ABSTRACT
El Haemophilus influenzae (Hi) causa enfermedad invasiva (EI). Se distinguen cepas capsuladas, como el serotipo b (Hib), y cepas no tipificables (HNT). Al año de declarada la pandemia por COVID-19, observamos un aumento de casos. Se describen las características clínico-epidemiológicas de niños con EI por Hi internados en el hospital (julio 2021-julio 2022). Hubo 14 casos; 12 previamente sanos. Aislamientos: Hib (n = 6), Hi serotipo a (n = 2), HNT (n = 5), 1 no se tipificó. Mediana de edad: 8,5 meses (RIC 4-21). Manifestaciones: meningitis (n = 5), neumonía (n = 6), celulitis (n = 2), artritis (n = 1). Nueve presentaron vacunación incompleta para Hib. Observamos un incremento de EI por Hi de 2,5 veces respecto a años previos. Estos datos sugieren el resurgimiento de Hib por la caída de las coberturas de vacunación y porque otras cepas de Hi no b están en aumento.
Haemophilus influenzae (Hi) causes invasive disease. There are encapsulated strains, such as serotype b (Hib), and non-typeable strains (NTHi). One year after the outbreak of the COVID-19 pandemic, the number of cases increased. In this report we describe the clinical and epidemiological characteristics of children hospitalized with invasive Hi disease (July 2021-July 2022). There were 14 cases; 12 were previously healthy children. Isolations: Hib (n = 6), Hi serotype a (n = 2), NTHi (n = 5); 1 case was not typified. Median age: 8.5 months (IQR: 421). Manifestations: meningitis (n = 5), pneumonia (n = 6), cellulitis (n = 2), arthritis (n = 1). Incomplete Hib immunization was observed in 9 children. Invasive Hi disease increased 2.5 times from previous years. These data suggest the reemergence of Hib due to a decline in vaccination coverage and an increase in other non-b-type Hi serotypes.
Subject(s)
Humans , Infant , Child, Preschool , Child , COVID-19/epidemiology , Haemophilus Infections/epidemiology , Haemophilus influenzae , Incidence , Disease Outbreaks , PandemicsABSTRACT
En ese sentido, el estudio de carga de enfermedad en el Perú del 2019 nos presenta las principales enfermedades y lesiones que han aportado mayor número de años de vida saludables perdidos en el país, reconociendo no solo aquellas que producen muerte prematura, sino también discapacidad. De esta manera, podemos disponer de información valiosa para la toma de decisiones en salud pública y dirigir las acciones hacia un mayor beneficio para la población de nuestro país. Los años de vida ajustados por discapacidad -AVISA- estiman la carga de la enfermedad, de acuerdo a las distintas causas o problemas de salud consideradas. Un AVISA corresponde a un año de vida sana perdido y la medición de la carga de enfermedad por este indicador significaría la brecha existente entre la situación actual de salud de una población y la ideal en la que cada miembro de esa población podría alcanzar la vejez libre de enfermedad y discapacidad.
Subject(s)
Disease , Epidemiology , Disease Outbreaks , Data Interpretation, Statistical , Cost of Illness , Disability EvaluationABSTRACT
Corynebacterium diphtheriae is responsible for both endemic and epidemic diphtheria. The predisposing factor for this disease is the failure to immunize during childhood. Humans are the only hosts of the organism and is present in the upper respiratory tract. The organism is transmitted via airborne route and can cause respiratory obstruction and heart failure because of the exotoxin it produces. There is presently a resurgence of diphtheria outbreaks in Nigeria. The Nigeria Center for Disease Control (NCDC) was notified of suspected diphtheria outbreaks in Lagos and Kano States, Nigeria, in December 2022 and has been issuing monthly reports since that time. This review of the diphtheria outbreaks following online database searches on PubMed and Google Scholar as well as the NCDC/WHO websites and grey literatures, describes the current trend of the outbreaks globally, elucidated the different strains of Corynebacterium responsible for the outbreaks, identified the recent vaccine formulation developed to tackle the outbreaks, and provide information on vaccine delivery and efficacy studies in the country and globally.
Subject(s)
Humans , Actinomycetales , Diphtheria-Tetanus-Pertussis Vaccine , Disease Outbreaks , Diphtheria , Vaccination CoverageABSTRACT
Introduction: Community Health Workers (CHW) are a critical resource for outbreak preparedness and response. However, CHWs´ ability to respond to outbreaks depends on their accurate knowledge of the disease and proper adoption of disease prevention practices. We explored knowledge and practices related to outbreaks in general, and COVID-19 among CHWs in Rwanda. Methods: this cross-sectional multimethod study used stratified simple random sampling to recruit three cadres of CHWs (agents de santé maternelle, female Binomes, and male Binomes ) from three rural Rwandan districts. We used telephone-based data collection to administer quantitative surveys (N=292) and qualitative interviews (N=24) in September 2020. We calculated descriptive statistics and conducted thematic analysis of qualitative data. We assessed for associations between general outbreak-related knowledge and receipt of training using Chi-square tests and between COVID-19 related knowledge and CHW characteristics and adoption of prevention methods using linear regression models. Results: only 56.2% of CHWs had received training on any health topic in 12 months prior to COVID-19 pandemic and only 19.2% had specifically received training on outbreak preparedness. Almost all CHWs reported preventing COVID-19 by wearing facemasks (98%), washing hands (95%), and social distancing in crowds (89%) with fewer reporting staying at home (50%), sneezing or coughing into an elbow (38%) or using hand sanitizer (18%). Almost all CHWs in our study knew that COVID-19 transmit through respiratory droplets (98%) and by infected surfaces (98%) and that asymptomatic spread is possible (91%). However, fewer than half of community health workers correctly affirmed that children were at low risk of becoming severely ill (48%) and only 32% correctly rejected the misconception that everyone with COVID-19 would become severely ill. There was no association between COVID-19-related knowledge and adoption of COVID-19 preventative practices. Qualitative findings suggested that while CHWs possessed lots of correct information about COVID-19 and reported good adherence to COVID-19 prevention practices, they also commonly held misconceptions that over-exaggerated the dangers of COVID-19. Conclusion: gaps in knowledge, training, and access to information point to a need for additional investment in supervision and credible informational systems to support CHWs.
Subject(s)
Linear Models , Community Health Workers , Knowledge , Hand Sanitizers , Physical Distancing , COVID-19 , Disease OutbreaksSubject(s)
Humans , Monkeypox/diagnosis , Monkeypox/epidemiology , Disease Outbreaks , Cross-Sectional StudiesABSTRACT
Introducción. El dengue es un problema de salud pública a nivel mundial. Confinado en sus orígenes a las zonas tropicales y subtropicales, en la actualidad se presenta en otras regiones como Argentina. Desde el año 2008 se presenta con brotes epidémicos en la Ciudad Autónoma de Buenos Aires, con escasos reportes en niños. Objetivo. Analizar y comparar las características clínicas, epidemiológicas, de laboratorio y evolutivas de los dos últimos brotes de dengue fuera del área endémica. Población y métodos. Estudio de series temporales. Se incluyeron pacientes menores de 18 años con dengue probable o confirmado, evaluados en un hospital pediátrico de la Ciudad de Buenos Aires durante los períodos 2015-2016 y 2019-2020. Resultados. Se incluyeron 239 pacientes, 29 (12 %) con antecedente de viaje. La mediana de edad fue de 132 meses (rango intercuartílico: 102-156). Todos tuvieron fiebre. Otros síntomas fueron: cefalea en 170 (71 %), mialgias en 129 (54 %) y exantema en 122 (51 %). Cuarenta pacientes (17 %) tenían comorbilidades. Presentaron signos de alarma 79 pacientes (33 %) y 14 (6 %) tenían dengue grave. Requirieron internación 115 pacientes (45 %) y ninguno falleció. El serotipo DENV-1 fue el más frecuente. El antecedente de viaje y la necesidad de internación predominaron en el primer período; el dengue grave y la infección previa, en el segundo. Conclusiones. Ningún paciente falleció de dengue en los períodos estudiados. Se observaron diferencias estadísticamente significativas en la frecuencia de internación; el antecedente de viaje fue más frecuente en el período 2015-2016 y el dengue grave, en el 2019-2020.
Introduction. Dengue is a public health problem worldwide. It was originally confined to tropical and subtropical areas, but it is now present in other regions, such as Argentina. Epidemic outbreaks have been observed in the City of Buenos Aires since 2008, with few reports in children. Objective. To analyze and compare the clinical, epidemiological, laboratory, and evolutionary characteristics of the latest 2 dengue outbreaks outside the endemic area. Population and methods. Time-series study. Patients under 18 years of age with probable or confirmed dengue and evaluated in a children's hospital of the City of Buenos Aires during the periods 2015-2016 and 2019-2020 were included. Results. A total of 239 patients were included; 29 (12%) had a history of travel. Their median age was 132 months (interquartile range: 102156). All had a fever. Other symptoms included headache in 170 (71%), myalgia in 129 (54%), and rash in 122 (51%). Forty patients (17%) had comorbidities. Warning signs were observed in 79 patients (33%); 14 (6%) developed severe dengue; 115 (45%) were hospitalized; none died. DENV-1 was the most common serotype. A history of travel and hospitalization prevailed in the first period; severe dengue and prior infection, in the second period. Conclusions. No patient died due to dengue in either study period. Statistically significant differences were observed in the frequency of hospitalization; a history of travel was more common in the 2015-2016 period and severe dengue, in the 2019-2020 period.
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Severe Dengue/epidemiology , Dengue/diagnosis , Dengue/epidemiology , Exanthema , Disease Outbreaks , Hospitals, PediatricABSTRACT
O objetivo desta pesquisa foi analisar a relação entre surtos de sarampo e as coberturas vacinais municipais na 11ª Região de Saúde de Sobral, noroeste do Ceará, ocorridos entre 2013 e 2015. Para isso, elaborou-se estudo misto por fonte de dados secundários, extraídos na referida região de saúde. Para análise quantitativa, foram investigadas 766 notificações de casos suspeitos de sarampo. Além disso, realizou-se pesquisa de campo pós-epidemia com profissionais envolvidos na imunização, por meio da aplicação de 31 questionários eletrônicos. A análise das informações permitiu identificar que 451 casos notificados da doença foram descartados; 65 foram considerados inconclusivos; e 217 foram confirmados. Os profissionais envolvidos sinalizaram como causa dos surtos: baixas coberturas vacinais, bolsões de suscetíveis, falta de capacitação dos profissionais e inexperiência na contenção de bloqueios. As estratégias de vacinação realizadas priorizaram a imunização da população de risco, a reorientação e sistematização das ações de bloqueio e a varredura.
This research aimed to analyze the relationship between measles outbreaks and municipal vaccination coverage in the 11th Health Region of Sobral, northwest of Ceará, which occurred between 2013 and 2015. To that end, a mixed study by source of secondary data, extracted in the health region was elaborated. For quantitative analysis, a total of 766 reports of suspected measles cases were investigated. Also, post-epidemic field research was carried out with professionals involved in immunization, by applying 31 electronic questionnaires. The analyzes of the information allowed us to identify that 451 notified cases of the disease were discarded; 65 were considered inconclusive; and 217 were confirmed. The professionals involved pointed out the following as the cause of the outbreaks: low vaccination coverage, pockets of susceptible people, lack of training of professionals and inexperience in containing blockages. The vaccination strategies prioritized the immunization of the population at risk, the reorientation and systematization of blocking and scanning actions.
El objetivo de este estudio fue analizar la relación entre los casos de sarampión y las coberturas municipales de vacunación en la 11.ª Región de Salud de Sobral, noreste de Ceará (Brasil), ocurridos en el periodo entre 2013 y 2015. Para ello, se utilizó un estudio mixto por fuente de datos secundarios, extraídos en la citada región. Para el análisis cuantitativo, se investigaron un total de 766 informes de casos sospechosos de sarampión. Se realizó investigación de campo postepidemia con los profesionales involucrados en inmunización, mediante la aplicación de 31 cuestionarios electrónicos. El análisis de la información permitió identificar que se descartaron 451 casos notificados de la enfermedad; 65 fueron no concluyentes y 217 confirmados. Los profesionales implicados señalaron las siguientes causas de los brotes: bajas coberturas de vacunación, bolsa de susceptibles, falta de formación profesional e inexperiencia en la contención de bloqueos. Las estrategias de vacunación priorizaron la inmunización de la población en riesgo, la reorientación y sistematización de las acciones de bloqueo y barrido.
Subject(s)
Measles Vaccine , Disease Outbreaks , MeaslesABSTRACT
La malaria en Colombia tiene un comportamiento heterogéneo y variable, entre las regiones. Para establecer su comportamiento epidemiológico en la región del Caribe colombiano entre 1960 y 2019 se realizó un estudio observacional, descriptivo y retrospectivo a partir de registros del Ministerio de Salud y otras fuentes secundarias. Se definieron variables epidemiológicas y se elaboraron medidas de frecuencia y tendencia central. Se registraron 155 096 casos. Las décadas con mayor número de casos fueron 1990-1999 (20,5%) y 1980-1989 (18,9%). El promedio de casos por década fue de 25 849,3. Los índices parasitarios más elevados se registraron en 1970 (3,3 por 1000 habitantes) y 1981 (3,9 por 1000 habitantes). La especie Plasmodium vivax fue la más frecuente y la mayoría de la carga por grupos de edad se registró en menores de 29 años, entre 2010-2019. La malaria presentó un patrón endemo-epidémico de baja y muy baja intensidad de transmisión, con una tendencia al descenso.
Malaria has a heterogeneous and variable behavior among Colombian regions. In order to establish its epidemiological behavior in the Colombian Caribbean region between 1960 and 2019, we carried out an observational, descriptive and retrospective study based on records from the Ministry of Health and other secondary sources. We defined epidemiological variables and used measures of frequency and central tendency. A total of 155,096 cases were registered. The decades with the highest number of cases were 1990-1999 (20.5%) and 1980-1989 (18.9%). The average number of cases per decade was 25,849.3. The highest parasite rates were recorded in 1970 (3.3 per 1000 population) and 1981 (3.9 per 1000 population). Plasmodium vivax was the most frequent species and most of the burden by age group was found in people under 29 years of age, between 2010-2019. Malaria showed an endemic-epidemic pattern of low and very low transmission intensity, with a decreasing trend.
Subject(s)
Plasmodium vivax , Public Health , Vector Borne Diseases , Malaria , Plasmodium falciparum , Epidemiologic Factors , Disease Outbreaks , Caribbean RegionABSTRACT
La Viruela Símica es una zoonosis viral (transmitida de animales a humanos) con síntomas parecidos a la viruela, aunque de menor gravedad. Fue aislada por primera vez en 1958 en brote de enfermedad parecida a viruela en colonias de monos en Dinamarca. El primer caso en humano se reportó en 1970, en la República Democrática del Congo. Con la erradicación de la viruela en 1980 y el posterior cese de la vacunación contra la misma, la viruela del simio se ha convertido en el ortopoxvirus más importante para la salud pública a nivel mundial. Desde 1970 a 2022, han sido 15 países los que han reportado casos, 11 de los cuales son africanos (Benín, Camerún, República Centroafricana, República Democrática del Congo, Gabón, Costa de Marfil, Liberia, Nigeria, República del Congo, Sierra Leona y Sudán del Sur) donde la enfermedad es endémica Por lo que los presentes Lineamientos técnicos establecen la detección oportuna y control de casos sospechosos o confirmados de viruela símica y serán revisados y actualizados cuando existan cambios o avances en los tratamientos y abordajes, o en la estructura orgánica o funcionamiento del MINSAL
Monkeypox is a viral zoonosis (transmitted from animals to humans) with symptoms similar to smallpox, although less severe. It was first isolated in 1958 in an outbreak of smallpox-like disease in monkey colonies in Denmark. The first human case was reported in 1970, in the Democratic Republic of the Congo. With the eradication of smallpox in 1980 and the subsequent cessation of vaccination against it, monkeypox has become the most important orthopoxvirus for public health worldwide. From 1970 to 2022, 15 countries have reported cases, 11 of which are African (Benin, Cameroon, Central African Republic, Democratic Republic of Congo, Gabon, Ivory Coast, Liberia, Nigeria, Republic of Congo, Sierra Leone and South Sudan) where the disease is endemic. Therefore, these technical guidelines establish the timely detection and control of suspected or confirmed cases of monkeypox and will be reviewed and updated when there are changes or advances in treatments and approaches, or in the organizational structure or operation of MINSAL.
Subject(s)
Signs and Symptoms , Disease , Monkeypox , Viral Zoonoses , Public Health , Disease Outbreaks , El SalvadorABSTRACT
La viruela símica es una enfermedad que ocurre en los monos, sin embargo también se han presentado casos en humanos desde 1970, transformándose en una zoonosis de origen viral, la sintomatología es similar a la viruela pero menos grave. Objetivo: Proporcionar información actualizada sobre la viruela símica, situación epidemiológica, sintomatología, letalidad, diagnóstico, tratamiento y medidas de prevención Materiales y métodos: Se realizó una búsqueda de literatura científica en las bases de datos Organización Mundial de la Salud, Google Académico y PubMed, se eligieron los descriptores o palabras relacionadas con la enfermedad y se realizó la búsqueda para la descripción de reportes de casos y brotes producidas por la viruela símica. Resultados: Desde que se reportó el primer caso en humanos, han existido brotes en el continente africano, fuera de éste, se han reportados varios casos y brotes en otros países, la mayoría en los Estados Unidos. El último evento se reporta en mayo de 2022 y es de preocupación mundial, debido a la aparición en varios países no endémicos. Conclusiones: La presencia de casos de viruela símica en humanos se ha mantenido desde su aparición, la ausencia de un tratamiento específico y vacunas autorizadas para su administración, podrían generar un aumento en la morbimortalidad(AU)
Monkeypox is a disease that occurs in monkeys, however there have also been cases in humans since 1970, becoming a zoonosis of viral origin, the symptoms are similar to smallpox but less severe. Objective: To provide updated information on monkeypox, epidemiological situation, symptomatology, lethality, diagnosis, treatment and prevention measures. Materials and methods: A search of scientific literature was carried out in the World Health Organization, Google Scholar and PubMed databases. , the descriptors or words related to the disease were chosen and the search was performed for the description of case reports and outbreaks caused by monkeypox. Results: Since the first human case was reported, there have been outbreaks on the African continent, outside of Africa, several cases and outbreaks have been reported in other countries, most in the United States. The last event is reported in May 2022 and is of global concern, due to the appearance in several non-endemic countries. Conclusions: The presence of cases of monkeypox in humans has been maintained since its appearance, the absence of a specific treatment and vaccines authorized for its administration, could generate an increase in morbidity and mortality(AU)
Subject(s)
World Health Organization , Disease Outbreaks , PubMed , Monkeypox/diagnosis , Therapeutics , Vaccines , Epidemiology , Mortality , Viral ZoonosesABSTRACT
Diferentes características socio demográficas describen una disminución en el proceso de vacunación en niños originando rebrotes de enfermedades que se suponían controladas. Objetivos, comprobar la confiabilidad del instrumento de investigación para medir los factores que intervienen en el cumplimiento del calendario de vacunación en las madres con niños menores de 5 años. Materiales y métodos: esta investigación se empleo la metodología mixta, de corte transversal, exploratoria, descriptiva, en la cualitativa se usó la técnica fenomenológica con instrumentos diseñados por los investigadores y validado por juicio de expertos, Resultados. El instrumento de recolección de datos es validado con un puntaje promedio de pertinencia 89, validez de 90 y coherencia 89. Equivalente a 89.33 de confiabilidad, alfa de Cronbach de 0,07, Conclusiones. El instrumento al ser confiable está en condiciones de ser utilizado en investigaciones subsiguientes, teniendo en cuenta que la población a la que se aplicó reúne condiciones específicas de una área rural, dentro de los factores que modifican el cumplimiento del proceso de vacunación se recalcó las creencias de las madres del sector, quienes manifiestan un estado de inseguridad e incertidumbre al oponerse a la aplicación de vacunas a sus hijos, se detalla el estado emocional con tendencia a la depresión con rasgos de ansiedad de las madres como resultado de la actitud de su cultura de desconfianza(AU)
Different sociodemographic characteristics describe a decrease in the vaccination process in children, causing outbreaks of diseases that were supposed to be controlled. Objectives, to verify the reliability of the research instrument to measure the factors that intervene in the fulfillment of the vaccination schedule in mothers with children under 5 years of age. Materials and methods: this research used the mixed, cross-sectional, exploratory, descriptive methodology, in the qualitative one the phenomenological technique was used with instruments designed by the researchers and validated by expert judgment, Results. The data collection instrument is validated with an average relevance score of 89, validity of 90 and coherence of 89. Equivalent to 89.33 reliability, Cronbach's alpha of 0.07, Conclusions. The instrument, being reliable, is able to be used in subsequent investigations, taking into account that the population to which it was applied meets specific conditions of a rural area, within the factors that modify compliance with the vaccination process, beliefs of the mothers of the sector, who manifest a state of insecurity and uncertainty when opposing the application of vaccines to their children, the emotional state with a tendency to depression with anxiety traits of the mothers as a result of the attitude of their culture is detailed. of mistrust(AU)
Subject(s)
Vaccines , Immunization Schedule , Mothers , Socioeconomic Factors , Child Health , Disease OutbreaksABSTRACT
Introducción Debido a la respuesta de los servicios de salud a la pandemia por COVID- 19, se han suspendido cirugías electivas como la artroplastía de rodilla. El objetivo de este estudio es determinar la incidencia de artroplastías de rodilla en 2020 reflejando el efecto de la pandemia, y estimar el tiempo y el costo para recuperar la situación de lista de espera previa a marzo de 2020. Métodos Estudio transversal. Se analizaron las bases de datos del Departamento de Estadística e Información en Salud de Chile de 2019 y 2020, identificando pacientes asociados a códigos de artroplastía de rodilla. Se calculó el número mensual de artroplastias realizadas durante 2019 para estimar el tiempo que tomará recuperar las cirugías no realizadas en 2020. El costo asociado a artroplastía de rodilla se hizo según el método de pago utilizado por el Fondo Nacional de Salud estimado por grupos relacionados por diagnóstico. Resultados En 2020 la tasa de incidencia de artroplastía de rodilla por 100 000 habitantes disminuyó 64% comparado con 2019. El impacto fue mayor en el sistema público (68%) y en beneficiarios del Fondo Nacional de Salud (63%). Un aumento en la productividad en 30% respecto a 2019 haría que en 27 meses se recuperen las cirugías no realizadas en 2020, significando un costo adicional mensual en el sistema público de 318 262 530 pesos chilenos (equivalentes a 378 mil dólares americanos, USD). Conclusiones Hubo una importante disminución de la tasa de artroplastías de rodilla en 2020, estimándose una caída del 64% en la incidencia por 100 000 habitantes. Esto muestra un incremento importante de personas que esperan la resolución a la artrosis de rodilla. Un aumento entre 20 y 40% respecto de 2019 permitiría recuperar las cirugías no realizadas en un plazo entre 20 y 41 meses, a un costo mensual en el sistema público que varía entre 210 y 425 millones pesos chilenos (de 250 a 506 mil dólares americanos, USD).
Introducción Debido a la respuesta de los servicios de salud a la pandemia por COVID- 19, se han suspendido cirugías electivas como la artroplastía de rodilla. El objetivo de este estudio es determinar la incidencia de artroplastías de rodilla en 2020 reflejando el efecto de la pandemia, y estimar el tiempo y el costo para recuperar la situación de lista de espera previa a marzo de 2020. Métodos Estudio transversal. Se analizaron las bases de datos del Departamento de Estadística e Información en Salud de Chile de 2019 y 2020, identificando pacientes asociados a códigos de artroplastía de rodilla. Se calculó el número mensual de artroplastias realizadas durante 2019 para estimar el tiempo que tomará recuperar las cirugías no realizadas en 2020. El costo asociado a artroplastía de rodilla se hizo según el método de pago utilizado por el Fondo Nacional de Salud estimado por grupos relacionados por diagnóstico. Resultados En 2020 la tasa de incidencia de artroplastía de rodilla por 100 000 habitantes disminuyó 64% comparado con 2019. El impacto fue mayor en el sistema público (68%) y en beneficiarios del Fondo Nacional de Salud (63%). Un aumento en la productividad en 30% respecto a 2019 haría que en 27 meses se recuperen las cirugías no realizadas en 2020, significando un costo adicional mensual en el sistema público de 318 262 530 pesos chilenos (equivalentes a 378 mil dólares americanos, USD). Conclusiones Hubo una importante disminución de la tasa de artroplastías de rodilla en 2020, estimándose una caída del 64% en la incidencia por 100 000 habitantes. Esto muestra un incremento importante de personas que esperan la resolución a la artrosis de rodilla. Un aumento entre 20 y 40% respecto de 2019 permitiría recuperar las cirugías no realizadas en un plazo entre 20 y 41 meses, a un costo mensual en el sistema público que varía entre 210 y 425 millones pesos chilenos (de 250 a 506 mil dólares americanos, USD).
Subject(s)
Humans , Arthroplasty, Replacement, Knee , COVID-19/epidemiology , Chile/epidemiology , Registries , Disease Outbreaks , Cross-Sectional StudiesSubject(s)
Humans , Female , Child, Preschool , Paralysis/etiology , Poliomyelitis/etiology , Central Nervous System Viral Diseases/diagnosis , Central Nervous System Viral Diseases/drug therapy , Muscle Hypotonia , Neuromuscular Diseases/diagnosis , Neuromuscular Diseases/therapy , Respiratory Tract Infections , Disease Outbreaks , MyelitisABSTRACT
The aim of this study was to investigate an outbreak caused by protozoa, which occurred in a municipality in the Brazil southern region. The investigations were carried out analyzing 47 fresh stool samples and 26 water samples by parasitological and molecular methods, as well as, direct immunofluorescence. After the filtrations of water samples and purification of stool samples, the concentrates were evaluated microscopically for presence of parasites. Molecular analyses were performed by polymerase chain reaction (PCR) for DNA detection of Giardia spp., Cryptosporidium parvum, C. hominis and Cyclospora cayetanensis. Out of 26 water samples, 30.8% (8/26) had waterborne protozoa and C. cayetanensis was the most prevalent (15.5%). Out of the 47 stool samples, 23.4% (11/47) were infected with C. cayetanensis and Giardia spp. The results showed that backwash water samples from filters of the Water Treatment Station were contaminated with C. cayetanensis, C. hominis and Giardia spp., suggesting the contamination of water sources with human waste brought by sewage. These results show the importance of protozoa investigation in water and stool samples by laboratory methodologies principally in outbreaks causing acute diarrheal disease (AU).
O objetivo do presente estudo foi investigar um surto causado por protozoários, ocorrido em um município da região sul do Brasil. As investigações foram realizadas analisando 47 amostras de fezes frescas e 26 amostras de água por métodos parasitológicos, moleculares e de imunofluorscência direta. Após as filtrações das amostras de água e purificação das amostras de fezes, os concentrados foram avaliados microscopicamente a procura de parasitas. A seguir, foram analisadas, pela reação em cadeia da polimerase (PCR), a detecção de DNA de Giardia spp., Cryptosporidium parvum, C. hominis e Cyclospora cayetanensis. Das 26 amostras de água, 30,8% (8/26) apresentaram protozoários de veiculação hídrica, sendo que, C. cayetanensis foi o mais prevalente (15,5%). Das 47 amostras de fezes, 23,4% (11/47) estavam infectadas por C. cayetanensis e Giardia spp. Os resultados mostraram que as águas de retrolavagem dos filtros da Estação de Tratamento de Água estavam contaminadas com C. cayetanensis, C. hominis e Giardia spp. sugerindo a contaminação dos mananciais com dejetos humanos trazidos pelo esgoto. Estes resultados mostram a importância da investigação de protozoários em água e fezes por metodologias laboratoriais, principalmente em surtos que causam doença diarreica aguda (AU).
Subject(s)
Protozoan Infections , Disease Outbreaks , Cryptosporidium , Cyclospora , Diarrhea , Waterborne Diseases , GiardiaABSTRACT
Introducción: Las enfermedades trasmitidas por alimentos se producen por la ingestión de alimentos y/o bebidas contaminados. Objetivo: Identificar los agentes causales que influyen en la aparición de estas enfermedades. Métodos: Se realizó un estudio observacional, descriptivo y transversal del total de brotes de enfermedades trasmitidas por alimentos en la provincia de Santiago de Cuba, desde enero de 2018 hasta diciembre de 2019. Las variables analizadas fueron: número de brotes, muestras de alimentos y muestras de heces fecales para coprocultivo, entre otras. Resultados: En todos los brotes se aisló un solo tipo de agente bacteriano, con predominio de las bacterias gramnegativas, donde la Salmonella fue el microorganismo más identificado. Los principales grupos de alimentos relacionados con la aparición de dichos brotes resultaron ser la carne y sus derivados, así como la ensalada fría. Conclusiones: La vigilancia epidemiológica de brotes de enfermedades transmitidas por alimentos, permitió identificar el verdadero agente causal en los brotes de ETA, al demostrarse identidad entre los aislamientos bacterianos obtenidos de muestras de alimentos y heces fecales.
Introduction: Diseases transmitted by foods take place due to the ingestion of foods and/or contaminated drinks. Objective: To identify the causal agents that influence in the emergence of these diseases. Methods: An observational, descriptive and cross-sectional study of all the diseases outbreaks transmitted by foods was carried out in Santiago de Cuba, from January, 2018 to December, 2019. The analyzed variables were: number of outbreaks, samples of foods and samples of stools for coproculture, among others. Results: In all the outbreaks a single type of bacterial agent was isolated, with prevalence of the gram-negative bacterias, where Salmonella was the most identified microorganism. The main groups of foods related to the emergence of these outbreaks were meat and its derived products, as well as cold salad. Conclusions: The epidemiologic surveillance of diseases outbreaks transmitted by foods, allowed to identify the true causal agent in the FTD outbreaks, when the identity between the bacterial isolations obtained from samples of foods and stools was demonstrated.
Subject(s)
Food Contamination , Eating , Epidemiological Monitoring , Disease OutbreaksABSTRACT
Introduction: Monkeypox is a zoonosis caused by the monkeypox virus. The first confirmed human case was in 1970, when the virus was isolated from a child in the Democratic Republic of the Congo. Since the beginning of May 2022, a large and unexpected outbreak has been documented globally, with the first cases initially described in the UK reaching around 70 countries today. The causes of this explosive increase in patients are not well understood, but exceed more than ten thousand10,000 infected by the third week of July 2022. Clinical and epidemiological presentations have been distinct from endemic cases and from small outbreaks previously described in non- endemic areas. Objective: The aim of this study was to describe the evolutionary and epidemiological, clinical characteristics of Monkeypox and human immunodeficiency virus co-infection in a patient treated at an STI/AIDS Reference Service in São Paulo, Brazil. Methods: information contained in this study was obtained through a review of the medical records, interviews with the patient, photographic record of the diagnostic methods, to which the patient was submitted and review of the literature. Results: A Brazilian man, with no epidemiological history of travel who was diagnosed with Monkeypox virus through polymerase chain reaction. At the same time of this diagnosis, he received a laboratory diagnosis of human immunodeficiency virus, Chlamydia Urethritis, and Late Latent Syphilis. Conclusion: To reduce the risk of the dissemination of Monkeypox, strategies at the public health level are necessary, with the dissemination of information and the development of prevention projects with targeted information and recommendations for vulnerable populations, especially men who have sex with men, with great prudence, seeking not to favor the development of stigmas as already experienced at the beginning of the human immunodeficiency virus epidemic.
Introdução: Monkeypox é uma zoonose causada pelo vírus monkeypox. O primeiro caso humano confirmado foi em 1970, quando o vírus foi isolado de uma criança na República Democrática do Congo. Desde o início de maio de 2022, um surto grande e inesperado tem sido documentado globalmente, com os primeiros casos inicialmente descritos no Reino Unido atingindo hoje cerca de 70 países. As causas desse aumento explosivo de pacientes não estão bem esclarecidas, mas ultrapassaram 10 mil infectados até a terceira semana de julho de 2022. As apresentações clínicas e epidemiológicas têm sido distintas dos casos endêmicos e dos pequenos surtos previamente descritos em áreas não endemicas. Objetivo: Neste relato descrevemos as características clínicas evolutivas e epidemiológicas da coinfecção do Monkeypox e do imunodeficiência humana em um paciente atendido em um serviço de referência em infecções sexualmente transmissíveis IST/Aids de São Paulo, Brasil. Métodos: as informações dos métodos contidas neste estudo foram obtidas por meio de revisão dos prontuários, entrevistas com o paciente, prontuário fotográfico dos métodos diagnósticos, aos quais o paciente foi submetido e revisão da literatura. Resultados: Homem brasileiro, sem antecedente epidemiológico de viagem, foi diagnosticado com Monkeypox por meio de reação em cadeia da polimerase. Simultaneamente a esse diagnóstico, recebeu diagnóstico laboratorial de vírus da imunodeficiência humana, uretrite por clamídia e sífilis latente tardia. Conclusão: Para reduzir o risco de disseminação do Monkeypox, são necessárias estratégias no âmbito da saúde pública, com disseminação da informação e elaboração de projetos de prevenção com informações direcionadas e recomendações para populações vulneráveis, especialmente homens que fazem sexo com homens, com bastante prudência, buscando não favorecer o desenvolvimento de estigmas como os já vivenciados no início da epidemia de imunodeficiência humana.