construcción de la línea base de la invaginación intestinal en niños menores de 1 año de edad, antes de la introducción de la vacunación contra rotavirus en Cuba(AU)

The knowledge of the baseline incidence rates of intussusception among infants in Cuba are necessary to introduce the rotavirus vaccine into the Cuban immunization schedule. With the aim of characterizing the clinical presentation and epidemiology of intussusception a surveillance study was performed in children less than 1 years old with intussusception, in the pediatric surgery service at the Centro Habana Pediatric Hospital in Havana city between November 2017 and April, 2018. This study is the precursor of an active sentinel hospital surveillance for intussusception in children under 1 year of age, as a part of the project Rotavirus vaccine promoted by Instituto Finlay de Vacunas. Data were collected for each notified case by surgeons using a brief study questionnaire (Sentinel surveillance file for intussusception). A total of nine patients were diagnosed with intussusception, most cases presented at 5 months of age (44.4 percent), and all cases were confirmed by abdominal ultrasonography. The incidence of intussusception was 1.41 percent. The most frequent symptoms were rectal bleeding (77.8 percent), irritability (66.7 percent) and vomiting (55.6 percent). Intussusceptions reduction by non-surgical methods was used in eight cases, mainly air enema (62.5 percent). These results are now available to build the body of scientific evidence for baseline rates of intussusception in children less than 1 year of age, prior to the introduction of the rotavirus vaccine in Cuba(AU)

Incidentes em sessões de hemodiálise à beira leito em unidades de terapia intensiva / Incidencias en las sesiones de hemodiálisis a pie de cama en las unidades de cuidados intensivos / Incidents in bedside hemodialysis sessions in intensive care units

RESUMO Objetivo: identificar associação entre diagnósticos de enfermagem relacionados à locomoção e ao cuidado corporal com incapacidade funcional em idosos hospitalizados. Método: estudo descritivo, transversal, realizado com 100 idosos em um hospital público, da Paraíba - Brasil, no ano de 2019. Utilizou-se instrumento semiestruturado e Índice de Barthel, sendo elencados diagnósticos a partir da CIPE®. A análise de dados utilizou a estatística descritiva. Resultados: a escala é composta por 17 itens distribuídos em sete domínios: Tratamento Medicamentoso, Assistência Pré-natal, Intervenção Baseada no Senso Comum, Entendimento das Recomendações com Apoio Familiar, Estilo de Vida, Intervenção Dietética e Cuidado de Si. A consistência interna dos domínios pelo alfa de Cronbach variou de 0,527 a 0,597. Conclusão: os diagnósticos identificados fornecem subsídios para planejamento e implementação de cuidados de enfermagem visando menor tempo de hospitalização, prevenindo desfechos desfavoráveis à saúde e garantindo assistência integral e individualizada para a população.

RESUMEN Objetivo: identificar la asociación entre diagnósticos de Enfermería relacionados a la locomoción y al cuidado corporal con incapacidad funcional en adultos mayores hospitalizados. Métodos: estudio descriptivo y transversal, realizado en el año 2019 con 100 adultos mayores en un hospital público de Paraíba - Brasil. Se utilizó un instrumento semiestructurado y el Índice de Barthel, y los diagnósticos se listaron a partir de la clasificación CIPE®. Para el análisis de los dados se utilizó estadística descriptiva. Resultados: la dependencia total se mostró asociada con Capacidad perjudicada para la higiene oral, Capacidad perjudicada para la higiene y Confinado a la cama. La dependencia grave estuvo asociada con Capacidad perjudicada para la higiene oral, Capacidad perjudicada para la higiene, Capacidad perjudicada para vestirse, Movilidad perjudicada y Confinado a la cama. Conclusión: los diagnósticos identificados proporcionan apoyos para planificar e implementar medidas de atención de Enfermería con vistas a reducir los tiempos de hospitalización, previniendo así consecuencias desfavorables para la salud y garantizando asistencia integral e individualizada para la población.

ABSTRACT Objective: to analyze incidents during bedside hemodialysis sessions held in Intensive Care Units. Method: cross-sectional, retrospective study, developed in Intensive Care Units of Goiânia, Brazil. Analysis of incidents identified in bedside hemodialysis sessions was performed between March and April 2018. Descriptive analysis was performed for categorical data and for continuous data, mean and standard deviation of the mean. Results: 873 sessions were analyzed, and 563 incidents were recorded. Among those reported, 259 (46%) were inherent to the treatment. Near miss was the most frequent type of incident, generating delay in the beginning of the session, and no support from the multi-professional team (p<0.05). In 132 (56.12%) of the notifiable circumstances, the professional worked for more than 12 uninterrupted hours (p<0.05). Conclusion: the analysis of the results allows students and experts in the area to subsidize improvement strategies for the service.

Analysis of AIDS sentinel surveillance among college students in Taizhou of Zhejiang Province in 2016‒2018 / 上海预防医学

Objective:To determine the prevalence of AIDS/HIV， sexual behavior， knowledge， and access to HIV-related services among college students in Taizhou from 2016 through 2018， and provide scientific evidence for developing targeted strategies and measures. Methods:Based on the National HIV/AIDS Sentinel Surveillance， a cross-sectional survey was conducted annually among college students in three sentinels by a multi-stage cluster sampling across Taizhou， using questionnaire and laboratory examination. Results:A total of 4 185 college students were surveyed during 2016–2018， in which the proportion of reporting sexual behavior was 7.7%， with 58.4% using condom at. Sexual behavior， with fixed sexual partners， casual partners， commercial partners， and homosexual partners accounted for 68.7%， 23%， 4.0%， and 4.0%， respectively. Sexual experience and sexual behavior with fixed partners were statistically different among colleges and gender， which was much higher in male and vocational schools. The awareness rate of HIV/AIDS knowledge was 65.8%； 3.6% was found to have HIV voluntary counseling and testing， in which 7.8% had sexual behavior， indicating an upward trend over years. No college student tested positive for HIV from 2016 to 2018， and only one tested positive for anti-syphilis antibody and one positive for anti-hepatitis C antibody. Conclusions:Young male and vocational students in Taizhou are likely to have more sexual behavior and lower awareness on HIV/AIDS. College students have at-risk sexual behavior， insufficient awareness of HIV/AIDS， which may facilitate high risk of infection. It warrants further strengthening HIV/AIDS health education.

Hepatitis C prevalence among five kinds of populations monitored in Liaoning Province from 2015 to 2019 / 预防医学

Objective@#To understand the prevalence of hepatitis C virus ( HCV ) infection in sentinel surveillance in Liaoning Province from 2015 to 2019, in order to provide evidence for the precise prevention and control of HCV.@*Methods@#The HCV sentinel surveillance data of 5 kinds of populations, including dialyzed patients, patients receiving invasive diagnosis and treatment, family planning outpatients, people receiving physical examination and unpaid blood donators in Liaoning Province from 2015 to 2019 were retrieved, and the HCV positive rates of different years, gender and age groups in the five populations were analyzed. @*Results@#There were 26 000 persons surveyed and 61 HCV positive cases were detected from 2015 to 2019. The HCV positive rate was 0.23%. The HCV positive rates of dialyzed patients, patients receiving invasive diagnosis and treatment, family planning outpatients, people receiving physical examination and unpaid blood donators were 0.40%, 0.70%, 0.25%, 0.24% and 0.14%, respectively. The HCV positive rates of dialyzed patients, patients receiving invasive diagnosis and treatment, and unpaid blood donators had significant downward trends ( P<0.05 ). The HCV positive rates of males and females were 0.22% and 0.26%, without any significant difference ( P>0.05 ). The HCV positive rate of people aged above 70 years old was 1.15%, the highest among different age groups. @*Conclusions@#The prevalence of HCV infection among the patients with hemodialysis and with invasive diagnosis and treatment is relatively high. The level of HCV antibody of older age groups should be monitored regularly.

Análise de causa raiz em internações por drogas de abuso como eventos sentinelas / Análisis de causa raíz em internaciones por drogas de abuso como eventos centinelas / Root cause analysis in hospitalizations due to drugs as sentinel surveillance

Objetivo: Analisar os fatores de iniciação e continuidade do uso de drogas, a partir do evento sentinela, internação hospitalar com diagnóstico de trauma associado à intoxicação por drogas de abuso. Métodos: Estudo exploratório e retrospectivo, com referencial de vigilância epidemiológica de 30 eventos sentinelas, a partir de revisão de documentos hospitalares e entrevista com familiar dos usuários de drogas. A matriz para avaliação foi a análise da causa raiz, estabelecida pela investigação e pelar e construção da trajetória do uso de drogas. Resultados: Houve predomínio de sexo masculino, baixa escolaridade e desemprego, com média de 40,1 anos. A droga mais utilizada foi o álcool, isolada ou associada a drogas ilícitas. Identificaram-se pontos críticos de vulnerabilidade social, permitindo uma discussão sobre o desempenho das políticas públicas. Conclusão: A maioria dos fatores subjacentes se relacionava à ausência ou à precariedade de políticas públicas, com pontos críticos na intersetorialidade (AU)

Objective: to analyze the initiation and continuity factors for drug use from the hospitalization sentinel surveillance diagnosed with trauma associated with drug intoxication. Methods: this is an exploratory and retrospective study with the epidemiological surveillance framework of 30 sentinel events based on hospital documents review and interviews with family members of drug users. The matrix for the evaluation was the root cause analysis, established by the investigation and reconstruction of the drug use trajectory. Results: we found predominance of male gender, low education and unemployment, with average 40.1 years. The most consumed drug was alcohol, alone or associated with illicit drugs. Critical points of social vulnerability were identified, admitting the discussion of public policies performance. Conclusions: most of the underlying factors were related to the absence or precariousness of public policies, with critical points in intersectoriality (AU)

Objetivo: analizar los factores de iniciación y continuidad para el consumo de drogas del evento centinela de hospitalización, diagnosticado con trauma asociado con la intoxicación por abuso de drogas. Métodos: estudio exploratorio y retrospectivo con el marco de vigilancia epidemiológica de 30 eventos centinela, basado en la revisión de documentos hospitalarios y entrevistas con familiares de usuarios de drogas. La matriz para la evaluación fue el análisis de la causa raíz, establecido por la investigación y reconstrucción de la trayectoria del consumo de drogas. Resultados: predominó el sexo masculino, baja educación y desempleo, con un promedio de 40,1 años. La droga más utilizada fue el alcohol, solo o asociado con drogas ilícitas. Se identificaron puntos críticos de vulnerabilidad social, lo que permite una discusión sobre el desempeño de las políticas públicas. Conclusión: la mayoría de los factores subyacentes estaban relacionados con la ausencia o precariedad de las políticas públicas, con puntos críticos en la intersectorialidad (AU)

AIDS sentinel surveillance of female sex workers in Songjiang District of Shanghai / 上海预防医学

Objective To investigate the knowledge of HIV/AIDS among the female sex workers in Songjiang District of Shanghai, changes in their related behaviors, and prevalence of human immunodeficiency virus(HIV), syphilis, and hepatitis C virus (HCV), providing evidence for related prevention and control work in this regard. Methods During 2011-2015 sentinel surveillance period, in the area of Songjiang District, according to the survey method of the National AIDS Sentinel Monitoring Implementation Program, questionnaires were conducted on the female sex workers and their venous blood was collected to detect HIV, syphilis and HCV antibodies. Results A total of 2 064 secret prostitutes were surveyed.The overall awareness rate of AIDS-related knowledge among them was 94.77%, and the annual awareness rates were 93.33%, 95.01%, 93.00%, 99.76%, and 92.57%, respectively(P < 0.05);The total proportion of the female sex workers who used condoms in the last commercial sex was 90.07%, and 84.05%, 80.55%, 93.72%, 99.06%, and 95.79% respectively in the calendar year(P < 0.05);The total proportion of the female sex workers who insisted on using condoms for commercial sex in the last 1 month was 76.74%, and 69.29%, 60.60%, 86.47%, 87.76%, and 78.96% respectively in the calendar year(P < 0.05);The average detection rate of HIV antibodies for 5 years was 0.00%, syphilis antibody detection rate was 3.00%, and HCV antibody detection rate was 0.34%. Conclusion The knowledge level of AIDS related knowledge is high among the female sex workers in Songjiang District.The persistent condom use rate during commercial sex is low in the last month; the syphilis detection rate is slightly higher than the national average.

AIDS sentinel surveillance of female sex workers in Songjiang District of Shanghai / 上海预防医学

Objective To investigate the knowledge of HIV/AIDS among the female sex workers in Songjiang District of Shanghai, changes in their related behaviors, and prevalence of human immunodeficiency virus(HIV), syphilis, and hepatitis C virus (HCV), providing evidence for related prevention and control work in this regard. Methods During 2011-2015 sentinel surveillance period, in the area of Songjiang District, according to the survey method of the National AIDS Sentinel Monitoring Implementation Program, questionnaires were conducted on the female sex workers and their venous blood was collected to detect HIV, syphilis and HCV antibodies. Results A total of 2 064 secret prostitutes were surveyed.The overall awareness rate of AIDS-related knowledge among them was 94.77%, and the annual awareness rates were 93.33%, 95.01%, 93.00%, 99.76%, and 92.57%, respectively(P < 0.05);The total proportion of the female sex workers who used condoms in the last commercial sex was 90.07%, and 84.05%, 80.55%, 93.72%, 99.06%, and 95.79% respectively in the calendar year(P < 0.05);The total proportion of the female sex workers who insisted on using condoms for commercial sex in the last 1 month was 76.74%, and 69.29%, 60.60%, 86.47%, 87.76%, and 78.96% respectively in the calendar year(P < 0.05);The average detection rate of HIV antibodies for 5 years was 0.00%, syphilis antibody detection rate was 3.00%, and HCV antibody detection rate was 0.34%. Conclusion The knowledge level of AIDS related knowledge is high among the female sex workers in Songjiang District.The persistent condom use rate during commercial sex is low in the last month; the syphilis detection rate is slightly higher than the national average.

Descripción de características demográficas y clínicas de una cohorte pacientes fallecidos por infección respiratoria aguda en Colombia durante los años 2009 a 2013 / Description of demographic and clinical characteristics of a cohort of patients with mortality due to acute respiratory infection in Colombia during the years 2009 to 2013

Objetivo: Describir las características clínicas, demográficas, aislamientos virales y hallazgos de histopatología de individuos que fallecieron por Infección Respiratoria Aguda (IRA) y que fueron notificados al Instituto Nacional de Salud (INS) entre los años 2009 y 2013. Métodos: Estudio observacional, descriptivo, retrospectivo, basado en la revisión de fichas epidemiológicas y reportes de estudios de virología e histopatología de muestras respiratorias de individuos fallecidos con diagnóstico de IRA. Resultados: De 1604 personas fallecidas se encontró que, 55% fueron hombres, 46,5% de los individuos tenía entre 20 y 59 años. La RT-PCR fue positiva en 18,3% de los casos, los virus más frecuentes fueron: influenza A(H1N1)pdm09 13,9%, A(H3N3) 1,9% e influenza B 0,5%. La letalidad de IRA fue mayor en los individuos que recibieron antiviral o antibiótico OR 2,80 (IC 95% 2,29 - 3,43) y 3,19 (IC 95% 2,63 - 3,86), respectivamente. Conclusión: El virus influenza A(H1N1) pdm09 fue el principal agente identificado en los casos fatales de IRA confirmada por laboratorio durante los años 2009 a 2013, con mayor letalidad en individuos entre 20 y 59 años; 64,7% de los casos fatales presentaron neumonitis. Se debe aclarar si el inicio de antivirales afecta el pronóstico en los casos graves de IRA.

Objective: To describe the clinical, demographic, viral isolates and histopathology findings of individuals who died of acute respiratory infection (ARI) and were reported to the National Institute of Health during the years 2009-2013. Methods: Observational, descriptive, retrospective study based on the review of epidemiological records and virology and histopathology reports of respiratory samples from deceased individuals diagnosed with ARI, that were received at the Colombian National Institute Health's Virology Group. Results: 1604 deaths, 55% were men, 46.5% of subjects were between 20 and 59 years, 13,5% received oseltamivir. RT-PCR was positive in 18,3% of cases, the most common viruses were: influenza A (H1N1)pdm09 13,9%, A(H3N3) 1.9% and influenza B 0,5 %. The lethality of ARI was higher in individuals who received antiviral or antibiotic OR 2,80 (95% CI 2,29 - 3,43) and 3.19 (95% CI 2,63 - 3,86), respectively. Conclusion: Influenza A (H1N1) pdm09 virus was the main agent identified in fatal cases of laboratory-confirmed ARI during the years 2009 to 2013, with the highest lethality in individuals between 20 and 59 years; 64.7% of fatal cases had pneumonitis. It must be clarified if the initiation of antivirals affects the prognosis in severe cases of ARI.

Chicken eggs as a surveillance tool for malaria and leishmaniasis vector presence

Abstract INTRODUCTION: Malaria and leishmaniases are transmitted by vectors during blood-feeding. Vector-infected animals develop antibodies against the vector's saliva. This study evaluated IgY antibody detection in the chicken eggs exposed to bites from Migonemyia migonei, Lutzomyia longipalpis and Anopheles aquasalis. METHODS: We used ELISA to quantify the antibody levels in the sera and exposed chicken eggs. RESULTS: High IgY levels were observed following immunization; furthermore, higher reactivity was observed in the eggs and species-specific immune response was observed post final immunization. CONCLUSIONS: Chicken eggs can be used as sentinels to surveil vector saliva antibodies.

Review on the etiology and complications of hand, foot and mouth disease, using data from the national sentinel surveillance program, in China, 2015-2016 / 中华流行病学杂志

Objective@#To understand the characteristics relating to the etiology and complications of hand, foot and mouth disease (HFMD) based on data from the pilot National Sentinel Surveillance (NSS) program so as to explore the feasibility, advantages and disadvantages of the NSS.@*Methods@#Data were extracted from the NSS system, conducted in 11 provinces of China from November 2015 to October 2016. Characteristics regarding the etiology, complications of HFMD and factors related to the positive rates of HFMD specimens were analyzed under the logistic regression method by SPSS 20.0 software.@*Results@#A total of 4 783 specimens were collected, including 3 390 from mild, 1 390 from severe and 3 from death cases. The overall positive rate was 81.43% (3 895/4 783). Other enteroviruses (non EV71/Cox A16 enteroviruses) appeared the major serotype (52.68%, 1 482/2 813) for mild infection of the disease while EV71 was for the severe cases (65.31%, 706/1 081). The serotype spectrum revealed by the pilot NSS was almost identical with the existing surveillance system. Other enteroviruses tended to infect younger children (χ2=130.17, P<0.001) than EV71 and Cox A16, in China. The multivariate logistic regression results showed that higher positive rate was associated with specimens which were collected from males, at children’ hospitals, in peak seasons, timely and in stools. The positive rates presented downwarding trends with the extension of the onset-sampling interval (χ2=14.47, P<0.001 in stool specimen; χ2=31.99, P<0.001 in throat swab; χ2=24.26, P<0.001 in anal swab). Aseptic meningitis, non-brainstem encephalitis and brainstem encephalitis appeared the top three complications of both EV71-associated and other enteroviruses-associated severe HFMD cases.@*Conclusions@#Factors as gender, season/place/timeliness of specimen collection, and types of hospital all appeared independently influenced the positive rates. NSS seemed feasible to be used as an alternative or supplement tool to the existing surveillance program in China.

HIV infection status and related factors in men who have sex with men in sentinel surveillance in Tianjin, 2016-2018 / 中华流行病学杂志

Objective@#To understand the HIV infection status and related factors in men who have sex with men (MSM) in Tianjin during 2016-2018.@*Methods@#According to the sentinel surveillance protocol, continuous cross-sectional studies were conducted to collect the information about the awareness of AIDS, related behaviors, HIV infection, syphilis prevalence and HCV infection in the MSM in Tianjin with the annual sample seize of 400 between April and June during 2016-2018.@*Results@#From 2016 to 2018, a total of 1 200 MSM were surveyed. The condom use rate in anal sex was 45.4% (544/1 198) in the past 6 months. The HIV test rate in MSM recruited through network declined with year (trend χ2=42.742, P<0.001). The overall HIV infection rate was 3.3% (40/1 200). The HIV-1 infection rate was 2.6% (95%CI: 1.7%-3.5%). The overall prevalence rate of syphilis was 6.7% (80/1 200). The overall HCV infection rate was 0.8% (9/1 200). Results from multivariate logistic regression analysis showed that the risk factors associated with HIV infection in the MSM included divorced or widowed (compared with unmarried, aOR=7.137, 95%CI: 1.621-31.419) and syphilis positive group (compared with syphilis negative group, aOR=3.684, 95%CI: 1.520-8.932). The protective factors for HIV infection in the MSM included consistent use of condom in the past 6 months (compared with occasional use of condom, aOR=0.343, 95%CI: 0.126-0.932) and HIV test (compared with receiving no HIV test, aOR=0.314, 95%CI: 0.123-0.801).@*Conclusions@#The HIV infection rate in the MSM in Tianjin was high from 2016 to 2018. Syphilis prevalence status in MSM should not be neglected. The rate of consistent condom use in anal sex was low in the MSM. It is necessary to take effective measures to promote condom use and strengthen HIV test in MSM.

Analysis of common pathogens and epidemiological characteristics of acute bacterial meningitis cases in Shandong Province / 中华预防医学杂志

Objective@#To analyze epidemiological characteristics of acute bacterial meningitis (ABM) cases and the common pathogens infected in Jinan, Shandong Province.@*Methods@#Epidemiological and clinical informations and cerebrospinal fluid (CSF) and blood specimens of acute meningitis/encephalitis syndrome (AMES) cases (total 3 918 cases) were collected in the six sentinel hospitals from 2013 to 2016. neisseria meningitidis (Nm), streptococcus pneumoniae (Sp) and haemophilus influenza (Hi) were detected by the methods of real-time fluorescent quantitative polymerase chain reaction (Real-time PCR), bacterial culture and latex agglutination. χ2 test was used to compare ABM cases with different feasures, and compare the difference of Nm, Sp and Hi cases in clinical and epidemiological characteristics.@*Results@#A total of 479 cases were diagnosed as ABM from 2013 to 2016, 82 cases of which were laboratory confirmed, including 54 cases infected with Nm, 25 cases infected with Sp, and 3 cases infected with Hi. The disease course in different age groups of ABM cases has statistically difference (χ2=40.95, P<0.001). The disease course of under 6 (63.6%, 161/253) and 7 to 17 (55.9%, 33/59) years old ABM cases mainly required 14-28 days, and over 18 years old cases mainly required less than 14 days (59.9%, 100/167). For Nm cases, there was a main onset period from October to March (75.9%, 41/54); on the disease course, under 6 (81.0%, 17/21) and 7 to 17 (16/18) years old cases mainly required less than 14 days, while over 18 years old cases mainly required 14-28 days (8/15), and there was a statistically difference in different age groups (χ2=8.44, P=0.015). For Sp cases, the major onset period was from December to May (84.0%, 21/25); on the disease course, all of under 6 and 7 to 17 years old cases were required 14-28 days, while over 18 years old cases mainly required less than 14 days (9/17), and there was a statistically difference in different age groups (χ2=6.62, P=0.037). 91.0% of the ABM cases (436/479) were healed or improvement, with the relatively higher ratio in under 6 (94.9%, 240/253) and 7 to 17 (98.3%, 58/59) years old groups, and poorer ratio in over 18 years old group (82.6%, 138/167), and the difference was significant in different age groups (χ2=22.77, P<0.001). For Nm, Sp and Hi cases, the ratio of cases that were healed or improvement were 87.0% (47/54), 92.0% (23/25) and 3/3, respectively, and there were no death cases.@*Conclusion@#ABM cases were found mostly in under 18 years old group in Jinan, Shandong Province, and the bigger age group had poor prognosis. Nm was the major pathogen causing ABM, followed by Sp and Hi. Distinguished differences of epidemiological characteristics were found on ABM cases suffered with different pathogens infected.