Acidentes com material biológico durante limpeza de produtos para saúde na Enfermagem / Accidentes con material biológico durante la limpieza de productos para la salud en enfermería / Accidents involving biological material during cleaning of reusable medical devices in nursing

Resumo Objetivo Avaliar a incidência e os fatores associados aos acidentes de trabalho envolvendo material biológico ocorridos durante a limpeza de produtos para a saúde em profissionais da equipe de enfermagem no Brasil. Métodos Estudo de coorte retrospectivo realizado entre 2015 e 2019. A população foi dividida em dois grupos para fins de comparação, sendo composto de profissionais que sofreram acidentes durante a limpeza de produtos para a saúde e o outro grupo dos profissionais que se acidentaram em outras circunstâncias. Os dados do estudo foram extraídos do Sistema de Informação de Agravos de Notificação (número de acidentes) e Cadastro Nacional de Estabelecimentos de Saúde (número de profissionais). Analisou-se os fatores associados à incidência de acidentes de trabalho envolvendo material biológico (variável dependente) durante a limpeza de produtos para a saúde por meio da regressão de Poisson múltipla. Resultados A taxa média de incidência de acidentes de trabalho envolvendo material biológico foi de 115,0 casos a cada 100 mil profissionais de enfermagem entre 2015 e 2020, e, entre os técnicos de enfermagem, a incidência, foi de 151,6 casos a cada 100 mil profissionais. Para os profissionais de enfermagem, verificou-se que o risco de acidentes foi 2,49 vezes maior em exposições percutâneas. O risco de acidentes foi 1,87 vez maior quando o material envolvido era sangue. O risco aumentou ainda quando o agente envolvido era lâmina/lanceta e outros agentes. Conclusão A taxa de incidência foi elevada e esteve associada aos fatores demográficos, laborais e relacionados ao acidente.

Resumen Objetivo Evaluar la incidencia y los factores asociados a los accidentes de trabajo con material biológico ocurridos durante la limpieza de productos para la salud por profesionales de equipos de enfermería en Brasil. Métodos Estudio de cohorte retrospectivo realizado entre 2015 y 2019. La población fue dividida en dos grupos para fines comparativos, uno con profesionales que sufrieron accidentes durante la limpieza de productos para la salud y el otro grupo con profesionales que se accidentaron en otras circunstancias. Los datos del estudio se extrajeron del Sistema de Información de Agravios de Notificación (número de accidentes) y del Registro Nacional de Establecimientos de Salud (número de profesionales). Se analizaron los factores asociados a la incidencia de accidentes de trabajo con material biológico (variable dependiente) durante la limpieza de productos para la salud mediante la regresión de Poisson múltiple. Resultados El índice promedio de incidencia de accidentes de trabajo con material biológico fue de 115,0 casos cada 100.000 profesionales de enfermería entre 2015 y 2020; y entre los técnicos de enfermería, la incidencia fue de 151,6 casos cada 100.000 profesionales. Se verificó que el riesgo de accidentes fue 2,49 veces más grande en exposiciones precutáneas entre los profesionales de enfermería. El riesgo de accidentes fue 1,87 veces más grande cuando el material era sangre. El riesgo aumentó más cuando el agente eran hojas/lancetas y otros agentes. Conclusión El índice de incidencia fue alto y se asoció a los factores demográficos, laborales y relacionados con el accidente.

Abstract Objective To assess incidence and factors associated with occupational accidents involving biological material that occur during the cleaning of reusable medical devices among nursing staff in Brazil. Methods This is a retrospective cohort study conducted between 2015 and 2019. The population was divided into two groups for comparison purposes, one composed of professionals who suffered accidents while cleaning reusable medical devices and the other composed of professionals who suffered accidents under other circumstances. The study data were extracted from the Notifiable Diseases Information System (number of accidents) and the Brazilian National Registry of Health Establishments (number of professionals). The factors associated with the incidence of occupational accidents involving biological material (dependent variable) during the cleaning of reusable medical devices were analyzed using multiple Poisson regression. Results The mean incidence rate of occupational accidents involving biological material was 115.0 cases per 100,000 nursing professionals between 2015 and 2020, and, among nursing technicians, the incidence was 151.6 cases per 100,000 professionals. For nursing professionals, it was found that the risk of accidents was 2.49 times higher in percutaneous exposure. The risk of accidents was 1.87 times higher when the material involved was blood. The risk increased even more when the device involved was a blade/blood lancet and others. Conclusion The incidence rate was high and was associated with demographic, work-related and accident-related factors.

Incidência de sífilis no estado do Rio de Janeiro e nomunicípio de Seropédica nos anos de 2010 a 2022 / Incidence of syphilis in the state of Rio de Janeiro andmunicipality of Seropédica in the years 2010 to 2022

Sífilis é uma infecção sexualmente transmissível (IST) que sinaliza a necessidade de efetivas políticas públicas devido ao aumento de casos na última década. Dessa forma, o objetivo do trabalho é descrever a incidência de sífilis no estado do Rio de Janeiro e no município de Seropédica. Métodos: foi realizado um estudo descritivo, com abordagem quantitativa. A coleta dos dados foi realizada por meio do Sistema de Informação de Agravos de Notificação (Sinan), referentes ao município de Seropédica e ao estado do Rio de Janeiro, no período de 2010 a 2022. Resultados: foram identificados 105.138, 79.609 e 42.819 casos de sífilis adquirida, em gestantes e congênita, respectivamente, no estado do Rio de Janeiro e 187, 140 e 79 casos de sífilis adquirida, em gestantes e congênita, respectivamente, no município de Seropédica. Foi observado uma incidência maior para sífilis adquirida entre homens em comparação com mulheres tanto no estado do Rio de Janeiro (62.719 versus 42.346) quanto no município de Seropédica (110 versus 77). Houve um aumento nas taxas de incidência de sífilis no estado do Rio de Janeiro e no município de Seropédica ao longo dos anos. Conclusão: a sífilis segue sendo uma doença com alta incidência no território do Rio de Janeiro. Nesse sentido, é importante elaborar estratégias em saúde pública mais efetivas às pessoas acometidas por tal infecção.

Syphilis is a sexually transmitted infection (STI) that signals the need for effective public policies due to the increase in cases in the last decade. Thus, the aim of this study is to describe the incidence of syphilis in the state of Rio de Janeiro and in the municipality of Seropédica. Methods: a descriptive study with a quantitative approach was carried out. Data collection was performed through the Sistema de Informação de Agravos de Notificação (Sinan), referring to the municipality of Seropédica and the state of Rio de Janeiro, from 2010 to 2022. Results: overall, 105.138, 79.609 and 42.819 cases of acquired syphilis, in pregnant women, and congenital syphilis, respectively, were identified in the state of Rio de Janeiro, and 187, 140, and 79 cases of acquired syphilis, in pregnant women, and congenital syphilis, respectively, were identified in the municipality of Seropédica. A higher incidence of acquired syphilis was observed among men compared to women both in the state of Rio de Janeiro (62.719 versus 42.346) and in the municipality of Seropédica (110 versus 77). There has been an increase in the incidence rates of syphilis in the state of Rio de Janeiro and the municipality of Seropédica over the years. Conclusion: syphilis continues to be a disease with a high incidence in the territory of Rio de Janeiro. In this sense, it is important to develop more effective public health strategies for people affected by this infection.

Incidencia de las enfermedades transmitidas por alimentos en Ecuador / Incidence of foodborne diseases in Ecuador

RESUMEN Con el objetivo de describir las tasas de incidencia por cada 100 000 habitantes de los casos de enfermedades transmitidas por alimentos (ETA) durante el periodo 2015-2020 en Ecuador se realizó un análisis secundario de los registros de vigilancia epidemiológica y de las proyecciones poblacionales del Instituto Nacional de Estadística y Censos. Se reportaron 113 695 casos con una incidencia superior a los 100 casos por cada 100 000 habitantes (2015-2019). En el 2020 los registros son considerablemente inferiores a los reportes de años anteriores. La mayoría de los casos se reportaron como «otras intoxicaciones alimentarias¼. Las tasas de incidencia de ETA más altas se observaron en la región amazónica. En general existe una marcada variabilidad anual en la incidencia de las ETA según las regiones geográficas del Ecuador. En conclusión, las ETA representan un problema de salud pública en el Ecuador. Se deben diseñar estrategias preventivas integrales con especial énfasis en la región amazónica.

ABSTRACT In order to describe the incidence rates per 100 000 population of foodborne disease (FBD) cases during the period 2015-2020 in Ecuador, we carried out a secondary analysis of epidemiological surveillance records and population projections from the National Institute of Statistics and Census. A total of 113,695 cases were reported with an incidence of more than 100 cases per 100 000 population (2015-2019). In 2020, the records are considerably lower than those reported in previous years. Most cases were reported as "other food poisoning". The highest incidence rates of FBD were found in the Amazon region. In general, there is a marked annual variability in the incidence of FBD according to the geographic regions of Ecuador. In conclusion, FBD represent a public health problem in Ecuador. Comprehensive preventive strategies should be designed with special emphasis on the Amazon region.

Infección por SARS-CoV- 2 en viajeros procedentes del exterior a su arribo a Santiago de Cuba

Introducción: El estudio de los viajeros es importante y ha resultado una variable asociada significativamente con el número de casos de covid-19. Objetivo: Caracterizar a los viajeros infectados por el SARS-CoV-2 según variables epidemiológicas y sociodemográficas de interés. Métodos: Se realizó un estudio ecológico de series temporales, de viajeros procedentes del exterior, residentes en Santiago de Cuba o cuyo destino final era esta provincia, que arribaron al país entre el 11 de marzo del 2020 y el 11 de noviembre del 2022. Las fuentes de información fueron los registros de viajeros establecidos por el Centro Provincial de Higiene, Epidemiologia y Microbiología de esta provincia y del Laboratorio Provincial de Microbiología. Resultados: Fueron recibidos 64 984 viajeros, de los cuales 568 resultaron positivos, con predominio de los asintomáticos y del diagnóstico al quinto día del arribo. Conclusiones: El control sobre los viajeros influyó en el patrón de transmisión de la enfermedad; en tanto, la realización de una segunda prueba al quinto día permitió hallar un porcentaje elevado de positividad. Algunas características de la morbilidad en este grupo de casos se diferenciaron de la incidencia en la población general, tales como las formas clínicas, la edad y la distribución espacial.

Introduction: The study of travelers is important and has been a variable significantly associated with the number of covid-19 cases. Objective: To characterize the travelers infected with SARS-CoV-2 according to epidemiologic and sociodemographic variables of interest. Methods: An ecological study of temporary series was carried out, of travelers from abroad, residents in Santiago de Cuba or whose final destination was this province, that arrived at the country between March 11, 2020 and November 11, 2022. The sources of information were the travelers' records established by the Provincial Center of Hygiene, Epidemiology and Microbiology of this province and the results of polymerase chain reaction tests of the Provincial Laboratory of Microbiology. Results: Sixty-four thousand nine-hundred eighty four travelers were received, of which 568 were positive, with prevalence of the asymptomatic and the diagnosis at the fifth day of arrival. Conclusions: The control on the travelers influenced in the pattern of transmission of the disease; as long as, the realization of a second test at the fifth day allowed to find a high percentage of positivity. Some characteristics of morbidity in this group of cases differed from the incidence in the general population, such as the clinical forms, age and space distribution.

Post operative wound infection: a descriptive study

Background: Surgical site infections is the third most commonly reported nosocomial infection which has an adverse impact on the hospital as well as the patient. This study was designed to evaluate the frequency, clinical presentation, common risk factors and different organisms involved.Methods: This study was performed at NRI Medical college, Chinnakakani. This is an Observational descriptive study over a period of one year from September 2022 to September 2023. Biodata of the patients together with their clinical features, diagnosis, type of surgery performed and the development of any complications including wound infection was noted and the data analyzed.Results: Out of 1509 patients in the study, 1101 belonged to obstetrics and 408 to gynaecology surgery. The overall incidence of surgical site infection in the study was 7.9%; 86 (7.8%) in obstetrics group and 33 (8%) in gynaecology group developed infection. Age more than 50 years was found to be a risk factor for postoperative wound infection. Obesity is known to be a well-established risk factor for postoperative wound infection. It was noted that surgical site infection was more common in patients that had low haemoglobin levels pre-operatively. The increased susceptibility to infection in diabetics is an established risk factor.Conclusions: Meticulous surgical technique, proper sterilization, judicious use of antibiotics, improvement of ward environments, control of malnutrition and obesity, treatment of infective foci and diseases like diabetes helps control the morbidity of surgical wound infections.

Incidence and characteristics of preeclampsia patients: a descriptive study

Background: More than 70% of maternal deaths are caused by preeclampsia and eclampsia. This study aimed to evaluate the characteristics of pregnant women with preeclampsia in the obstetrics emergency room of Prof. Dr. I. Gusti Ngoerah Gede (I.G.N.G.) Ngoerah General Hospital, Denpasar, in 2022. Methods: This study was conducted with a high level of thoroughness and detail. Data obtained include age data, gestational age, parity, employment, education, history of hypertension, history of pregnancy with preeclampsia before, blood pressure measurement results, body mass index (BMI), laboratory examination results, NST picture, complications, mode of delivery, APGAR, and birth weight. The collected data was meticulously tabulated, analyzed, and presented as tables and narratives. Results: The findings of this study are significant for the field of obstetrics and gynecology. The incidence of preeclampsia in the obstetrics emergency room of Prof. Dr. I.G.N.G. Ngoerah General Hospital reached 15.75% in 2022 with a 0% case fatality rate. The average age was 31 years. Sixty-one subjects (62.89%) were primiparous, 41 subjects (42.27%) had a history of hypertension, and 23 subjects (23.71%) had a history of pregnancy with preeclampsia. The median BMI reached 22.3 kg/m2. The mean platelet of 354 103/µl, creatinine of 0.7 mg/dl, and 93 subjects (95.88%) were positive for proteinuria. Based on the NST picture obtained, 37 (38.14%) patients had reactive non-stress test pictures. APGAR score >7 of 76 subjects (78.35%) with a median birth weight of 1,850 grams. Conclusions: This study is expected to be a reference for further research. Further research is needed to assess the relationship between demographic characteristics and the risk factors of preeclampsia.

Incidence of human rabies following bite or exposure to laboratory confirmed rabid animals

Background: Rabies is one of the important endemic fatal zoonotic viral disease afflicting humans and animals in Punjab, India. The present study investigated the incidence of rabies in humans bitten/exposed to laboratory confirmed rabid animals, as well as incidence after use of vaccine or rabies immunoglobulin (RIG) and clinico-epidemiological studies. Methods: A study was conducted during August 2021 to September 2022 on forty (40) rabies suspected animals presented to diagnose rabies by direct fluorescent antibody test (dFAT) at rabies diagnostic laboratory (RDL), Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Punjab, India. A detailed questionnaire was prepared for obtaining information about exposure/bite of humans by rabid animals, death of humans, demographic and epidemiological information of victims. Results: Out of total forty (40) suspected rabies cases, 30(75%) were found positive for rabies by dFAT. Laboratory confirmed rabies (LCR) incidence was 60.80% and 21.73% in stray and pet dogs, respectively. All pet dogs were vaccinated but no stray dog was vaccinated. The LCR incidence in buffaloes and cattle was 77.77% and 100%, respectively. Further in humans exposed to rabid animals (59), males were at more risk than females. The human rabies incidence was 3.38% (2/59). Highest incidence of dog bites in adult males on lower limb was observed from urban stray dogs (60.80%) followed by children. Post exposure vaccination was given to 98.3% humans exposed to rabid animals. Human’s rabies in two cases was due to no vaccination or RIG. Conclusions: Vaccination is an important step in controlling rabies in India. There is a need for integrated and comprehensive management of street dogs and bite management.

Prevalencia de enfermedad maligna no anticipada en la histopatología de histerectomía indicada por condición benigna / Prevalence of unexpected malignant disease in the histopathology of hysterectomy indicated for benign condition

RESUMEN Objetivo: describir la prevalencia de patología maligna incidental posterior a una histerectomía por causa benigna. Método: estudio de corte transversal descriptivo, basado en registros hospitalarios. Se incluyeron mujeres a quienes se les realizó una histerectomía por causa benigna en un hospital general de referencia entre 2013 y 2021. Se excluyeron mujeres con histerectomía obstétrica. Variables medidas: edad, vía de la histerectomía, tipo de histerectomía, diagnóstico histopatológico de lesión premaligna o de cáncer invasor, tipo de cáncer. Análisis: descriptivo, se estimó la prevalencia en el periodo global de condiciones preneoplásicas y neoplásicas. Resultado: de 816 registros clínicos se analizaron 674 casos (87 %) que cumplieron los criterios de inclusión. Predominó la población premenopáusica. Se identificaron 26 casos de enfermedad maligna no anticipada para una prevalencia del 3,8 % y 13 casos de patología premaligna (1,9 %). El origen más frecuente fue el cuello uterino (40 %) seguido del ovario (33 %). Conclusiones: se debe considerar informar riesgo de lesión no esperada a las pacientes que serán sometidas a histerectomía por condición benigna. Se enfatiza la importancia de realizar una adecuada aproximación prequirúrgica, en especial para descartar cáncer de ovario y cérvix en nuestro medio. Se requieren estudios de seguimiento de las pacientes con cáncer no anticipado para determinar el tratamiento y su pronóstico en la región.

ABSTRACT Objective: To describe the prevalence of incidental malignant pathology following a hysterectomy performed for benign reasons. Method: A descriptive cross-sectional study based on hospital records. Women who underwent hysterectomy for benign reasons at a general referral hospital between 2013 and 2021 were included. Women with obstetric hysterectomy were excluded. Measured variables: age, route of hysterectomy, type of hysterectomy, histopathological diagnosis of premalignant lesion or invasive cancer, type of cancer. Analysis: Descriptive, the prevalence of preneoplastic and neoplastic conditions was estimated for the overall period. Results: Of 816 clinical records, 674 cases (87 %) met the inclusion criteria and were ana-lyzed. The premenopausal population predominated. Twenty- six cases of unex-pected malignant disease were identified, yielding a prevalence of 3.8 %, and 13 cases of premalignant pathology (1.9 %). The most common origin was the cervix (40 %), followed by the ovary (33 %). Conclusions: Patients undergoing hysterectomy for benign conditions should be informed about the risk of unexpected injury. The importance of performing, in our context an adequate preoperative approach to rule out cervix uteri and ovarian cancer is emphasized. Follow-up studies of patients with unanticipated cancer are required to determine their treatment and prognosis in the region.

Tendencias y factores asociados al aumento de casos de dengue en Cochabamba: un estudio longitudinal 2019-2024 / Tendências e Fatores Associados ao Aumento de Casos de Dengue em Cochabamba: um Estudo Longitudinal 2019-2024 / Trends and Factors Associated with the Increase in Dengue Cases in Cochabamba: a Longitudinal Study 2019-2024

Introducción: el dengue, transmitido por el mosquito Aedes aegypti, es un problema de salud pública global creciente, especialmente en Cochabamba, donde factores climáticos y urbanización favorecen su proliferación. Entre 2020 y 2023, los casos aumentaron alarmantemente, subrayando la necesidad de vigilancia y prevención. Este estudio analizará las tendencias de 2019 a 2024, relacionando incidencia y lluvias. Metodología: este estudio cuantitativo, longitudinal y retrospectivo analizó las tendencias de casos sospechosos de dengue en Cochabamba de 2019 a 2024. Utilizó datos del formulario 302 del SNIS Bolivia, abarcando períodos epidemiológicos y de lluvia. Se realizó análisis descriptivo con SPSS y comparación con estudios previos para validar resultados y formular políticas de salud. Resultados: los datos semanales de dengue en Cochabamba, divididos en períodos inter-epidémicos y de lluvias, muestran un aumento significativo de casos en 2023-2024 (13,940 casos) comparado con años anteriores. Los picos más altos se observan durante el final del período de lluvias, especialmente en la semana 21 de 2023-2024, destacando la estacionalidad de la enfermedad. Discusión: el análisis de los casos sospechosos de dengue en Cochabamba (2019-2024) muestra un drástico aumento en 2023-2024, con 13,940 casos. Este incremento puede estar influenciado por el cambio climático, crecimiento urbano y variaciones en vigilancia epidemiológica. Los picos se concentran durante la temporada de lluvias, subrayando la necesidad de fortalecer medidas de control y prevención.

Introduction: dengue, transmitted by the Aedes aegypti mosquito, is a growing global public health problem, particularly in Cochabamba, where climatic factors and urbanization favor its proliferation. Between 2020 and 2023, cases increased alarmingly, underscoring the need for surveillance and prevention. This study will analyze trends from 2019 to 2024, correlating incidence with rainfall. Methodology: this quantitative, longitudinal, and retrospective study analyzed trends in suspected dengue cases in Cochabamba from 2019 to 2024. It used data from Form 302 of the SNIS Bolivia, covering epidemiological and rainy periods. Descriptive analysis was performed with SPSS and compared with previous studies to validate results and formulate health policies. Results: weekly dengue data in Cochabamba, divided into inter-epidemic and rainy periods, show a significant increase in cases in 2023­2024 (13,940 cases) compared to previous years. The highest peaks are observed during the end of the rainy period, especially in week 21 of 2023-2024, highlighting the seasonality of the disease. Discussion: the analysis of suspected dengue cases in Cochabamba (2019-2024) shows a drastic increase in 2023­2024, with 13,940 cases. This increase may be influenced by climate change, urban growth, and variations in epidemiological surveillance. The peaks are concentrated in the rainy season, emphasizing the need to strengthen control and prevention measures.

Introdução: a dengue, transmitida pelo mosquito Aedes aegypti, é um crescente problema de saúde pública global, especialmente em Cochabamba, onde fatores climáticos e urbanização favorecem sua proliferação. Entre 2020 e 2023, os casos aumentaram alarmantemente, sublinhando a necessidade de vigilância e prevenção. Este estudo analisará as tendências de 2019 a 2024, correlacionando incidência e chuvas. Metodologia: este estudo quantitativo, longitudinal e retrospectivo analisou as tendências de casos suspeitos de dengue em Cochabamba de 2019 a 2024. Utilizou dados do formulário 302 do SNIS Bolívia, abrangendo períodos epidemiológicos e de chuva. Foi realizada análise descritiva com SPSS e comparação com estudos anteriores para validar os resultados e formular políticas de saúde. Resultados: os dados semanais de dengue em Cochabamba, divididos em períodos inter-epidêmicos e de chuvas, mostram um aumento significativo de casos em 2023-2024 (13.940 casos) em comparação com anos anteriores. Os picos mais altos são observados durante o final do período de chuvas, especialmente na semana 21 de 2023-2024, destacando a sazonalidade da doença. Discussão: A análise dos casos suspeitos de dengue em Cochabamba (2019-2024) mostra um aumento drástico em 2023-2024, com 13.940 casos. Este aumento pode estar influenciado pelas mudanças climáticas, crescimento urbano e variações na vigilância epidemiológica. Os picos se concentram durante a temporada de chuvas, sublinhando a necessidade de fortalecer as medidas de controle e prevenção

Sífilis congênita em sorocaba: incidência e aspectos clínicos em mães e recém-nascidos / Congenital syphilis in sorocaba: incidence and clinical aspects in mothers and newborn / Sífilis congénita en sorocaba: incidencia y aspectos clínicos en madres y recién nacido

Objetivo: Analisar a incidência de sífilis congênita e descrever o perfil epidemiológico das mães e recém-nascidos diagnosticados no município de Sorocaba, SP. Métodos: Estudo descritivo e inferencial, utilizando dados provenientes da notificação compulsória de casos confirmados de sífilis congênita. A coleta dessas informações ocorreu no período de 2018 a 2022, a partir do banco de dados do Centro Municipal de Atenção Especializada. Resultados: Foram notificados 164 casos e a incidência de sífilis congênita foi de 3,66 novos casos. O perfil sociodemográfico das mães, predominantemente jovens, de etnia branca e com escolaridade desconhecida, reflete desafios na identificação e tratamento. A associação significativa entre o esquema de tratamento materno e a escolaridade, especialmente no ensino superior, destaca a importância do acesso à informação na prevenção da transmissão vertical. Apesar da cobertura universal do pré-natal, a presença majoritária de tratamentos inadequados ou não realizados sugere barreiras práticas e socioeconômicas. A significativa proporção de parceiros não tratados ou desconhecidos destaca a necessidade de abordagens abrangentes. Conclusão: Os resultados destacam a importância de estratégias integradas que ultrapassem o âmbito clínico. A implementação de medidas preventivas, educacionais e de apoio socioeconômico é imperativa para avançar em direção à redução efetiva da sífilis congênita em Sorocaba. (AU)

Objective: To analyze the incidence of congenital syphilis and to describe the epidemiological profile of mothers and newborns diagnosed in the city of Sorocaba, Southeastern Brazil. Methods: This was a descriptive and inferential study using data from the compulsory notification of confirmed cases of congenital syphilis. This information was collected from 2018 to 2022, using the database of the Municipal Center for Specialized Care. Results: 164 cases were reported and the incidence of congenital syphilis was 3.66 new cases. The sociodemographic profile of the mothers, who were predominantly young, of white ethnicity and with unknown schooling, reflects challenges in identification and treatment. The significant association between maternal treatment regimen and schooling, especially in higher education, highlights the importance of access to information in the prevention of mother-to-child transmission. Despite universal prenatal coverage, the majority of inadequate or non-performing treatments suggests practical and socioeconomic barriers. The significant proportion of untreated or unknown partners highlights the need for comprehensive approaches. Conclusion: The results highlight the importance of integrated strategies that go beyond the clinical scope. The implementation of preventive, educational and socioeconomic support measures is imperative to move towards the effective reduction of congenital syphilis in Sorocaba. (AU)

Objetivo: Analizar la incidencia de sífilis congénita y describir el perfil epidemiológico de madres y recién nacidos diagnosticados en la ciudad de Sorocaba, Sudeste de Brasil. Métodos: Estudio descriptivo e inferencial con datos de la notificación obligatoria de casos confirmados de sífilis congénita. Esta información se recolectó de 2018 a 2022, utilizando la base de datos del Centro Municipal de Atención Especializada. Resultados: Se notificaron 164 casos y la incidencia de sífilis congénita fue de 3,66 casos nuevos. El perfil sociodemográfico de las madres, predominantemente jóvenes, de etnia blanca y con escolaridad desconocida, refleja dificultades en la identificación y el tratamiento. La asociación significativa entre el régimen de tratamiento materno y la escolaridad, especialmente en la educación superior, pone de relieve la importancia del acceso a la información en la prevención de la transmisión maternoinfantil. A pesar de la cobertura prenatal universal, la mayoría de los tratamientos inadecuados o ineficaces plantean barreras prácticas y socioeconómicas. La importante proporción de parejas no tratadas o desconocidas pone de relieve la necesidad de adoptar enfoques integrales. Conclusión: Los resultados ponen de manifiesto la importancia de las estrategias integradas que van más allá del ámbito clínico. La implementación de medidas de apoyo preventivo, educativo y socioeconómico es imprescindible para avanzar hacia la reducción efectiva de la sífilis congénita en Sorocaba. (AU)

Incidencia de diabetes gestacional en Chile durante el periodo 2001-2022 / Incidence of gestational diabetes in Chile during the period 2001-2022

Introducción: La diabetes mellitus gestacional (DG) se define como una hiperglucemia que se diagnostica por primera vez durante la gestación. Objetivo: Describir la incidencia de diabetes gestacional (DG) durante el periodo 2001-2022 en Chile. Método: Estudio observacional, descriptivo, ecológico y longitudinal. Se incluyeron los egresos hospitalarios consignados como diabetes durante el embarazo y DG en el periodo 2001-2022, de la base de datos del Departamento de Estadística e Información en Salud. Se determinó la incidencia de DG por la cantidad de partos institucionalizados, para cada año. Se analizaron la tendencia en el periodo y las diferencias entre regiones. Resultados: Se determinó un aumento de 2,615 casos de DG por 1000 partos atendidos por año en el periodo 2001-2022. En particular, en el periodo 2016-2022 la incidencia aumentó hasta 6,746 casos de DG por 1000 partos por año. En el año 2022, la región de La Araucanía presentó una incidencia de 284,4 casos por 1000 partos, lo que representa un aumento del 503% en relación con la incidencia media nacional (56,5 casos por 1000 partos). Conclusiones: Se demuestra un aumento significativo de la DG, en especial desde 2016. La situación en La Araucanía podría relacionarse con los niveles de pobreza multidimensional.

Introduction: Gestational diabetes mellitus (GDM) is defined as hyperglycemia first diagnosed during pregnancy. Objetive: To describe the incidence of gestational diabetes (GD) during the period 2001-2022 in Chile. Method: Observational, descriptive, ecological, longitudinal study. Hospital records of diabetes during pregnancy and GD in the period 2001-2022 were included, from the database of the Department of Statistics and Health Information. The incidence of GD was determined by the number of births, for each year. Trends in the period and differences between regions were analysed. Results: The results show an increase of 2.615 GD cases per 1000 births per year in the period 2001-2022. Particularly, in the period 2016-2022 the incidence increased to 6.746 cases of GD per 1000 births per year. In 2022, La Araucanía region presented an incidence of 284.4 cases per 1000 births, which represents an increase of 503% in relation to the mean national incidence (56.5 cases per 1000 births). Conclusions: A significant increase in DG is demonstrated, especially since 2016. The situation in La Araucanía could be related to the levels of multidimensional poverty.

Space-temporal analysis of the incidence, mortality and case fatality of COVID-19 in the State of Rio Grande do Norte, in the period from 2020 to 2022, in the Northeast of Brazil

Introduction: the COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus, has had a great impact on the state of Rio Grande do Norte, as well as around the world, constituting a relevant challenge for public health. Since its emergence, the disease has spread widely, causing a significant number of confirmed cases and deaths in the state. Objective: to analyze the trend of incidence, mortality and case fatality of COVID-19 in the state of Rio Grande do Norte, located in the Northeast region of Brazil, between 2020 and 2022. Methods: consists of an ecological analysis of time series of retrospective secondary data in population level. Incidence and mortality rates per 100,000 inhabitants were estimated, as well as case fatality and daily percentage variation, both expressed in percentages. The daily percentage variation was calculated using the generalized linear regression technique using the Prais-Winsten method, and served to classify the trend as increasing, decreasing or stationary, considering a significance level of 95%. Results: data analysis showed the registration of 582,618 cases and 8,689 deaths from COVID-19 in the state of Rio Grande do Norte, during the period from March 2020 to December 2022. There was an initial increase in the incidence rate in 2020, followed by a significant reduction in 2021 and 2022. Mortality showed a decreasing trend in 2021 and a stationary trend in 2022, without notable variation in 2020. The case fatality rate decreased in 2020, but did not show significant trends in the following years. Conclusion: the epidemiological analysis of COVID-19 in the state of Rio Grande do Norte revealed variations in incidence, mortality and case fatality over the study period. The daily percentage change over the total period of the incidence time series was stationary, while mortality and case fatality were decreasing.

Introdução: a pandemia de COVID-19, causada pelo coronavírus SARS-CoV-2, tem exercido grande impacto sobre o estado do Rio Grande do Norte, bem como em todo o mundo, constituindo-se um desafio relevante para a saúde pública. Desde sua emergência, a doença propagou-se amplamente, ocasionando uma quantidade expressiva de casos confirmados e óbitos no Estado. Objetivo: analisar a tendência da incidência, mortalidade e letalidade da COVID-19 no estado do Rio Grande do Norte, situado na região Nordeste do Brasil, entre 2020 e 2022. Método: consiste em uma análise ecológica de séries temporais de dados secundários retrospectivos em nível populacional. Foram estimadas as taxas de incidência e mortalidade por 100.000 habitantes, assim como a letalidade e a variação percentual diária, ambas expressas em porcentagem. A variação percentual diária foi calculada por meio da técnica de regressão linear generalizada utilizando o método de Prais-Winsten, e serviu para classificar a tendência em crescente, decrescente ou estacionária, considerando um nível de significância de 95%. Resultados: a análise dos dados mostrou o registro de 582.618 casos e 8.689 óbitos de COVID-19 no estado do Rio Grande do Norte, durante o período de março de 2020 a dezembro de 2022. Houve um aumento inicial na taxa de incidência em 2020, seguido por uma redução significativa em 2021 e 2022. A mortalidade apresentou uma tendência decrescente em 2021 e uma tendência estacionária em 2022, sem variação notável em 2020. A taxa de letalidade diminuiu em 2020, mas não mostrou tendências significativas nos anos seguintes. Conclusão: a análise epidemiológica da COVID-19 no estado do Rio Grande do Norte revelou variações na incidência, mortalidade e letalidade ao longo do período de estudo. A variação percentual diária no período total da série temporal de incidência foi de movimento estacionário, enquanto da mortalidade e letalidade foram decrescente.

Epidemiological evolution of COVID-19: a three-year perspective on coping with the pandemic in the States of Rio Grande do Sul and Paraná, Southern Region of Brazil

Introduction: The novel Coronavirus disease (COVID-19) is caused by SARS-CoV-2 and represents the agent responsible for a respiratory and metabolic disease with a high fatality rate, remaining a public health problem to this day. There has been an exacerbation of social inequalities experienced in Brazil and worldwide. Notably, the absence of a consolidated and universal healthcare system has contributed to the increased inequalities and survival opportunities for those affected by SARS-CoV-2 infection and manifestation of COVID-19. The southern region has become the second region with the highest number of cases in Brazil. Objective: To avaluate the epidemiological outcomes of incidence, lethality, and mortality among the states of Rio Grande do Sul and Paraná in the southern region of Brazil. Methods: An ecological time-series study was conducted using official secondary data on COVID-19 cases and deaths publicly disclosed by the health departments of the states of Rio Grande do Sul and Paraná. Time series were constructed applying the Prais-Winsten regression model. Statistical analyses were performed using STATA 14.0 software. Results: It was observed that for the state of Rio Grande do Sul, the trends regarding incidence were increasing in 2020 and decreasing in 2021 (p<0.05). Regarding mortality, it increased in 2020 and decreased in 2021 and 2022 (p<0.05). When assessing lethality, a decreasing trend was observed for the entire period (p<0.05). In relation to Paraná, incidence increased in 2020 and over the entire period, while it decreased in 2021 and 2022 (p<0.05). Mortality was stationary in 2020 and decreased in 2021 and 2022 (p<0.05). Conclusion: The COVID-19 pandemic is a serious public health problem in the states of Paraná and Rio Grande do Sul. Paraná presented a more severe epidemiological outcome compared to Rio Grande do Sul.

Reduction in the incidence of invasive infections caused by encapsulated bacteria after the onset of the COVID-19 pandemic / Reducción de la incidencia de infecciones invasivas por bacterias capsuladas luego del inicio de la Pandemia por COVID-19

Abstract Interaction between severe acute respiratory coronavirus 2 (SARS-CoV-2) and IIEB remains under investigation. Objective: to compare IIEB incidence before and during COVID-19 pandemic, and assess incidence of coinfection with COVID-19 and case fatality. A cross-sectional study was performed on data from a centralized microbiology laboratory serving a network of healthcare centers comprising 713 pediatric and adult inpatient beds, expanded by 20% during the pandemic. Three periods were evaluated: (1) pre-pandemic: March 1, 2019-February 29, 2020; (2) pandemic year 1: March 1, 2020-February 28, 2021; (3) pandemic year 2: March 1, 2021-July 31, 2021. Descriptive statistical analysis was performed. 56502 samples (96% blood cultures) from 27224 patients were analyzed. Of these, 54 samples (from 54 patients) were positive for encapsulated bacteria. IIEB incidence was: 167.4, 32.6, and 50.4 per 100000 samples for periods 1, 2, and 3, respectively. Twelve IIEB episodes occurred during the pandemic period: 10 Streptococcus pneumoniae, and 2 Haemophilus influenzae, of which 7 were SARS-CoV-2/S. pneumoniae coinfections, with an incidence of 5.68 per 10000 COVID-19-related hospitalizations (0.056%). IIEB case fatality was 31%, 29%, and 60% for each period, respectively, 3/7 patients with coinfection died (43%). Case fatality for invasive pneumococcal disease (IPD) in patients without COVID-19, was 32.5%. Significant reduction in IIEB incidence was observed during the pandemic, coinciding with implementation of containment measures. The incidence of SARS-CoV-2/S. pneumoniae coinfection was low, with higher case fatality than IPD patients without COVID-19.

Resumen La interacción entre SARS-CoV-2 e infecciones invasivas por bacterias capsuladas (IIBC) continúa bajo estudio. Objetivos: comparar la incidencia de IIBC antes y durante la pandemia por COVID-19, evaluar la incidencia de coinfección con COVID-19 y la letalidad. Estudio transversal de registros de un laboratorio centralizado de Microbiología, que asiste a una red de centros asistenciales con 713 camas de internación para adultos y pediátricos, expandida 20% durante la pandemia. Tres periodos evaluados: 1) Pre-pandemia: 1-Marzo-2019 al 29-Febrero-2020; 2) Primer año de Pandemia: 1-Marzo-2020 al 28-Febrero-2021; 3) Pandemia 2021: 1-Marzo-2021 al 31-Julio-2021. Análisis estadístico descriptivo: Se analizaron 56.502 muestras (96% hemocultivos) correspondientes a 27.224 pacientes. De estas, 54 muestras (de 54 pacientes) fueron positivas para bacterias capsuladas. La incidencia de IIBC fue 167,4, 32,6 y 50,4 por cada 100.000 muestras para los periodos 1, 2 y 3, respectivamente. Doce IIBC ocurrieron durante la pandemia: 10 Streptococcus pneumoniae y dos Haemophilus influenzae, siete de ellos corresponden a coinfección SARS-CoV-2/S. pneumoniae, con una incidencia de 5,68 por cada 10.000 internaciones por COVID 19 (0,056%). La letalidad de las IIBC fue de 31, 29 y 60% para los tres periodos, respectivamente, 3/7 coinfectados fallecieron (43%). La letalidad por enfermedad neumocócica invasiva (ENI), sin COVID fue de 32,5%. Se evidenció una reducción significativa de la incidencia de IIBC luego del comienzo de la pandemia, coincidente con la implementación de las medidas sanitarias de contención de la pandemia. La incidencia de coinfección de SARS-CoV-2/S. pneumoniae fue baja y presentó mayor letalidad que las ENI sin COVID-19.

Incidencia del Síndrome Confusional (delirio) en un Hospital Universitario Latinoamericano / Incidence of confusional syndrome (delirium) in a Latin American university hospital

resumen Introducción: Poco se conoce acerca de la incidencia del delirio en pacientes hospitalizados en diferentes servicios de hospitales universitarios en Latinoamérica y de los subtipos que se presentan. Objetivo: Determinar la incidencia del delirio, la frecuencia de los subtipos motores y los factores asociados en pacientes hospitalizados en diferentes servicios de un hospital uni versitario en Bogotá, Colombia. Métodos: Se dio seguimiento a una cohorte de pacientes mayores de 18 arios hospitalizados en los servicios de Medicina Interna, Geriatría, Cuidado Intensivo, Cirugía General y Orto pedia de un hospital universitario entre enero y junio de 2018. Para identificar la presencia de delirio, se utilizó la escala CAM (Confusion Assessment Method) y la CAM-ICU si el paciente presentaba disminución de las capacidades de comunicación. El subtipo de delirio se carac terizó utilizando la escala RASS (Richmond Agitation and Sedation Scale). Los pacientes fueron valorados el día de ingreso y luego cada 2 días hasta su alta hospitalaria. Se derivó a los pacientes en quienes se identificó delirio para tratamiento especializado interdisciplinario intrainstitucional. Resultados: Se evaluó a 531 pacientes que ingresaron durante ese periodo a los servicios mencionados. La incidencia global del delirio fue del 12% (IC95%, 0,3-14,8). En orden des cendiente, el 31,8% de los pacientes hospitalizados en el servicio de Geriatría, el 15,6% en Cuidado Intensivo, el 8,7% en Medicina Interna, el 5,1% en Ortopedia y el 3,9% en Cirugía. El subtipo motor más frecuente fue el mixto (60,9%), seguido por el normoactivo (34,4%) y el hipoactivo (4,7%). Los factores asociados con la incidencia del delirio fueron la edad (RR ajustada = 1,07; IC95%, 1,05-1,09), la presencia de 4 o más comorbilidades (RR ajustada = 2,04; IC95%, 1,31-3,20) y la hospitalización en Cuidado Intensivo (RR ajustada = 2,02; IC95%, 1,22 3,35). Conclusiones: La incidencia del delirio es heterogénea en los diferentes servicios del hospital universitario. La mayor incidencia se presentó en pacientes ingresados en el servicio de Geriatría; el subtipo más frecuente fue el mixto y los principales factores asociados fueron la edad, la presencia de 4 o más comorbilidades y la hospitalización en Cuidado Intensivo.

abstract Bacfeground: Little is known about the incidence of delirium and its subtypes in patients admitted to different departments of university hospitals in Latin America. Objective: To determine the incidence of delirium and the frequency of its subtypes, as well as its associated factors, in patients admitted to different departments of a university hospital in Bogotá, Colombia. Methods: A cohort of patients over 18 years of age admitted to the internal medicine (IM), geriatrics (GU), general surgery (GSU), orthopaedics (OU) and intensive care unit (ICU) ser vices of a university hospital was followed up between January and June 2018. To detect the presence of delirium, we used the CAM (Confusion Assessment Method) and the CAM-ICU if the patient had decreased communication skills. The delirium subtype was characterised using the RASS (Richmond Agitation and Sedation Scale). Patients were assessed on their admission date and then every two days until discharged from the hospital. Those in whom delirium was identified were referred for specialised intra-institutional interdisciplinary management. Results: A total of 531 patients admitted during the period were assessed. The overall incidence of delirium was 12% (95% CI, 0.3-14.8). They represented 31.8% of patients in the GU, 15.6% in the ICU, 8.7% in IM, 5.1% in the OU, and 3.9% in the GSU. The most frequent clinical display was the mixed subtype, at 60.9%, followed by the normoactive subtype (34.4%) and the hypoactive subtype (4.7%). The factors most associated with delirium were age (adjusted RR = 1.07; 95% CI, 1.05-1.09), the presence of four or more comorbidities (adjusted RR = 2.04; 95% CI, 1.31-3.20), and being a patient in the ICU (adjusted RR = 2.02; 95% CI, 1.22-3.35). Conclusions: The incidence of delirium is heterogeneous in the different departments of the university hospital. The highest incidence occurred in patients that were admitted to the GU. The mixed subtype was the most frequent one, and the main associated factors were age, the presence of four or more comorbidities, and being an ICU patient.

Estadio, perfil biológico y tendencias de incidencia y mortalidad de cáncer de mama en Uruguay: análisis por franjas etarias / Stage, biological profile and trends in the incidence and mortality of breast cancer in Uruguay: analysis by age groups / Estágio, perfil biológico e tendências da incidência e mortalidade por cáncer de mama no Uruguai: análise por faixa etária

Introducción: el cáncer de mama es el tumor maligno más frecuente y la primera causa de muerte por cáncer en mujeres en Uruguay y en el mundo. La evidencia epidemiológica sugiere que el cáncer de mama en diferentes grupos de edades se comportaría como patologías distintas. El objetivo de este trabajo es caracterizar el cáncer de mama en Uruguay para diferentes estratos de edades. Material y método: se analizaron las tendencias temporales de la incidencia de cáncer de mama en mujeres en Uruguay en el período 2002-2019, y de la mortalidad por esta causa en 1990-2020. Para el quinquenio 2015-2019, se analiza además la distribución de estadios al diagnóstico y de perfiles biológicos (luminales, triple negativos y HER2 positivos). Se analizan tres segmentos de edades: mujeres de 20 a 44 años, de 45 a 69 y de 70 y más años. Resultados: las tasas de incidencia para el conjunto de edades se presentaron estables en el período 2002-2019, mientras que la mortalidad presenta una tendencia decreciente en el período 1990-2020. En las mujeres menores de 45 años se encuentra un aumento en la incidencia, con mortalidad que decrece hasta el 2010, seguido de una estabilización de las tasas; en las mujeres de 45 a 69 años la incidencia se mantiene estable y la mortalidad decrece; en las mayores de 70 años, la incidencia decrece mientras la mortalidad se mantiene estable. Más del 70% de los casos se diagnostican en estadios I y II. Los tumores luminales (receptores hormonales positivos, HER2 negativos) son el subtipo más frecuente para todos los grupos, la proporción de tumores con estas características aumenta con la edad, mientras decrece la proporción de HER2 positivo y triple negativo. Conclusión: en las mujeres uruguayas el cáncer de mama presenta características diferenciales para las tres franjas de edades analizadas.

Introduction: Breast cancer is the most common malignant tumor and the leading cause of cancer death in women in Uruguay and worldwide. Epidemiological evidence suggests that breast cancer in different age groups behaves as distinct pathologies. The objective of this work is to characterize breast cancer in Uruguay for different age groups. Method: Temporal trends in the incidence of breast cancer in women in Uruguay are analyzed for the period 2002-2019, along with mortality trends for this cause from 1990 to 2020. For the five-year period 2015-2019, the distribution of stages at diagnosis and biological profiles (Luminal, Triple-negative, and Her2 positive) is also analyzed. Three age segments are analyzed: women aged 20 to 44 years, 45 to 69 years, and 70 years and older. Results: The incidence rates for all age groups remained stable during the period 2002-2019, while mortality showed a decreasing trend in the period 1990-2020. In women under 45, there is an increase in incidence, with mortality decreasing until 2010, followed by a stabilization of rates; in women aged 45 to 69, incidence remains stable and mortality decreases; in those over 70, incidence decreases while mortality remains stable. More than 70% of cases are diagnosed at stages I and II. Luminal tumors (hormone receptor positive, Her2 negative) are the most frequent subtype for all age groups. The proportion of tumors with these characteristics increases with age, while the proportion of Her2 positive and triple-negative tumors decreases. Conclusions: In Uruguayan women, breast cancer presents differential characteristics for the three age groups analyzed.

Introdução: O câncer de mama é o tumor maligno mais comum e a principal causa de morte por câncer em mulheres no Uruguai e no mundo. Evidências epidemiológicas sugerem que o câncer de mama se comportaria como patologias distintas em diferentes faixas etárias. O objetivo deste trabalho é caracterizar o câncer de mama no Uruguai para diferentes faixas etárias. Materiais e Métodos: São analisadas as tendências temporais da incidência de câncer de mama em mulheres no Uruguai no período 2002-2019 e a mortalidade por esta causa no período 1990-2020. Para o quinquénio 2015-2019 são também analisadas a distribuição dos estádios ao diagnóstico e os perfis biológicos (Luminal, Triplo negativo e Her2 positivo). São analisados três segmentos etários: mulheres dos 20 aos 44 anos, dos 45 aos 69 anos e dos 70 anos ou mais. Resultados: As taxas de incidência para todas as idades permaneceram estáveis no período 2002-2019 enquanto a mortalidade apresentou tendência decrescente no período 1990-2020. Nas mulheres com menos de 45 anos verifica-se um aumento da incidência, com uma redução da mortalidade até 2010, seguida de uma estabilização das taxas; nas mulheres de 45 a 69 anos, a incidência permanece estável e a mortalidade diminui; nas pessoas com mais de 70 anos, a incidência diminui enquanto a mortalidade permanece estável. Mais de 70% dos casos são diagnosticados nos estágios I e II. Os tumores luminais (receptor hormonal positivo, Her2 negativo) são o subtipo mais comum para todos os grupos sem do que a proporção de tumores com essas características aumenta com a idade, enquanto a proporção de (Her2 positivo e triplo negativo) diminui. Conclusão: Nas mulheres uruguaias, o câncer de mama apresenta características diferenciadas para as três faixas etárias analisadas.

Perfil de ocorrência da COVID-19 em uma instituição de ensino superior privada da área de saúde do interior de Minas Gerais, Brasil, 2020‒2021 / Occurrence of COVID-19 in a private higher education institution in the health area from the interior of Minas Gerais, Brazil, 2020‒2021

Objetivo: apresentar um panorama epidemiológico dos casos de COVID-19 em uma escola médica privada de Minas Gerais, Brasil. Métodos: estudo transversal de série temporal que utilizou dados da Comissão de Biossegurança de uma escola médica. Os dados foram coletados durante 13 meses (outubro/2020−outubro2021) em uma população de 900 indivíduos. Foram registrados os casos-contatos, -suspeitos e-confirmados de COVID-19. Um caso-contato foi considerado quando o indivíduo permaneceu no mesmo ambiente de um caso-confirmado, sem utilização de máscara facial. Um caso-suspeito foi considerado quando o indivíduo possuía sinais/sintomas sugestivos, sem um teste laboratorial confirmatório. Um caso-confirmado foi determinado por meio de testes laboratoriais confirmatórios. Os dados foram analisados por meio de estatística descritiva, cálculo de taxas e correlação-r. Resultados: no período avaliado, foram registradas 1.291 notificações, com 147 casos-confirmados (média de 11,3±1,3 casos). Não houve correlação entre o número de casos-contatos e -suspeitos ou -confirmados. Houve uma correlação positiva entre o número de casos-suspeitos e-confirmados (r=0,59; p=0,03). A taxa mensal de casos-confirmados variou entre 0,3−2,1 por 100 pessoas-mês. A incidência acumulada de casos-confirmados foi de 16,3 por 100 pessoas. Conclusão: evidencia-se um adequado controle sanitário local, com número reduzido de casos-confirmados durante os 13 meses avaliados. Esses achados podem ser úteis para outras escolas médicas na condução de crises sanitárias futuras.

Objective to demonstrate an epidemiological overview of COVID-19 cases within a private medical school in Minas Gerais, Brazil. Methods: cross-sectional time series study that used data from the Biosafety Committee of a medical school. Data were collected for 13 months (October/2020−October2021) in a population of 900 individuals. Contact-, suspected-, and confirmed- cases of COVID-19 were recorded. A contact-case was considered when the individual remained in the same environment as a confirmed-case, without using a face mask. A suspected-case was considered when the individual had suggestive signs/symptoms without a confirmatory laboratory test. A confirmed-case was determined through confirmatory laboratory tests. Data were analyzed using descriptive statistics, rate calculation, and correlation-r. Results: during the period evaluated, 1,291 notifications were registered, with 147 confirmed-cases (average of 11.3±1.3 cases). There was no correlation between the number of contact- and suspected- or confirmed-cases. There was a positive correlation between the number of suspected- and confirmed-cases (r=0.59; p=0.03). The monthly rate of confirmed-cases varied between 0.3−2.1 per 100 persons-month. The accumulated incidence of confirmed-cases was 16.3 per 100 persons. Conclusion: there is evidence of adequate local health control, with a reduced number of confirmed-cases during the 13 months evaluated. These findings may be useful to other medical schools in managing future health crises.

Risk and determinants of catastrophic health expenditure among rural households in rivers state

Background: Concerns about how the expense of healthcare impacts rural families' ability to pay their bills are rising, especially in environments where prepayment systems are inadequate and people pay cash while using health services. This research evaluated the method of payment, frequency, and contributing factors of catastrophic health expenditure (CHE) among rural inhabitants of Rivers State. Methods: This retrospective longitudinal study was conducted among 450 inhabitants in six rural communities in Rivers State. The participants were chosen using a multistage sampling process. A validated semi-structured questionnaire which was interviewer administered was used to obtain the data. IBM statistical package for the social sciences version 25 was used to analyze the data. Data were summarized using means, frequency, and proportions while bivariate and multivariate binary logistic regression were used to explore determinants of CHE with p?0.05 considered statistically significant. Results: The result showed that 94.9% of rural households pay for health care via out-of-pocket payment and 88.4% rural residents experience catastrophic health payment. Household income of less than N100,000 (AOR=2.8, 95% C.I.=1.4-5.4, p=0.002) and having two or more dependents (AOR=3.3, 95% C.I.=1.3-8.0 p=0.002) were determinants of CHE. Conclusions: There is need to increase public funding for healthcare as well as expand the coverage of the NHIS to mitigate the effect of health care cost on rural residents in Rivers State.

Risk factors for developmental dysplasia of the hip in infants in Yili area / 公共卫生与预防医学

Objective To investigate the in-hospital screening results of developmental dysplasia of the hip (DDH) in infants and young children in Ili area, and to analyze the risk factors affecting the occurrence of DDH. Methods According to the cluster sampling method 5 536 infants and young children who underwent DDH screening in the pediatric outpatient department and orthopedic outpatient department of our hospital from December 2019 to June 2022 were selected as the research objects. The children who met the diagnostic criteria of DDH were selected as the observation group (n=35), and 100 normal children were selected as the control group. Univariate and multivariate analysis were used to determine the independent risk factors affecting the occurrence of DDH in infants. Results Among the 39 cases were positive in primary screening, 35 cases were positive in secondary screening, and the positive rate was 6.32‰ . The results of single factor analysis showed that the proportion of women, second birth and above, caesarean section, breech delivery, family history, high altitude area, living environment room temperature °C, and leg binding when swaddling in the observation group was higher than that in the control group (P°C and leg binding in infants are related to the occurrence of DDH in infants, which can provide some reference for clinical screening, diagnosis and treatment.