ABSTRACT
Introducción: El control de la tuberculosis requiere procesos renovados de monitoreo y evaluación.Objetivo: Analizar la notificación y las brechas de la tuberculosis en países latinoamericanos y caribeños en 2021.Métodos: Aplicación de un modelo renovado de categorización del control utilizando las tasas de notificación de casos de cada país y las brechas con relación a las tasas estimadas. La versión simplificada contiene siete categorías y la detallada incluye subcategorías. Se calcularon los porcentajes y la mediana de las tasas de los países para cada categoría simplificada, el menor valor fue referencia para calcular las diferencias absolutas y relativas. A partir de la razón de detección, se aplicó una escala de calificación y se obtuvo la correlación entre las tasas de notificación. Las categorías de control insuficiente fueron contrastadas con las categorías de control casi-satisfactorio, control satisfactorio y ultracontrol. Resultados: De los 40 países que notificaron casos de tuberculosis a la OMS en 2021, 15 (37,5%) estaban en la categoría de control insuficiente; 2 (5%) en pre-eliminación y 4 (10%) en eliminación. La desigualdad absoluta fluctuó desde 31,8 por 100.000 en control insuficiente hasta 2,5 en ultra-control, mayor que en la referencia. La correlación realizada fue débil, al encontrarse los puntos de la dispersión alejados de la recta y más cercanos a cero. Conclusiones: La categorización puede aplicarse a todos los países y al interior de ca-da uno para valorar el progreso "paso a paso" del control hacia la eliminación de la tuberculosis como problema de salud pública.
Introduction: Tuberculosis control requires renewed monitoring and evaluation processes. Objective: To analyse tuberculosis notification and gaps in Latin American and Caribbean countries in 2021.Methods: Application of a revamped control categorisation model using each country's case notification rates and gaps in relation to estimated rates. The implified version contains seven categories and the detailed version includes subcategories. Percentages and median country rates were calculated for each simplified category, the lowest value being the reference for calculating absolute and relative differences. From the detection ratio, a rating scale was applied and the correlation between reporting rates was obtained. The categories of poor control were contrasted with the categories of near-satisfactory control, satisfactory control and ultracontrol.Results: Of the 40 countries that reported tuberculosis cases to WHO in 2021, 15 (37.5%) were in the poor control category; 2 (5%) in pre-elimination and 4 (10%) in eli-mination. The absolute inequality ranged from 31.8 per 100,000 in insufficient control to 2.5 in ultra-control, higher than the baseline. The correlation performed was weak, as the points of the dispersion were far from the straight line and closer to zero. Conclusions: The categorisation can be applied across and within countries to assess 'step-by-step' progress in control towards elimination of tuberculosis as a public health problem.
Subject(s)
Humans , Tuberculosis/prevention & control , Public Health , Health Programs and Plans , Incidence , Cross-Sectional Studies , Caribbean Region , Disease Notification , Health Services Accessibility , Latin AmericaABSTRACT
Los empiemas fúngicos representan una entidad potencialmente fatal, con tasas de mortalidad elevadas en la mayoría de las series. Se presenta el caso de un empiema por Candida albicans tratado exitosamente en un paciente diabético. Se demuestra la importancia del inicio precoz y agresivo del tratamiento.
Fungal empyemas represent a potentially fatal entity, with high mortality rates in most series. A case of empyema due to Candida albicans successfully treated in a diabetic patient is presented, demonstrating the importance of early and aggressive initiation of treatment.
Subject(s)
Humans , Male , Adult , Pleural Effusion , Candida albicans/isolation & purification , Celiac Disease , Diabetes Mellitus , Empyema/drug therapy , Thoracoscopy , Wounds and Injuries , Incidence , Mortality , Fever , Laparotomy , Leukocytosis , Antifungal Agents/therapeutic useABSTRACT
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.
Subject(s)
Incidence , Food Safety , Epidemiological Monitoring , Foodborne Diseases , Public Health , Epidemiology , Amazonian Ecosystem , Censuses , EcuadorABSTRACT
Introducción. La infección asociada a catéter venoso central (CVC) es la principal complicación que presentan los pacientes en hemodiálisis en los que se usa este tipo de acceso. Objetivo. Estimar la incidencia de bacteriemia asociada a CVC no tunelizado, analizar la frecuencia de agentes causales y explorar factores de riesgo asociados en niños en hemodiálisis. Población y métodos. Estudio retrospectivo realizado en niños en hemodiálisis por CVC no tunelizado entre el 1 junio de 2015 y el 30 de junio de 2019. Para evaluar factores de riesgo predictores de bacteriemia asociada a CVC, se realizó regresión logística. Los factores de riesgo independiente se expresaron con odds ratio con sus respectivos intervalos de confianza del 95 %. Se consideró estadísticamente significativo un valor de p <0,05. Resultados. En este estudio se incluyeron 121 CVC no tunelizados. La incidencia de bacteriemia fue de 3,15 por 1000 días de catéter. El microorganismo aislado con mayor frecuencia fue Staphylococcus epidermidis (16 casos, 51,5 %). La infección previa del catéter fue el único factor de riesgo independiente encontrado para el desarrollo de bacteriemia asociada a CVC no tunelizado (OR: 2,84; IC95%: 1,017,96; p = 0,04). Conclusiones. El uso prolongado de los CVC no tunelizados para hemodiálisis crónica se asoció con una incidencia baja de bacteriemia. Los gérmenes grampositivos predominaron como agentes causales. La presencia de infección previa del CVC aumentó en casi 3 veces el riesgo de bacteriemia asociada a CVC en nuestra población pediátrica en hemodiálisis.
Introduction. Central venous catheter (CVC)-related infection is the main complication observed in patients undergoing hemodialysis with this type of venous access. Objective. To estimate the incidence of non-tunneled CVC-related bacteremia, analyze the frequency ofcausative agents, and explore associated risk factors in children undergoing hemodialysis. Population and methods. Retrospective study in children receiving hemodialysis via a non-tunneled CVC between June 1 st, 2015 and June 30 th, 2019. A logistic regression was carried out to assess risk factors that were predictors of CVC-related bacteremia. Independent risk factors were described as odds ratios with their corresponding 95% confidence interval (CI). A value of p < 0.05 was considered statistically significant. Results. A total of 121 non-tunneled CVCs were included in this study. The incidence of bacteremia was 3.15 per 1000 catheter-days. The most commonly isolated microorganism was Staphylococcus epidermidis(16 cases, 51.5%). Prior catheter infection was the only independent risk factor for the development of bacteremia associated with non-tunneled CVC (OR: 2.84, 95% CI: 1.017.96, p = 0.04). Conclusions. Prolonged use of non-tunneled CVCs for chronic hemodialysis was associated with a low incidence of bacteremia. Gram-positive microorganisms prevailed among causative agents. A prior CVC infection almost trebled the risk for CVC-related bacteremia in our pediatric population receiving hemodialysis.
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Renal Dialysis/adverse effects , Bacteremia/etiology , Bacteremia/epidemiology , Catheter-Related Infections/etiology , Catheter-Related Infections/microbiology , Catheter-Related Infections/epidemiology , Central Venous Catheters/adverse effects , Catheterization, Central Venous/adverse effects , Incidence , Retrospective Studies , Risk FactorsABSTRACT
El objetivo de este estudio es determinar la densidad de incidencia de lesiones y sus características, según la propuesta STROBE-SIIS, en las basquetbolistas sub-18 participantes de la Liga de Básquetbol Femenino del Sur (FEMISUR) en su temporada 2023. Se utilizó un tipo de estudio con enfoque positivista observacional descriptivo de tipo longitudinal prospectivo, con una muestra no probabilística, de selección intencional. Se enviaron por correo electrónico formularios diseñados según STROBE-SIIS a 59 jugadoras de 12 clubes durante 22 semanas. Se calculó la densidad de incidencia, dividiendo número de lesiones por número de horas de exposición, normalizando por 1000 horas. Para la descripción de las características de las lesiones se determinó frecuencia absoluta y relativa según inicio, mecanismo, tejido, zona anatómica y severidad. Ocurrieron 108 lesiones, con una incidencia de 36,21 lesiones/1000 horas de exposición. La mayor frecuencia fue de inicio agudo repentino (n=77; 71,3%), mecanismo de no contacto (n=46; 42,6%), en músculo/tendón (n=61; 45,5%), ligamento/capsular articular (n=19; 14,2%) y huesos (n=14; 10,4%); y tobillo (n=55; 27,1%), pierna (n=40; 19,7%) y rodilla (n=34; 16,7%). Las lesiones leves fueron más frecuentes (n=68;63%). Se encontró una alta incidencia de lesiones en las basquetbolistas sub-18 participantes de la Liga FEMISUR, siendo las lesiones más frecuentes las de inicio agudo repentino, mecanismo de no contacto, en músculo/tendón, tobillo y severidad leve. Esta información beneficiará a los equipos multidisciplinarios que trabajan con basquetbolistas sub-18, con el fin de implementar un plan de prevención o realizar análisis comparativos.
The objective of this study is to determine the incidence density of injuries and their characteristics, according to the STROBE-SIIS proposal, in the under-18 basketball players participating in the Southern Women's Basketball League (FEMISUR) in its 2023 season. A type of study with a positivist, observational, descriptive, longitudinal, prospective approach was used, with a non-probabilistic, intentional selection sample. Forms designed according to STROBE-SIIS were emailed to 59 players from 12 clubs over 22 weeks. The incidence density was calculated by dividing the number of lesions by the number of hours of exposure, normalizing by 1000 hours. To describe the characteristics of the injuries, absolute and relative frequency was determined according to onset, mechanism, tissue, anatomical area and severity. 108 injuries occurred, with an incidence of 36.21 injuries/1000 hours of exposure. The highest frequency was sudden acute onset (n=77; 71.3%), non-contact mechanism (n=46; 42.6%), muscle/tendon (n=61; 45.5%), ligament articular/capsular (n=19; 14.2%) and bones (n=14; 10.4%); and ankle (n=55; 27.1%), leg (n=40; 19.7%) and knee (n=34; 16.7%). Minor injuries were more frequent (n=68; 63%). A high incidence of injuries was found in the under-18 basketball players participating in the FEMISUR League. The most frequent injuries being those of sudden acute onset, non-contact mechanism, in muscle/tendon, ankle and mild severity. This information will benefit multidisciplinary teams that work with under-18 basketball players, in order to implement a prevention plan or perform comparative analyses.
O objetivo deste estudo é determinar a densidade de incidência de lesões e suas características, segundo a proposta do STROBE-SIIS, nas jogadoras de basquete sub-18 participantes da Liga Sul de Basquete Feminino (FEMISUR) na temporada 2023. Utilizou-se estudo do tipo positivista, observacional, descritivo, longitudinal, prospectivo, com amostra não probabilística e de seleção intencional. Formulários elaborados de acordo com o STROBE-SIIS foram enviados por e-mail para 59 jogadores de 12 clubes durante 22 semanas. A densidade de incidência foi calculada dividindo o número de lesões pelo número de horas de exposição, normalizando por 1000 horas. Para descrever as características das lesões, foram determinadas frequências absoluta e relativa de acordo com início, mecanismo, tecido, área anatômica e gravidade. Ocorreram 108 lesões, com incidência de 36,21 lesões/1000 horas de exposição. A maior frequência foi início agudo súbito (n=77; 71,3%), mecanismo sem contato (n=46; 42,6%), músculo/tendão (n=61; 45,5%), ligamento articular/capsular (n=19; 14,2%) e ossos (n=14; 10,4%); e tornozelo (n=55; 27,1%), perna (n=40; 19,7%) e joelho (n=34; 16,7%). Lesões leves foram mais frequentes (n=68;63%). Foi encontrada alta incidência de lesões nos basquetebolistas sub-18 participantes da Liga FEMISUR. As lesões mais frequentes são as de início agudo súbito, mecanismo sem contato, em músculo/tendão, tornozelo e gravidade leve. Esta informação beneficiará equipas multidisciplinares que trabalham com jogadores de basquetebol sub-18, para implementar um plano de prevenção ou realizar análises comparativas.
Subject(s)
Humans , Female , Adolescent , Athletic Injuries/epidemiology , Basketball/injuries , Incidence , Longitudinal StudiesABSTRACT
INTRODUCTION: The growing older population increases proportionately the demand for hospital care due to the increase in health problems. OBJECTIVE: To estimate the prevalence and incidence of hospitalizations, and to investigate associated factors in older adults from the Zona da Mata of Minas Gerais, Brazil, between 2016-2018. Secondly, to provide a more comprehensive epidemiological overview of hospitalizations, the following were estimated: monthly hospitalization rate; hospital mortality rate; frequency of hospitalizations according to diagnosis, hospitalizations for conditions sensitive to primary care and in-hospital death; and hospital costs. METHODS: This is an ecological and descriptive-analytic study. Data were obtained from the Brazilian Hospital Information System (SIH/SUS). RESULTS: The prevalence of hospitalizations was 35.1% (31.2% in women and 39.7% in men). The monthly rate of hospitalizations was higher in older men when compared with older women (Rate-Ratio=1.35 [95% CI=1.27-1.43]) and adult men between 4059 years (Rate Ratio=2.42 [95% CI=2.26-2.58]). The cumulative incidence of hospitalization was 144/1,000 older persons (125/1,000 women and 169/1,000 men). Factors significantly associated with hospitalizations were: male sex (PR=1.52 [95% CI=1.11-2.08]); hospitalization in surgical bed (PR=1.93 [95% CI=1.05-3.56]); absence of death (PR=1.94 [95% CI=1.03-3.65]); and hospital stay ≥15 days (PR=0.71 [95% CI=0.54 0.95]). The cost of hospitalizations was R$ 220,8 million (mean of R$ 201,700/day). CONCLUSÃO: The findings strengthen the need for preventive healthcare for the older population living in the Zona da Mata of Minas Gerais and alert managers to the substantial socioeconomic impact of hospitalizations.
INTRODUÇÃO: O crescente aumento da população idosa faz aumentar proporcionalmente a demanda por cuidados hospitalares devido ao aumento dos problemas de saúde. OBJETIVO: Estimar a prevalência e incidência de hospitalizações, e investigar fatores associados, em idosos da Zona da Mata Mineira, Brasil, entre 2016-2018. Secundariamente, com intuito de fornecer um panorama epidemiológico mais abrangente acerca das hospitalizações, foram estimadas: taxa mensal de hospitalização; taxa de mortalidade hospitalar; frequência de hospitalizações conforme o diagnóstico, internações por condições sensíveis à atenção primária (ICSAP) e óbito hospitalar; e custos hospitalares. MÉTODO: Trata-se de um estudo ecológico e descritivo-analítico. Os dados foram obtidos do Sistema de Informação Hospitalar brasileiro (SIH/SUS). RESULTADOS: A prevalência de hospitalizações em idosos foi de 35,1% (31,2% em mulheres e 39,7% em homens). A taxa mensal de hospitalização foi maior em homens idosos quando comparados com mulheres idosas (Razão-de-Taxas=1,35 [IC 95%=1,27-1,43]) e homens adultos entre 4059 anos (Razão-de-Taxas=2,42 [IC 95%=2,26-2,58]). A incidência acumulada de hospitalização foi de 144/1.000 idosos (125/1.000 mulheres e 169/1.000 homens). Os fatores significativamente associados com as hospitalizações foram: sexo masculino (RP=1,52 [IC 95%=1,112,08]), internação em leito cirúrgico (RP=1,93 [IC 95%=1,053,56]), ausência de óbito (RP=1,94 [IC 95%=1,03-3,65]) e permanência hospitalizado ≥15 dias (RP=0,71 [IC 95%=0,54-0,95]). O custo das hospitalizações foi de R$ 220,8 milhões (média de R$ 201,7 mil/dia). CONCLUSÃO: Os resultados reforçam a necessidade de cuidados preventivos à saúde da população idosa da Zona da Mata Mineira e alertam gestores para o substancial impacto socioeconômico gerado pelas hospitalizações.
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Incidence , Prevalence , Hospitalization/statistics & numerical data , Epidemiology, Descriptive , Hospital Information Systems , Hospital Costs , Ecological StudiesABSTRACT
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)
Subject(s)
Syphilis , Syphilis, Congenital , Health Profile , Incidence , Infectious Disease Transmission, VerticalABSTRACT
Pregnancy, despite being a physiological process, can lead to morbidity and mortality, which is increased at risk ages, defined as younger or equal to15 years and older or equal to 35 years. For an adequate approach it is necessary to know the local reality of the population, therefore, the objective of this study is to describe and analyze the discharges of births and cesarean sections at risk age in the Maule Region from 2017 to 2021 using the database collected from the Biostatistics Unit of the Maule Health Service, which includes the hospitals of the region. Within the observed period, a total of 30,599 deliveries and cesarean sections were studied, being these a total of 5,581 at risk age, of which 0.65% corresponds to women younger or equal to 15 years and 17.57% to women older or equal to 35 years. There is a downward tendency in births in general, mostly evidenced in less or equal to 15 years, and on the contrary, a rise in births and cesarean sections of more or equal to 35 years, differing with the statistics at the country level. The tendency of increasing maternal age of pregnancies in the Maule region and its consequences are a fundamental factor when planning new public policies, so we consider it of vital importance to promote research and update the evidence, with a focus on the local population.
El embarazo a pesar de ser un proceso fisiológico puede conllevar morbimortalidad, la cual se acrecienta en edades de riesgo, definida como menor o igual a 15 años y mayor o igual a 35 años. Para el adecuado enfrentamiento se necesita conocer la realidad local, por ello, el objetivo de este estudio es describir y analizar los egresos de partos y cesáreas en edad de riesgo en la Región del Maule desde el año 2017 a 2021 utilizando la base de datos recogida desde la Unidad de Bioestadística del Servicio de Salud Maule, la cual incluye los hospitales de la región. Dentro del periodo observado se estudió un total de 30.599 partos y cesáreas, siendo estos un total de 5.581 en edad de riesgo, de los cuales 0.65% corresponde a mujeres menores o igual a 15 años y 17.57% a mujeres mayores o igual a 35 años. Existe una tendencia a la baja de los nacimientos en general, mayormente evidenciado en menores o igual a 15 años, y por el contrario, un alza en los partos y cesáreas de mayores o igual a 35 años, difiriendo con las estadísticas a nivel país. El aumento de la edad materna de los embarazos en la región del Maule y sus consecuencias son un factor fundamental a la hora de planificar nuevas políticas públicas, por lo que consideramos de vital importancia promover la realización de investigaciones y actualización de la evidencia sobre el tema, con un enfoque en la población local.
Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Cesarean Section/statistics & numerical data , Maternal Health Services/statistics & numerical data , Chile/epidemiology , Epidemiology, Descriptive , Incidence , Hospital Statistics , Risk Factors , Maternal Age , Pregnancy, High-Risk , Parturition , Hospitals, Public/statistics & numerical dataABSTRACT
Mpox (viruela símica) es una enfermedad viral que puede producir síntomas como erupción cutánea, adenomegalias y fiebre. Pese a su baja tasa de mortalidad, se relaciona con complicaciones que pueden comprometer la calidad de vida de las personas. Fue identificada por primera vez en humanos en 1970, desde entonces se mantenía una distribución geográfica y una incidencia controladas. No obstante, desde el año 2022 su incidencia ha aumentado al igual que su distribución geográfica alcanzando un total de 89.596 casos confirmados por laboratorio y 663 casos probables, incluidas 157 muertes, reportados al 28 de agosto de 2023; llegando incluso a países no endémicos. A continuación, se presenta una revisión narrativa con base en información recolectada en bases de datos como UpToDate, Google Scholar, Medline, ClinicalKey, Scopus, Embase, Pubmed; con el objetivo de describir los aspectos más relevantes de Mpox en humanos desde una perspectiva epidemiológica actual, además de presentar datos fisiopatológicos, de diagnóstico, tratamiento, pronóstico y rehabilitación.
Mpox (monkeypox) is a viral zoonotic disease capable of producing symptoms such as fever, rash, and lymphadenopathy. Even though its mortality rate is low, it is related to a wide spectrum of complications that can compromise people's quality of life. It was first identified in humans in 1970, since then a controlled geographic distribution and incidence have been managed. However, since 2022 its incidence has increased as has its geographical distribution, reaching a total of 89,596 laboratory-confirmed cases and 663 probable cases, including 157 deaths, reported as of August 28, 2023; reaching even non-endemic countries. Below is a narrative review based on information collected in databases such as UpToDate, Google Scholar, Medline, ClinicalKey, Scopus, Embase, Pubmed; with the aim of describing the most relevant aspects of Mpox in humans from a current epidemiological perspective, in addition to presenting pathophysiological, diagnostic, treatment, prognostic and rehabilitation data.
Subject(s)
Humans , Smallpox , Mpox (monkeypox)/diagnosis , Mpox (monkeypox)/drug therapy , Americas/epidemiology , DNA , Vaccines , Incidence , Colombia/epidemiology , Mpox (monkeypox)/prevention & control , Mpox (monkeypox)/epidemiologyABSTRACT
Objective: To analyze temporal trends in the incidence and spatial distribution of spider bites in Santa Catarina. Methods: This was a mixed ecological study, with a descriptive approach involving multiple groups and a temporal trend analysis, of spider bite notifications recorded in the Information System for Notifiable Diseases from 1 Jan 2011 to 31 Dec 2021. Result: There were 62,671 reported cases, corresponding to an average annual rate of 83.27 per 100,000 population. The linear regression indicated an annual decline rate of 2.94 per 100,000 population. Conclusion: There was a high incidence of spider bites, higher than the national average, with a declining trend during the study period. The occurrences were concentrated in the Western and Northern regions of the state, in urban areas. Most victims were young adults. The lethality and mortality rates were low, and most patients had favorable outcomes
Objetivo: analisar a tendência temporal da taxa de incidência e distribuição espacial de picadas de aranha em Santa Catarina. Método: Estudo ecológico misto, descritivo, de múltiplos grupos, e com análise de tendência temporal, das notificações de picada de aranha registradas no Sistema de Informação de Agravos de Notificação, entre 1º de janeiro de 2011 e 31 de dezembro de 2021. Resultado: Houve 62.671 casos notificados, o que corresponde a taxa média anual de 83,27 casos/100.000 hab. A regressão linear indicou taxa de queda anual de 2,94 casos/100.000 hab. Conclusão: Houve elevada taxa de incidência de picadas de aranhas, superior à média nacional, com tendência de queda no período. As ocorrências se concentraram na Região Oeste e Norte do estado, em áreas urbanas. As vítimas, na maioria, são adultos jovens. A taxa de letalidade e mortalidade foi considerada baixa, e a grande maioria dos casos teve evolução favorável
Subject(s)
Spider Bites , Spiders , Bites and Stings , Incidence , Health Information Systems , Patients , Population , Accidents , Linear Models , Residence Characteristics , Mortality , Urban Area , MethodsABSTRACT
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.
Subject(s)
Breast Neoplasms , Incidence , Mortality , Age Groups , Neoplasm Staging , Uruguay/epidemiologyABSTRACT
Objective: To evaluate health promotion and prevention in the Brazilian Unified Health System (SUS) between 2008 and 2022. Method: An epidemiological study was conducted, with an ecological approach, as a time series. APPS-related data available in the Outpatient Information System of the SUS (SIA/SUS) over the last 15 years were used, normalized to every 100,000 Brazilian residents, characterizing the incidence. COVID-19 pre- and post-pandemic periods were outlined to verify its impact on productivity. The data were analyzed with a significance level of 5%. Result: Between 2008 and 2022, 6,933,081,931 APPS were carried out in the SUS. The most frequent modality was home visits (56.3%), and the most common health professionals were health and endemic agents (59.8%). For the entire study period, the incidence was 3,407,327 APPS per 100,000 Brazilian residents, with an annual median of 281,999. Furthermore, there was a significant decreasing trend over the last 15 years (p <0.001), whose annual percentage change was estimated at -6.7%. Disregarding COVID-19 pandemic years, the trend remained to decrease (p = 0.028). At last, when comparing it to the pre-pandemic period, the incidence of APPS were 32% lower in the first, 26% lower in the second, and 21% lower in the third year after the COVID-19 pandemic onset (p <0.001). Conclusion: It was possible to conclude that APPS in the SUS have reduced in the last 15 years
Objetivo: Avaliar as ações de promoção e prevenção em saúde (APPS) realizadas no Sistema Único de Saúde (SUS) entre 2008 e 2022. Método: Foi conduzido um estudo epidemiológico, com abordagem ecológica, do tipo série temporal. Foram utilizados os dados relativos às APPS no Sistema de Informações Ambulatoriais do SUS (SIA/SUS) nos últimos 15 anos, normalizada a cada 100.000 residentes brasileiros, caracterizando a incidência. Foram delineados períodos pré e pós-pandemia da COVID-19 para verificar o seu impacto na produtividade. Os dados foram analisados com nível de significância de 5%. Resultado: Entre 2008 e 2022, 6.933.081.931 APPS foram realizadas no SUS. A modalidade mais frequente foram as visitas domiciliares (56,3%) e os profissionais da saúde mais comuns foram os agentes de saúde e endemias (59,8%). Para todo o período, a incidência foi de 3.407.327 APPS a cada 100.000 residentes brasileiros, com mediana anual de 281.999. Ademais, houve uma tendência de redução ao longo dos últimos 15 anos (p <0,001), cuja variação percentual anual foi estimada em -6,7%. Desconsiderando o período da pandemia da COVID-19, a tendência permaneceu decrescente (p = 0,028). Por fim, ao compará-la com o período pré-pandemia, a incidência de APPS foi 32% menor no primeiro, 26% menor no segundo e 21% menor no terceiro ano após o início da pandemia da COVID-19 (p <0,001). Conclusão: Foi possível concluir que as APPS no SUS reduziram nos últimos 15 anos
Subject(s)
Humans , Epidemiologic Studies , Health Personnel , Endemic Diseases , COVID-19 , Health Promotion , Unified Health System , Health , Incidence , Efficiency , Disease Prevention , Pandemics , MethodsABSTRACT
Introducción: El cáncer de pulmón (CP) es una enfermedad con gran impacto a nivel mundial en el número de muertes y en costos en salud. La alta incidencia y mortalidad de esta enfermedad asociada al diagnóstico tardío, y la mejoría del pronóstico ante una detección temprana, determinan que sea una patología pasible de beneficiarse mediante detección temprana. La tomografía de baja dosis de radiación (TCBD) demostró ser un método que se pue- de realizar periódicamente a un grupo de personas con alto riesgo de desarrollar CP y así reducir la mortalidad por esta enfermedad. Sin embargo, este beneficio es tal cuan- do se encuentra desarrollado bajo un programa organizado y con participación multi- disciplinaria especializada en cáncer de pulmón. Métodos: Se plantea determinar lineamientos básicos para el desarrollo de la detección temprana de cáncer de pulmón en América Latina para que pueda ser realizada en forma uniforme, con el menor riesgo y el máximo beneficio esperado. Se analizaron las principales publicaciones referidas a este tema, contemplando la diversidad de atención y acceso de América Latina. Resultado: Se desarrollan requerimientos mínimos para la implementación de un pro- grama. Discusión: El número de programas en la región es escaso y depende más de esfuerzos individuales que de políticas generales de salud. Consideramos que estos lineamien- tos pueden servir de apoyo para el desarrollo de más programas en la región y de for- ma más homogénea.
Introduction: Lung cancer (LC) is a disease with a great impact worldwide in the number of deaths and health costs. The high incidence and mortality of this disease associated with late diagnosis and the improved prognosis with early detection determine that it is a pathology that can benefit from early detection. Low radiation dose tomography (LDCT) demonstrated a method that can be performed periodically to a group of people at high risk of developing CP and thus reduce mortality from this disease. However, this benefit is such when it is developed under an organized program with multidisciplinary participation specialized in lung cancer. Methods: It is proposed to determine basic guidelines for the development of early de- tection of lung cancer in Latin America so that it can be carried out uniformly, with the lowest risk and the maximum expected benefit. The main publications referring to this topic were analyzed, considering the diversity of care and access in Latin America. Result: Minimum requirements are developed for the implementation of a program. Discussion: The number of programs in the region is small and depends more on individual efforts than on general health policies. We consider that these guidelines can serve as support for the development of more programs in the region and in a more ho- mogeneous way.
Subject(s)
Humans , Health Programs and Plans , Early Detection of Cancer , Lung Neoplasms/diagnosis , Patient Care Team/organization & administration , Preventive Health Services/organization & administration , Tomography/methods , Incidence , Mortality , Education, Professional , Health Policy , Latin AmericaABSTRACT
El cáncer causa millones de muertes a nivel mundial por lo que su registro es fundamental, existiendo registros clínicos, hospitalarios y poblacionales. Estos últimos son el estándar de oro para la información sobre incidencia y supervivencia de cáncer en una región definida. En Chile se cuenta con cinco registros poblacionales ubicados en ciertas zonas del país. El Registro Nacional del Cáncer chileno surge como un desafío para conformar una herramienta transversal a los tres tipos de registro con la finalidad de, al menos, conocer la cantidad de casos por tipo de cáncer. Su diseño implicó un despliegue de acciones orientadas a lograr consensos entre diversos actores respecto de la información, validación y eventos necesarios de registrar. Se identificaron cuatro etapas en el proceso de atención y el registro: sospecha de diagnóstico, confirmación morfológica (biopsia), resolución clínica (comité oncológico incluyendo la indicación de tratamiento), tratamiento y seguimiento oncológico. A su vez, el desarrollo de la plataforma (años 2018 a 2021) implicó levantamiento de información y acuerdos sobre los requerimientos para el co-diseño del registro, incluyendo un exitoso pilotaje con más de 20 establecimientos de salud del sector público y privado con registro de cerca de 7500 casos de cáncer. El despliegue y uso del Registro Nacional de Cáncer a nivel nacional depende de la autoridad sanitaria. Se trata de un sistema de información que recolecta, almacena, procesa y analiza de forma continua y sistemática datos sobre todos los casos y tipos de cánceres que ocurren en el país. En este trabajo se presenta el diseño y desarrollo de la herramienta, los desafíos abordados, sus fortalezas y debilidades.
Cancer causes millions of deaths worldwide, making its registration essential. There are clinical, hospital, and population-based registries in place. The latter is the gold standard for information on cancer incidence and survival in a defined region. Chile has five population-based registries located in specific areas of the country. The Chilean National Cancer Registry emerged with the challenge of creating a tool encompassing all three types of registries to identify the number of cancer cases by type. Its design involved a series of actions to achieve consensus among various actors regarding information, validation, and events to be registered. Four stages were identified in the care and registration process: suspected diagnosis, morphological confirmation (biopsy), clinical resolution (oncology committee, including treatment recommendations), treatment, and oncological follow-up. The platform's development (from 2018 to 2021) involved gathering information and agreements on the requirements for co-designing the registry, including a successful pilot program with over 20 public and private healthcare facilities that recorded nearly 7500 cancer cases. The deployment and use of the National Cancer Registry at a national level depends on the healthcare authority. It is an information system that continuously and systematically collects, stores, processes, and analyzes data on all cancer cases and types occurring in the country. This work presents the design and development of the tool, the challenges addressed, as well as its strengths and weaknesses.
Subject(s)
Humans , Neoplasms/therapy , Neoplasms/epidemiology , Information Systems , Chile/epidemiology , Registries , IncidenceABSTRACT
OBJECTIVE@#To assess the risk of aristolochic acid (AA)-associated cancer in patients with AA nephropathy (AAN).@*METHODS@#A retrospective study was conducted on patients diagnosed with AAN at Peking University First Hospital from January 1997 to December 2014. Long-term surveillance and follow-up data were analyzed to investigate the influence of different factors on the prevalence of cancer. The primary endpoint was the incidence of liver cancer, and the secondary endpoint was the incidence of urinary cancer during 1 year after taking AA-containing medication to 2014.@*RESULTS@#A total of 337 patients diagnosed with AAN were included in this study. From the initiation of taking AA to the termination of follow-up, 39 patients were diagnosed with cancer. No cases of liver cancer were observed throughout the entire follow-up period, with urinary cancer being the predominant type (34/39, 87.17%). Logistic regression analysis showed that age, follow-up period, and diabetes were potential risk factors, however, the dosage of the drug was not significantly associated with urinary cancer.@*CONCLUSIONS@#No cases of liver cancer were observed at the end of follow-up. However, a high prevalence of urinary cancer was observed in AAN patients. Establishing a direct causality between AA and HCC is challenging.
Subject(s)
Humans , Retrospective Studies , Incidence , Carcinoma, Hepatocellular , Liver Neoplasms/epidemiology , Kidney Diseases/chemically induced , Aristolochic Acids/adverse effectsABSTRACT
Background@#Due to the increasing number of elderly patients being referred to anesthesia for surgical procedures, there is a growing interest with regard to the incidence of postoperative delirium and its contributing factors.@*Objectives@#The primary objective of this study is to determine the incidence of postoperative delirium in the charity elderly patients at the Philippine General Hospital (PGH).@*Methods@#The incidence of postoperative delirium was assessed in an analytic prospective study conducted at the PGH among elderly patients undergoing elective surgeries. Through interviews and chart reviews, the collected data focused on baseline intellectual status, age, gender, ASA classification, level of education, comorbidities, vices, previous surgeries, maintenance medications, preoperative diagnostics, duration of surgery, duration of anesthesia, type of anesthetic technique, and pain scores at the recovery room and 24 hours postoperatively. Responses to the Short Portable Mental Status Questionnaire (SPMSQ), the Preoperative and Postoperative assessment forms and the Confusion Assessment Method (CAM) instrument were analyzed.@*Results@#It was observed that there was a 2.5% incidence of postoperative delirium in the study population and among the risk factors assessed, polypharmacy and presence of moderate to severe pain scores on the first day following surgery were significant contributors in its occurrence.@*Conclusion@#In this preliminary study, the incidence of postoperative delirium as well as the significant contributing factors were described. In succeeding investigations, it is recommended to extend the observation and follow-up periods.
Subject(s)
Aged , Emergence Delirium , IncidenceABSTRACT
Objective: To analyze the epidemiological characteristics and clinical features of pertussis cases reported in Shandong Province of China. Methods: Data on pertussis cases in Shandong Province from 2007 to 2022 were collected from China Information System for Disease Control and Prevention. At the same time, some case information was collected from the database of notifiable pertussis in Shandong Province from 2007 to 2022. The distribution characteristics and clinical features of pertussis were analyzed. A spatial distribution map of pertussis cases in Shandong Province was drawn. Results: A total of 26 122 pertussis cases were reported in Shandong Province during 2007-2022, with an annual incidence rate ranging from 0.11 to 5.77 cases per 100 000 people. Cases occurred throughout the whole year, with a seasonal peak occurring in spring and summer, especially in July and August. In recent years, reported cases were mainly distributed in the central and western regions of Shandong Province, with fewer cases in the eastern region. The hot spots of the disease shifted from Heze and Dezhou City in 2007-2013 to Jinan and Tai'an city in 2014-2022. The age range of onset was from 1 day to 93 years old. The proportion of cases with age≤1 year was the largest (41.81%, 10 922/26 122), and the proportion of cases aged 0-6 months decreased from 32.21% (67/208)-55.67% (157/282) within the period of 2007 to 2013 to 16.78% (883/5 263)-41.97% (444/1 058) within the period of 2014 to 2022, with a statistically significant trend (χ² trend=670.01, P<0.001). There were 13 682 male cases and 12 440 female cases, with a male-female ratio of 1.10∶1. The male-female ratio was 1.45∶1 (806∶556) from 2007 to 2013 and 1.08∶1 (12 876∶11 884) from 2014 to 2022. The proportion of women increased from 42.31% (88/208) in 2007 to 47.84% (2 518/5 263) in 2022, and with a significant trend (χ² trend=22.25, P<0.001). In pertussis cases, the proportions of scattered children, kindergarten children and students were 71.38% (18 645/26 122), 15.13% (3 951/26 122), and 11.60% (3 031/26 122), respectively. The top five clinical symptoms of pertussis cases were paroxysmal spasmodic cough (86.33%, 21 411 cases), flushing (39.61%, 9 824 cases), restless sleep (34.51%, 8 558 cases), fever (30.80%, 7 638 cases), and crowing (27.53%, 6 829 cases). Among 24 802 cases, there were 15 542 cases (62.66%) with a history of immunization against pertussis vaccine. Conclusion: From 2007 to 2022, the incidence rate of pertussis cases in Shandong Province shows an upward trend, with the majority being young children, and the clinical symptoms are relatively typical.
Subject(s)
Child , Humans , Male , Female , Child, Preschool , Infant, Newborn , Whooping Cough/epidemiology , Incidence , China/epidemiology , Vaccination , SeasonsABSTRACT
Objective: To analyze the trend of incidence and mortality of thyroid cancer and estimate its age-period-cohort effect in Shandong Province from 2012 to 2022. Methods: The Joinpoint regression was used to analyze the trend of incidence and mortality of thyroid cancer and calculate the average annual percentage change (AAPC) based on the data on thyroid cancer from 2012 to 2022. The age-period-cohort model was used to analyze the age-effect, time-effect and cohort-effect of thyroid cancer risk in the population aged over 20 years. Results: From 2012 to 2022, the incidence of thyroid cancer in Shandong province showed a significant upward trend, with an AAPC of 21.68% (95%CI: 19.14%-24.27%, P<0.001). The incidence of females was higher than that of males, and the incidence of urban areas was higher than that of rural areas. The trend of thyroid cancer mortality was relatively stable with an AAPC of -3.04% (95%CI:-8.81%-3.09%, P=0.323). The age effect of incidence increased with age before 60 years old and decreased with age after 60 years old. The incidence peaked in the age group of 55-59. The period effect increased with time. The cohort effect showed that the cohort born before 1957 had a downward trend over time, while the cohort born after 1957 had an upward trend. Conclusion: The incidence of thyroid cancer in Shandong shows a rising trend from 2012 to 2022. Age is an important factor affecting the risk of thyroid cancer. The mortality of thyroid cancer remains stable.
Subject(s)
Male , Female , Humans , Adult , Middle Aged , Incidence , Rural Population , Risk , Urban Population , Thyroid Neoplasms/epidemiology , China/epidemiologyABSTRACT
Objective: To analyze the epidemiological characteristics and clinical features of pertussis cases reported in Shandong Province of China. Methods: Data on pertussis cases in Shandong Province from 2007 to 2022 were collected from China Information System for Disease Control and Prevention. At the same time, some case information was collected from the database of notifiable pertussis in Shandong Province from 2007 to 2022. The distribution characteristics and clinical features of pertussis were analyzed. A spatial distribution map of pertussis cases in Shandong Province was drawn. Results: A total of 26 122 pertussis cases were reported in Shandong Province during 2007-2022, with an annual incidence rate ranging from 0.11 to 5.77 cases per 100 000 people. Cases occurred throughout the whole year, with a seasonal peak occurring in spring and summer, especially in July and August. In recent years, reported cases were mainly distributed in the central and western regions of Shandong Province, with fewer cases in the eastern region. The hot spots of the disease shifted from Heze and Dezhou City in 2007-2013 to Jinan and Tai'an city in 2014-2022. The age range of onset was from 1 day to 93 years old. The proportion of cases with age≤1 year was the largest (41.81%, 10 922/26 122), and the proportion of cases aged 0-6 months decreased from 32.21% (67/208)-55.67% (157/282) within the period of 2007 to 2013 to 16.78% (883/5 263)-41.97% (444/1 058) within the period of 2014 to 2022, with a statistically significant trend (χ² trend=670.01, P<0.001). There were 13 682 male cases and 12 440 female cases, with a male-female ratio of 1.10∶1. The male-female ratio was 1.45∶1 (806∶556) from 2007 to 2013 and 1.08∶1 (12 876∶11 884) from 2014 to 2022. The proportion of women increased from 42.31% (88/208) in 2007 to 47.84% (2 518/5 263) in 2022, and with a significant trend (χ² trend=22.25, P<0.001). In pertussis cases, the proportions of scattered children, kindergarten children and students were 71.38% (18 645/26 122), 15.13% (3 951/26 122), and 11.60% (3 031/26 122), respectively. The top five clinical symptoms of pertussis cases were paroxysmal spasmodic cough (86.33%, 21 411 cases), flushing (39.61%, 9 824 cases), restless sleep (34.51%, 8 558 cases), fever (30.80%, 7 638 cases), and crowing (27.53%, 6 829 cases). Among 24 802 cases, there were 15 542 cases (62.66%) with a history of immunization against pertussis vaccine. Conclusion: From 2007 to 2022, the incidence rate of pertussis cases in Shandong Province shows an upward trend, with the majority being young children, and the clinical symptoms are relatively typical.
Subject(s)
Child , Humans , Male , Female , Child, Preschool , Infant, Newborn , Whooping Cough/epidemiology , Incidence , China/epidemiology , Vaccination , SeasonsABSTRACT
Objective: To analyze the trend of incidence and mortality of thyroid cancer and estimate its age-period-cohort effect in Shandong Province from 2012 to 2022. Methods: The Joinpoint regression was used to analyze the trend of incidence and mortality of thyroid cancer and calculate the average annual percentage change (AAPC) based on the data on thyroid cancer from 2012 to 2022. The age-period-cohort model was used to analyze the age-effect, time-effect and cohort-effect of thyroid cancer risk in the population aged over 20 years. Results: From 2012 to 2022, the incidence of thyroid cancer in Shandong province showed a significant upward trend, with an AAPC of 21.68% (95%CI: 19.14%-24.27%, P<0.001). The incidence of females was higher than that of males, and the incidence of urban areas was higher than that of rural areas. The trend of thyroid cancer mortality was relatively stable with an AAPC of -3.04% (95%CI:-8.81%-3.09%, P=0.323). The age effect of incidence increased with age before 60 years old and decreased with age after 60 years old. The incidence peaked in the age group of 55-59. The period effect increased with time. The cohort effect showed that the cohort born before 1957 had a downward trend over time, while the cohort born after 1957 had an upward trend. Conclusion: The incidence of thyroid cancer in Shandong shows a rising trend from 2012 to 2022. Age is an important factor affecting the risk of thyroid cancer. The mortality of thyroid cancer remains stable.