Epidemiology of suicide mortality in Mexican young people (ages 15-29) from 1990 to 2020 / Epidemiología del suicidio en jóvenes mexicanos (15-29 años) de 1990 a 2020

Abstract Introduction In 2020, suicide was the third leading cause of death in Mexico among young people ages 15 and 29, accounting for 43.0% of all suicides in the country, making it a major public health issue. Objective To explore changes in the geographic distribution of suicide rates by state and to analyze the magnitude, distribution, and pattern of suicide mortality in young Mexicans ages 15 to 29 between 1990 and 2020. Method Descriptive, ecological time-series study, based on official information. Standardized mortality rates were calculated using information on deaths (INEGI) and population estimates (CONAPO). The magnitude, distribution, and patterns of suicide mortality at the national level and by state were analyzed using the Joinpoint segmented regression model. Results From 1990 to 2020, suicide mortality in young people increased by 198% and was higher in women (285%) than men (178%). The states with the highest suicide mortality rates from 2016 to 2020 were Chihuahua (18.5 suicides/100,000 young people ages 15-29), Aguascalientes (16.6), Yucatán (14.4), Guanajuato (14.1), and San Luis Potosí (12.9), accounting for 23.0% of total suicide deaths. Discussion and conclusion The study of mortality trends could contribute to the management of a national suicide prevention strategy in young Mexicans, providing support for public health decision-making, such as the identification of the states and regions that should be prioritized.

Resumen Introducción En 2020, el suicidio fue la tercera causa de muerte en México en los jóvenes de 15 a 29 años y concentró el 43.0% del total de suicidios del país. Por lo tanto, es un problema de salud pública muy relevante. Objetivo Explorar los cambios en la distribución geográfica de las tasas de suicidio por entidad federativa, así como analizar la magnitud, distribución y tendencia de la mortalidad por suicidio, en los jóvenes mexicanos de 15 a 29 años entre 1990 y 2020. Método Estudio ecológico descriptivo de series de tiempo, a partir de la información de fuentes oficiales. Se calcularon las tasas estandarizadas de mortalidad utilizando la información sobre defunciones (INEGI) y las estimaciones de población (CONAPO). Se analizó la magnitud, distribución y tendencias de la mortalidad por suicidio a nivel nacional y por entidad federativa, utilizando el modelo de regresión segmentada Joinpoint. Resultados De 1990 a 2020, la mortalidad por suicidio en jóvenes creció 198%, siendo mayor en las mujeres (285%) que en los hombres (178%). Las entidades con mayor mortalidad por suicidio, de 2016 a 2020, fueron Chihuahua (18.5 suicidios/100 mil jóvenes 15-29 años), Aguascalientes (16.6), Yucatán (14.4), Guanajuato (14.1) y San Luis Potosí (12.9), las cuales concentraron el 23.0% del total de muertes por suicidios. Discusión y conclusión El estudio de las tendencias de la mortalidad podría contribuir a la gestión de una estrategia nacional para la prevención del suicidio en jóvenes mexicanos, proporcionando sustento para la toma de decisiones en salud pública, como la identificación de las entidades federativas y regiones del país que deben recibir la máxima prioridad.

Development of a convolutional neural network for diagnosing osteoarthritis, trained with knee radiographs from the ELSA-Brasil Musculoskeletal / Desenvolvimento de rede neural convolucional para o diagnóstico radiográfico de osteoartrite dos joelhos no ELSA-Brasil Musculoesquelético

Abstract Objective: To develop a convolutional neural network (CNN) model, trained with the Brazilian "Estudo Longitudinal de Saúde do Adulto Musculoesquelético" (ELSA-Brasil MSK, Longitudinal Study of Adult Health, Musculoskeletal) baseline radiographic examinations, for the automated classification of knee osteoarthritis. Materials and Methods: This was a cross-sectional study carried out with 5,660 baseline posteroanterior knee radiographs from the ELSA-Brasil MSK database (5,660 baseline posteroanterior knee radiographs). The examinations were interpreted by a radiologist with specific training, and the calibration was as established previously. Results: The CNN presented an area under the receiver operating characteristic curve of 0.866 (95% CI: 0.842-0.882). The model can be optimized to achieve, not simultaneously, maximum values of 0.907 for accuracy, 0.938 for sensitivity, and 0.994 for specificity. Conclusion: The proposed CNN can be used as a screening tool, reducing the total number of examinations evaluated by the radiologists of the study, and as a double-reading tool, contributing to the reduction of possible interpretation errors.

Resumo Objetivo: Desenvolver um modelo computacional - rede neural convolucional (RNC) - treinado com radiografias da linha de base do Estudo Longitudinal de Saúde do Adulto Musculoesquelético (ELSA-Brasil Musculoesquelético), para a classificação automática de osteoartrite dos joelhos. Materiais e Métodos: Trata-se de um estudo transversal abrangendo todos os exames da linha de base do ELSA-Brasil Musculoesquelético (5.660 radiografias dos joelhos em incidência posteroanterior). Os exames foram interpretados por médico radiologista com treinamento específico e calibração previamente publicada. Resultados: A RNC desenvolvida apresentou área sob a curva característica de operação do receptor de 0,866 (IC 95%: 0,842-0,882). O modelo pode ser calibrado para alcançar, não simultaneamente, valores máximos de 0,907 para acurácia, 0,938 para sensibilidade e 0,994 para especificidade. Conclusão: A RNC desenvolvida pode ser utilizada como ferramenta de triagem, reduzindo o número total de exames avaliados pelos radiologistas do estudo, e/ou como ferramenta de segunda leitura, contribuindo com a redução de possíveis erros de interpretação.

Caracterização e geoespacialização da sífilis gestacional e congênita no Paraná, Brasil, 2012-2020 / Characterization and geospacialization of gestational and congenital syphilis in Paraná, Brazil, 2012-2020 / Caracterización y geoespacialización de sífilis gestacional y congénita en Paraná, Brasil, 2012-2020

A sífilis persiste como um problema de saúde pública, sobretudo pelos entraves existentes no enfrentamento da sífilis gestacional e congênita. Considerando que a ocorrência dessas infecções se relaciona a fatores maternos e programáticos, este estudo buscou analisar as características epidemiológicas do binômio mãe-filho exposto à sífilis e sua distribuição espacial no Paraná entre 2012 e 2020. Trata-se de estudo descritivo e ecológico, com dados dos sistemas nacionais de informação do Brasil. Foram considerados os casos de gestantes e de crianças registrados entre 2012 e 2020 no estado do Paraná. Foram apresentadas as frequências absolutas e relativas para a caracterização, calculando-se a variação percentual entre o primeiro e o último triênio. Ainda, foi empregado o índice de Moran para a geoespacialização segundo regiões de saúde. Houve predomínio em mulheres de 20 a 39 anos (71,24%), brancas (67,22%) e com até oito anos de estudo (80,76%), com diagnóstico nas fases primária e latente (76,42%). Os casos concentraram-se em crianças do sexo masculino (48,72%), diagnosticadas na fase recente (96,42%), e naquelas cujas mães aderiram ao pré-natal (88,88%), mas os parceiros, por sua vez, não foram tratados (69,46%). Houve aumento do diagnóstico materno durante o pré-natal (16,61%) e redução dos óbitos infantis por sífilis (31,25%). Observou-se concentração das notificações nas regiões Metropolitana e de Pato Branco. Em suma, as gestantes apresentaram idade reprodutiva e baixa escolaridade e foram tratadas durante o pré-natal, contudo, sem a inclusão dos parceiros. Ademais, evidenciou-se comportamento espacial aleatório nas regiões de saúde, com disparidade entre a sífilis gestacional e a congênita.

Syphilis remains as serious public health issue due to existing obstacles in combating gestational and congenital syphilis. Since the onset of these infections is related to maternal and programmatic factors, this study analyzed the epidemiological profile of the mother-child binomial exposed to syphilis and its spatial distribution in Paraná from 2012 to 2020. This is a descriptive, ecological study with data from Brazilian national information systems. Cases of pregnant women and children recorded between 2012 and 2020 in the state of Paraná were considered. Absolute and relative frequencies were estimated for characterization, calculating the percentage variation between the first and last three years. The Moran index was also used for geospacialization according to health regions. Most women were aged 20 to 39 years (71.24%), white (67.22%), and had up to 8 years of schooling (80.76%), with diagnosis in the primary and latent stages (76.42%). Most cases concerned male children (48.72%), diagnosed in the recent phase (96.42%), and from mothers who adhered to prenatal care (88.88%), but the partners were untreated (69.46%). Maternal diagnosis increased during prenatal care (16.61%) and infant deaths by syphilis decreased (31.25%). Most cases were notified in the Metropolitan and Pato Branco regions. In short, the pregnant women were of reproductive age, had low education, and were treated during prenatal care, but their partners were not included. The health regions showed random spatial behavior, with disparity between gestational and congenital syphilis.

La sífilis persiste como un problema de salud pública, principalmente por los obstáculos en hacer frente la sífilis gestacional y congénita. Teniendo en cuenta que la ocurrencia de estas infecciones está relacionada con los factores maternos y programáticos, este estudio tuvo como objetivo analizar las características epidemiológicas del binomio madre-hijo expuestos a la sífilis y la distribución espacial en Paraná (Brasil) entre 2012 y 2020. Se trata de un estudio descriptivo y ecológico, con datos de los sistemas de información nacionales de Brasil. Se consideraron los casos de mujeres embarazadas y niños registrados entre 2012 y 2020 en Paraná. Se presentaron las frecuencias absolutas y relativas, calculando la variación porcentual entre el primer y el último trienio. Asimismo, se utilizó el índice de Moran, según regiones de salud. Predominaron las mujeres de entre 20 y 39 años de edad (71,24%), blancas (67,22%), con hasta ocho años de estudio (80,76%), con diagnóstico en estadio primario y latente (76,42%). Los casos se concentraron en hijos varones (48,72%), diagnosticados en fase reciente (96,42%), y en aquellos cuyas madres tuvieron acceso a los cuidados prenatales (88,88%), pero su pareja no recibió el tratamiento (69,46%). Hubo un aumento en el diagnóstico materno durante la atención prenatal (16,61%) y una reducción en las muertes de niños por sífilis (31,25%). Se observó una concentración de casos en las regiones Metropolitana y de Pato Branco. En resumen, las mujeres embarazadas se encontraban en edad reproductiva, tenían bajo nivel de estudios y eran atendidas durante el prenatal, sin incluir su pareja. Además, se evidenció un comportamiento espacial aleatorio en las regiones de salud, con disparidad entre sífilis gestacional y congénita.

Práticas alimentares de professores da educação básica de um município do interior do Rio Grande do Sul: um estudo transversal / Feeding practices of basic education teachers in a city in the countryside of Rio Grande do Sul: a cross-sectional study

Introdução: no Brasil, é possível identificar mudanças nas práticas alimentares nas últimas décadas, alimentos tradicionais como arroz e feijão perderam a importância e foram substituídos por alimentos prontos para o consumo. Objetivo: diante disso, o objetivo do estudo foi avaliar as práticas alimentares de professores da rede municipal de educação de Passo Fundo, RS. Metodologia: foi realizado um estudo transversal com professores de ambos os sexos da rede municipal de educação. Os professores foram convidados a participar do estudo por meio de correio eletrônico da prefeitura municipal. A coleta de dados foi mediante formulário eletrônico com questões sobre condições sociodemográficas, saúde e práticas alimentares Resultados: foram avaliados 108 professores, a média de idade foi de 42,81 anos (DP=8,85) e 95,4% eram mulheres. Em relação às práticas alimentares, observou-se que 68,7% (n=71) apresentaram práticas alimentares satisfatórias, sendo que a média de pontuação foi de 45,46 (DP=8,33). Conclusão: apesar do elevado percentual de práticas alimentares excelentes, observa-se práticas alimentares inadequadas que podem contribuir para a ocorrência de excesso de peso ao longo do tempo.

Introduction: in Brazil, it is possible to identify changes in eating practices in recent decades, traditional foods such as rice and beans have lost importance and have been replaced by ready-to-eat foods. Objective: therefore, the objective of the study was to evaluate the eating habits of teachers from the public education system of Passo Fundo, RS. Methodology: a cross-sectional study was carried out with male and female teachers from the municipal public education system. Teachers were invited to participate in the study via e-mail from the municipal government. Data were collected using an electronic form with questions about sociodemographic conditions, health and eating practices. Results: 108 teachers were evaluated; the average age was 42.81 years (SD=8.85) and 95.4% were women. Regarding eating practices, it was observed that 68.7% (n=71) had satisfactory eating practices, with an average score of 45.46 (SD=8.33). Conclusion: despite the high percentage of excellent eating practices, it was be observed that inadequate eating practices can contribute to the occurrence of excess weight over time.

Características clínico-epidemiológicas de pacientes post-COVID-19 en Baracoa, Guantánamo

Fundamento un elevado porcentaje de personas que han padecido COVID-19, refieren tras la recuperación de la fase aguda, manifestaciones que se prolongan por más de tres semanas, e incluso, durante tres meses después del cuadro clínico original. Objetivo caracterizar desde el punto clínico y epidemiológico a pacientes confirmados al SARS-CoV-2 en la etapa post-COVID-19. Métodos se realizó un estudio descriptivo transversal, en pacientes confirmados al SARS-CoV-2 en etapa post-COVID-19, pertenecientes al Policlínico Hermanos Martínez Tamayo, en el periodo octubre-noviembre de 2021. Se estudiaron todos los pacientes (N=400) atendidos en consulta post-COVID-19 en el periodo declarado. La información se obtuvo mediante encuestas epidemiológicas realizadas. Resultados predominaron los pacientes con edades entre 50 y 59 años, del sexo femenino. Las manifestaciones clínicas más frecuente fueron tos, pérdida del gusto y del olfato. El esquema de vacunación incompleto fue el más frecuente. El lugar de ingreso más utilizado fueron los centros de aislamiento, así como el uso del Nasalferon como tratamiento. Las complicaciones predominaron en pacientes no vacunados, y con edad de 60 años y más. Conclusiones un elevado porcentaje de pacientes presentó manifestaciones clínicas tras el periodo agudo de la enfermedad. La COVID-19, a mediano plazo, tuvo mayores implicaciones en el sistema respiratorio, nervioso y osteomioarticular. Las campañas de vacunación ayudan a prevenir los síntomas graves del virus y a contrarrestar las complicaciones.

Background a high percentage of people who have suffered from COVID-19 report, after recovery from the acute phase, manifestations that last for more than three weeks, and even for three months after the original clinical picture. Objective to characterize, from the clinical and epidemiological point of view, patients confirmed to SARS-CoV-2 in the post-COVID-19 stage. Methods a descriptive cross-sectional study was carried out in patients confirmed to SARS-CoV-2 in the post-COVID-19 stage, belonging to the Hermanos Martínez Tamayo Polyclinic, from October to November 2021. All patients were studied (N= 400) attended in post-COVID-19 consultation in the declared period. The information was obtained through epidemiological surveys carried out. Results there was a predominance of patients aged between 50 and 59 years old, female. The most frequent clinical manifestations were cough, loss of taste and smell. The incomplete vaccination scheme was the most frequent. The most used place of admission were isolation centers, as well as the use of Nasalferon as a treatment. Complications predominated in unvaccinated patients, and aged 60 years and over. Conclusions a high percentage of patients presented clinical manifestations after the acute period of the disease. COVID-19, in the medium term, had greater implications in the respiratory, nervous and osteomyoarticular systems. Vaccination campaigns help prevent serious symptoms of the virus and counteract complications.

Trastornos de la infancia y características sociodemográficas asociadas a la depresión en adultos en una ciudad de Colombia / Childhood disorders and sociodemographic characteristics associated with depression in adults from a Colombian city / Transtornos da infância e características sócio-demográficas associadas à depressão em adultos de uma cidade colombiana

Introducción: Los trastornos emocionales y del comportamiento que se inician en la infancia llevan a cambios que se extienden hasta la edad adulta, con consecuencias sociales. Objetivo: Determinar la asociación de la depresión en la adultez con trastornos mentales de inicio en la infancia y otras condiciones, en Envigado, 2017. Materiales y métodos: Estudio con enfoque cuantitativo, tipo observacional, transversal con intención analítica. El tamaño de la muestra fue de 737 individuos, entre 18 y 65 años. Se aplicó el instrumento CIDI - CAPI de la OMS. El procesamiento y análisis se llevó a cabo en SPSS v. 21 de la Universidad CES y Epidat 4.2. Resultados: La proporción de depresión en la adultez es de 10,8%, en la población de estudio que tuvo antecedente de trastorno por déficit de atención e hiperactividad (TDAH) fue aproximadamente 5,6 veces más que en aquellos que no tenían este antecedente (OR= 6,62; IC95% 1,92-22,7). Conclusiones: El TDAH en la infancia incrementa la probabilidad de presentar depresión en la adultez en la población de Envigado, lo cual soporta la importancia de promover acciones de salud mental en la niñez, para prevenir la depresión en la edad adulta.

Introduction: Emotional and behavioral disorders that begin in childhood lead to adult changes, which have social consequences. Objective: To determine the association of adult depression with childhood onset of mental disorders and other factors in Envigado (Colombia). Materials and methods: A quantitative observational and cross-sectional study was carried out. The sample size was 737 individuals aged between 18 to 65 years. The CIDI-CAPI instrument of the WHO was used. Data processing and analysis was conducted through SPSS v. 21 software from the CES University and Epidat 4.2. Results: The percentage of depression in adults was 10.8%. This figure was 5.6 times greater in the study population that had history of attention deficit hyperactivity disorder (ADHD) compared to individuals who did not have this disorder (OR= 6.62; 95% CI 1.92-22.7). Conclusions: Childhood ADHD increases the probability of depression in the adult population of Envigado, which supports the importance of promoting mental health programs in children in order to prevent adulthood depression.

Introdução: Os transtornos emocionais e comportamentais que se iniciam na infância levam a alterações que se estendem até a idade adulta, com consequências sociais. Objetivo: Determinar a associação da depressão na idade adulta com transtornos mentais de início na infância e outras condições, em Envigado, 2017. Materiais e métodos: um estudo foi realizado com abordagem quantitativa, observacional, transversal e com intenção analítica. O tamanho da amostra foi de 737 indivíduos, entre 18 e 65 anos de idade. Foi aplicado o instrumento CIDI - CAPI da OMS. O processamento e análise foram realizados no SPSS v. 21 da Universidad CES e Epidat 4.2. Resultados: A proporção de depressão na idade adulta é de 10,8%, na população estudada que tinha histórico de transtorno de déficit de atenção e hiperatividade (TDAH) foi aproximadamente 5,6 vezes maior do que naquelas sem esse histórico (OR= 6,62; 95 % CI 1,92-22,7). Conclusões: O TDAH na infância aumenta a probabilidade de apresentar depressão na idade adulta na população de Envigado, o que reforça a importância de promover ações de saúde mental na infância, para prevenir a depressão na idade adulta.

Distribución geográfica de la incidencia de cáncer de beneficiarios de un convenio de atención oncológica en Chile

Cancer incidence reported by The Global Cancer Observatory (GLOBOCAN) is an estimate based on the registries available in each country. Their validity in regions such as Latin America is affected by the lack of reliable data and less access to healthcare among the population. Studying the geographic distribution of the incidence of malignant tumors facilitates the search for risk factors and allows prioritizing health resources. Aim: To estimate the incidence of the main malignant tumors in Chilean people with access to a private healthcare insurance at an oncological institute, and to know its geographical distribution. Material and Methods: Incident cancer cases during 2017 and 2018 were obtained from the institution's Tumor Registry. The incidence was adjusted by age and sex of the Chilean population obtained from the 2017 Census. Cancer rates were calculatedfor each of the 16 administrative regions in Chile. Results: Overall, the incidence of breast, lung, colon and thyroid cancers in the studied population was significantly higher than estimates for Chile reported by GLOBOCANfor 2020, especiallyfor thyroid cancer. There is a higher incidence of breast cancer in Greater Santiago and of lung cancer in men in the Antofagasta Region. Conclusions: The regional differences observed are explained by known risk factors. However the high incidence of lung and colon cancer in the Los Ríos Region requires further studies.

Analysis of epidemic characteristics of tuberculosis in schools in Shijiazhuang during 2011-2020 / 中国学校卫生

Objective@#To analyze the trend and characteristics of school tuberculosis epidemic in Shijiazhuang from 2011 to 2020, and to provide reference for school tuberculosis prevention and control.@*Methods@#Descriptive methods were used to analyze the epidemiological characteristics of tuberculosis among students and the epidemic situation of tuberculosis in schools in Shijiazhuang from 2011 to 2020. The χ 2 test and χ 2 trend test were used to analyze the characteristics and trend of school tuberculosis.@*Results@#A total of 4 896 cases of tuberculosis were registered among students in Shijiazhuang from 2011 to 2020. The average annual registered incidence rate of students was 24.69/100 000, and the difference in incidence rate was statistically significant ( χ 2=318.50, P <0.01) the overall registered incidence rate of tuberculosis among students in the past 10 years was on the rise ( χ 2 trend =87.79, P <0.01). Among the student cases, male accounted for 53.89%, female accounted for 46.11%. The age group of students aged >18 and above accounted for the largest proportion(50.35%), followed by the age group aged 16-18( 35.80 %). Most students cases occurred in April and September-November, with September the highest(12.03%). A total of 22 clustered outbreaks (174 cases) and the aggregate epidemic accounted for 3.55% of the total number of students with tuberculosis.@*Conclusion@#The prevention and control of tuberculosis epidemic in schools in Shijiazhuang should not be underestimated, and strengthen the supervision, management, publicity and education of students in key age groups to avoid clusters of outbreaks.

Epidemiological characteristics and secular trend of the HIV/AIDS cases among 15-24 years old population in Hefei from 2004 to 2022 / 中国学校卫生

Objective@#To investigate the characteristics of HIV/AIDS cases among 15-24 year old population reported in Hefei from 2004 to 2022, so as to provide insights into AIDS control among adolescents.@*Methods@#The epidemiological data regarding HIV/AIDS cases between 15 and 24 years old reported in Hefei from 2004 to 2022 were captured from the AIDS comprehensive prevention and control information system of Chinese disease prevention and control information system, and data regarding temporal distribution, population distribution, and routes of infections and detection were descriptively analyzed by descriptive epidemiological methods.@*Results@#From 2004 to 2022, 865 cases of HIV/AIDS were reported in Hefei among 15-24 years old youth, accounting for 21.80% of the total reported cases. Among the HIV/AIDS patients, males accounted for 92.60%(801 cases), the unmarried ones accounted for 93.41% (808 cases)，those with college degree or above accounted for 60.12% (520 cases)，and 25.78%(223 cases) of them were students. The proportion of student cases increased annually( χ 2 trends =47.67, P <0.01). Homosexual transmission accounted for 81.39%, both showed an increasing trend( χ 2 trends =51.23, P <0.01)．Totally 55.49% of cases were found through testing and consultation, and the proportion of cases increased by year( χ 2 trends =112.18, P <0.01). In 2004-2022，the number of newly reported cases among people aged 15-24 showed a rising trend at an average rate of 24.46% by year( Z=4.92, P <0.01), which was higher than the average rate of 21.54% for the entire population( Z=12.75, P <0.01).@*Conclusion@#The epidemic of HIV/AIDS among population aged 15-24 years is serious in Hefei. Comprehensive measures for HIV education and prevention intervention are desperately needed to be reinforced among targeted students.

Epidemiological situation of hepatitis D in the gathering area of Mongolian population in Inner Mongolia Autonomous Region of China / 临床肝胆病杂志

Objective To investigate the status and molecular epidemiology of hepatitis D virus (HDV) infection in the gathering area of Mongolian population in Inner Mongolia Autonomous Region of China. Methods A total of 230 patients with positive hepatitis B surface antigen (HBsAg) who attended Inner Mongolia International Mongolian Hospital from April 2019 to October 2020 were enrolled, and according to related information, they were divided into hepatitis B+liver cirrhosis group( n =18) and hepatitis B group( n =212). According to HBsAg quantification with a cut-off value of 250 IU/mL, the patients were divided into HBsAg < 250 IU/mL group( n =104) and HBsAg ≥250 IU/mL group( n =126). ELISA was used to detect HDV antibody, and quantitative real-time PCR was used to measure HDV RNA in patients with positive HDV antibody. Genotyping was performed for HDV RNA-positive samples. The chi-square test was used for comparison of categorical data between two groups. Results The positive rate of HDV antibody was 16.09%, and among the patients with positive HDV antibody, the positive rate of HDV RNA was 91.89%. Among the 18 patients with hepatitis B and liver cirrhosis, the positive rate of HDV antibody was 44.44%, and among the patients with positive HDV antibody, the positive rate of HDV RNA was 100%. There were 104 patients with HBsAg < 250 IU/mL, among whom only 3 patients (2.88%) were positive for hepatitis D antibody, and there were 126 patients with HBsAg ≥250 IU/mL, with a positive rate of HDV antibody of 26.98%. Genotype 1 was observed in all the samples that could be genotyped. Conclusion There is a relatively high infection rate of HDV in Inner Mongolia Autonomous Region, especially in patients with HBsAg ≥250 IU/mL or those with liver cirrhosis. It is necessary to strengthen the detection of hepatitis D in HBsAg-positive patients and perform early diagnosis and treatment to prevent the further progression of hepatitis.

Analysis of an outbreak of influenza A in a primary school in Jing an District, Shanghai / 中国学校卫生

Objective@#To investigate the epidemiological data of an outbreak of influenza A in a primary school in Shanghai, to provide reference for targeted prevention and control measures.@*Methods@#A field epidemiological method was used to investigate and collect the data of influenza A outbreak in a primary school in Jing an District from November 8 to December 6, 2022, through on site follow up and telephone return visit to health teachers and cases. The distribution characteristics of the epidemic were analyzed by descriptive epidemiology.@*Results@#The first case developed symptoms of cough, sore throat, and fever on the morning of November 8th 2022, with a maximum body temperature of 38.6 ℃. Later, the clinical diagnosis was influenza A. The total number of influenza like cases reported in this outbreak is 99, including 92 students and 7 teachers. The total incidence rate was 9.45%. The clinical symptoms of all cases were fever, sore throat, and cough; 27 cases of influenza A were diagnosed by hospital rapid diagnostic reagents. The second grade students had the highest case incidence rate(24.46%), and there was a statistically significant difference in case incidence rates among students of different grades ( χ 2=48.28, P ＜0.01). The case incidence rate on the second floor was the highest (23.47%), and there was a statistically significant difference between the case incidence rates on different floors ( χ 2=52.38, P ＜ 0.01 ). Etiological testing showed that the influenza virus causing this outbreak was type A H3N2 virus.@*Conclusion@#This outbreak is a campus cluster outbreak caused by influenza A (H3N2) virus. The health and education departments should strengthen cooperation to effectively implement prevention and control measures of infectious diseases, and timely identify the source of infection and cut off the transmission route.

Prevalence trend and related factors of scoliosis and myopia co-morbidities among primary and middle school students in Inner Mongolia Autonomous Region from 2019 to 2022 / 中国学校卫生

Objective@#To analyze the prevalence trend of scoliosis among myopic students in Inner Mongolia Autonomous Region during 2019-2022, to explore the common etiology of myopia and scoliosis co-morbidities, so as to provide a reference for the development of relevant measures.@*Methods@#The method of stratified random cluster sampling was used to select 181 533, 141 552 , 200 987, 190 918 primary and secondary school students from 12 leagues(103 banners) in Inner Mongolia Atuonomous Region in September each year from 2019 to 2022. And scoliosis screening, vision examination and questionnaire survey were conducted among students in the included studies. The χ 2 test was used to analyze the data, and the binary multivariate Logistic regression model was used to screen the influencing factors of scoliosis and myopia co-morbidities.@*Results@#From 2019 to 2022, the myopia rate of primary and secondary school students in Inner Mongolia Autonomous Region was 55.55%-59.72%, scoliosis rate was 1.56 %-2.81% and the rates of scoliosis and myopia co-morbidities were 1.14%-1.95%, and the difference between different years was statistically significant ( χ 2=595.01, 775.56, 461.84, P < 0.05 ). In 2022, the co-morbidity rate was higher in girls than in boys(1.32% vs 0.97%), the rate of urban areas was higher than that of rural areas(2.57% vs 0.62%), the rate of students in vocational high school and high school was higher than that in junior high school and primary school (3.82%,2.47% vs 1.70%,0.42%), the rate of over developed areas was higher than that of poor areas (1.21% vs 0.99%)( χ 2=52.19, 1 269.82, 1 361.52, 17.29, P < 0.05 ). Logistic regression analysis showed that at least 1 h of moderate and high intensity exercise every day on weekends, the number of physical education classes per week was more than 3 sessions, the height of desks and chairs was adjusted according to height, resting outdoors, limiting screen time, and strictly requiring standing and sitting posture were the negative correlated with scoliosis and myopia, and the OR value was 0.65-0.90, reading books or electronic screens while participating in cram classes, walking or riding in the car were positively correlated with comorbid scoliosis and myopia, and the OR values were 1.27 and 1.13 ( P < 0.05), respectively.@*Conclusion@#Behavioral habits severely affect scoliosis and myopic of students. Prevention and control of scoliosis and myopia co-morbidity should start with students behavioral habits, early screening and early intervention.

Epidemiological characteristics of injury deaths among children and adolescents in China, 2010-2020 / 中国学校卫生

Objective@#To explore the epidemic characteristics of injury related deaths in children and adolescents aged 1-24 years old in China from 2010 to 2020, so as to provide a basis for the formulation of policies and measures related to the control of injuries and deaths among children and adolescents.@*Methods@#The data were sourced from the China Death Cause Monitoring Dataset from 2010 to 2020. Annual percentage change (APC) and average annual percentage change (AAPC) of injury deaths in China in this age group during the period 2010 to 2020 were analyzed by Join point regression.@*Results@#From 2010 to 2020, the standardized death rate of injury showed a decreasing trend (AAPC=-6.90%, t =4.58, P <0.01). The standardized death rates of male and rural injuries showed an overall downward trend, with AAPC rates of -8.37% and -7.79%( t =11.87, 10.34, P <0.01). An increasing trend was observed in the 20-24 year-old age group during 2010-2018 (APC=18.11%, t =6.50, P <0.01). The death rate from injuries was higher in males than females, and higher in rural areas compared with urban areas ( χ 2=16 483.64, 3 268.65 , P <0.01). A downward trend was observed in accidental falls and suicide, the overall standardized mortality rate of traffic accidents, accidental poisoning, fire, drowning, homicide and other injuries (AAPC=-10.22%, -6.21%, -7.50%, -7.94%, -9.01% , -10.97%, t =16.23, 7.29, 2.53, 9.32, 7.88, 4.58, P <0.05). @*Conclusion@#From 2010 to 2020, the overall injury standardized mortality rate in the 1-24 year-old age group shows a decreasing trend, but it remains at a relatively high level. Prevention efforts should be continuously strengthened, especially for urban areas, and should focus on women and those aged 20-24 years old, as well as accidental falls and suicide prevention.

Epidemiological investigation of an outbreak of pertussis in a primary school in Rizhao / 中国学校卫生

Objective@#To investigate the epidemiological characteristics of a pertussis outbreak in a primary school in Rizhao City, so as to provide reference for the prevention and control strategy of pertussis.@*Methods@#The method of field epidemiological investigation was used to determine case definition for case search and case investigation,and the characteristics of the outbreak were comprehensively analyzed through descriptive epidemiological method.@*Results@#The outbreak lasted for 29 days from April 19 to May 17, 2022, with a total of 14 cases detected. All the cases were students aged 6-7 years from Class 2, Grade 1 in this primary school,including 6 boys and 8 girls. The attack rates of boys and girls were 30.00% and 34.78%, respectively. The time interval from onset to diagnosis of 14 cases ranged from 2 to 22 days, with a median of 10 days. All of them had received 4 doses of Diphtheria and Tetanus and acellular Pertussis(DTaP) combined vaccine, and the interval between the last vaccination and the onset of disease was 5-6 years. After isolated treatment, all the 14 sick students recovered, without severe or death cases.@*Conclusion@#The outbreak of pertussis in a primary school may be related to the decline in the effectiveness of pertussis vaccine protection over time, the lax implementation of a school registration and reporting system for sick absenteeism, and the poor sensitivity of existing pertussis surveillance systems.

Prevalence of internet addiction and associated factors in students / Prevalência de adicção em internet e fatores associados em estudantes

Objective: A cross-sectional study that estimated the prevalence of Internet Addiction and associated factors among High School and College students in Montes Claros - Minas Gerais, Brazil. Methods: Internet Addiction was evaluated through the Internet Addiction Test, and demographic, socioeconomic, and lifestyle factors, as well as internet usage profile characteristics, were examined. Descriptive analysis and the Poisson regression model were applied. Results: Of the 2,519 participants, 52.3% were considered with Internet Addiction Problems. In High School, the following factors were identified: are women and girls, age over >16, class C, alcohol consumption, impaired sleep, frequent use of social networks, and time spent connected. In Higher Education, the following factors: are women and girls, age over >23, paid activity, class C and D/E, alcohol consumption, impaired sleep, imbalanced diet, frequent use of social networks, and time spent connected. Conclusion: There was an expressive prevalence of Internet Addiction Problems, an outcome associated with the demographic, socioeconomic, lifestyle, and internet use characteristics.

Objetivo: Estudo transversal que estimou prevalência de Adicção em Internet e fatores associados entre estudantes do Ensino Médio e Superior em Montes Claros - Minas Gerais, Brasil. Métodos: A Adicção em Internet foi avaliada pelo Internet Addiction Test e se investigaram fatores demográficos, socioeconômicos, estilo de vida e perfil de uso de internet. Foram realizadas análises descritivas e modelo de regressão de Poisson. Resultados: Dos 2.519 participantes, 52,3% apresentaram problemas de Adicção em Internet. No grupo de estudantes de Ensino Médio examinado, identificaram-se os seguintes fatores: sexo feminino, idade >16, classe C, consumo de álcool, sono prejudicado, uso frequente das redes sociais e tempo de conexão. No Ensino Superior, foram constatados: sexo feminino, idade >23, atividade remunerada, classe C e D/E, consumo de álcool, sono prejudicado, alimentação não balanceada, uso frequente das redes sociais e tempo de conexão. Conclusão: Houve expressiva prevalência de Problemas com Adicção em Internet, desfecho associado a características demográficas, socioeconômicas, ao estilo de vida e ao uso da internet.

Temporal trends in hematopoietic stem cell transplantation in Argentina between 2009 and 2018: A collaborative study by GATMO-TC and INCUCAI

Special Article Introduction Hematopoietic stem cell transplantation is the only curative treatment for many disorders and international data shows a growing trend. Method We aimed to evaluate the temporal trends in HSCT transplant rates in Argentina. A time-series analysis was performed for the period 2009 to 2018 using the national database from the National Central Coordinating Institute for Ablations and Implants. Crude and standardized transplant rates were calculated. A permutation joinpoint regression model analysis was used to identify significant changes over time. Results Altogether, 8,474 transplants were reported to INCUCAI by 28 centers (autologous 67.5%); the main indication was multiple myeloma (30%). The WHO age-sex standardized HSCT rates for the entire country were 153.3 HSCT/10 million inhabitants (95% CI 141.7-165.8) in 2009 and 260.1 HSCT/10 million inhabitants (95% CI 245.5-275.5) in 2018. There was a large gap in HSCT rates among the states and regions. The transplant rate was higher for autologous transplants throughout the years. Within the allogeneic group, the related donor transplant rate was higher than the unrelated donor transplant rate. The joinpoint regression analysis of HSCT rates for the whole country over time showed an observed annual percentage change of 6.3% (95% CI 5.4-7.3; p< 0.01). No changes were observed for unrelated donors during the study period. Conclusions Age-sex standardized HSCT rates in Argentina are increasing, mainly due to autologous and family donor allogeneic transplants. A wide variation across the country was found, demonstrating differences in the access to transplantation among Argentine regions.

Temporal trends in Hematopoietic Stem Cell Transplantation in Argentina: regional differences that mirror the global reality

Introduction: Hematopoietic stem cell transplantation is the only curative treatment for many disorders and international data shows a growing trend. Method: We aimed to evaluate the temporal trends in HSCT transplant rates in Argentina. A time-series analysis was performed for the period 2009 to 2018 using the national database from the National Central Coordinating Institute for Ablations and Implants. Crude and standardized transplant rates were calculated. A permutation joinpoint regression model analysis was used to identify significant changes over time. Results: Altogether, 8,474 transplants were reported to INCUCAI by 28 centers (autologous 67.5%); the main indication was multiple myeloma (30%). The WHO age-sex standardized HSCT rates for the entire country were 153.3 HSCT/10 million inhabitants (95% CI 141.7 −165.8) in 2009 and 260.1 HSCT/10 million inhabitants (95% CI 245.5−275.5) in 2018. There was a large gap in HSCT rates among the states and regions. The transplant rate was higher for autologous transplants throughout the years. Within the allogeneic group, the related donor transplant rate was higher than the unrelated donor transplant rate. The joinpoint regression analysis of HSCT rates for the whole country over time showed an observed annual percentage change of 6.3% (95% CI 5.4-7.3; p < 0.01). No changes were observed for unrelated donors during the study period. Conclusions: Age-sex standardized HSCT rates in Argentina are increasing, mainly due to autologous and family donor allogeneic transplants. A wide variation across the country was found, demonstrating differences in the access to transplantation among Argentine regions

Mix contraceptivo e fatores associados ao tipo de método usado pelas mulheres brasileiras: estudo transversal de base populacional / Contraceptive mix and factors associated with the type of method used by Brazilian women: a population-based cross-sectional study / Combinación anticonceptiva y factores asociados al tipo de método utilizado por las mujeres brasileñas: un estudio transversal de base poblacional

O objetivo deste estudo é descrever o mix contraceptivo e analisar os fatores associados ao tipo de contraceptivo usado pelas mulheres brasileiras em idade reprodutiva. Trata-se de estudo transversal, de base populacional, com dados de 19.962 mulheres de 15 a 49 anos. Os desfechos foram uso e tipo de contraceptivo, classificados em: contraceptivos reversíveis de curta duração (SARC), longa duração (LARC) e permanentes. As variáveis explicativas foram: características da história reprodutiva, sociodemográficas e de acesso aos serviços de saúde. Utilizou-se a regressão logística multinomial para estimativas da odds ratio (OR), tendo os SARC como categoria de referência. As análises foram realizadas no módulo survey do software Stata, que considerou o efeito do plano amostral complexo da Pesquisa Nacional de Saúde de 2019. A prevalência do uso de contraceptivos foi de 83,7%. Do total de usuárias, 72% usavam SARC, 23,2% métodos permanentes e 4,8%, LARC. Mulheres com maior escolaridade, plano de saúde, que tiveram partos e participaram de grupos de planejamento reprodutivo tiveram maior chance de usar LARC na comparação com o uso de SARC, enquanto o cadastro na unidade básica de saúde se associou a menor chance de uso. Ainda, quanto maior a idade e paridade, além de viver com o companheiro, maior a chance de usar métodos permanentes em relação ao uso de SARC. Apesar da elevada cobertura de contracepção, o mix contraceptivo permanece obsoleto, com predomínio do uso de SARC. Além disso, observou-se importante desigualdade de acesso, sendo os LARC acessíveis apenas por mulheres com melhores condições socioeconômicas, enquanto os métodos permanentes foram associados a um perfil de maior vulnerabilidade social.

This study aims to describe the contraceptive mix and analyze the factors associated with the type of contraceptive used by Brazilian women of reproductive age. This is a cross-sectional, population-based study with data from 19,962 women aged 15 to 49 years. The outcomes were use and type of contraceptive, classified as: short-acting reversible contraceptives (SARC), long-acting (LARC), and permanent. The explanatory variables were characteristics of reproductive history, sociodemographic history, and access to health services. Multinomial logistic regression was used for odds ratio (OR) estimates, with SARC being the reference category. The analyses were performed in the Survey module of the Stata software, which considered the effect of the complex sampling plan of the 2019 Brazilian National Health Survey. The prevalence of contraceptive use was 83.7%. Of the total number of users, 72% used SARC, 23.2% permanent methods, and 4.8% LARC. Women with higher education, health insurance, who had deliveries, and who participated in reproductive planning groups had a higher chance of using LARC when compared with the use of SARC, while registration at the basic health unit was associated with a lower chance of use. Still, the higher the age and parity, in addition to living with the partner, the greater the chance of using permanent methods in relation to the use of SARC. Despite the high coverage of contraception, the contraceptive mix remains obsolete, with a predominance of the use of SARC. In addition, important inequalities in access were observed, with LARC being accessible only to women with better socioeconomic conditions, while permanent methods were associated with a profile of greater social vulnerability.

El objetivo fue describir la combinación anticonceptiva y analizar los factores asociados al tipo de anticonceptivo usado por las mujeres brasileñas en edad reproductiva. Estudio transversal, de base poblacional, con datos de 19.962 mujeres de 15 a 49 años. Los resultados fueron el uso y el tipo de anticonceptivo, clasificados en: anticonceptivos reversibles de corta duración (SARC), de larga duración (LARC) y permanentes. Las variables explicativas fueron características de la historia reproductiva, sociodemográficas y de acceso a los servicios de salud. Se utilizó la regresión logística multinomial para las estimaciones de la odds ratio (OR), siendo los SARC la categoría de referencia. Los análisis fueron realizados en el módulo survey, del software Stata, que consideró el efecto del sistema de muestreo complejo de la Encuesta Nacional de Salud de 2019. La prevalencia del uso de anticonceptivos fue del 83,7%. Del total de usuarias, 72% usaban SARC, el 23,2% métodos permanentes y el 4,8% LARC. Las mujeres con mayor educación, plan de salud, que tuvieron partos y participaron de grupos de planificación reproductiva tuvieron mayor posibilidad de usar LARC cuando comparados al uso de SARC, mientras que el registro en la unidad básica de salud se asoció con una menor posibilidad de uso. Además, cuanto mayor sea la edad y la paridad, además de vivir con el compañero, mayor será la posibilidad de utilizar métodos permanentes en relación con el uso de SARC. A pesar de la alta cobertura de anticoncepción, la combinación anticonceptiva sigue siendo obsoleta, con un uso predominante de SARC. Además, se observaron importantes desigualdades en el acceso, siendo los LARC accesibles solo para mujeres con mejores condiciones socioeconómicas, mientras que los métodos permanentes se asociaron con un perfil de mayor vulnerabilidad social.

Epidemiological evaluation of patient compliance regarding oral health and hygiene during the COVID-19 period

ABSTRACT Objective This work aimed to report values regarding oral hygiene habits at home during the pandemic and compare the difference with previous oral hygiene habits. Methods This study was performed anonymously and had patients answer an online questionnaire. The questionnaire consisted of 11 closed-answer questions (except 1) concerning oral hygiene habits at home at the time of COVID-19 and participant characteristics, including gender and age. A total of 1,136 questionnaires were filled in via a link sent by email to the patients. Results Among the 1,136 patients examined, 32.4% (372) were male and 67.6% (775) were female, and almost half (47.9%) of the patients who answered the questionnaire were aged 18-40 years. Patients who participated in our survey were asked questions related to dental and tongue hygiene. The answers showed that although they had more time during the pandemic, they brushed their teeth less and did not brush their tongues regularly. Conclusion Patients with periodontal problems usually have less time for brushing and do not have good plaque control. The questionnaire showed the opposite, such that the patient's compliance and motivation matters more than time. Thus, dentists and dental hygienists must encourage and make patients understand the importance of oral hygiene at home.

Uso ambulatorio de medicamentos potencialmente inapropiados en adultos mayores usuarios de la RAP Metropolitana de ASSE durante 2019 / Potentially inappropriate medication use in older adults assisted as outpatients in ASSE's Metropolitan RAP (Primary Health Care) during 2019 / Uso ambulatorial de medicamentos potencialmente inapropriados em idosos usuários da RAPE Metropolitana da ASSE durante 2019

Introducción: los adultos mayores son una población de riesgo para el desarrollo de reacciones adversas a los medicamentos. Los medicamentos potencialmente inapropiados son aquellos que representan mayores riesgos que beneficios en este grupo etario. Se cuenta con herramientas de apoyo a la prescripción en geriatría que permiten identificar a estos medicamentos y mediante la aplicación de estudios de utilización de medicamentos, podemos describir o analizar el uso de los mismos en una población. Objetivos: reconocer disponibilidad de medicamentos potencialmente inapropiados para adultos mayores en la RAP metropolitana de ASSE durante 2019 y establecer un diagnóstico de situación de consumo de los mismos durante ese año. Método: se realizó un análisis del vademécum institucional mediante la aplicación de los Criterios de Beers 2019 y dos escalas de riesgo anticolinérgico para identificar medicamentos potencialmente inapropiados. Posteriormente se realizó un estudio de utilización de los medicamentos identificados, mediante datos de dispensación de farmacia entre el 1 de enero y 31 de diciembre de 2019. El consumo se expresó en Dosis Diarias Definidas por cada 1000 adultos mayores-año (DHD). Resultados: se identificaron 16 medicamentos potencialmente inapropiados, de los cuales los más usados fueron clonazepam (DHD 69), quetiapina (65,6), alprazolam (DHD 43,7), flunitrazepam (DHD 42,7) y zolpidem (DHD 36,4). Conclusiones: la aplicación de herramientas explícitas facilita la identificación de medicamentos potencialmente inapropiados para adultos mayores y se evidenció un consumo elevado de los mismos durante el año 2019 a expensas de derivados benzodiazepínicos y quetiapina.

Introduction: older adults are at higher risk for developing adverse drug reactions. Potentially inappropriate medications are drugs that have more risks than benefits in this age group. There are a number of tools to support the prescription of medication in geriatrics that allow the identification of these medications, and by applying studies developed on the use of medications we may describe or analyze their impact on a given population. Objectives: to recognize availability of potentially inappropriate medications in older adults in ASSE's Metropolitan RAP during 2019 and to draw conclusions about the current situation in terms of the consumption of this kind of medications. Method: an institutional analysis of medications available in each healthcare provided was conducted through the application of Beers Criteria 2019, and two anticholinergic risk scales were used to identify potentially inappropriate medications. Subsequently, the use of the medications identified was studied by applying pharmacy dispensing data between January 1 and December 31, 2019. Consumption was expressed in defined daily doses every 1000 adults per year (DHD). Results: 16 potentially inappropriate medications were identified, the most widely used of which were clonazepam (DHD 69), quetiapine (65.6), alprazolam (DHD 43.7), flunitrazepam (DHD 42.7) and zolpidem (DHD 36.4). Conclusions: Applying explicit tools makes it easier to identify potentially inappropriate medications for older adults. An increased consumption of these kinds of drugs was noticed during 2019, as a result of benzodiazepine derivatives and quetiapine.

Introdução: os idosos são uma população de risco para o desenvolvimento de reações adversas a medicamentos. Medicamentos potencialmente inapropriados são aqueles que apresentam maiores riscos do que benefícios nessa faixa etária. Existem ferramentas de apoio à prescrição em geriatria que permitem identificar esses medicamentos e, por meio da aplicação de estudos de utilização de medicamentos, descrever ou analisar seu uso em uma população. Objetivos: reconhecer a disponibilidade de medicamentos potencialmente inapropriados para idosos na RAP metropolitana da ASSE durante o ano de 2019 e estabelecer um diagnóstico de consumo durante esse ano. Método: o formulário institucional foi analisado utilizando os Critérios de Beers 2019 e duas escalas de risco anticolinérgico para identificar medicamentos potencialmente inapropriados. Posteriormente, foi realizado um estudo de consumo dos medicamentos identificados, através dos dados de dispensação da farmácia entre 1 de janeiro e 31 de dezembro de 2019. O consumo foi expresso em Doses Diárias Definidas por 1000 idosos-ano (DHD). Resultados: foram identificados 16 medicamentos potencialmente inapropriados, sendo clonazepam (DHD 69), quetiapina (65,6), alprazolam (DHD 43,7), flunitrazepam (DHD 42,7) e zolpidem (DHD 36,4) os mais utilizados Conclusões: a aplicação de ferramentas explícitas facilita a identificação de medicamentos potencialmente inapropriados para idosos; foi observado um alto consumo dos mesmos em detrimento dos derivados benzodiazepínicos e da quetiapina durante o período do estudo.