Progress in research on HIV cluster detection and response / 中华流行病学杂志

HIV cluster detection and response (CDR) is a critical strategy to end the HIV epidemic by offering information to identify prevention and care services gaps. The risk metrics for HIV clusters can be classified into three groups: growth-based metrics, characteristic-based metrics, and phylogeny-based metrics. When identifying HIV risk clusters, the public health response can reach people in the affected networks, including people with undiagnosed HIV, people with diagnosed HIV who might not be accessing HIV care or other services, and people without HIV who would benefit from prevention services. To provide references for HIV precise prevention in China, we summarized the risk metrics and the intervention measures for CDR.

Estimation of COVID-19 incidence in Shanghai under optimized epidemic prevention and control strategies / 中华流行病学杂志

Objective: To quantitatively estimate the incidence of COVID-19 in different backgrounds, including vaccination coverage, non-pharmacological interventions (NPIs) measures, home quarantine willingness and international arrivals, and the demands of healthcare resource in Shanghai in the context of optimized epidemic prevention and control strategies. Methods: Based on the natural history of 2019-nCoV, local vaccination coverage and NPI performance, an age-structured Susceptible-Exposed-Infections-Removed (SEIR) epidemic dynamic model was established for the estimation of the incidence of COVID-19 and demand of hospital beds in Shanghai by using the data on December 1, 2022 as the basis. Results: Based on current vaccination coverage, it is estimated that 180 184 COVID-19 cases would need treatment in hospitals in Shanghai within 100 days. When the booster vaccination coverage reaches an ideal level, the number of the cases needing hospitalization would decrease by 73.20%. School closure or school closure plus workplace closure could reduce the peak demand of regular beds by 24.04% or 37.73%, respectively, compared with the situation without NPI. Increased willingness of home quarantine could reduce the number of daily new cases and delay incidence peak of COVID-19. The number of international arrivals has little impact on the development of the epidemic. Conclusions: According to the epidemiological characteristics of COVID-19 and the actual situation of vaccination in Shanghai, the incidence of COVID-19 and health resource demand might be reduced by increasing vaccination coverage and early implementation of NPI.

Incidência de casos confirmados de dengue no Estado do Paraná Brasil nos anos de 2016 a 2021 / Incidence of confirmed dengue cases in the State of Paraná Brazil in the years of 2016 to 2021 / Incidencia de casos confirmados de dengue en el Estado de Paraná Brasil en los años 2016 a 2021

A dengue é uma doença dolorosa e debilitante transmitida por insetos da espécie Aedes aegypti. Ela é definida como uma doença viral que, nos últimos anos, se espalhou vertiginosamente por todas as regiões tropicais e subtropicais do planeta. Este estudo teve como objetivo identificar e discutir o número e a taxa de incidência de casos de dengue no estado do Paraná utilizando-se dos boletins emitidos por semana epidemiológica nos anos de 2016 a 2021, considerando a sazonalidade da doença. Também se objetivou debater a incidência por macrorregional, as possíveis causas de períodos epidêmicos e ações de combate vetorial para redução dos casos da patologia. Foram utilizados como fonte de informações o banco de dados da Dengue/SVS/SESA, por meio de informes técnicos, disponibilizados pelo portal online de Boletins da Dengue Paraná da Secretaria de Estado de Saúde do Paraná. Conclui-se que o ano epidemiológico de 2019/2020 foi o de maior incidência e os anos epidemiológicos 2016/2017 e 2017/2018 apresentaram os menores casos durante todo período analisado. Dessa forma, a vigilância epidemiológica é muito importante para avaliação espacial da distribuição de casos para execução de ações estratégicas para redução da infestação do vetor. As políticas públicas e a disponibilização de inseticidas para aplicação também são essenciais para o combate da Dengue.

Dengue is a painful and debilitating disease transmitted by insects of the Aedes aegypti species. It is defined as a viral disease that, in recent years, has spread vertiginously throughout the tropical and subtropical regions of the planet. This study aimed to identify and discuss the number and incidence rate of dengue cases in the state of Paraná using the bulletins issued by epidemiological week in the years 2016 to 2021, considering the seasonality of the disease. The aim was also to discuss the incidence per macro-region, the possible causes of epidemic periods, and vectorial combat actions to reduce the cases of the pathology. The Dengue/SVS/SESA database was used as a source of information, through technical reports, made available by the online portal of Dengue Paraná Bulletins of the Paraná State Health Department. It is concluded that the epidemiological year 2019/2020 was the one with the highest incidence and the epidemiological years 2016/2017 and 2017/2018 had the lowest cases during the entire period analyzed. Thus, epidemiological surveillance is very important for the spatial assessment of the distribution of cases to carry out strategic actions to reduce vector infestation. Public policies and the availability of insecticides for application are also essential to combat Dengue.

El dengue es una enfermedad dolorosa y debilitante transmitida por insectos de la especie Aedes aegypti. Se define como una enfermedad viral que, en los últimos años, se ha extendido vertiginosamente por las regiones tropicales y subtropicales del planeta. Este estudio tuvo como objetivo identificar y discutir el número y la tasa de incidencia de los casos de dengue en el estado de Paraná utilizando los boletines emitidos por la semana epidemiológica en los años 2016 a 2021, considerando la estacionalidad de la enfermedad. También se pretendía discutir la incidencia por macrorregiones, las posibles causas de los periodos epidémicos y las acciones de control de vectores para la reducción de los casos de la enfermedad. Se utilizó como fuente de información la base de datos de Dengue/SVS/SESA, por medio de informes técnicos, puestos a disposición por el portal online de Boletines de Dengue Paraná de la Secretaría de Salud del Estado de Paraná. Se concluye que el año epidemiológico 2019/2020 fue el de mayor incidencia y los años epidemiológicos 2016/2017 y 2017/2018 presentaron los menores casos durante todo el periodo analizado. Por lo tanto, la vigilancia epidemiológica es muy importante para la evaluación espacial de la distribución de los casos para la implementación de acciones estratégicas para reducir la infestación del vector. Las políticas públicas y la disponibilidad de insecticidas para su aplicación también son esenciales para combatir el dengue.

Epidemiological characteristics of local COVID-19 epidemics and control experience in routine prevention and control phase in China / 中华流行病学杂志

The COVID-19 pandemic is still ongoing in the world, the risk of COVID-19 spread from other countries or in the country will exist for a long term in China. In the routine prevention and control phase, a number of local COVID-19 epidemics have occurred in China, most COVID-19 cases were sporadic ones, but a few case clusters or outbreaks were reported. Winter and spring were the seasons with high incidences of the epidemics; border and port cities had higher risk for outbreaks. Active surveillance in key populations was an effective way for the early detection of the epidemics. Through a series of comprehensive prevention and control measures, including mass nucleic acid screening, close contact tracing and isolation, classified management of areas and groups at risk, wider social distancing and strict travel management, the local COVID-19 epidemics have been quickly and effectively controlled. The experiences obtained in the control of the local epidemics would benefit the routine prevention and control of COVID-19 in China. The occurrence of a series of COVID-19 case clusters or outbreaks has revealed the weakness or deficiencies in the COVID-19 prevention and control in China, so this paper suggests some measures for the improvement of the future prevention and control of COVID-19.

Rethinking of institutional reform and development of disease control and prevention system in post COVID-19 epidemic era in China / 中华流行病学杂志

The problems and shortcomings revealed in our response to COVID-19 epidemic have suggested us to take measures to improve the disease control and prevention system of China. For the reform and development of China's disease control and prevention institution in the new era,we need to rethink the function orientation of the disease control and prevention institution, the key and difficult points in institutional mechanism reform and the building of core competence and essential capacity of disease control and prevention system.

Prevalencia de paperas en Bagdad. Irak - 2015 y 2016 / Prevalence of Mumps in Baghdad, Iraq - 2015 & 2016

Antecedentes: las paperas son una infección viral que se transmite por contacto directo, gotitas y fómites. Irak es testigo de varias epidemias de paperas. Objetivo: Informar sobre la última epidemia de paperas 2015-2016. Métodos: El lado de Bagdad de Al-Rusafa fue seleccionado al azar de dos lados de Bagdad. Se llevó a cabo una revisión de los datos del Departamento de Salud Pública de la Dirección de Salud de Bagdad / Al-Rusafa. Los datos fueron todos los casos notificados de paperas para los años 2015-2016. Resultados: Los casos registrados de paperas fueron 9780 y 33728 para 2015 y 2016, respectivamente. La edad máxima en 2015 y 2016 fue de 5 a 14 años. Los picos de casos de paperas se registraron en octubre, diciembre de 2015 y enero de 2016, y desaparecieron en junio de 2016. Conclusiones: La epidemia de paperas fue clara en Bagdad. La lucha social juega un papel en el desarrollo de la epidemia.

Background: Mumps is a viral infection transmitted by direct contact, droplet infection and fomites. Iraq witnesses several epidemics of mumps. Objective: To report on last epidemic of mumps 2015- 2016. Methods: Al-Rusafa side of Baghdad was selected randomly from two sides of Baghdad. A review of data from department of public health, Directorate of Health of Baghdad / Al-Rusafa was carried out. The data was all the notification cases of mumps for the years 2015-2016. Results: The registered cases of mumps were 9780 and 33728 for 2015 and 2016, respectively. The peak age in 2015 and 2016 was 5-14 year. The peaks mumps cases were in October, December 2015 and January 2016, and disappear in June 2016. Conclusions: Epidemic of mumps was clear in Baghdad. Social strife plays a role in developing the epidemic.

Evaluación de la infección por VIH en Chile: pronunciamiento del Comité VIH de la Academia Chilena de Medicina / Evaluation of HIV epidemic in Chile: a statement of the Chilean Academy of Medicine

The Chilean Academy of Medicine convened a commission to evaluate the status of HIV epidemic and the national response to it, regarding its achievements, gaps and challenges, aiming to recommend actions to optimize assessment quality and national response. This publication summarizes the agreed upon opinion of its members. The epidemic is overwhelmingly sexually transmitted, predominant in homo/bisexual men. Vertical transmission is very low. An increasing number of new diagnoses is occurring, with relative over representation of foreign people lately. There is a legal guarantee of confidentiality, nondiscrimination and treatment for those affected, both in the private and public sector. All public health services have active HIV care units. Modern antiviral drugs and monitoring tests are also available. Despite these clear achievements, insufficient, occasionally inadequate public policies and certain rigid regulations thwart optimal effectivity and efficiency of the programs, contributing to the slow and incomplete compliance with international commitments. Shortcomings worth highlighting are: suboptimal educational and preventive programs directed to youngsters, vulnerable and general population; persistent underdiagnosis of infected population; cumbersome requirements to request and inform diagnostic tests, thus discouraging testing; excessive centralization and long latency of diagnosis confirmation and monitoring tests; incomplete epidemiologic analysis and public reporting of findings; non flexibility and slow updating of therapeutic guidelines; insufficient adaptation of care and drug delivery modalities to patients' needs; excessive administrative requirements at care centers and restrictive legislation for outcome and interventional clinical research. Recommendations to deal with these issues were proposed.

Orientações para a prevenção e o controle de infecções pelo novo coronavírus (SARS-CoV-2) em Instituições de Longa Permanência para Idosos (ILPI) / Guidelines for the prevention and control of infections by the new coronavirus (SARS-CoV-2) in Long-Term Care Facilities for the Elderly (ILPI)

Reconhece-se que a população idosa que reside nas Instituições de Longa Permanência para Idosos (ILPI), em geral, é mais vulnerável, com níveis variados de dependência e possui necessidades complexas. Como a nova doença respiratória, COVID-19, que está se espalhando globalmente e que apresenta letalidade elevada na população idosa (pessoas com 60 anos ou mais), as ILPI devem implementar medidas de prevenção e controle de infecção para evitar ou reduzir ao máximo que os residentes, seus cuidadores e profissionais que atuem nesses estabelecimentos sejam infectados pelo vírus e, mais significativamente, reduzir a morbi-mortalidade entre os idosos nessas instituições. As medidas de prevenção que devem ser aplicadas são as mesmas para detectar e impedir a propagação de outros vírus respiratórios, como por exemplo a influenza. A doença classificada como COVID-19 é causa dada pelo novo coronavírus (SARS-CoV-2), que foi identificado pela primeira vez na cidade de Wuhan, na China. Outras infecções por coronavírus incluem o resfriado comum, a Síndrome Respiratória do Oriente Médio (MERS-CoV) e a Síndrome Respiratória Aguda Grave(SARS-CoV).Nesta Nota Técnica, serão abordadas orientações mínimas para as ILPI quanto às medidas de prevenção e controle que devem ser adotadas durante a assistência aos residentes, principalmente com relação aos casos suspeitos ou com diagnóstico confirmado de COVID-19, segundo as orientações divulgadas pela Organização Mundial da Saúde(OMS)e outros órgãos. No entanto, ressaltamos que este é um documento que pode ser alterado a qualquer momento, conforme novas informações estiverem disponíveis, já que se trata de um microrganismo novo no mundo e portanto, com poucas evidências sobre ele.

O novo normal da Odontologia: revisão das recomendações para retomada da assistência odontológica durante a pandemia da COVID-19 / The New Normal of Dentistry: Review of Recommendations for the Resumption of Dental Care during the COVID-19 Pandemic

Objetivo: este artigo tem como objetivos identificar as recomendações para a retomada dos atendimentos odontológicos eletivos após surto epidêmico da COVID-19 e identificar os consensos e controvérsias entre as sugestões encontradas nos documentos. Material e Métodos: foi realizada uma pesquisa documental comparativa sobre as recomendações para o retorno do atendimento odontológico eletivo após o surto epidêmico da COVID-19. Secundariamente, foi realizada uma revisão da literatura a partir de busca nas bases: Portal Regional da Biblioteca Virtual em Saúde (BVS), que incorpora Lilacs, SciELO, MEDLINE, a partir da estratégia de busca ("COVID-19" AND "dentistry"). Resultados: foram analisados documentos oficiais do Ministério da Saúde ou de órgãos correspondentes e de entidades de classe de onze diferentes países do mundo e encontrados seis artigos que abordavam as recomendações para o retorno aos atendimentos eletivos. Conclusão: há um consenso quanto aos requisitos para as instalações do consultório, à indicação de realização de triagem antes do agendamento e atendimento e quanto aos cuidados recomendados durante o atendimento. Não há consenso quanto ao uso de bochechos antissépticos prévios ao procedimento, ao uso sistemático de testes rápidos antes do atendimento, ao tipo de proteção respiratória que deve ser utilizada pela equipe odontológica e ao tempo mínimo de pausa antes da realização da higienização da sala de trabalho quando são realizados procedimentos geradores de aerossol

Objective: This paper aims to identify the recommendations for the resumption of elective dental care after the epidemic outbreak of COVID-19 and to identify consensus and disagreements among the suggestions found in the documents. Materials and Methods: a comparative documentary research was carried out on the recommendations for the resumption of elective dental care after the outbreak of COVID-19. Additionally, a literature review was carried out based on a search in the Brazilian Regional Portal of the Virtual Health Library (VHL), which incorporates Lilacs, SciELO and MEDLINE databases, using the search query: ("COVID-19" AND "dentistry"). Results: government documents from the Ministry of Health or corresponding bodies and professional associations from eleven different countries in the world were analyzed and six articles were found addressing the recommendations for the resumption of elective dental care. Conclusion: there is a consensus about the requirements for dental facilities, the recommendation of screening patients before scheduling and appointments and the procedures performed during dental care. There is no consensus on the use of preprocedural antiseptic mouth rinses, the systematic use of rapid tests before the appointment, the type of respiratory protection that should be used by the dental team and the minimum interval to be allowed before cleaning the patient room when aerosol-generating procedures are performed

Anopheles gambiae no Brasil: antecedentes para um " alastramento silencioso ", 1930-1932 / Anopheles gambiae in Brazil: the background to a " silent spread, " 1930-1932

Resumo O artigo analisa a chegada e identificação do mosquito africano Anopheles gambiae no Brasil em 1930 e as primeiras reações de cientistas e autoridades de saúde pública contra as epidemias de malária causadas por essa espécie. Apesar de ter sido reconhecido como perigoso vetor da malária, sua presença em território nacional foi negligenciada a partir de 1932, após ações emergenciais na capital do Rio Grande do Norte, favorecendo um alastramento silencioso que resultou em uma grande epidemia de malária em 1938. São abordadas questões científicas e políticas que contribuíram para que o combate ao mosquito fosse colocado em segundo plano nas articulações entre a Divisão Sanitária Internacional da Fundação Rockefeller e autoridades brasileiras até 1937.

Abstract The article analyzes the arrival and identification of the African mosquito Anopheles gambiae in Brazil in 1930, and the initial reactions of scientists and public health authorities against the epidemics of malaria caused by this species. Although this mosquito was recognized as a dangerous vector of malaria, its presence in Brazil was neglected after initial emergency actions in the city of Natal in 1932; this encouraged it to spread silently, resulting in a major malaria epidemic in 1938. This article examines scientific and political issues which caused the fight against mosquitoes to be pushed into the background until 1937 in cooperative efforts between the Rockefeller Foundation's International Health Division and the Brazilian authorities.

Salud pública, espacio urbano y exclusión social en la España de posguerra: la epidemia de tifus exantemático en la ciudad de Valencia, 1941-1943 / Public health, urban space and social exclusion in postwar Spain: the exanthematic typhus epidemic in the city of Valencia, 1941-1943

Resumen Tras la Guerra Civil, las deficientes condiciones higiénico-dietéticas de gran parte de la población española favorecieron la aparición de enfermedades epidémicas. El tifus exantemático puso en jaque a las autoridades sanitarias, especialmente durante la primavera de 1941, cuando el ciclo epidemiológico de la enfermedad y la falta de infraestructuras se aliaron para provocar una grave crisis sanitaria. El régimen franquista, consciente de que esta situación dificultaba su legitimación, no dudó en utilizar la exclusión social como parte de su política sanitaria contra esta epidemia. El artículo analiza en profundidad el caso de Valencia, una ciudad que durante la guerra, por hallarse en la retaguardia republicana, había acogido sucesivas oleadas de refugiados a medida que avanzaban las tropas franquistas.

Abstract After the Spanish Civil War, poor hygiene and nutritional deficiencies among a large part of Spain's population contributed to the rise of epidemic diseases. Exanthematic typhus posed a challenge to the health authorities, especially during the spring of 1941, when the epidemiological cycle of the disease and the lack of infrastructures combined to create a serious health crisis. The Franco regime, aware that this situation posed a threat to its legitimacy, promptly used social exclusion as part of its health policy against the epidemic. This article provides an in-depth analysis of the case of Valencia, a city that was behind Republican lines during the war, and therefore received successive waves of refugees as Franco's troops advanced.

Representaciones, discursos y prácticas profilácticas durante la epidemia de cólera (1886-1887, Mendoza, Argentina) / Prophylactic representations, discourses and practices during the cholera epidemic (1886-1887, Mendoza, Argentina)

Resumen El artículo busca indagar en los proyectos de disciplinamiento sancionados por el Estado de la provincia de Mendoza (Argentina) durante la epidemia de cólera ocurrida en el verano de 1886 y 1887. Si bien los planes tenían como finalidad mejorar el estado sanitario de toda la población y de la ciudad, apuntaron y se aplicaron con mayor intensidad sobre los sectores populares y sus espacios. Esto se debió a las ideas y representaciones que en torno de la enfermedad y la muerte construyó el grupo dirigente durante estos periodos.

Abstract The article takes a look into the disciplinary projects approved by the authorities in the province of Mendoza (Argentina) during the cholera epidemic that took place during the summer of 1886-1887. Although the projects were intended to ameliorate the sanitary conditions of the whole of the population, these were focused and applied more intensively on the underprivileged sectors and their areas of inhabitance. This follows the ideas and representations created by the State regarding the illness and its death during this period.

Scorpionism by Hemiscorpius spp. in Iran: a review

Scorpions are distributed throughout Iran and the genus Hemiscorpius is particularly important in this region. Hemiscorpius lepturus is the most significant species within the genus in the country. Since scorpionism provoked by Hemiscorpius comprises a medical emergency, the present study is focused on this important issue. In order to perform the present work, a review of the medical and health-related literature was carried out in several databases. The current findings indicate that six species of Hemiscorpius are found in 15 states of Iran, mainly in the south and southwest. Deaths caused by stings were reported only for two species. The morphological characteristics and geographical distribution of H. lepturus in Iran, its venom and the toxic compounds, epidemiologic data and clinical manifestations of envenomation as well as treatment for affected people are herein reviewed and described. H. lepturus venom toxicity differs from other Iranian scorpions regarding duration and severity. Scorpionism is an important public health problem in Iran, especially in southwest and south regions and in urban areas. It is more prevalent in children and young people. H. lepturus venom is primarily a cytotoxic agent and has hemolytic, nephrotoxic and to some extent hepatotoxic activity. The use of polyvalent antivenom to prevent scorpion sting symptoms is recommended. A well-planned health education program might be useful in preventing scorpionism.