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1.
Semergen ; 50(6): 102274, 2024 Jun 11.
Article in English | MEDLINE | ID: mdl-38865758

ABSTRACT

OBJECTIVE: To evaluate the epidemiological evolution and economic impact of COVID-19 pandemic in the European Union (EU) and worldwide, and the effects of control strategies on them. MATERIAL AND METHODS: We collected incidence, mortality, and gross domestic product (GDP) data between the first quarter of 2020 and of 2023. Then, we reviewed the effectiveness of the mitigation and zero-COVID control strategies. The statistical analysis was done calculating the incidence rate ratio (IRR) of two rates and its 95% confidence interval (CI). RESULTS: In the EU, COVID-19 presented six epidemic waves. The sixth one at the beginning of 2022 was the biggest. Globally, the biggest wave occurred at the beginning of 2023. Highest mortality rates were observed in the EU during 2020-2021 and globally at the beginning of 2021. In mitigation countries, mortality was much higher than in zero-COVID countries (IRR=6.82 [95% CI: 6.14-7.60]; p<0.001). A GDP reduction was observed worldwide, except in Asia. None of the eight zero-COVID countries presented a GDP growth percentage lower than the EU percentage in 2020, and 3/8 in 2022 (p=0.054). COVID-19 pandemic caused epidemic waves with high mortality rates and a negative impact on GDP. CONCLUSION: The zero-COVID strategy was more effective in avoiding mortality and potentially had a lower impact on GDP in the first pandemic year.

3.
J Infect ; 74(3): 294-301, 2017 03.
Article in English | MEDLINE | ID: mdl-27840270

ABSTRACT

BACKGROUND: During the 2014-2015 Ebola Virus Disease (EVD) outbreak in N'Zérékoré, Forested Guinea, modes of transmission remained unexamined for a number of new cases. We used network visualization to investigate EVD transmission chains (TC) in seven sub-prefectures of N'Zérékoré in order to adapt outbreak response. METHODS: Between August 2014 and February 2015, the EVD outbreak response team including the World Health Organization (WHO) and local health authorities routinely collected information among new cases regarding hospital visits, cases within a household, participation in burials, as well as dates of symptom onset, serial intervals (SI) and exposure to EVD. SI's were defined as the interval between symptom onset in an index case and symptom onset in a secondary case infected by that index case. Cases who reported hospital visits, contact with a case in the household or participating in burials were attributed to these exposures. RESULTS: We identified seven TC (two urban and five rural) gathering characteristics of 109 probable/confirmed cases. Overall, 61% (66 cases, SI range: 7-20 days) were household related, 32% (35 cases, SI range 8-30 days) were household or burial related and 7% (8 cases, SI range: 4-20 days) were hospital-related. In the urban chains (18 cases, SI range: 7-20 days), 12 cases were household related and 6 cases were hospital related, none where household or burial related. In the rural chains (84 cases, SI range: 7-30 days), 60% (50 cases) were household related, 1% (1 case) was hospital related and 39% (34 cases) were household or burial related. No cases reported multiple exposures. CONCLUSIONS: Network visualization during field response is crucial in enhancing local control strategies, refining outbreak response and aiding rapid response teams in insuring psychosocial and socio-economic recovery. Urban settings need to focus on reducing hospital EVD transmission whereas rural settings should focus on raising awareness of transmission within a household and safeguarding EVD burials.


Subject(s)
Disease Outbreaks , Hemorrhagic Fever, Ebola/epidemiology , Hemorrhagic Fever, Ebola/transmission , Disease Outbreaks/prevention & control , Ebolavirus/genetics , Ebolavirus/isolation & purification , Epidemiological Monitoring , Genome, Viral , Guinea/epidemiology , Hemorrhagic Fever, Ebola/prevention & control , Hemorrhagic Fever, Ebola/virology , High-Throughput Nucleotide Sequencing , Humans , Rural Population , World Health Organization
4.
Int Health ; 8(3): 227-9, 2016 05.
Article in English | MEDLINE | ID: mdl-27059272

ABSTRACT

BACKGROUND: During the Ebola outbreak in Guinea, community resistance obstructed case investigation and response. We investigated a cluster of Ebola cases that were hiding in the forest, refusing external help, to identify sociocultural determinants related to community resistance. METHODS: Participant observation, interviews and focus group discussions were carried out. RESULTS: Most villagers feared the Ebola treatment centre (ETC) as there was the belief that people were killed in ETCs for organ trade. Four survivors accompanied back to the village from the ETC shared their experiences and reassured their neighbours. Subsequently, community compliance with contact tracing improved, leading to the timely detection of cases. CONCLUSIONS: Engaging Ebola virus disease survivors improved community compliance. Understanding the sociocultural context and community perceptions may improve community engagement and prevent Ebola virus transmission.


Subject(s)
Community Participation/statistics & numerical data , Cultural Characteristics , Disease Outbreaks/prevention & control , Hemorrhagic Fever, Ebola/prevention & control , Sociological Factors , Cluster Analysis , Focus Groups , Forests , Guinea/epidemiology , Hemorrhagic Fever, Ebola/epidemiology , Humans , Observation , Qualitative Research
5.
J R Soc Interface ; 13(117)2016 Apr.
Article in English | MEDLINE | ID: mdl-27097653

ABSTRACT

Development of arbuscular mycorrhizal fungal colonization of roots and the surrounding soil is the central process of mycorrhizal symbiosis, important for ecosystem functioning and commercial inoculum applications. To improve mechanistic understanding of this highly spatially and temporarily dynamic process, we developed a three-dimensional model taking into account growth of the roots and hyphae. It is for the first time that infection within the root system is simulated dynamically and in a spatially resolved way. Comparison between data measured in a calibration experiment and simulated results showed a good fit. Our simulations showed that the position of the fungal inoculum affects the sensitivity of hyphal growth parameters. Variation in speed of secondary infection and hyphal lifetime had a different effect on root infection and hyphal length, respectively, depending on whether the inoculum was concentrated or dispersed. For other parameters (branching rate, distance between entry points), the relative effect was the same independent of inoculum placement. The model also indicated that maximum root colonization levels well below 100%, often observed experimentally, may be a result of differential spread of roots and hyphae, besides intrinsic plant control, particularly upon localized placement of inoculum and slow secondary infection.


Subject(s)
Hyphae/growth & development , Models, Biological , Mycorrhizae/growth & development
6.
Euro Surveill ; 20(1)2015 Jan 08.
Article in English | MEDLINE | ID: mdl-25613651

ABSTRACT

On 6 October 2014, a case of Ebola virus disease (EVD) acquired outside Africa was detected in Madrid in a healthcare worker who had attended to a repatriated Spanish missionary and used proper personal protective equipment. The patient presented with fever <38.6 °C without other EVD-compatible symptoms in the days before diagnosis. No case of EVD was identified in the 232 contacts investigated. The experience has led to the modification of national protocols.


Subject(s)
Contact Tracing , Disease Outbreaks/prevention & control , Hemorrhagic Fever, Ebola/transmission , Infectious Disease Transmission, Patient-to-Professional , Fever/etiology , Hemorrhagic Fever, Ebola/diagnosis , Hemorrhagic Fever, Ebola/epidemiology , Humans , Liberia , Spain
7.
Rev Esp Sanid Penit ; 16(2): 48-58, 2014.
Article in English | MEDLINE | ID: mdl-25072789

ABSTRACT

Patterns of migration can change greatly over time, with the size and composition of migrant populations reflecting both, current and historical patterns of migration flows. The recent economic crisis has caused a decrease on migration flows towards the most affected areas, as well as cut offs in health interventions addressed to migrants. The objective of this paper is to review available data about interventions on migrants' health in Europe, and to describe changes in migrant health policies across Europe after the economic crisis, that can have a negative effect in their health status. Although migrants have the right to health care under legal settlements issued by the EU, there is no a standard European approach to offer health care to migrants, since; policies in each EU Member State are developed according to specific migrant experience, political climate, and attitudes towards migration. Migrants use to face greater health problems and major health care access barriers, compared with their counterparts from the EU. Therefore, migrant health policies should focus in protects this vulnerable group, especially during economic hardship, taking into account economic and socio-demographic risk factors. There is an especial need for research in the cost-effectiveness of investing in the health care of the migrant population, demonstrating the benefit of such, even in the health of the European native population, and the need for constant intervention despite of resource constraints.


Subject(s)
Minority Health , Transients and Migrants , Europe , HIV Infections/epidemiology , Health Policy , Humans , Occupational Health , Prisons , Reproductive Health , Tuberculosis/epidemiology , Vaccination
8.
Technol Cancer Res Treat ; 13(1): 47-55, 2014 Feb.
Article in English | MEDLINE | ID: mdl-23819493

ABSTRACT

To quantitatively evaluate the extent to which fiducial-based image-guidance improves dose coverage of the target volume and sparing of critical organs for prostate cancer patients treated with intensity modulated radiotherapy (IMRT) and determination of planning margins by original approach of detailed daily dose volume histogram (DVH) and patient's position correction analysis. Sixty-two patients divided in two groups (clinical target volume (CTV) → planning target volume (PTV) margin 10 and 7 mm) were treated with IMRT using implanted fiducial markers. Each patient's treatment fraction was recalculated as it would have been treated without fiducial-guided positioning. For both plans (IGRT and non-IGRT), equivalent uniform doses (EUD), maximal and minimal doses for target volumes, normal tissue complication probability (NTCP), maximum and mean doses for organs at risk and the whole DVH differences were assessed. In the group with 10 mm margins, the only significant difference was worse rectal NTCP by 4.5%, but the CTV dose coverage remained at the same level. Recalculated plans with 7 mm margin could not achieve the prescribed target volume coverage, and the EUD decreased by 3.7 and 0.6 Gy for PTV and CTV, respectively. Desired CTV → PTV margin for non-IGRT plans should be no lower than 12 mm to guarantee 95% instances when delivered dose to CTV maintain as planned, for IGRT plans decrease this requirement to 2 mm. Prostate IMRT strategies involving margin reduction below 7 mm require image-guidance to maintain the planned dose coverage. Using fiducial-based image-guidance and large margins seems to be superfluous.


Subject(s)
Prostatic Neoplasms/radiotherapy , Radiotherapy Planning, Computer-Assisted , Radiotherapy, Intensity-Modulated/methods , Fiducial Markers , Humans , Male , Prostatic Neoplasms/pathology , Radiotherapy Dosage , Tomography, X-Ray Computed
9.
Klin Onkol ; 26(6): 409-14, 2013.
Article in Czech | MEDLINE | ID: mdl-24320589

ABSTRACT

BACKGROUND: Intensity modulated radiotherapy (IMRT) plays a crucial role in the treatment of prostate cancer thanks to its capacity for healthy tissue sparing. This work reports on the acute and late toxicity rates among 233 patients treated with high-dose IMRT. MATERIAL AND METHODS: From June 2003 to December 2007, 233 men with clinically localized prostate cancer underwent radical radiotherapy. One hundred sixty patients were treated with IMRT to the prostate and the base of seminal vesicles to 78 Gy in 39 fractions, 73 patients underwent simultaneous integrated boost. Prescribed doses were 82 Gy and 73,8 Gy in 41 fractions to the prostate and seminal vesicles, respectively. Late toxicity was evaluated prospectively using a RTOG/FC-LENT score. RESULTS: Thirty patients (12.8%) experienced acute Grade 2 gastrointestinal (GI) toxicity. No acute Grade 3 or 4 GI toxicity developed. Forty two patients (18.1%) experienced acute Grade 2 genitourinary toxicity and 23 patients (9.9%) had Grade 3 GU toxicity. Grade 4 Genitourinary toxicity was observed in nine (3.8%) patients, due to a need of short-term urinary catheterization. With a median follow-up of 49.2 months, the estimated 5-year cumulative incidence of Grade 2 gastrointestinal toxicity was 22.4%. The estimated 5-year cumulative incidence of Grade 2 genitourinary toxicity was 17.7%. CONCLUSION: Intensity modulated radiotherapy enables dose escalation to 78-82 Gy with an acceptable toxicity.


Subject(s)
Prostatic Neoplasms/radiotherapy , Radiotherapy, Intensity-Modulated/adverse effects , Radiotherapy, Intensity-Modulated/methods , Aged , Aged, 80 and over , Catheterization/methods , Digestive System/radiation effects , Humans , Male , Middle Aged , Radiotherapy Dosage , Urogenital System/radiation effects
10.
J BUON ; 18(4): 949-53, 2013.
Article in English | MEDLINE | ID: mdl-24344022

ABSTRACT

PURPOSE: To retrospectively investigate the impact of prostate specific antigen (PSA) level after neoadjuvant androgen- deprivation therapy (ADT) on biochemical relapse-free survival in patients with prostate cancer who received radical radiotherapy (RT). METHODS: Between March 2003 and March 2008, 128 men with localized prostate cancer underwent neoadjuvant ADT for 4-6 months followed by radical RT. Biochemical relapse-free survival was compared between patients with pre-RT PSA ≤ 0.1 vs > 0.1 ng/mL. RESULTS: At a median follow up of 47.3 months, biochemical relapse-free survival was significantly higher in patients with a pre-RT PSA ≤ 0.1 ng/mL compared with pre-RT PSA > 0.1 ng/mL (85.6 vs 63.2%, p = 0.0025). CONCLUSION: The current analysis demonstrating better treatment outcome in patients with excellent biochemical response to neoadjuvant ADT, supports an individualized treatment strategy.


Subject(s)
Androgen Antagonists/therapeutic use , Antineoplastic Agents, Hormonal/therapeutic use , Kallikreins/blood , Neoadjuvant Therapy , Prostate-Specific Antigen/blood , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/radiotherapy , Aged , Aged, 80 and over , Chemotherapy, Adjuvant , Disease-Free Survival , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Neoplasm Grading , Patient Selection , Prostatic Neoplasms/blood , Prostatic Neoplasms/mortality , Prostatic Neoplasms/pathology , Retrospective Studies , Time Factors , Treatment Outcome
11.
Ceska Gynekol ; 78(3): 257-62, 2013 Jun.
Article in Czech | MEDLINE | ID: mdl-23869832

ABSTRACT

OBJECTIVE: To provide an actual review of radiotherapy in the treatment of vulvar carcinoma. DESIGN: A review article. SETTING: Department of Oncology and Radiotherapy, University Hospital in Hradec Králové. METHODS: A review article evaluating the application of ionizing radiation in the treatment of early and advanced vulvar carcinoma, based on the most significant previously published studies. CONCLUSION: Postoperative groin irradiation in patients with positive groin lymph-nodes improves local control, time to progression, and overall survival; especially in 2 positive nodes and in N2/3 initial findings. In case of positive inguinal nodes, radiotherapy of both groins and at least lower pelvic iliac node-chains should follow. Adjuvant irradiation of the primary remains controversial, except for positive resection margins where radiotherapy improves overall survival. Concurrent chemoradiotherapy seems to be appropriate primary treatment of advanced vulvar carcinomas, in attempt to avoid mutilating intervention or exenteration. Chemoradiation should be followed by subsequent surgery, including potential groin dissection in case of lymph-node involvement. Definitive chemoradiotherapy is of limited evidence, and radical dose escalation to the gross tumor is essential for its implementation. Modern radiotherapy techniques, especially with intensity modulation, are convenient for dose escalation.


Subject(s)
Vulvar Neoplasms/radiotherapy , Biopsy , Chemoradiotherapy , Female , Groin/pathology , Groin/surgery , Humans , Lymph Nodes/pathology , Lymph Nodes/surgery , Middle Aged , Vulvar Neoplasms/drug therapy , Vulvar Neoplasms/mortality , Vulvar Neoplasms/surgery
12.
Mol Ecol Resour ; 12(2): 219-32, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22059700

ABSTRACT

Quantitative real-time PCR (qPCR) is slowly becoming established as a tool to quantify abundance of different arbuscular mycorrhizal fungal (AMF) taxa in roots and in soil. Here, we describe the development and field validation of qPCR markers (i.e. primers with associated hydrolysis probes), targeting taxon-specific motifs in the nuclear large ribosomal subunit RNA genes. Design of such markers is complicated by the multinuclear and multigenomic cellular organization of these fungi and the high DNA sequence diversity within the smallest biologically relevant units (i.e. single-spore isolates). These limitations are further compounded by inefficient biomass production of these fungi, resulting in limited availability of pure genomic DNA (gDNA) of well-defined isolates for cross-specificity testing of the markers. Here we demonstrate, using a number of AMF isolates, the possibility to establish stringent qPCR running conditions allowing quantification of phylogenetically disjunctive AMF taxa. Further, we show that these markers can more generally be used to quantify abundance (i.e. number of target gene copies or amount of gDNA) of what is usually considered the level of AMF species, regardless of the isolate identities. We also illustrate the range of variation within qPCR signal strength across different AMF taxa with respect to the detected number of gene copies per unit amount of gDNA. This information is paramount for interpretation of the qPCR analyses of field samples. Finally, the field validation of these markers confirmed their potential to assess composition of field AMF communities and monitor the changes owing to agricultural practices such as soil tillage.


Subject(s)
Fungi/genetics , Fungi/isolation & purification , Mycorrhizae/genetics , Mycorrhizae/isolation & purification , Real-Time Polymerase Chain Reaction/methods , Soil Microbiology , Calibration , DNA Primers/genetics , DNA, Fungal/genetics , Fungi/classification , Molecular Sequence Data , Mycorrhizae/classification , Phylogeny , Real-Time Polymerase Chain Reaction/standards
13.
Euro Surveill ; 16(37)2011 Sep 15.
Article in English | MEDLINE | ID: mdl-21944556

ABSTRACT

A study of aggregate data collected from the literature and official sources was undertaken to estimate expected and observed prevalence of Trypanosoma cruzi infection, annual incidence of congenital transmission and rate of underdiagnosis of Chagas disease among Latin American migrants in the nine European countries with the highest prevalence of Chagas disease. Formal and informal data sources were used to estimate the population from endemic countries resident in Europe in 2009, diagnosed cases of Chagas disease and births from mothers originating from endemic countries. By 2009, 4,290 cases had been diagnosed in Europe, compared with an estimated 68,000 to 122,000 expected cases. The expected prevalence was very high in undocumented migrants (on average 45% of total expected cases) while the observed prevalence rate was 1.3 cases per 1,000 resident migrants from endemic countries. An estimated 20 to 183 babies with congenital Chagas disease are born annually in the study countries. The annual incidence rate of congenital transmission per 1,000 pregnancies in women from endemic countries was between none and three cases. The index of under diagnosis of T. cruzi infection was between 94% and 96%. Chagas disease is a public health challenge in the studied European countries. Urgent measures need to be taken to detect new cases of congenital transmission and take care of the existing cases with a focus on migrants without legal residency permit and potential difficulty accessing care.


Subject(s)
Chagas Disease/epidemiology , Emigrants and Immigrants/statistics & numerical data , Infectious Disease Transmission, Vertical/statistics & numerical data , Population Surveillance/methods , Trypanosoma cruzi/isolation & purification , Chagas Disease/prevention & control , Chagas Disease/transmission , Data Collection , Enzyme-Linked Immunosorbent Assay , Epidemiologic Studies , Europe/epidemiology , Female , Humans , Incidence , Latin America/ethnology , Male , Prevalence , Risk Factors , Trypanosoma cruzi/immunology
14.
J Food Prot ; 73(1): 125-31, 2010 Jan.
Article in English | MEDLINE | ID: mdl-20051215

ABSTRACT

The objective of this study was to evaluate the use of clinical-epidemiological profiles for classifying non-laboratory-confirmed outbreaks of foodborne disease (FBD) in Catalonia between 2002 and 2006 and for elucidating associations among factors contributing to these outbreaks. A total of 275 nonfamily outbreaks were studied, of which 190 (69.1%) were laboratory confirmed and 85 (30.9%) were not. In 176 (92.6%) of laboratory-confirmed outbreaks and 69 (81.2%) of non-laboratory-confirmed outbreaks, information was obtained on contributing factors (P = 0.009). In 72% of non-laboratory-confirmed outbreaks, the etiology was assigned by using clinical-epidemiological profiles; thus, 93% of outbreaks eventually were associated with an etiology. In laboratory-confirmed outbreaks, poor personal hygiene was positively associated with norovirus (odds ratio [OR], 2.69; 95% confidence interval [CI], 1.47 to 4.89; P = 0.0007) and negatively associated with Salmonella and Campylobacter (OR, 0.54; 95% CI, 0.33 to 0.89; P = 0.01), and an unsafe source was positively associated with Salmonella and Campylobacter (OR, 4.07; 95% CI, 1.72 to 10.09; P = 0.001) and negatively associated with norovirus (OR, 0.14; 95% CI, 0.04 to 0.58; P = 0.001). No differences were found among contributing factors associated with outbreaks with a laboratory-confirmed etiology and those associated with outbreaks with an etiology assigned according to the clinical-epidemiological profiles. Clinical-epidemiological profiles are useful for determining what prevention and control strategies are appropriate to the agents involved in each community and for designing outbreak investigations.


Subject(s)
Food Contamination/analysis , Food Handling/methods , Foodborne Diseases/epidemiology , Foodborne Diseases/etiology , Hygiene , Campylobacter/isolation & purification , Disease Outbreaks , Foodborne Diseases/microbiology , Foodborne Diseases/pathology , Humans , Norovirus/isolation & purification , Odds Ratio , Population Surveillance , Salmonella/isolation & purification , Salmonella Food Poisoning/epidemiology , Salmonella Food Poisoning/etiology , Salmonella Food Poisoning/microbiology , Salmonella Food Poisoning/pathology , Spain/epidemiology
15.
Clin Microbiol Infect ; 16(9): 1364-7, 2010 Sep.
Article in English | MEDLINE | ID: mdl-20041897

ABSTRACT

To evaluate compliance with preparedness plans, actors simulating avian influenza attended various hospital emergency departments and public health centres during the last quarter of 2007. Most centres (89%) did not respond correctly. The useful information obtained was sent to the medical and administrative staff who were responsible for the preparedness plans. Awareness of these errors and their rectification can lead to improvements in the response to any case of influenza with pandemic potential and in the capacity to combat any other emergent or re-emergent community infection.


Subject(s)
Civil Defense/methods , Communicable Disease Control/methods , Health Services Research , Influenza, Human/diagnosis , Influenza, Human/therapy , Pandemics/prevention & control , Patient Simulation , Adult , Female , Humans , Male
16.
Clin Microbiol Infect ; 16(6): 568-74, 2010 Jun.
Article in English | MEDLINE | ID: mdl-19681961

ABSTRACT

During a 2-year period (2003-2004), tuberculosis (TB) transmission in Barcelona and the factors related to transmission among the Spanish- and foreign-born populations were studied by molecular epidemiology. Data were obtained from TB cases and Conventional Contact Tracing registries and genotyping was performed using restriction fragment length polymorphism (RFLP)-IS6110 and MIRU12 as a secondary typing method. Of the 892 TB cases reported, 583 (65.3%) corresponded to Spanish-born and 309 (34.6%) to foreign-born. Six hundred and eighty-seven cases (77%) were confirmed by culture. RFLP typing of 463/687 (67.4%) isolates was performed, revealing 280 (60.5%) unique and 183 (39.5%) shared patterns, which were grouped into 65 clusters. Spanish-born individuals were significantly more clustered than foreign-born individuals (44.6% vs. 28.8%; p 0.016). Clustering in foreign-born individuals was associated with HIV (p 0.051, odds ratio = 3.1, 95% confidence interval 1-10.9) and alcohol abuse (p 0.022), whereas, in the Spanish-born individuals, clustering was associated with age in the range 21-50 years, (p 0.024). Of the total clusters, 36/65 (55.3%) included only Spanish-born patients, whereas 22/65 (33.8%) included individuals from both populations. In mixed clusters, the index case was Spanish-born in 53% and foreign-born in 47%. Among the foreign-born, 2.8% were ill on arrival, 30% developed TB within the first year and 50.3% developed TB within the first 2 years; 58.3% were from South America. In conclusion, half of the foreign-born TB patients developed the disease during the first 2 years after arrival, which, in most cases, was the result of endogenous reactivation. Recent TB transmission among Spanish-born and foreign-born populations, as well as bidirectional transmission between communities, contributed significantly to the burden of TB in Barcelona, suggesting the need to improve Public Health interventions in both populations.


Subject(s)
Mycobacterium tuberculosis/classification , Mycobacterium tuberculosis/isolation & purification , Tuberculosis/epidemiology , Tuberculosis/transmission , Adolescent , Adult , Aged , Aged, 80 and over , Alcoholism/complications , Bacterial Typing Techniques/methods , Child , Child, Preschool , Cluster Analysis , DNA Fingerprinting/methods , DNA, Bacterial/genetics , Emigrants and Immigrants , Female , Genotype , HIV Infections/complications , Humans , Infant , Infant, Newborn , Male , Middle Aged , Molecular Epidemiology/methods , Mycobacterium tuberculosis/genetics , Polymorphism, Restriction Fragment Length , Risk Factors , Spain/epidemiology , Young Adult
17.
J Food Prot ; 72(9): 1958-62, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19777900

ABSTRACT

Foodborne diseases (FBD) are a major cause of disease and death, but their etiologies are not always known. Factors associated with determination of the etiologic agent of FBD outbreaks reported to the Department of Health in Catalonia (Spain) during 2002 to 2005 were studied. For each outbreak, the year, number of persons affected, hospitalization, and availability of samples from patients, food handlers, and foods were collected. The delay between the date of onset of symptoms of the second case and the report to the surveillance unit was calculated. The relationship between explanatory variables and determination of the cause of each outbreak was studied by logistic regression. The causal agent was identified in 242 (73.3%) of 330 outbreaks. Factors associated with determining the etiologic agent of the outbreak in the univariate analysis were availability of samples from cases (odd ratio [OR] of 6.0, 95% confidence interval [CI] of 3.2 to 11.1), hospitalization (OR of 5.1, 95% CI of 2.6 to 11.1), availability of samples from food handlers (OR of 2.7, 95% CI of 1.6 to 4.5), size > or = 10 cases (OR of 2.2, 95% CI of 1.3 to 3.2), availability of samples from food (OR of 1.8, 95% CI of 1.1 to 3.0), and the last year (2005) of the study period (OR of 1.9, 95% CI of 1.0 to 3.6). In the multivariate analysis, hospitalization (adjusted OR of 5.1, 95% CI of 2.4 to 11.2), size > or = 10 cases (adjusted OR of 2.1, 95% CI of 1.2 to 3.7), and the year 2005 (OR of 2.1, 95% CI of 1.1 to 4.0) remained associated. Collection and processing of clinical samples from cases and appropriate laboratory diagnoses of all possible etiologies of FBD, including viruses, are very important. Efforts by physicians and public health services to coordinate and improve their activity in these areas may help provide more accurate knowledge concerning the etiologies of FBD outbreaks and lead to more effective preventive procedures.


Subject(s)
Disease Outbreaks/statistics & numerical data , Food Contamination/analysis , Foodborne Diseases/epidemiology , Foodborne Diseases/etiology , Gastroenteritis/epidemiology , Gastroenteritis/etiology , Analysis of Variance , Food Handling/methods , Foodborne Diseases/microbiology , Gastroenteritis/microbiology , Hospitalization , Humans , Logistic Models , Odds Ratio , Risk Factors , Sentinel Surveillance , Spain/epidemiology
18.
J Viral Hepat ; 15 Suppl 2: 51-6, 2008 Oct.
Article in English | MEDLINE | ID: mdl-18837835

ABSTRACT

A universal vaccination program for preadolescents, aged 12 years, with the hepatitis A + B vaccine was introduced in 1998 in Catalonia (Spain) with the aim of protecting the whole population against hepatitis A. The hepatitis A + B vaccine program replaced the hepatitis B vaccination program for preadolescent started in 1991. The impact of the hepatitis A + B vaccination program was studied by assessment of the trend of reported cases of hepatitis A. All cases of viral hepatitis reported from 1992 to 2006 were included in the study. To evaluate changes in the epidemiology of hepatitis A, two periods were considered: a prevaccination period (1992-1998) and a post-vaccination period (2001-2006). The ratios of the rates were calculated according to age and sex. The comparison of rates and proportions was made by calculation of the normal z statistic. A total of 7536 cases of viral hepatitis were reported, of which 4109 (54.52%) were hepatitis A. The incidence rate of hepatitis A fell from 5.44 per 100 000 person-years in the prevaccination period to 3.02 in the post-vaccination period. In males, the rate fell from 6.85 to 3.89 and in females from 4.10 to 2.18. The male-female ratio of incidence rates was lower in the post-vaccination period. In males the global decline of incidence rate was 43.26% and in females 46.96%. The greatest decline occurred in the 15 to 19 years age group in both sexes (79.1% in men and 78.34% in women) but declines in the 10-14 years age group were also very important (69.21% and 67.88%, respectively). In conclusion, hepatitis A incidence fell in Catalonia in the post-vaccination period in vaccinated adolescents and also in other unvaccinated groups who have benefited from the indirect effects of the vaccination program.


Subject(s)
Hepatitis A Vaccines/administration & dosage , Hepatitis A/epidemiology , Immunization Programs , Vaccination/statistics & numerical data , Adolescent , Adult , Child , Female , Hepatitis A/prevention & control , Hepatitis A Antibodies/blood , Humans , Incidence , Male , Population Surveillance , Sex Ratio , Spain/epidemiology , Young Adult
19.
Rev Clin Esp ; 206(11): 560-5, 2006 Dec.
Article in Spanish | MEDLINE | ID: mdl-17265572

ABSTRACT

OBJECTIVE: To calculate excess mortality in an annual cohort of tuberculosis patients and study the factors associated with death. MATERIAL AND METHOD: Cases of tuberculosis reported in Catalonia (May 1996-April 1997). Patients were classified as completed treatment/cured (compliant), non-compliant, failures, transfers out and deaths. Excess mortality was defined as the ratio actual deaths/expected deaths (according to general mortality figures for Catalonia, May 1996-April 1997). Factors associated with death were determined by a comparative study of variables (demographic, substance abuse, comorbidity, tuberculosis-related disease) in deaths after diagnosis and survivors. Time from diagnosis to death was recorded. RESULTS: Patients included: 2,085. Patients classified as: completed treatment/cured (compliant), 1,406 (67.43 %); noncompliant, 165 (7, 91%); failures, 5 (0.24%); transfers out, 25 (1.21%); deaths, 133 (6.38%), 28 of which occurred before diagnosis and 105 after diagnosis. Insufficient data in medical record for classification, 351 (16.83%) patients. Excess mortality: 5.98 (95% CI: 4.96-7.0). Factors associated with death: treatment with non-standardized guidelines, 46%; OR: 10.3 (6.2-17.4); HIV infection, 40%; OR: 13.0 (6.6-25.8); age greater than 64 years, 40%; OR: 14.6 (3.0-69.8); alcoholism, 25%; OR: 2.0 (1.1-3.6); neoplasm, 16%; OR: 3.9 (1.8-8.6; renal failure, 8%; OR: 10.1 (3.1-32.3). The shortest time from diagnosis to death was in patients with only one risk factor, except for HIV infection, where the time passed was the longest observed. CONCLUSIONS: We found substantial excess mortality in tuberculosis patients. Death was associated with the efficacy of treatment, HIV coinfection, advanced age, alcoholism and the coexistence of neoplasms or renal failure.


Subject(s)
Tuberculosis/mortality , Adolescent , Adult , Age Distribution , Aged , Antitubercular Agents/therapeutic use , Cause of Death , Child , Female , Humans , Male , Middle Aged , Risk Factors , Sex Distribution , Spain/epidemiology , Tuberculosis/drug therapy
20.
Mycorrhiza ; 16(1): 61-66, 2005 Dec.
Article in English | MEDLINE | ID: mdl-16133255

ABSTRACT

Arbuscular mycorrhizal fungal (AMF) spore communities were surveyed in a long-term field fertilization experiment in Switzerland, where different amounts of phosphorus (P) were applied to soil. Plots receiving no P as well as plots systematically fertilized in excess to plant needs for 31 years were used to test the hypothesis that application of P fertilizer changes the composition and diversity of AMF communities. AMF spores were isolated from the field soil, identified, and counted so as to quantify the effect of P fertilization on AMF spore density, composition, and diversity. Trap cultures were established from field soil with four host plants (sunflower, leek, maize, and Crotalaria grahamiana), and the spore communities were then analyzed in substrate samples from the pots. Altogether, nine AMF species were detected in the soil. No evidence has been acquired for effect of P fertilization on spore density, composition, and diversity of AMF in both the field soil and in trap cultures. On the other hand, we observed strong effect of crop plant species on spore densities in the soil, the values being lowest under rapeseed and highest under Phacelia tanacetifolia covercrop. The identity of plant species in trap pots also significantly affected composition and diversity of associated AMF communities, probably due to preferential establishment of symbiosis between certain plant and AMF species. AMF spore communities under mycorrhizal host plants (wheat and Phacelia in the fields and four host plant species in trap pots) were dominated by a single AMF species, Glomus intraradices. This resulted in exceptionally low AMF spore diversity that seems to be linked to high clay content of the soil.


Subject(s)
Fungi/growth & development , Fungi/isolation & purification , Mycorrhizae/growth & development , Soil Microbiology , Biodiversity , Colony Count, Microbial , DNA, Fungal/chemistry , DNA, Fungal/genetics , DNA, Ribosomal/chemistry , DNA, Ribosomal/genetics , Fertilizers/microbiology , Fungi/classification , Fungi/drug effects , Intercellular Signaling Peptides and Proteins/pharmacology , Molecular Sequence Data , Mycorrhizae/drug effects , Phosphorus/pharmacology , Plants/microbiology , Sequence Analysis, DNA , Spores, Fungal/classification , Spores, Fungal/isolation & purification , Switzerland
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