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1.
Article in Chinese | WPRIM | ID: wpr-913066

ABSTRACT

Objective To investigate the changes in the awareness rate of Taenia solium taeniasis and cysticercosis control knowledge among medical professionals before and after training in Fangcheng County, a disease-elimination pilot area of Henan Province, so as to evaluate the effectiveness of the training. Methods Three townships in Fangcheng County were randomly selected as the study townships, including Dushu, Bowang and Yangji townships, while Erlangmiao, Yanglou and Xiaoshidian townships in the county were randomly selected as the control townships. The grassroots medical professionals in the study townships were given once training on T. solium taeniasis and cysticercosis control knowledge each year from 2016 to 2020, while those in the control townships were given no interventions. All village-level doctors and a part of township-level public health professionals were sampled from the study and control townships as intervention and control groups. The baseline and final assessments of the awareness of T. solium taeniasis and cysticercosis control knowledge were performed using questionnaire survey in intervention and control groups in 2016 and 2020, and the awareness of T. solium taeniasis and cysticercosis control knowledge was compared between the two groups. Results A total of 663 medical professionals were investigated in Fangcheng County from 2016 to 2020, including 474 participants in the intervention group and 189 participants in the control group. Results from the 2016 baseline survey showed that the awareness rate of T. solium taeniasis and cysticercosis control knowledge was 28.83% (47/163) among grassroots medical professionals in Fangcheng County, and there were no significant differences in the awareness between the intervention (32.47%, 25/77) and control groups (25.58%, 22/86) (χ2 = 0.939, P > 0.05), between men (30.50%, 43/141) and women (18.18%, 4/22) (χ2 = 1.406, P > 0.05) or between village- (31.39%, 43/137) and township-level medical professionals (15.38%, 4/26) (χ2 = 2.727, P > 0.05), while significant differences were found in the awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in terms of education levels (χ2 = 8.190, P < 0.05) and duration of working experiences (χ2 = 12.617, P < 0.05), and the awareness rate of T. solium taeniasis and cysticercosis control knowledge increased with education levels among medical professionals (χ2 = 6.768, P < 0.05). Only 5.52% (9/163) of the medical professionals had a history of diagnosis and therapy of T. solium taeniasis or cysticercosis, and only 1.23% (2/163) received training on T. solium taeniasis and cysticercosis control knowledge during the past 5 years. Results from the 2020 questionnaire survey showed a higher awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in the intervention group (93.55%, 116/124) than in the control group (46.60%, 48/103) (χ2 = 61.845, P < 0.05), and no significant differences were seen in the awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in terms of gender, level of medical professionals, duration of working experiences or history of diagnosis/therapy of T. solium taeniasis and cysticercosis in the intervention group (χ2 = 1.089, 0.140, 0.081 and 0.453, all P values > 0.05), while there was a significant difference in the awareness rate among medical professionals with different education levels (χ2 = 36.338, P < 0.05). In addition, the awareness rate of T. solium taeniasis and cysticercosis control knowledge significantly increased among medical professionals with various chracteristics in 2020 than in 2016. Conclusions In the low-prevalence areas of T. solium taeniasis and cysticercosis, long-term and persistent training may improve the awareness of T. solium taeniasis and cysticercosis control knowledge among grassroots medical professionals, which facilitates the timely identification of T. solium taeniasis and cysticercosis and the establishment of a sensitive disease surveillance system.

2.
Article in Chinese | WPRIM | ID: wpr-913062

ABSTRACT

Currently, the national schistosomiasis control program of China is moving from transmission control and transmission interruption to elimination; however, there is still a threat of schistosomiasis outbreak in area where the transmission of schistosomiasis has not been interrupted, and in areas where transmission interruption and even elimination have been achieved because of the complex factors relating to schistosomiasis transmission, as well as socioeconomic factors and natural environments, which greatly affects the consolidation of schistosomiasis control outcomes and the achievement of the goal of schistosomiasis elimination in the country. Here, we summarized the outbreaks of schistosomiasis in China during the past six decades, evaluated the impact of schistosomiasis outbreak on the national schistosomiasis control program and proposed management of schistosomiasis outbreak and prevention of schistosomiasis resurgence as the key point and difficulty for schistosomiasis control in the current stage. Improving the surveillance-response mechanisms and minimizing the development of schistosomiasis outbreak and the resultant damages and losses are recommended to provide technical supports for elimination of schistosomiasis in China.

3.
Article in Chinese | WPRIM | ID: wpr-913060

ABSTRACT

The RTS,S/AS01 is a subunit malaria vaccine against the pre-erythrocytic stage of Plasmodium falciparum. After over 30 years of research and development and clinical trials, this vaccine has been recommended by the WHO for use among children living in highly malaria endemic areas. Although the RTS, S/AS01 vaccine suffers from problems of a low protective efficacy (about 30%), need of four doses and short duration of protective immunity, this malaria vaccine is expected to save tens of thousands of children’s lives, and avoid tens of millions of malaria cases annually, because there have been tens of thousands of childhood deaths due to malaria recently. The introduction of the RTS, S/AS01 vaccine is therefore, widely accepted as a milestone in the history of battle against malaria, which brings a hope to contain malaria and even eventually eliminate malaria. Although there are still multiple challenges in the development of a satisfactory malaria vaccine, the success of the RTS, S/AS01 malaria greatly facilitates the progress towards the development of parasitic disease vaccines, and a more perfect malaria vaccine deserves expectations.

4.
Article in Chinese | WPRIM | ID: wpr-942357

ABSTRACT

Oncomelania hupensis is the only intermediate host of Schistosoma japonicum, and O. hupensis control is an important measure for schistosomiasis control. With the progress of national schistosomiasis control program, the prevalence of schistosomiasis is low in China; however, there are still multiple challenges for O. hupensis breeding and schistosomiasis transmission risk. Considering the target of the national schistosomiasis elimination program and environmental protection in the new era, the introduction of precision identification, precision interventions and precision assessment into O. hupensis control may facilitate the progress towards elimination of schistosomiasis in China.

5.
Article in Chinese | WPRIM | ID: wpr-940943

ABSTRACT

Currently, the national schistosomiasis control program of China is moving from transmission interruption to elimination, and there are multiple challenges during the stage moving towards the progression of schistosomiasis elimination, including a high difficulty in shrinking snail-infested areas, unstable achievements for infectious source control, imperfect surveillance system and a reduction in schistosomiasis control and administration. Based on the core suggestions proposed in the 2022 WHO guideline on control and elimination of human schistosomiasis, recommendations on schistosomiasis surveillance system building, development of novel diagnostics, adjustment of the schistosomiasis control strategy and maintaining and improvements of the schistosomiasis control capability are proposed for the national schistosomiasis control program of China in the new era according to the actual status of schistosomiasis control in China. Formulation of the national schistosomiasis control strategy and goal from One Health perspective, verification of transmission interruption and elimination of schistosomiasis, precision implementation of schistosomiasis control interventions with adaptations to local circumstances, development and application of highly sensitive and specific diagnostics are recommended for elimination of schistosomiasis in China. In addition, the implementation of the 2022 WHO guideline on control and elimination of human schistosomiasis may guide the elimination of schistosomiasis in China.


Subject(s)
Animals , China/epidemiology , Goals , Humans , Schistosomiasis/prevention & control , Snails , World Health Organization
6.
Article in Chinese | WPRIM | ID: wpr-940942

ABSTRACT

Schistosomiasis is a parasitic disease that seriously hinders socioeconomic developments and threatens public health security. To achieve the global elimination of schistosomiasis as a public health problem by 2030, WHO released the guideline on control and elimination of human schistosomiasis on February, 2022, with aims to provide evidence-based recommendations for schistosomiasis morbidity control, elimination of schistosomiasis as a public health problem, and ultimate interruption of schistosomiasis transmission in disease-endemic countries. Following concerted efforts for decades, great achievements have been obtained for schistosomiasis control in China where the disease was historically highly prevalent, and the country is moving towards schistosomiasis elimination. This article reviews the successful experiences from the national schistosmiasis control program in China, and summarizes their contributions to the formulation and implementation of the WHO guideline on control and elimination of human schistosomiasis. With the progress of the "Belt and Road" initiative, the world is looking forward to more China's solutions on schistosomiasis control.


Subject(s)
China/epidemiology , Disease Eradication , Humans , Public Health , Schistosomiasis/prevention & control , World Health Organization
7.
Article in Chinese | WPRIM | ID: wpr-940941

ABSTRACT

Preventive chemotherapy is one of the pivotal interventions for the control and elimination of schistosomiasis, which is effective to reduce the morbidity and prevalence of schistosomiasis. In order to promote the United Nations' sustainable development goals and the targets set for schistosomiasis control in the Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030, WHO released the guideline on control and elimination of human schistosomiasis in 2022, with major evidence-based updates of the current preventive chemotherapy strategy for schistosomiasis. In China where great success has been achieved in schistosomiasis control, the preventive chemotherapy strategy for schistosomiasis has been updated several times during the past seven decades. This article reviews the evolution of the WHO guidelines on preventive chemotherapy and Chinese national preventive chemotherapy schemes, compares the current Chinese national preventive chemotherapy scheme and the recommendations for preventive chemotherapy proposed in the 2022 WHO guideline on control and elimination of human schistosomiasis, and proposes recommendations for preventive chemotherapy during the future implementation of the 2022 WHO guideline, so as to provide insights into schistosomiasis control among public health professionals engaging in healthcare foreign aid.


Subject(s)
China/epidemiology , Humans , Prevalence , Public Health , Schistosomiasis/prevention & control , World Health Organization
8.
Article in Chinese | WPRIM | ID: wpr-940940

ABSTRACT

On February 2022, WHO released the evidence-based guideline on control and elimination of human schistosomiasis, with aims to guide the elimination of schistosomiasis as a public health problem in disease-endemic countries by 2030 and promote the interruption of schistosomiasis transmission across the world. Based on the One Health concept, six evidence-based recommendations were proposed in this guideline. This article aims to analyze the feasibility of key aspects of this guideline in Chinese national schistosomiasis control program and illustrate the significance to guide the future actions for Chinese national schistosomiasis control program. Currently, the One Health concept has been embodied in the Chinese national schistosomiasis control program. Based on this new WHO guideline, the following recommendations are proposed for the national schistosomiasis control program of China: (1) improving the systematic framework building, facilitating the agreement of the cross-sectoral consensus, and building a high-level leadership group; (2) optimizing the current human and livestock treatments in the national schistosomiasis control program of China; (3) developing highly sensitive and specific diagnostics and the framework for verifying elimination of schistosomiasis; (4) accelerating the progress towards elimination of schistosomiasis and other parasitic diseases through integrating the national control programs for other parasitic diseases.


Subject(s)
China/epidemiology , Disease Eradication , Humans , Public Health , Schistosomiasis/prevention & control , World Health Organization
9.
Chinese Journal of Dermatology ; (12): 196-199, 2022.
Article in Chinese | WPRIM | ID: wpr-933536

ABSTRACT

Objective:To analyze clinical and pathological features of childhood perforating pilomatricoma, and to explore its pathogenesis.Methods:A retrospective analysis was conducted on clinical and histopathological data from 29 children with perforating pilomatricoma in Department of Dermatology, Beijing Children′s Hospital from 2014 to 2020.Results:Among the 29 patients, 11 were males, and 18 were females, with a male-to-female ratio of 1∶1.64. Their age at onset ranged from 3 months to 14 years and 10 months, and the median age at onset was 4.58 years. The disease duration ranged from 2 months to 2 years, with an average of 8.72 months. The perforation occurred 2 days to 1 year and 6 months after the onset of pilomatricoma, with an average of 1.85 months. Ulceration occurred in 1 patient after the treatment with ichthammol, as well as in 3 patients after local scratching or bumping, and spontaneous ulceration without definite precipitating factors occurred in the remaining 25 patients. The average duration from the onset of disease to tumor perforation was 6.87 months. Skin lesions occurred on the face in 15 cases, on the lateral neck in 8, on the upper limb in 4, as well as on the scalp in 2. Perforating pilomatricoma clinically manifested as indurated subcutaneous nodules with crusts or ulcers, and was classified into 3 subtypes: ulcerative type (19 cases) , horny type (8 cases) , and crusted type (2 cases) . The tumor diameter ranged from 0.3 to 2.5 cm, with an average of 1.2 cm. Histopathological examination showed that the tumor was located in the superficial to middle dermis, and mainly consisted of basophils and ghost cells; in 19 cases, the tumor mass was extruded onto the skin surface through a perforated epidermal channel, and the epidermis around the perforation site was hyperplastic and invaginated into the dermis, forming epithelial tunnels surrounding the tumor; in 4 cases, the skin on the tumor surface was thinned and ruptured; in 6 cases, the perforation site could not be observed due to surgical separation of the epidermis and tumor. All lesions were resected, and no infection or recurrence was observed during the postoperative follow-up.Conclusions:Childhood perforating pilomatricoma mostly occurs on the face and neck, usually with rapid progress, and can be classified into ulcerative type, horny type and crusted type. Histological findings suggest that transepithelial elimination is an important mechanism underlying the occurrence of perforation in pilomatricoma.

10.
Article in Chinese | WPRIM | ID: wpr-923778

ABSTRACT

Objective To create a risk assessment indicator system for re-establishment of imported malaria. Methods The risk assessment indicator system for re-establishment of imported malaria was preliminarily constructed through literature review and thematic discussions. A total of 26 malaria control experts were selected to carry out a two-round Delphi consultation of the indicator system. The active coefficient, authority coefficient and coordination coefficient of the experts and the coefficient of variation on each indicator were calculated for indicator screening and the weight of each indicator was calculated. The reliability of the indicator system was evaluated using Cronbach’s coefficient α, and the content validity of the indicator system was evaluated using the authority coefficient of the expert, while the structural validity of the indicator system was evaluated using Kaiser-Meyer-Olkin (KMO) test and factor analysis. Results Two rounds of Delphi expert consultations were completed by 23 malaria control experts, and a risk assessment indicator system for re-establishment of imported malaria was constructed, including 3 primary indicators, 7 secondary indicators, and 21 tertiary indicators. The active coefficient (100.00% vs. 88.46%; P < 0.01) and coordination coefficient of the expert (0.372 vs. 0.286; P < 0.01) were significantly greater in the second round of the Delphi expert consultation than in the first round. After the second round of the Delphi expert consultation, the authority coefficient of the experts ranged from 0.757 to 0.930 on each indicator, and the coefficients of variation were 0.098 to 0.136, 0.112 to 0.276 and 0.139 to 0.335 for the primary, secondary and tertiary indicators, respectively. The overall Cronbach’s coefficient α of the indicator system was 0.941, and there were significant differences in the KMO values for primary (KMO value = 0.523; χ2 = 18.192, P < 0.05), secondary (KMO value = 0.694, χ2 = 51.499, P < 0.01) and tertiary indicators (KMO value = 0.519; χ2 = 477.638, P < 0.01), while the cumulative contribution rate of six principal components in the tertiary indicators was 84.23%. The normalized weights of three primary indicators of the source of infection, transmission condition and control capability were 0.337, 0.333 and 0.329, and the three secondary indicators with the greatest normalized weights included the number of imported cases and malaria parasite species (0.160), introduction of imported cases in China and medical care seeking (0.152), vector species and density (0.152), while the five tertiary indicators with the greatest normalized weights included the malaria parasite species of imported cases (0.065), vector populations (0.064), and the time interval from onset to medical care seeking (0.059), number of imported cases (0.056), and the time interval from medical care seeking to definitive diagnosis (0.055). Conclusions A risk assessment indicator system for re-establishment of imported malaria is successfully created, which provides insights into the assessment of the risk of re-establishment of imported malaria and management of key high-risk factors in malaria-eliminated areas.

11.
Article in Chinese | WPRIM | ID: wpr-923771

ABSTRACT

Malaria caused a heavy disease, economic and social burdens in China. Following 70-year concerted efforts, China has been awarded a malaria-free certification by the WHO on June 2021. This paper summarizes the control strategies of Anopheles vectors from malaria control to post-elimination stages in China, emphasizes the risk of imported malaria cases caused re-transmission and the challenges of Anopheles control after malaria elimination in China. Sustainable and precise vector control is still required in China during the post-elimination stage to consolidate malaria elimination achievements in the country. In addition, China’s innovative vector control strategies, technologies and experiences will contribute to global malaria control and elimination programs.

12.
Article in Chinese | WPRIM | ID: wpr-923770

ABSTRACT

China was certificated malaria-free by WHO in 2021 and has continued to maintain malaria elimination. However, there are still huge challenges in malaria control in the border regions between Yunnan Province, China and Myanmar due to lack of geographic barriers and frequent cross-border travel. Hereby, we review the direction contributions of the Global Fund Malaria Program implemented by Health Poverty Action (HPA), an international non-governmental organization (NGO), to malaria elimination in China, and analyze the challenges of malaria control caused by external environmental factors, such as COVID-19, in regions where the Global Fund Malaria Program is implemented. In addition, some suggestions are proposed for cross-border collaboration on malaria control.

13.
Article in Chinese | WPRIM | ID: wpr-923769

ABSTRACT

China was certified malaria-free by the WHO on June, 2021. Nevertheless, there are thousands of overseas imported malaria cases annually in China, and there are deaths of imported malaria cases reported every year in the country. In addition, there are secondary cases of imported malaria, and malaria vectors remain in regions where malaria were formerly endemic, resulting in a high risk of local transmission of imported malaria in eliminated regions in China. This article analyzes the risk of malaria control and the challenges of malaria surveillance and response during the post-elimination stage in China, and proposes some suggestions for future priorities.

14.
Article in Chinese | WPRIM | ID: wpr-923768

ABSTRACT

On June 2021, China was certified malaria-free by WHO. However, the global number and death of malaria cases have recently increased, and the malaria vectors will continue to inhabit in China, resulting in a high difficulty in consolidation of malaria elimination achievements. Hereby, we analyze the current challenges and propose the future priority of the national malaria control program in China, in order to provide insights into prevention of re-establishment of imported malaria in the country.

15.
Frontiers of Medicine ; (4): 10-16, 2022.
Article in English | WPRIM | ID: wpr-929200

ABSTRACT

Malaria remains a global health challenge, although an increasing number of countries will enter pre-elimination and elimination stages. The prompt and precise diagnosis of symptomatic and asymptomatic carriers of Plasmodium parasites is the key aspect of malaria elimination. Since the launch of the China Malaria Elimination Action Plan in 2010, China has formulated clear goals for malaria diagnosis and has established a network of malaria diagnostic laboratories within medical and health institutions at all levels. Various external quality assessments were implemented, and a national malaria diagnosis reference laboratory network was established to strengthen the quality assurance in malaria diagnosis. Notably, no indigenous malaria cases have been reported since 2017, but the risk of re-establishment of malaria transmission cannot be ignored. This review summarizes the lessons about malaria diagnosis in the elimination phase, primarily including the establishments of laboratory networks and quality control in China, to better improve malaria diagnosis and maintain a malaria-free status. A reference is also provided for countries experiencing malaria elimination.


Subject(s)
China/epidemiology , Clinical Laboratory Techniques , Global Health , Humans , Laboratories , Malaria/prevention & control
16.
Rev. Soc. Bras. Med. Trop ; 55: e0738, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1376352

ABSTRACT

ABSTRACT Background: Although primaquine (PQ) is indicated for G6PD-deficient patients, data on weekly PQ use in Brazil are limited. Methods: We aimed to investigate malaria recurrences among participants receiving daily and weekly PQ treatments in a real-life setting of two municipalities in the Amazon between 2019 and 2020. Results: Patients receiving weekly PQ treatment had a lower risk of recurrence than those receiving daily PQ treatment (risk ratio: 0.62, 95% confidence interval: 0.41-0.94), using a model adjusted for study site. Conclusions: Weekly PQ use did not increase the risk of malaria recurrence. Further studies with larger populations are warranted.

17.
rev. udca actual. divulg. cient ; 24(2): e1818, jul.-dic. 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1361221

ABSTRACT

ABSTRACT Cacao has high social importance in Colombia but requires cultivation techniques that improve its productivity, especially in the production of organic cacao. Pruning and organic fertilizers were assessed as treatments to increase the bean yield in an old cacao crop in Cundinamarca. The positive effects of organic fertilizer application and pruning on the pod morphometry and bean yield were established. The application of organic fertilizers with pruning, in general, increased the length and circumference of cacao pods. A negative correlation (R=-0.618) was found among the relative chlorophyll contents in leaves at the end of the harvest period and with the number of pods per tree. A positive correlation (R=0.748) was obtained between the fresh weight of pods and the dry weight of beans. No correlation was established between the relative chlorophyll contents in leaves and the bean dry weight. Pruning plus organic fertilization increased the total dry weight of beans per tree at almost 15 %, which makes pruning with organic fertilizer application the best tool for increasing yield in organic cacao production in old plantations in Cundinamarca.


RESUMEN El cultivo de cacao tiene una alta importancia social en Colombia, pero requiere la implementación de técnicas de cultivo que mejoren su productividad, principalmente, en la producción de cacao orgánico. La poda y los fertilizantes orgánicos fueron evaluados, como los tratamientos para incrementar el rendimiento de cacao, en una plantación antigua en el departamento Cundinamarca. La aplicación de fertilizantes orgánicos y la poda tuvieron efectos positivos sobre la morfometría del fruto y el rendimiento del cacao. La aplicación de fertilizantes orgánicos con poda, en general, aumentó la longitud y el diámetro de frutos de cacao. Se encontró una correlación negativa (R=-0,618) entre el contenido relativo de clorofila en hojas al final del período de cosecha y el número de frutos por árbol. Se obtuvo una correlación positiva (R=0,748) entre el peso fresco de frutos y el peso seco de semillas. No se estableció correlación entre el contenido relativo de clorofila en hojas y el peso seco de semillas. La poda más fertilización orgánica aumentó el peso seco total de semillas por árbol, en casi un 15 %, lo que convierte la poda con aplicación de fertilizante orgánicos en una herramienta para aumentar el rendimiento de cacao orgánico en antiguas plantaciones, en el departamento Cundinamarca.

18.
Rev. méd. Chile ; 149(11)nov. 2021.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1389394

ABSTRACT

Background: 24-hour urine collection accuracy is generally evaluated based on the values of urine creatinine (UCr) excretion, usually using ranges adjusted by weight. UCr excretion depends on several factors. Equations to estimate UCr in 24-hour collection (UCr/24h) that consider these factors have been developed. However, these formulas have not been evaluated in a sample of Latinamerican origin. Aim: To evaluate the performance of the existing UCr/24 h estimation equations in a sample of Latinamerican origin. Material and Methods: 24-hour urine collections from 181 ambulatory patients were analyzed. Measured UCr/24h was compared with estimated UCr (eUCr) through the equations of Ix (CKD-EPI), Gerber-Mann, Goldwasser, Cockcroft-Gault, Rule, Walser, Kawasaki, Tanaka and Huidobro. Performance of the nine equations to estimate UCr/24h was evaluated with the Pearson correlation and Lin concordance coefficients, and Bland-Altman method. Bias, precision, and accuracy (percentage of collections within 30% of measured UCr or P30) were also calculated. Results: Measured UCr/24h in the 181 patients was 1236 + 378 mg. Correlation coefficient (Pearson) of the eUCr/24h with the equations of Walser, Ix and Huidobro and the measured UCr/24h was strongly positive. Rule and Kawasaki equations had the lowest positive correlation coefficients. Bias was similar using the formulas of Walser, Goldwasser, Kawasaki, Ix and Huidobro. Walser, Ix, Huidobro, Cockcroft-Gault and Goldwasser equations had good accuracy (P30 > 85%), while Gerber-Mann, Tanaka, Rule and Kawasaki formulas had a P30 < 65%. Conclusions: Walser, Ix and Huidobro equations had the best performance to estimate UCr/24h excretion in a population of latinamerican origin.

19.
Medicina (B.Aires) ; 81(2): 252-256, June 2021. graf
Article in English | LILACS | ID: biblio-1287277

ABSTRACT

Abstract The clinical management of hepatitis C virus (HCV) infection presents several challenges today. WHO's goal is to eliminate it by 2030. It is an ambitious goal and difficult to meet given the barriers to care that arise. This is possible today thanks to the discovery of direct-acting antivirals (DAAs). This treatment achieves a high cure rate and is virtually free of adverse effects. To try to comply with this, in addition to the use of DAAs, it is necessary to reduce the rate of undiagnosed patients and facilitate the access of those diagnosed to care and treatment. For that, it is proposed to carry out a simplified treatment of HCV. This involves reducing controls during and after treatment. This simplification varies according to whether patients have cirrhosis or not. In this way, it seeks to increase significantly the number of patients treated and cured to reduce the burden on public health of this disease.


Resumen El manejo clínico de la infección por el virus la hepatitis C (HCV) presenta varios desafíos en la actualidad. El objetivo de la OMS es eliminarlo para el 2030. Es un objetivo ambicioso y muy difícil de cumplir dadas las barreras al cuidado que se presentan. Sin embargo, esto es posible hoy gracias al descubrimiento de los antivirales de acción directa (AAD). Este tratamiento logra una alta tasa de curación y prácticamente está libre de efectos adversos. Para tratar de cumplirlo, además del uso de los AAD, es nece sario reducir la tasa de pacientes no diagnosticados y facilitar el acceso de los diagnosticados al cuidado y el tratamiento. Para eso se propone llevar adelante el tratamiento simplificado del HCV. Esto implica reducir los controles durante y después del tratamiento. Esta simplificación varía según los pacientes tengan o no cirrosis. De esta manera se busca aumentar significativamente el número de pacientes tratados y curados para así poder reducir el impacto en la salud pública de esta enfermedad.


Subject(s)
Humans , Hepatitis C/drug therapy , Hepatitis C, Chronic/drug therapy , Antiviral Agents/therapeutic use , Hepacivirus , Liver Cirrhosis
20.
Rev. cuba. pediatr ; 93(1): e1302, ene.-mar. 2021. tab, fig
Article in Spanish | LILACS, CUMED | ID: biblio-1251745

ABSTRACT

Introducción: En Cuba se plantean metas progresivas para la eliminación de la tuberculosis en niños. Objetivo: Evaluar las desigualdades en la ocurrencia de la tuberculosis en menores de 15 años en cinco provincias occidentales cubanas y sus municipios. Métodos: Estudio ecológico de series temporales en las provincias Pinar del Río, Artemisa, La Habana, Mayabeque y Matanzas. Los datos provinieron del Sistema de Vigilancia del Ministerio de Salud Pública. Se analizaron el número de casos y las tasas de notificación por 100 000 habitantes. Se calcularon los porcentajes por grupos de edad; las tasas anuales, sus variaciones 2011-2015 y las tendencias mediante regresión lineal simple. Se estimaron las medias geométricas de las tasas, la menor fue la referencia para calcular las diferencias absolutas y relativas. Se estratificaron las provincias y sus municipios según las metas progresivas hacia la eliminación de la tuberculosis. Resultados: Las provincias occidentales notificaron 56,1 por ciento del total Cuba. Pinar del Río fue la provincia de referencia, mostró una reducción de 100 por ciento de su tasa. La tendencia en La Habana y Mayabeque fue ligeramente ascendente con tasas 17 y 14 veces mayores que la de referencia. Artemisa, Matanzas y Pinar del Río estuvieron en preeliminación; cinco municipios de La Habana, dos de Mayabeque y uno de Matanzas están en ultracontrol muy avanzado. Conclusiones: Las desigualdades de la tuberculosis en menores de 15 años para algunas provincias fueron relevantes, así el control debe ser fortalecido sostenidamente en La Habana y Mayabeque(AU)


Introduction: In Cuba, progressive goals are set for the elimination of tuberculosis in children. Objective: Assess inequalities in the occurrence of tuberculosis in children less than 15 years in five western Cuban provinces and their municipalities. Methods: Ecological study of time series in the following provinces: Pinar del Río, Artemisa, Havana, Mayabeque and Matanzas. The data came from the Surveillance System of the Ministry of Public Health. The number of cases and reporting rates per 100,000 inhabitants were assessed. Percentages by age group were calculated, and the annual rates, their variations in 2011-2015 and trends were assessed through simple linear regression. The geometric means of the rates were estimated; the lower was the reference for calculating absolute and relative differences. Provinces and their municipalities were stratified according to progressive goals for TB elimination. Results: Western provinces reported 56.1 percent of the total in Cuba. Pinar del Río was the reference province, showing a 100 percent reduction in its rate. The trend in Havana and Mayabeque was slightly upward with rates 17 and 14 times higher than the reference rate. Artemisa, Matanzas and Pinar del Río were in pre-elimination stage; five municipalities in Havana, two in Mayabeque and one in Matanzas are in a very advanced far-control. Conclusions: TB inequalities in children under 15 years old for some provinces are relevant, so control must be strengthened steadily in Havana and Mayabeque(AU)


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Tuberculosis , Time Series Studies , Surveillance in Disasters , Goals
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