Detection of gestational and congenital syphilis in Paraná state, Brazil, 2007-2021: a time series analysis / Detección de sífilis gestacional y congénita en Paraná, Brasil, 2007-2021: análisis de series temporales / Detecção de sífilis gestacional e congênita no Paraná, 2007-2021: análise de séries temporais

Abstract Objective: To describe temporal trends in the detection rates of gestational and congenital syphilis, by maternal age and health macro-region of the state of Paraná, Brazil, 2007-2021. Methods: This was a time-series study using surveillance data; the trend analysis was performed by means of joinpoint regression, and average annual percent change (AAPC) and 95% confidence intervals (95%CI) were estimated. Results: An increase in statewide detection of gestational syphilis (AAPC = 21.7; 95%CI 17.7; 32.8) and congenital syphilis (AAPC = 14.8; 95%CI 13.0; 19.7) was found; an increase was also found in the health macro-regions, with the Northwest (gestational, AAPC = 26.1; 95%CI 23.4; 31.6) and North (congenital, AAPC = 23.8; 95%CI 18.8; 48.9) macro-regions standing out; statewide rising trends were observed for young women [gestational, AAPC = 26.2 (95%CI 22.4; 40.6); congenital, AAPC = 19.4 (95%CI 17.6; 21.8)] and adult women [gestational, AAPC = 21.3 (95%CI 16.9; 31.9); congenital, AAPC = 13.7 (95%CI 11.9; 19.3)]. Conclusion: Maternal and child syphilis detection rates increased in the state, regardless of maternal age and health macro-region.

Resumen Objetivo: Describir las tendencias temporales en las tasas de detección de sífilis gestacional y congénita, por grupo de edad materna y macrorregión de salud de Paraná, 2007-2021. Métodos: Estudio de series temporales utilizando datos de vigilancia; se realizó análisis de tendencia mediante regresión segmentada, estimando cambios porcentuales anuales promedio (CPAP) e intervalos de confianza del 95% (IC95%). Resultados: Se identificaron aumentos en la detección estatal de sífilis gestacional (CPAP = 21,7; IC95% 17,7;32,8) y congénita (CPAP = 14,8; IC95% 13,0;19,7); las macrorregiones mostraron incrementos, destacándose la Noroeste (gestacional, CPAP = 26,1; IC95% 23,4;31,6) y la Norte (congénita, CPAP = 23,8; IC95% 18,8;48,9); las tendencias estatales fueron crecientes para mujeres jóvenes [gestacional, CPAP = 26,2 (IC95% 22,4;40,6); congénita, CPAP = 19,4 (IC95% 17,6;21,8)] y adultas [gestacional, CPAP = 21,3 (IC95% 16,9;31,9); congénita, CPAP = 13,7 (IC95% 11,9;19,3)]. Conclusión: Las tasas de detección de sífilis materno-infantil estuvieron en aumento en el estado, independientemente de la edad materna y la macrorregión de salud.

Resumo Objetivo: Descrever as tendências temporais nas taxas de detecção de sífilis gestacional e congênita, por faixa etária materna e macrorregião de saúde do Paraná, Brasil, 2007-2021. Métodos: Estudo de séries temporais, utilizando-se dados de vigilância; realizou-se análise de tendência por regressão segmentada, sendo estimadas variações percentuais anuais médias (VPAM) e intervalos de confiança de 95% (IC95%). Resultados: Foram identificados acréscimos na detecção estadual de sífilis gestacional (VPAM = 21,7; IC95% 17,7;32,8) e congênita (VPAM = 14,8; IC95% 13,0;19,7); as macrorregiões de saúde registraram incrementos, destacando-se as macrorregiões Noroeste (gestacional, VPAM = 26,1; IC95% 23,4;31,6) e Norte (congênita, VPAM = 23,8; IC95% 18,8;48,9); as tendências estaduais foram crescentes para mulheres jovens [gestacional, VPAM = 26,2 (IC95% 22,4;40,6); congênita, VPAM = 19,4 (IC95% 17,6;21,8)] e mulheres adultas [gestacional, VPAM = 21,3 (IC95% 16,9;31,9); congênita, VPAM = 13,7 (IC95% 11,9;19,3)]. Conclusão: As taxas de detecção de sífilis materno-infantil foram ascendentes no estado, independentemente da idade materna e da macrorregião de saúde.

Caracterización clínica-epidemiológica de COVID-19

Las epidemias y las pandemias son eventos de ocurrencia natural. La aparición de una nueva enfermedad infecciosa supone siempre una situación compleja, sobre todo si lo hace como una epidemia de extensión o gravedad significativa, con el objetivo de describir las características clínico-epidemiológicas en pacientes confirmados con COVID-19. Se realizó un estudio descriptivo y retrospectivo sobre las características clínico-epidemiológicas de los 161 pacientes diagnosticados con esta enfermedad, en el municipio Yara, de la provincia Granma durante el período comprendido de junio de 2020-2021. Se estudiaron las variables: edad, sexo, lugar de infección, presencia o no de síntomas y signos, antecedentes patológicos personales, área de salud y consejo popular. El 60,8% de los afectados fueron del sexo femenino con 98 pacientes y el grupo de 30-44 años de edad quedó representado por 50 pacientes (31.0%); en 150 casos, la transmisión fue mayormente autóctona (93,1%) y asintomática en 86 casos para el 53,4%. De los pacientes sintomáticos fueron las manifestaciones respiratorias, los principales síntomas con 70 casos para el 93,3%, 63 pacientes tenían antecedentes personales de hipertensión arterial (39,1%). El área de salud que más casos notificó fue "Luis Enrique de la Paz" con 106 pacientes para el 65,8% y Yara el consejo popular más afectado con 72 casos (44,7%), la mayoría de los pacientes fueron del sexo femenino, predominó la transmisión autóctona y la presentación asintomática. La epidemia en el municipio Yara se comportó similar al resto del país.

Epidemics and pandemics are naturally occurring events. The emergence of a new infectious disease is always a complex situation, especially when it occurs as an epidemic of significant spread or severity. The aim of this study was to describe the clinical-epidemiologic characteristics of patients confirmed with COVID-19. A descriptive and retrospective study was carried out on the clinical-epidemiological characteristics of 161 patients diagnosed with this disease, in the municipality of Yara, province of Granma. The following variables were studied: age, sex, site of infection, presence or not of symptoms and signs, personal pathological antecedents, health area and locality. Out of the total, 98 patients were female (60.8%), and the age group 30-44 years was represented by 50 patients (31.0%). Transmission was generally autochthonous in 150 cases (93.1%), and asymptomatic in 86 cases (53.4%). Among the symptomatic patients, respiratory manifestations were the main symptom in 70 cases (93.3%). Also, 63 patients had a personal medical history of hypertension (39.1%). Luis Enrique de la Paz was the health area that reported the most cases with 106 patients (65.8%), and Yara was the most affected locality with 72 cases (44.7%). The majority of patients were female; and autochthonous transmission and asymptomatic presentation predominated. The epidemic in Yara municipality behaved alike in the whole country.

Epidemias e pandemias são eventos naturais. O surgimento de uma nova doença infecciosa é sempre uma situação complexa, especialmente se for uma epidemia de extensão ou gravidade significativa, com o objetivo de descrever as características clínico-epidemiológicas em pacientes confirmados com COVID-19. Foi realizado um estudo descritivo e retrospectivo sobre as características clínico-epidemiológicas dos 161 pacientes diagnosticados com essa doença, no município de Yara, província de Granma, no período de junho de 2020 a 2021, as variáveis foram estudadas: idade, sexo, local de infecção, presença ou não de sintomas e sinais, história patológica pessoal, área de saúde e conselho popular. O 60,8% dos acometidos eram do sexo feminino com 98 pacientes e a faixa etária de 30 a 44 anos foi representada por 50 pacientes (31,0%); Em 150 casos, a transmissão foi predominantemente autóctone (93,1%) e assintomática em 86 casos para 53,4%, entre os sintomáticos foram manifestações respiratórias, sendo os principais sintomas 70 casos para 93,3%, 63 pacientes tinham história pessoal de hipertensão arterial (39,1%). A área de saúde que mais registrou casos foi "Luis Enrique de la Paz" com 106 pacientes para 65,8% e Yara o município popular mais afetado com 72 casos (44,7%), a maioria dos pacientes era do sexo feminino, de transmissão autóctone e apresentação assintomática. A epidemia no município de Yara se comportou de forma semelhante ao resto do país.

Morphometry of the wings of Anopheles aquasalis in simulated scenarios of climate change

ABSTRACT Background: Climate change has significant implications on ecosystems. We verified the effects of climate change on the malaria vector Anopheles aquasalis using simulated climate change scenarios (SSCCs). Methods: An experimental model was designed for SSCCs, which composed of air-conditioned 25 m3 rooms. Results: The wing size was significantly different between SSCCs. A colony of Anopheles aquasalis could not be established in extreme scenarios. Conclusions: Increases in temperature and CO2 in the atmosphere may modify the global epidemiology of malaria, marking its emergence in currently malaria-free areas.

The influence of growth time on the identification of Bartonella henselae strains by MALDI-TOF mass spectrometry

ABSTRACT Bartonella spp. are bacteria responsible for neglected diseases worldwide. Bartonella henselae is the species most associated with human infections. It is associated with a large spectrum of clinical manifestations and is potentially fatal. The identification of Bartonella spp. is considered a challenge in clinical routine. These bacteria are fastidious, and the time required to isolate them varies from one to six weeks. MALDI-TOF mass spectrometry has emerged as an application for research on Bartonella spp. , and has still been little explored. We investigated whether three different B. henselae strains with different growth times—14 and 28 days—could be correctly identified by MALDI-TOF mass spectra fingerprint comparison and matching. We found that the spectra from strains with different growth times do not match each other, leading to misidentification. We suggest creating database entries with multiple spectra from strains with different growth times to increase the chances of accurate identification of Bartonella spp. by MALD-TOF MS.

Transmissão vertical do HIV na rede de saúde: reflexões bioéticas sobre gênero e cuidado a partir de um caso emblemático / Vertical transmission of HIV in the health network: bioethics reflections on gender and care based on an emblematic case

Resumo Num cenário epidêmico ainda preocupante, a prevenção da Transmissão Vertical (TV) do HIV impõe problemas complexos, devido as vulnerabilidades individual, social e moral das mulheres vivendo com o vírus, somadas às fragilidades da rede de saúde. A partir de um caso emblemático, este estudo buscou compreender os desafios bioéticos do cuidado para a prevenção da TV do HIV no âmbito do Comitê de Porto Alegre/RS. Os eixos analíticos desenvolvidos refletem sobre como a produção do cuidado se articula, por um lado, com discursos e práticas relacionais pautadas no gênero e interseccionadas por raça e classe social e, por outro, com vulnerabilidades programáticas das políticas de saúde. Vislumbrou-se um processo de extrema estigmatização, em que as poucas ofertas para as mulheres cisgênero se dirigiam à regulação reprodutiva e perpetuavam dinâmicas de violência estrutural. Discute-se caminhos para a construção de um cuidado que incorpore a perspectiva decolonial e busque produzir equidade e justiça social ao reconhecer as trajetórias das mulheres.

Abstract In a still worrying epidemic scenario, the prevention of Vertical Transmission (VT) of HIV poses complex problems, due to the individual, social, and moral vulnerabilities of women living with the virus, in addition to the weaknesses of the health network. Based on an emblematic case, this study sought to understand the bioethical challenges of HIV VT prevention in the scope of the Porto Alegre/RS Committee. The analytical categories developed reflect on how the production of care is articulated, on the one hand, with relational discourses and practices based on gender and intersected by race and social class and, on the other, with programmatic vulnerabilities of health policies. A process of extreme stigmatization was revealed, in which the few offers for cisgender women were aimed toward reproductive regulation and perpetuated dynamics of structural violence. We discuss ways of building care that incorporates a decolonial perspective and seeks to produce equity and social justice by recognizing women's trajectories.

Prevalencia de enfermedades infecciosas y parasitarias en el servicio de pacientes con necesidades especiales de la Facultad de Estomatología de la Universidad Peruana Cayetano Heredia / Prevalence of infectious and parasitic diseases in the service of patients with special needs of the Faculty of Stomatology of the Universidad Peruana Cayetano Heredia / Prevalência de doenças infecciosas e parasitárias no serviço de pacientes com necessidades especiais da Faculdade de Estomatologia da Universidad Peruana Cayetano Heredia

RESUMEN Objetivo: Determinar la prevalencia de diagnósticos médicos de las enfermedades infecciosas y/o parasitarias de pacientes que acudieron al servicio de Estomatología en Pacientes Especiales (EPE) de la Universidad Peruana Cayetano Heredia. Material y métodos: La población (n = 38) estuvo conformada por el número de diagnósticos médicos de pacientes con enfermedades infecciosas y/o parasitarias que acudieron al servicio de EPE durante los años 2015 y 2016. La información se trasladó a una base de datos en el programa Excel 2017, para posteriormente ser procesada y analizada de acuerdo con lo requerido por el programa Stata 12. Resultados: De un total de 1718 diagnósticos médicos, las enfermedades infecciosas y/o parasitarias tuvieron una prevalencia de 2,21 % (n = 38). Dentro de este grupo de enfermedades, el virus de inmunodeficiencia humana (VIH) fue el más prevalente con 63,2 % (n = 24), siendo el sexo masculino el más prevalente con 79 % (n = 19); y dentro del grupo etario de 21 a 40 años de edad, el segundo diagnóstico específico más prevalente fue la hepatitis A con un 15,8 % (n = 6), en donde el sexo femenino fue el más prevalente con 83 % (n = 5). Conclusiones: El diagnóstico específico, dentro del grupo de las enfermedades infecciosas y/o parasitarias, con mayor prevalencia fue el VIH con un 63,2 % (n = 24).

ABSTRACT Objective: To determine the prevalence of medical diagnoses of infectious and/or parasitic diseases in patients who attended the Special Patients Stomatology Service (EPE) of the Cayetano Heredia Peruvian University. Material and methods: The population (n = 38) comprised the number of medical diagnoses of patients with infectious and/or parasitic diseases who attended the EPE service during 2015 and 2016. The information was transferred to a database in the Excel 2017 program to be processed and analyzed as required by the Stata 12 program. Results: Of 1718 medical diagnoses, infectious and/or parasitic diseases had a prevalence of 2.21% (n = 38). Within this group of diseases, human immunodeficiency virus (HIV) was the most prevalent, with 63.2 % (n = 24), with the male sex being the most prevalent with 79 % (n = 19). Within the age group of 21 to 40 years of age, the second most prevalent specific diagnosis was hepatitis A with 15.8 % (n = 6), whereas the female sex was the most prevalent with 83 % (n = 5). Conclusions: The specific diagnosis within the group of infectious and/or parasitic diseases with the highest prevalence was HIV, with 63.2% (n = 24).

RESUMO Objetivo: Determinar a prevalência de diagnósticos médicos de doenças infecciosas e/ou parasitárias em pacientes que frequentaram o Serviço de Estomatologia para Pacientes Especiais (EPE) da Universidad Peruana Cayetano Heredia. Material e métodos: A população (n = 38) consistiu no número de diagnósticos médicos de pacientes com doenças infecciosas e/ou parasitárias que frequentaram o serviço EPE durante 2015 e 2016. A informação foi transferida para uma base de dados em Excel 2017, para posteriormente ser processada e analisada conforme requerido pelo programa Stata 12. Resultados: De um total de 1718 diagnósticos médicos, as doenças infeciosas e/ou parasitárias tiveram uma prevalência de 2,21 % (n = 38). Dentro deste grupo de doenças, o vírus da imunodeficiência humana (VIH) foi o mais prevalente com 63,2 % (n = 24), sendo o sexo masculino o mais prevalente com 79 % (n = 19); e dentro do grupo etário dos 21-40 anos, o segundo diagnóstico específico mais prevalente foi a hepatite A com 15,8 % (n = 6), sendo o sexo feminino o mais prevalente com 83 % (n = 5). Conclusões: O diagnóstico específico mais prevalente no grupo das doenças infecciosas e/ou parasitárias foi o VIH com 63,2 % (n = 24).

Infectious human diseases: Regions, habitats, threats, and mitigation strategies: The issues—Part II

Globally, vaccines against 47 infectious etiologic agents are approved by at least one regulatory authority as of December 2022. The numbers of viral diseases, infections caused by mycoplasma, bacterial and protozoal diseases, mycoses, diseases caused by parasitic worms, and other infectious diseases of unknown etiology run into thousands. Therefore, more vaccines are required to be developed to keep more populations disease free. Climate change and global increase in temperature may promote sea level rises and an increase in the intensity of rains, causing an upsurge in certain infectious diseases in regions of the human population and even causing movement of habitats. In societies where the expenditure on health as a percentage of gross domestic product is higher, people are more capacitated to tackle the treatment and spread of infectious diseases. As several of such conditions are zoonotic, well-planned strategies for controlling the spread would go a long way in the proper direction. Poverty and contagious diseases are infallibly linked. Major infectious diseases of poverty include tuberculosis, human immunodeficiency virus (HIV)/ acquired immuno deficiency syndrome (AIDS), malaria, measles, pneumonia, diarrheal diseases, and several neglected tropical diseases. The world is not yet unified in action to jointly work to contain the global problem of infectious diseases in every human habitat. There was a visible divide between and among the rich countries versus the developing countries regarding accessibility and deployment of vaccines against COVID-19 flu. To contain the spread of infectious diseases in the future, the whole world would have to work together, raising funds, strengthening epidemiological surveys, inventing effective vaccines, and vaccinating the eligible population, as also treating the infected with therapy in time, besides resorting to other preventive measures for overall human progress. The developmental efforts are to be pursued jointly and together to benefit all people, respecting the world as one.

Aborto infectocontagioso em éguas: uma revisão bibliográfica / Infectious-contagious abortion in mares: a literature review / Aborto infecto-contagioso en yeguas: una revisión de la literatura

O aborto infectocontagioso em éguas é um tema de grande relevância e interesse para os médicos veterinários e criadores de equinos. Além dos impactos econômicos decorrentes de perdas e redução das taxas reprodutivas, os surtos de abortos causados por doenças infectocontagiosas representam uma ameaça significativa para a saúde equina. Neste trabalho, realizamos uma revisão bibliográfica abrangente sobre as principais doenças que causam abortos infecciosos em éguas. Nosso objetivo é fornecer uma visão geral das patologias mais relevantes nesse contexto, abordando suas características clínicas, epidemiologia, diagnóstico e medidas de controle. Para isso, realizamos uma busca em bancos de dados renomados, como o PubMed e o Scopus, por artigos científicos relevantes publicados nos últimos dez anos. As informações selecionadas foram cuidadosamente analisadas, comparadas e sintetizadas, com o intuito de identificar as principais doenças e suas implicações na saúde reprodutiva das éguas. Esta revisão pretende auxiliar veterinários, pesquisadores e profissionais da área a compreenderem melhor essas doenças e desenvolverem estratégias eficazes de prevenção e controle.(AU)

El aborto infeccioso en yeguas es un tema de gran relevancia e interés para veterinarios y criadores de equinos. Además de las repercusiones económicas derivadas de las pérdidas y la reducción de las tasas reproductivas, los brotes de aborto causados por enfermedades infecciosas representan una importante amenaza para la salud equina. En este artículo, realizamos una revisión exhaustiva de la literatura sobre las principales enfermedades que causan abortos infecciosos en yeguas. Nuestro objetivo es ofrecer una visión general de las patologías más relevantes en este contexto, abordando sus características clínicas, epidemiología, diagnóstico y medidas de control. Para ello, buscamos en bases de datos de renombre como PubMed y Scopus artículos científicos relevantes publicados en los últimos diez años. La información seleccionada fue cuidadosamente analizada, comparada y sintetizada con el fin de identificar las principales enfermedades y sus implicaciones en la salud reproductiva de las yeguas. El objetivo de esta revisión es ayudar a veterinarios, investigadores y profesionales del sector a comprender mejor estas enfermedades y desarrollar estrategias eficaces de prevención y control.(AU)

Infectious abortion in mares is a topic of great relevance and interest for veterinarians and equine breeders. In addition to economic impacts from losses and reduced reproductive rates, abortion outbreaks caused by infectious diseases represent a significant threat to equine health. In this paper, we conduct a comprehensive literature review on the major diseases that cause infectious abortions in mares. Our goal is to provide an overview of the most relevant pathologies in this context, addressing their clinical features, epidemiology, diagnosis, and control measures. To this end, we searched renowned databases such as PubMed and Scopus for relevant scientific articles published in the last ten years. The selected information was carefully analyzed, compared and synthesized in order to identify the main diseases and their implications in the reproductive health of mares. This review aims to assist veterinarians, researchers, and professionals in the field to better understand these diseases and develop effective prevention and control strategies.(AU)

In vitro antiparasitic and antibacterial evaluation of organic extracts of Salvadoran flora / Evaluación antiparasitaria y antibacterial in vitro de extractos orgánicos de la flora salvadoreña

Currently, in developing countries, parasitic and bacterial diseases as amebiasis, giardiasis, trichonomiasis, leishmaniasis, trypanosomiasis, tuberculosis, and nocardiasis are a public health problem. The pharmacological treatment for these diseases is not completely effective and causes several side effects in patients. Therefore, the search for new compounds with biological activity is very important to develop new drugs safely and more efficiently. In this study, different organic extracts obtained from thirty-seven species of the Salvadoran flora were evaluated in several in vitro models to determine their potential activity against five protozoa (Entamoeba histolytica, Giardia lamblia, Trichomonas vaginalis, Leishmania mexicana, and Trypanosoma cruzi) and three bacteria (Acinetobacter baumanni, Mycobacterium tuberculosis, and Nocardia brasiliensis). The results showed the activity of eight extracts with IC50values of less than 100 µg/mL against L. mexicanaand five extracts with MICs values less than <50 µg/mL against M. tuberculosis. Besides, seven plant species showed MICs ≤3.125 µg/mL against N. brasiliensis. Additionally, secondary metabolites (flavonoids and monoterpene oxygenate) previously reported as active were fingerprint by UPLC-MS to establish a potential correlation with the biological activity showed.

Actualmente, en los países en vías de desarrollo, enfermedades parasitarias y bacterianas como la amebiasis, giardiasis, trichonomiasis, leishmaniasis, tripanosomiasis, tuberculosis y nocardiasis son un problema de salud pública. El tratamiento farmacológico de estas enfermedades no es del todo eficaz y provoca varios efectos secundarios en los pacientes. Por lo tanto, la búsqueda de nuevos compuestos con actividad biológica es muy importante para desarrollar nuevos fármacos, seguros y eficaces. En este estudio se evaluaron diferentes extractos orgánicos obtenidos de treinta y siete especies de la flora salvadoreña en varios modelos in vitro para determinar su actividad potencial contra cinco parásitos (Entamoeba histolytica, Giardia lamblia, Trichomonas vaginalis, Leishmania mexicana y Trypanosoma cruzi) y tres bacterias (Acinetobacter baumanni, Mycobacterium tuberculosis y Nocardia brasiliensis). Los resultados mostraron la actividad de ocho extractos con valores de CI50 menores a 100 µg/mL contra L. mexicana y cinco extractos con valores de CIMs <50 µg/mL contra M. tuberculosis. Además, siete especies de plantas presentaron CIM ≤3,125 µg/mL frente a N. brasilienses. Finalmente, los metabolitos secundarios (flavonoides y monoterpenos oxigenados) previamente reportados como activos fueron determinados por UPLC-MS para establecer una posible correlación con la actividad biológica mostrada.

Construction and validation of an algorithm for disinfection of ambulances transporting patients with contagious infectious diseases / Construcción y validación de algoritmo para desinfección de ambulancia para transporte de pacientes con enfermedades transmisibles / Construção e validação de algoritmo para desinfecção de ambulância para transporte de pacientes com doenças infectocontagiosas

ABSTRACT Objectives: to develop and validate an algorithm to guide professionals in cleaning and disinfecting ambulances after transferring patients with contagious infectious diseases. Methods: the study was conducted between September and November 2021. The developed algorithm was validated by 104 judges, including nurses, physical therapists, and physicians who care for patients with contagious infectious diseases. It used the Delphi technique and content validity index. Results: in the first evaluation, the judges considered the algorithm "unsuitable" and "fully suitable". The algorithm reviewed according to the judges' suggestions was rated between "suitable" and "fully suitable" in the second evaluation. The overall content validity index was 0.960 and 0.998 in the first and second evaluations. Conclusions: the algorithm to guide the cleaning and disinfection of ambulances after transferring patients with contagious infectious diseases was developed and validated by specialists in the field, with consensus among the judges in the second evaluation.

RESUMEN Objetivos: desarrollar y validar algoritmo para orientar profesionales en la limpieza y desinfección de ambulancia tras transferencia de paciente con enfermedades transmisibles. Métodos: estudio realizado entre septiembre y noviembre de 2021. El algoritmo desarrollado fue validado por 104 jueces, incluyendo enfermeros, fisioterapeutas y médicos que asisten a pacientes con enfermedades transmisibles. Utilizada técnica Delphi e índice de validez de contenido. Resultados: en la primera evaluación, los jueces consideraron el algoritmo entre "inadecuado" y "totalmente adecuado". El algoritmo revisado conforme sugestiones de los jueces fue clasificado entre "adecuado" y "totalmente adecuado" en la segunda evaluación. El índice de validez de contenido general fue de 0,960 y 0,998 en la primera y segunda evaluación, respectivamente. Conclusiones: el algoritmo para orientar en la limpieza y desinfección de ambulancia tras transferencia de paciente con enfermedades transmisibles fue construido y validado por especialistas en el área, habiendo consenso entre los jueces en la segunda evaluación.

RESUMO Objetivos: desenvolver e validar um algoritmo para orientar profissionais na limpeza e desinfecção de ambulância após transferência de paciente com doenças infectocontagiosas. Métodos: estudo realizado entre setembro e novembro de 2021. O algoritmo desenvolvido foi validado por 104 juízes, incluindo enfermeiros, fisioterapeutas e médicos que prestam assistência aos pacientes com doenças infectocontagiosas. Utilizaram-se a técnica Delphi e o índice de validade de conteúdo. Resultados: na primeira avaliação, o algoritmo foi considerado pelos juízes entre "inadequado" e "totalmente adequado". O algoritmo revisado segundo as sugestões dos juízes foi classificado entre "adequado" e "totalmente adequado" na segunda avaliação. O índice de validade de conteúdo geral foi de 0,960 e 0,998 na primeira e segunda avaliação, respectivamente. Conclusões: o algoritmo para orientar na limpeza e desinfecção de ambulância após transferência de paciente com doenças infectocontagiosas foi construído e validado por especialistas na área, havendo consenso entre os juízes na segunda avaliação.

Changes in access to water and incidence of waterborne diseases after the Vale dam collapse in Brumadinho (MG), Brazil / Alterações no acesso à água e na incidência de doenças de veiculação hídrica após o rompimento da barragem da Vale em Brumadinho (MG)

ABSTRACT Objective: To describe, within the Human Rights to Water and Sanitation (HRWS) framework, the access to water supply services and the incidence of waterborne diseases in the communities affected by the dam disaster in Brumadinho (MG), Brazil. Methods: A quantitative and qualitative methodology was used, having as variables information on access to water supply services and waterborne diseases. The primary data were extracted from the "Brumadinho Health Project", using a sample stratum with 981 people interviewed, totaling 92.5% of the eligible population in the affected communities of Córrego do Feijão and Parque da Cachoeira. The secondary data from Brumadinho was extracted from the project "Sanitation conditions and the River Basin of the B1 River Basin of Mineradora Vale between 2017 and 2020", available in public databases between 2017 and 2020, and qualitative data was collected in 2022 through individual interviews with health professional also live in the communities. Results: With regard to access to water supply services, the results of this combined data analysis indicate that the HRWS is being neglected, especially with regard to availability, accessibility, acceptability and quality of water. The study also shows a significant increase in the incidence of waterborne diseases in the region after the disaster. Conclusion: It is necessary to use the HRWS as the basis to the implementation of public policies aiming to reduce vulnerability in access to water supply services.

RESUMO Objetivo: Descrever, na ótica dos direitos humanos à água e ao esgotamento sanitário (DHAES), o acesso à água e a incidência de doenças de veiculação hídrica na região atingida pelo rompimento da barragem da Mina B1 em Brumadinho (MG). Métodos: Utilizou-se a metodologia quantitativa e qualitativa, tendo como variáveis, em ambos os métodos, informações sobre o acesso à água e as doenças de veiculação hídrica. Os dados primários foram extraídos do Projeto de Saúde Brumadinho, sendo aqui utilizado um estrato amostral com 981 pessoas entrevistadas, totalizando 92,5% da população elegível das comunidades atingidas de Córrego do Feijão e Parque da Cachoeira. Os dados secundários de Brumadinho foram coletados pelo Projeto Condições de Saneamento e Saúde da População da Bacia do Rio Paraopeba, a Jusante da Barragem B1 da Mineradora Vale, entre 2017 e 2020, em banco de dados públicos entre 2017 e 2020, e os dados qualitativos foram coletados em 2022 por meio de entrevistas individuais com profissionais de saúde residentes nas comunidades atingidas. Resultados: No tocante ao acesso à água, a análise combinada dos dados apontou que os DHAES estão sendo negligenciados na região, de maneira especial no que se refere à disponibilidade, acessibilidade física, aceitabilidade e qualidade da água. Observou-se também que houve aumento significativo na incidência das doenças de veiculação hídrica na região após o desastre. Conclusão: É necessária utilização dos DHAES como marco referencial na implementação de políticas públicas voltadas para reduzir as situações de vulnerabilidade relacionadas ao acesso à água.

Vertical transmission of HIV to neonates in a reference hospital in Northeastern Brazil from 2013 to 2017

ABSTRACT The aim of this study was to estimate the rate of Mother-to-child Transmission (MTCT) of HIV to neonates in a reference university hospital in Sao Luis city, the capital of Maranhao State (MA), evaluating MTCT-associated factors. A retrospective cohort study based on data from the Notifiable Diseases Data System (SINAN) was carried out and included all HIV-exposed neonates notified from 2013 to 2017 by the university hospital. The study population comprised 725 HIV-exposed neonates, of whom 672 neonates were exposed and uninfected, and 53 were exposed and infected. The estimated rate of MTCT in the period of 2013 to 2017 was 7.3%. Most pregnant women were ≥ 20 years old (86.9%), reported ≥ 8 years of schooling (53.2%), reported full-time or independent paid work (46.9%) and were residents in other cities of the state (61.7%). Regarding healthcare, 86.3% received prenatal care, 74.6% received Antiretroviral Therapy (ART) as prophylaxis during pregnancy, 81.8% received ART prophylaxis during childbirth and 78.1% underwent cesarean section. Among the neonates, 92.8% received ART prophylaxis and 94.3% were not breastfed. Despite these variables, the 7.3% MTCT rate found in this study makes it clear that the interventions recommended by the Ministry of Health were not fully adopted.

Profile of pregnant women and children accompanied due to T. gondii exposure at a referred healthcare center: What has changed in 10 years? / Perfil de gestantes e crianças acompanhadas por exposição ao Toxoplasma gondii num centro de referência: O que mudou 10 anos depois?

Abstract Objectives: to characterize the profile of pregnant women and newborns accompanied at a reference center for infectious-parasitic diseases, after the exposure of T. gondii, establishing comparisons with a previous study, in the same location, ten years ago. Methods: this is a retrospective cohort study, with a follow-up of four years (2016 to 2019), using the previous study carried out from 2002 to 2010 as a comparative for the variables assessed. Mothers who presented tests suggestive of seroconversion for the disease during prenatal care and their respective concepts, followed up over a year, were included. The chi-square test was used, assuming a significance level of 5% for the comparison of the groups in the two periods. Results: during the period from 2016 to 2019, 79 binomials were studied, whereas 58 binomials were accompanied in the previous period. Comparing both periods, the findings showed lower proportions of adolescents (p<0.001), with low schooling (p<0.001), with low serological testing (p<0.001) and with late or postnatal diagnosis (p<0.001). As to the children, the findings showed fewer changes in fundoscopy (p<0.001), strabismus (p=0.002), hepatomegaly (p=0.026) and any sequelae (p<0.001). Conclusion: a positive advance was observed regarding the care provided for the mother-child binomial affected by T. gondii, with a reduction in negative outcomes for the child. However, there are still challenges concerning the diagnosis and proper management of the disease.

Resumo Objetivos: caracterizar o perfil de gestantes e neonatos acompanhadas em um centro de referência em doenças infecto-parasitárias, após exposição ao Toxoplasma gondii, estabelecendo comparações em relação a estudo prévio, no mesmo local, há dez anos. Métodos: trata-se de estudo de coorte retrospectivo, com seguimento de quatro anos (2016 a 2019), servindo o estudo prévio realizado de 2002 a 2010 como comparativo para as variáveis estudadas. Foram incluídas mães que apresentaram durante o pré-natal exames sugestivos soroconversão para a doença e seus respectivos conceptos, acompanhados ao longo de um ano. Utilizou-se o teste qui-quadrado, assumindo-se nível de significância de 5% para a comparação dos grupos nos dois períodos. Resultados: durante o período de 2016 a 2019, foram estudados 79 binômios, enquanto no período anterior foram acompanhados 58 binômios. Comparando-se os dois períodos, em relação às mães, registraram-se menores proporções de adolescentes (p<0,001), de baixa escolaridade (p<0,001), baixa realização de testes sorológicos (p<0,001) e com diagnóstico tardio ou pós-natal (p<0,001). Em relação às crianças, verificaram-se menores proporções de alterações de fundoscopia (p<0,001), estrabismo (p=0,002), hepatomegalia (p=0,026) e qualquer sequela (p<0,001). Conclusão: observou-se um avanço em relação aos cuidados para o binômio mãe-filho acometido pelo T. gondii, com redução de desfechos negativos sobre a criança. Todavia, ainda existem desafios para o diagnóstico e adequado manejo da doença.

The COVID-19 pandemic in sub-Saharan Africa: The significance of presumed immune sufficiency

A novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in China in 2019 and later ignited a global pandemic. Contrary to expectations, the effect of the pandemic was not as devastating to Africa and its young population compared to the rest of the world. To provide insight into the possible reasons for the presumed immune sufficiency to coronavirus disease 2019 (COVID-19) in Africa, this review critically examines literature published from 2020 onwards on the dynamics of COVID-19 infection and immunity and how other prevalent infectious diseases in Africa might have influenced the outcome of COVID-19. Studies characterising the immune response in patients with COVID-19 show that the correlates of protection in infected individuals are T-cell responses against the SARSCoV-2 spike protein and neutralising titres of immunoglobin G and immunoglobin A antibodies. In some other studies, substantial pre-existing T-cell reactivity to SARS-CoV-2 was detected in many people from diverse geographical locations without a history of exposure. Certain studies also suggest that innate immune memory, which offers protection against reinfection with the same or another pathogen, might influence the severity of COVID-19. In addition, an initial analysis of epidemiological data showed that COVID-19 cases were not severe in some countries that implemented universal Bacillus Calmette­Guerin (BCG) vaccination policies, thus supporting the potential of BCG vaccination to boost innate immunity. The high burden of infectious diseases and the extensive vaccination campaigns previously conducted in Africa could have induced specific and non-specific protective immunity to infectious pathogens in Africans.

Factors associated with COVID-19 fatality among patients admitted in Mashonaland West Province, Zimbabwe 2020-2022: a secondary data analysis

Introduction: approximately 15% of COVID-19 patients develop symptoms necessitating admission. From 2020 to 2022, Mashonaland West Province had an institutional case fatality rate of 23% against a national rate of 7%. Therefore, we evaluated the COVID-19 admissions in the province to determine the factors associated with COVID-19 mortality. Methods: we conducted an analytical cross-sectional study based on secondary data from isolation centers across the province using all 672 death audit forms and patient records. We obtained data on patient demographics, signs and symptoms, clinical management and oxygen therapy administered, among other things. Data were entered into an electronic form and imported into Epi-info 7 for analysis bivariate and multivariate was conducted. Results: we found that being an older man, aOR 1.04 (1.03-1.05), who had diabetes aOR 6.0 (95% CI: 3.8-9.2) and hypertension aOR 4.5 (95% CI: 2.8-6.5) were independent risk factors. Patients put on dexamethasone aOR 2.4 (95% CI: 1.6-3.4) and heparin/clexane aOR 1.6 (95% CI: 1.1-2.2) had a higher mortality risk. However, vitamin C aOR 0.48 (95% CI: 0.31-0.71) and oxygen therapy aOR 0.14 (95% CI: 0.10-0.19) and being pregnant aOR 0.06 (95% CI: 0.02-0.14) were protective. Conclusion: mortality risk increased in older male patients with comorbidities and with those on dexamethasone and heparin therapy. Oxygen therapy and vitamin C were protective. There is a need to conduct further study of the source of these variations in risk across patients to establish the true impact of differences in individuals' mortality.

Clinical study of common inflammatory indicators in children with infectious diseases / 中国小儿急救医学

Objective:To evaluate the clinical significance of commonly used clinical inflammatory indicators in children with infectious diseases.Methods:A total of 354 children diagnosed with infectious diseases in our hospital from December 2018 to October 2020 were selected and divided into viral infection group(83 cases), sepsis group (65 cases), atypical pathogen infection group(23 cases), fungal infection group (11 cases), and bacterial infection group(172 cases). The data of serum amyloid A(SAA), procalcitonin(PCT), C-reactive protein(CRP), SAA/CRP, and interleukin (IL) in each group were collected.The fever peak, duration of fever, and fever subsidence time after admission were recorded.The receiver operating characteristic (ROC) curve was plotted, and the area under the curve(AUC), cut-off value, sensitivity and specificity were recorded.The correlation between fever and inflammatory indicators was analyzed.Results:The duration of fever in the atypical pathogen infection group was significantly higher than that in the other groups.Compared with the sepsis group, the differences regarding the levels of SAA, CRP, PCT, and IL-6 were statistically significant compared with those in the bacterial infection group, the atypical pathogen infection group, and the viral infection group (all P<0.05). SAA/CRP was the highest in the viral infection group, and its mean value was nearly twice compared with that in the sepsis group ( P<0.05). IL-10 was significantly different between bacterial infection group and viral infection group( P<0.05). Compared with the fungal infection group, the difference of interferon-γ was statistically significant compared with that in the bacterial infection group, viral infection group and sepsis group (all P<0.05). The ROC curves suggested that the AUC of SAA/CRP and IL-10 was the largest and the same in the viral infection group.The AUC of PCT in the sepsis group was the largest of 0.877, and the specificity was the highest at 91.7% when the PCT was 1.055 ng/mL.Correlation analysis found that SAA and CRP detected for the first time at admission were positively correlated with the time to heat remission. Conclusion:SAA/CRP has significant significance in differentiating sepsis and virus infection, and significantly increased PCT is an important sign of sepsis.

Construction of the index system of nurses′ability to cope with new infectious diseases based on ability-based education theory / 中国实用护理杂志

Objective:To construct a scientific and feasible index system for nurses′ ability to cope with new infectious diseases based on ability-based education theory, so as to provide reference for the training of nurses′ ability to cope with new infectious diseases.Methods:After consulting domestic and foreign literaturesuch as China National Knowledge Internet, Wanfang, VIP, PubMed, Web of Science, etc. from the establishment of the database to October 2020, based on the theory of "ability-based education", taking the action framework of the theory of "life cycle of emergency" and "sudden infectious disease events proposed" by WHO as the structural framework, the index items were preliminarily constructed, and the Delphi expert consultation method was used to conduct two rounds of expert consultation for 15 experts, so as to finally establish the index system of nurses′ ability to cope with new infectious diseases.Results:The effective recovery rate of the two rounds of expert consultation questionnaires was 100.00%, and the authority coefficient was 0.930. Kendall′s concordance coefficients of two rounds of consultation experts in the tertiary indicators were 0.363, 0.304 and 0.269, respectively, with statistically significant differences (all P<0.01), and the coefficient of variation of each index was 0.000-0.167. The index system of nurses′ ability to cope with new infectious diseases included 3 primary indicators, 12 secondary indicators and 44 tertiary indicators. Conclusions:The index system of nurses′ ability to cope with new infectious diseases based on ability-based education theory is scientific, reliable and practical, which can provide reference for the training and assessment of new infectious diseases coping ability of nurses.

The application and effect of "Trinity" emergency chain in the management of patients with epidemic respiratory tract infection under the coordination of multi-branches / 中华急诊医学杂志

Objective:To summarize the application and effect of "Trinity" emergency chain in the management of patients with epidemic respiratory tract infection under the cooperation of multiple hospitals and districts, and to provide a reference for medical institutions to improve the risk response ability.Methods:Based on the collaborative management of multi-branches, the "Trinity" emergency chain of pre-hospital-emergency-critical care, identification-triage-treatment, expansion-training-dispatch was implemented to optimize and integrate medical resources.Results:During the two months, 43,000 patients were admitted to the fever clinic, with an increase of 36.08%. The average waiting time for treatment was 19.83 min, and the average admission time to ICU was 25.35 min.Conclusions:The "Trinity" emergency chain treatment scheme under the coordination of multi-branches can effectively deal with the public health events of respiratory tract infectious diseases, improve the efficiency of rescue and treatment, and enhance the risk response ability of medical institutions.

Development progress and application of monoclonal antibody drugs against respiratory virus / 中国生物制品学杂志

@#Abstract：In recent years，the outbreak and prevalence of respiratory infectious diseases in the world seriously endanger human health，among which the respiratory infectious diseases caused by viral infection account for a large proportion. The use of vaccines and common antiviral drugs is an effective way to fight viral infection，but there are also problems such as lag and drug resistance. Monoclonal antibodies against respiratory viral infections provide a new strategy for clinical treatment. This paper reviews the development of monoclonal antibody against respiratory virus and its application in respiratory viral infectious diseases. Keywords：Respiratory viral infectious diseases；Respiratory syncytial virus（RSV）；Influenza virus（IFV）；Coronavirus （CoV）；Monoclonal antibody

Analysis of the current situation and trend of infectious disease public health emergencies in Hainan Province from 2013 to 2022 / 中国热带医学

@#Abstract：Objective To evaluate the basic development status of public health emergencies of infectious diseases in Hainan Province from 2013 to 2022, analyze the distribution and characteristics of these emergencies, as to provide important scientific basis for the study and formulation of economic health development planning policies, for the health security policies and infectious disease prevention and control strategies in Hainan Province. Methods The relevant statistical data of public health emergencies involving infectious diseases reported in Hainan Province from 2013 to 2022 were collected, and the status quo of these emergencies was analyzed by using descriptive data statistical analysis method. The ARIMA model was used to predict the number of public health emergencies reported by infectious diseases in Hainan Province from 2023 to 2025. Results From 2013 to 2022, a total of 482 public health emergencies were reported in Hainan Province, of which 426 were infectious disease public health emergencies, accounting for 88.38%, with a total of 8 876 cases, an incidence rate of 0.61%, and eight deaths, a case fatality rate of 0.09%. The major public health emergencies of infectious diseases were unclassified events and general events, accounting for 69.25% and 29.58%, respectively. The main diseases were novel coronavirus infection, chickenpox and hand, foot and mouth disease, accounting for 45.07%, 15.49% and 11.97%, respectively; in terms of time distribution, the number of reported incidents showed an upward trend over time, with a decline in 2021, and mainly had three peak periods, April, August and December, with a total of 220 cases reported; in terms of regional distribution, the major cities and counties reported were Haikou, Wanning and Wenchang, accounting for 27.46%, 19.25% and 9.86%, respectively; in terms of location distribution, the events mainly occurred in schools, accounting for 42.02% of the total number of incidents. The ARIMA(1, 1, 0) model was used to predict infectious disease public health emergencies, and the results showed that the forecast state would be stable from 2023 to 2025, with no obvious upward trend, that is, the fluctuation range of public health emergencies related to infectious diseases in Hainan Province would be stable in the next three years. Conclusion The number of infectious disease public health emergencies reported in Hainan Province from 2013 to 2022 has increased year by year, with a decline in 2021. Although the forecast shows that public health emergencies such as infectious diseases are relatively stable with no obvious upward trend, the prevention and control of the epidemic should not be taken lightly. Hainan Province should continue to increase the investment in monitoring public health emergencies, improve the information system of public disease prevention and control, and carry out real-time monitoring of public health emergencies of infectious diseases.