[Epidemiological surveillance of syphilis in the city of Valencia. Impact and evolution of the period 2003-2014]. / Vigilancia epidemiológica de la sífilis en la ciudad de Valencia. Impacto y evolución del período 2003-2014.

UNLABELLED: In Spain syphilis shows an increasing trend from last decade and multiple papers reported an increasing of exposed population. Our aim was to describe the evolution of the incident of the syphilis in the geographical frame of the city of Valencia, to identify the characteristics and practices of risk of the affected ones. A classic design of vigilance of public health was applied, longitudinal retrospective study. Geographical area: the city of Valencia. PERIOD: January 2003-December 2014. VARIABLES: age and sex, national origin, dates of access to the sanitary system, date of diagnosis, clinical forms of presentation, conducts of risk, and practices of risk. The annual impact of the disease evolved from 2.4 × 10(5) in 2004 up to 14.5 × 10(5) in 2014. Males (82.96%) masculinity rate: 4.8. Major specific incidence took places on age-groups 35-39 years with 16.49 × 10(5) and 40-44 years with 16.98 × 10(5). The difference between women stands out according to origin: middle ages in autochthonous (39.72 years) opposite to foreigners (32.91 years); P = .004. The primary forms were 5 times more probable in males. The major factor of risk was to have multiple couples (54.89%), man-to-man homo or bisexuals reaches 90.0% of it. The HIV (human immunodeficiency virus) infection was 29.07% in males and 4.35% in women. Precedent of multiple couple relations would not be a minor of 42 times more likely among the homosexual population with syphilis. Major determinant of risk were the relations with multiple pairs and the prevention will have to be focused to the group of men who practice sex with men.

Vigilancia epidemiológica de la sífilis en la ciudad de Valencia. Impacto y evolución del período 2003-2014 / Epidemiological surveillance of syphilis in the city of Valencia. Impact and evolution of the period 2003-2014

En España, la sífilis muestra una tendencia creciente desde la década pasada y diversas publicaciones alertan del incremento de población expuesta. El objetivo fue describir la evolución de la incidencia de la sífilis en el marco geográfico de la ciudad de Valencia e identificar las características y las prácticas de riesgo de los afectados. Se aplicó un diseño clásico de vigilancia de salud pública, estudio longitudinal retrospectivo. Ámbito geográfico: la ciudad de Valencia. Ámbito temporal: enero de 2003-diciembre de 2014. Variables de estudio: edad y sexo, origen nacional, fechas de acceso al sistema sanitario, fecha de diagnóstico, formas clínicas de presentación, conductas de riesgo y prácticas de riesgo. El impacto anual de la enfermedad evolucionó desde 2,4 ¥ 105 en 2004 hasta 14,5 ¥ 105 en 2014. El 82,96% eran varones, con razón de masculinidad de 4,8. La incidencia específica se sitúa en los grupos de 35-39 años (16,49 ¥ 105 ) y 40-44 años (16,98 ¥ 105 ). Destaca la diferencia entre mujeres según su origen: edad media en autóctonas (39,72 años) frente a extranjeras (32,91 años); p = 0,004. Las formas primarias fueron 5 veces más probables en varones. El mayor factor de riesgo fue tener parejas múltiples (54,89%), que entre varones homosexuales o bisexuales alcanza el 90,0%. La coinfección por el VIH (virus de la inmunodeficiencia humana) fue del 29,07% en varones y del 4,35% en mujeres. Se estima que la probabilidad de antecedente de parejas múltiples no sería menor de 42 veces entre la población homosexual enferma de sífilis respecto de la heterosexual. El mayor determinante de riesgo fueron las relaciones con múltiples parejas y la prevención deberá focalizarse al colectivo de varones que practican sexo con varones

In Spain syphilis shows an increasing trend from last decade and multiple papers reported an increasing of exposed population. Our aim was to describe the evolution of the incident of the syphilis in the geographical frame of the city of Valencia, to identify the characteristics and practices of risk of the affected ones. A classic design of vigilance of public health was applied, longitudinal retrospective study. Geographical area: the city of Valencia. Period: January 2003-December 2014. Variables: age and sex, national origin, dates of access to the sanitary system, date of diagnosis, clinical forms of presentation, conducts of risk, and practices of risk. The annual impact of the disease evolved from 2.4 ¥ 105 in 2004 up to 14.5 ¥ 105 in 2014. Males (82.96%) masculinity rate: 4.8. Major specific incidence took places on age-groups 35-39 years with 16.49 ¥ 105 and 40-44 years with 16.98 ¥ 105 . The difference between women stands out according to origin: middle ages in autochthonous (39.72 years) opposite to foreigners (32.91 years); P = .004. The primary forms were 5 times more probable in males. The major factor of risk was to have multiple couples (54.89%), man-to-man homo or bisexuals reaches 90.0% of it. The HIV (human immunodeficiency virus) infection was 29.07% in males and 4.35% in women. Precedent of multiple couple relations would not be a minor of 42 times more likely among the homosexual population with syphilis. Major determinant of risk were the relations with multiple pairs and the prevention will have to be focused to the group of men who practice sex with men

Consensus on the criteria needed for creating a rare-disease patient registry. A Delphi study.

BACKGROUND: Patient registries (PRs) are important tools for public-health surveillance and rare-disease research. The purpose of this study is to identify the most important criteria for the creation of a rare-disease PR that could be used by public-health authorities to develop health policies. METHODS: A consensus-development Delphi study was used, with participants selected for their expertize in rare diseases and registries. Participants were asked to complete a questionnaire on the most important criteria for creating PRs. Three rounds were performed. RESULTS: Agreement was reached on half the questions in the first round and on 89% of questions in the final round, with a total expert participation rate of around 60% by the final stage. This study made it possible to reach a broader consensus starting from experts' initial assessment of the features that should be considered for the creation of a rare-disease PR. CONCLUSION: The consensus method used made it possible to define the characteristics of a PR based on expert opinion within a rare-disease framework. This study may serve as a guide for helping other researchers plan and build a rare-disease PR.

Reemergencia del sarampión. Situación epidémica en la Comunidad Valenciana durante los años 2011 y 2012 / Reemergence of measles. Epidemic situation in the Valencian Community during the years 2011 and 2012

La incidencia del sarampión descendió hasta llegar a ser una notificación esporádica e infrecuente en la última década. La reemergencia de la enfermedad alcanzó 744 casos en 2012, tasa de 14,50 × 105 habitantes. Se aplicó un diseño clásico en Vigilancia de Salud Pública: análisis retrospectivo de incidencia acumulada y características de los sujetos afectados. Se cruzaron los datos de encuesta con los de la Red Microbiológica Valenciana (RedMIVA). En total, 976 casos de sarampión fueron confirmados en el período epidémico 2011-2012. La distribución temporal muestra 3 ondas de amplitud constante: 12 a 15 semanas. La proporción de sujetos no vacunados y con estado vacunal desconocido alcanzó el 85% de los casos. Se documentaron 25 brotes, 499 casos asociados; en 7 de 10 brotes comunitarios, el inicio ocurrió en población de etnia gitana sin vacunar. En la ciudad de Valencia se aplicó profilaxis postexposición en 32 colegios, observándose bajas coberturas, entre el 63 y el 77%, en 8 centros e inferiores al 50% en 4. La tasa de serologías negativas fue del 12,4%, destacando los menores de 16 meses con el 44,8%. Las cohortes de 20 a 59 años presentaron tasas de negatividad del 13,5 al 5,9%. La epidemia tuvo su origen en la importación de casos a un territorio con insuficiente protección inmunitaria contra el sarampión. Su impacto y desarrollo estuvo condicionado por la cobertura vacunal previa, el patrón social y étnico de diferentes territorios y barrios, y la aplicación extensiva de profilaxis postexposición a contactos escolares y familiares de casos

Measles incidence declined until becomes a sporadic reporting and infrequent notification in the last decade. The reemergence of the disease reached 744 cases in 2012, a rate of 14.50 × 105 inhabitants. A classic design in Public Health Surveillance was performed: retrospective analysis of cumulative incidence and characteristics of the affected subjects. Those dates were in record linkage with Valencia Microbiology Network (RedMIVA). Finally, 976 cases of measles were confirmed in 2011-2012 epidemic period. Time-line distribution shows three waves with amplitude length on 12-15 weeks. Proportion of unvaccinated or unknown subjects came up to 85% of cases. 25 outbreaks were reported, 499 cases associated. In 7 of the 10 community outbreaks early cases were from Roma population unvaccinated. In the city of Valencia was applied post-exposure prophylaxis in 32 schools and was observed low coverage: between 63% and 77% in 8 schools and less than 50% in 4. Serum negative rate was 12.4% and we highlight the rate under 16 months: 44.8%. Cohorts of 20- 59 years had negative rates between 13.5 to 5.9%. The origin of the epidemic was the importation of cases to a territory with inadequate immune protection against measles. Its impact and development was conditioned by previous immunization coverage, the social and ethnic pattern of different areas or quarters and the extensive application of post-exposure prophylaxis at school and family contacts of cases

Reemergencia del sarampión. Situación epidémica en la Comunidad Valenciana durante los años 2011 y 2012 / Reemergence of measles. Epidemic situation in the Valencian Community during the years 2011 and 2012

La incidencia del sarampión descendió hasta llegar a ser una notificación esporádica e infrecuente en la última década. La reemergencia de la enfermedad alcanzó 744 casos en 2012, tasa de 14,50 × 105habitantes.Se aplicó un diseño clásico en Vigilancia de Salud Pública: análisis retrospectivo de incidencia acumulada y características de los sujetos afectados. Se cruzaron los datos de encuesta con los de la Red Microbiológica Valenciana (RedMIVA).En total, 976 casos de sarampión fueron confirmados en el período epidémico 2011-2012. La distribución temporal muestra 3 ondas de amplitud constante: 12 a 15 semanas. La proporción de sujetos no vacunados y con estado vacunal desconocido alcanzó el 85% de los casos. Se documentaron 25 brotes, 499 casos asociados; en 7 de 10 brotes comunitarios, el inicio ocurrió en población de etnia gitana sin vacunar. En la ciudad de Valencia se aplicó profilaxis postexposición en 32 colegios, observándose bajas coberturas, entre el 63 y el 77%, en 8 centros e inferiores al 50% en 4. La tasa de serologías negativas fue del 12,4%, destacando los menores de 16 meses con el 44,8%. Las cohortes de 20 a 59 años presentaron tasas de negatividad del 13,5 al 5,9%.La epidemia tuvo su origen en la importación de casos a un territorio con insuficiente protección inmunitaria contra el sarampión. Su impacto y desarrollo estuvo condicionado por la cobertura vacunal previa, el patrón social y étnico de diferentes territorios y barrios, y la aplicación extensiva de profilaxis postexposición a contactos escolares y familiares de casos (AU)

Measles incidence declined until becomes a sporadic reporting and infrequent notification in the last decade. The reemergence of the disease reached 744 cases in 2012, a rate of 14.50 × 105 inhabitants. A classic design in Public Health Surveillance was performed: retrospective analysis of cumulative incidence and characteristics of the affected subjects. Those dates were in record linkage with Valencia Microbiology Network (RedMIVA).Finally, 976 cases of measles were confirmed in 2011-2012 epidemic period. Time-line distribution shows three waves with amplitude length on 12-15 weeks. Proportion of unvaccinated or unknown subjects came up to 85% of cases. 25 outbreaks were reported, 499 cases associated. In 7 of the 10 community outbreaks early cases were from Roma population unvaccinated. In the city of Valencia was applied post-exposure prophylaxis in 32 schools and was observed low coverage: between 63% and 77% in 8 schools and less than 50% in 4. Serum negative rate was 12.4% and we highlight the rate under 16 months: 44.8%. Cohorts of 20-59 years had negative rates between 13.5 to 5.9%.The origin of the epidemic was the importation of cases to a territory with inadequate immune protection against measles. Its impact and development was conditioned by previous immunization coverage, the social and ethnic pattern of different areas or quarters and the extensive application of post-exposure prophylaxis at school and family contacts of cases (AU)