ABSTRACT
Tackling health inequalities to achieve health equity is currently one of the main challenges for developed and developing countries. Aware of this reality, and knowing how relevant for economic and social growth the inequalities in health are, the Spanish Ministry of Health and Social Policy has established "Innovation in Public Health: monitoring social determinants of health and reduction of health inequalities" as one of the priorities for the Spanish presidency of the European Union in the first semester of 2010. Furthermore, a national strategy to tackle health inequalities is being developed in the current political term. By choosing this priority, the Spanish Ministry of Health an Social Policy aims to contribute to move forward a coherent and effective agenda at both European and national level, in a new world stage more aware of the social and economic expenditure of inequity in health and its repercussions on countries welfare and development.
Subject(s)
Health Status Indicators , Information Systems , Public Health , Socioeconomic Factors , Developed Countries , Developing Countries , European Union , Health Policy , Humans , Organizational Innovation , Public Policy , SpainABSTRACT
Actualmente uno de los principales retos para las sociedades, tanto desarrolladas como en vías de desarrollo, es disminuir las desigualdades en salud para conseguir una equidad efectiva. El Ministerio de Sanidad y Política Social, consciente de esta realidad y conocedor de la importancia que las desigualdades en salud tienen en el desarrollo económico y social de un país, ha establecido como prioridad para la Presidencia española de la Unión Europea del primer semestre de 2010 la «Innovación en Salud Pública: monitorización de los determinantes sociales de la salud y reducción de las desigualdades en salud». Además, para esta legislatura también se ha marcado la reducción de las desigualdades como una prioridad y se está trabajando en el desarrollo de una estrategia nacional. Al elegir esta prioridad para la Presidencia se pretende, por tanto, dar un nuevo impulso a la equidad en salud en la agenda política, tanto nacional como europea, en un momento en el que contamos con un nuevo escenario mundial más consciente del coste social y económico de la desigualdad, y de sus repercusiones en el bienestar y desarrollo de los países(AU)
Tackling health inequalities to achieve health equity is currently one of the main challenges for developed and developing countries. Aware of this reality, and knowing how relevant for economic and social growth the inequalities in health are, the Spanish Ministry of Health and Social Policy has established «Innovation in Public Health: monitoring social determinants of health and reduction of health inequalities» as one of the priorities for the Spanish presidency of the European Union in the first semester of 2010. Furthermore, a national strategy to tackle health inequalities is being developed in the current political term. By choosing this priority, the Spanish Ministry of Health an Social Policy aims to contribute to move forward a coherent and effective agenda at both European and national level, in a new world stage more aware of the social and economic expenditure of inequity in health and its repercussions on countries welfare and development(AU)
Subject(s)
Humans , Male , Female , Public Health/methods , Public Health/trends , Health Status Disparities , Economic Indexes , Indicators of Health Services , Health Status Indicators , Quality Indicators, Health Care , 34628 , Public Policy , European Union/economics , European Union/organization & administration , European Union/statistics & numerical data , Socioeconomic FactorsABSTRACT
En el presente trabajo se han revisado los resultados deseroprevalencia frente a sarampión, rubéola y parotiditis obtenidosen la III Encuesta de Serovigilancia de la Comunidad deMadrid (III ESVCM) realizada en 1999-2000 y la posteriorevolución de estas tres enfermedades en esta región.En la III ESVCM la prevalencia de anticuerpos frente asarampión, rubéola y parotiditis fue respectivamente >90%,>95% y <90%. Pese a los buenos resultados obtenidos pararubéola y sarampión, en los años 2005 y 2006 surgieron enMadrid dos importantes brotes de estas enfermedades. El brotede rubéola de 2005 (460 casos) afectó especialmente a poblacióninmigrante de ambos sexos (procedentes mayoritariamentede América Central y del Sur) y varones adultos españoles. Elbrote de sarampión de 2006 (174 casos) fue importado, una elevadaproporción de casos eran adultos, la mayoría de los pacientesno estaban vacunados y no se observaron diferencias por delsexo. En la Comunidad de Madrid la circulación del virus de laparotiditis ha continuado desde 1999 hasta la actualidad y se handetectado ondas epidémicas en los periodos 2000-2001 y 2006-2007. Durante el período 2006-2007 una importante proporciónde los casos presentaron antecedentes de vacunación.Cada una de estas tres enfermedades presenta característicaspropias. Sin embargo, las tres muestran en común el cambioen la edad de aparición con una frecuencia cada vez mayorde casos entre adultos jóvenes(AU)
In this study results against measles, rubella and mumpsobtained in the III Sero-epidemiological Survey of theAutonomous Region of Madrid, performed in 1999-2000,were related to the posterior evolution of these diseases in thisRegion.The prevalence of antibodies against measles, rubella andmumps was >90%, >95% and <90 %, respectively. Despite ofthe good results obtained for rubella and measles, in 2005 and2006 two important outbreaks of these diseases occurred inMadrid. The rubella outbreak in 2005 (450 cases) affectedespecially to immigrants of both sexes (mainly from Central andSouth America) and Spanish adults males. The 2006 measlesoutbreak (174 cases) was imported, a high proportion of caseswere adults and most of the patients were unvaccinated. Nodifferences according to sex were observed. In Madrid mumpsvirus circulation has continued from 1999 to present. Twoepidemic waves in the periods 2000-2001 and 2006-2007 havebeen detected. During 2006-2007, an important proportion ofcases showed antecedents of vaccination.Each one of these three diseases has typicalcharacteristics. However, the three has in common the changein the age of apparition, with a growing frequency of casesamong young adults(AU)
Subject(s)
Humans , Rubella/epidemiology , Measles/epidemiology , Parotitis/epidemiology , Seroepidemiologic Studies , Health Surveys , Epidemiological Monitoring/trends , Disease Outbreaks , Age DistributionABSTRACT
In this study results against measles, rubella and mumps obtained in the III Sero-epidemiological Survey of the Autonomous Region of Madrid, performed in 1999-2000, were related to the posterior evolution of these diseases in this Region. The prevalence of antibodies against measles, rubella and mumps was >90%, >95% and <90 %, respectively. Despite of the good results obtained for rubella and measles, in 2005 and 2006 two important outbreaks of these diseases occurred in Madrid. The rubella outbreak in 2005 (450 cases) affected especially to immigrants of both sexes (mainly from Central and South America) and Spanish adults males. The 2006 measles outbreak (174 cases) was imported, a high proportion of cases were adults and most of the patients were unvaccinated. No differences according to sex were observed. In Madrid mumps virus circulation has continued from 1999 to present. Two epidemic waves in the periods 2000-2001 and 2006-2007 have been detected. During 2006-2007, an important proportion of cases showed antecedents of vaccination. Each one of these three diseases has typical characteristics. However, the three has in common the change in the age of apparition, with a growing frequency of cases among young adults.
Subject(s)
Antibodies, Viral/blood , Measles/blood , Measles/epidemiology , Mumps/blood , Mumps/epidemiology , Rubella/blood , Rubella/epidemiology , Adolescent , Adult , Child , Child, Preschool , Female , Health Surveys , Humans , Male , Seroepidemiologic Studies , Spain , Urban Health , Young AdultABSTRACT
OBJECTIVE: to ascertain the seroprevalence of antibodies to varicella-zoster virus in the Madrid population prior to the introduction of vaccination. STUDY DESIGN: Cross-sectional antibody seroprevalence study. POPULATION: persons aged 2 to 40 years in Madrid. Field work: September 1999 to April 2000. Data were collected on demographic and socio-economic variables and on a number of exposures. IgG antibodies were determined using Enzyme Linked ImmunoSorbent Assay (ELISA), and antibody prevalence broken down by age group. Logistic regression was used to analyse the association between the presence of antibodies and the respective study variables. The results were compared against those of an earlier seroprevalence survey in Madrid (1993). RESULTS: A total of 2,131 subjects were included, with a non-response rate of 20.4%. Antibody prevalence was estimated at 90.2%; the 90% mark was reached at 11 years of age and almost 100% of adults presented with antibodies. In the case of children, school attendance associated with the presence of antibodies. No significant differences were observed vis-à-vis the results of the earlier survey. CONCLUSIONS: The seroprevalence profile coincides with those of other Spanish regions and European countries, and remains stable over time. Antibody presence rises sharply in children from aged 2 years to adolescence. Further seroprevalence studies are called for to study the disease trend and assess preventive measures.
Subject(s)
Chickenpox/epidemiology , Herpes Zoster/epidemiology , Herpesvirus 3, Human/isolation & purification , Adolescent , Adult , Age Distribution , Analysis of Variance , Antibodies, Viral/blood , Chickenpox/blood , Child , Child, Preschool , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay , Female , Herpes Zoster/blood , Herpesvirus 3, Human/immunology , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Logistic Models , Male , Middle Aged , Seroepidemiologic Studies , Spain/epidemiologyABSTRACT
BACKGROUND AND OBJECTIVE: The availability of antipneumococcal vaccines makes it necessary to go deeply into the knowledge of pneumococcal disease. This study aims at describing the magnitude and incidence of pneumococcal disease in the Region of Madrid from 1998 to 2006. MATERIAL AND METHOD: Retrospective study of Computerized Hospital Discharge Data registered from 1998 to 2006. Incidence per 100,000 inhabitants and lethality were calculated. Temporal evolution was analyzed. RESULTS: 20,813 cases of pneumococcal disease were registered (annual average incidence 41.87/100,000 inhabitants). Incidence was 40.65 for pneumoniae and 0.77 for meningitis. People over 64 years old (185.04) and under 1 year of age (67.22) showed the highest incidence. Lethality was 10.1% (15.8% for meningitis). Incidence in 2004--2006 was lower than 1998--2000 (before the introduction of conjugate vaccine). Incidence trend has declined slightly. CONCLUSIONS: The incidence is higher than that shown by other studies. Selected source of data can explain this difference, since our data included suspected cases. However, pneumococcal meningitis incidence is similar to that described by others.
Subject(s)
Pneumococcal Infections/epidemiology , Adolescent , Adult , Age Factors , Aged , Child , Child, Preschool , Female , Humans , Incidence , Infant , Infant, Newborn , Male , Meningitis, Pneumococcal/epidemiology , Middle Aged , Pneumococcal Infections/mortality , Pneumonia, Pneumococcal/epidemiology , Retrospective Studies , Sex Factors , Spain/epidemiologyABSTRACT
Fundamento y objetivo: La disponibilidad de vacunas antineumocócicas hace necesario profundizar en el conocimiento de la enfermedad neumocócica. El objetivo del estudio ha sido describir la magnitud y la evolución de la enfermedad por Streptococcus pneumoniae en la Comunidad de Madrid durante 1998-2006. Material y método: Se ha realizado un estudio retrospectivo del Conjunto Mínimo Básico de Datos de Altas Hospitalarias en el período 1998-2006. Se calcularon las tasas de incidencia por 100.000 habitantes y la letalidad, y se analizó la evolución temporal. Resultados: En el período estudiado se registraron 20.813 casos de enfermedad neumocócica (incidencia media anual: 41,87 casos/ 100.000 habitantes). La incidencia fue de 40,65 para neumonía y de 0,77 para meningitis. La mayor incidencia se presentó en personas mayores de 64 años (185,04) y en menores de 1 año (67,22). La letalidad fue del 10,1% (el 15,8% para meningitis). La incidencia fue menor en 2004-2006 que en 1998-2000 (antes de la autorización de la vacuna conjugada). La evolución de la incidencia muestra una ligera tendencia descendente. Conclusiones: La incidencia obtenida es superior a la de algunos estudios debido a que se incluyen sospechas clínicas. La incidencia de meningitis es similar a la descrita
Background and objective: The availability of antipneumococcal vaccines makes it necessary to go deeply into the knowledge of pneumococcal disease. This study aims at describing the magnitude and incidence of pneumococcal disease in the Region of Madrid from 1998 to 2006. Material and method: Retrospective study of Computerized Hospital Discharge Data registered from 1998 to 2006. Incidence per 100,000 inhabitants and lethality were calculated. Temporal evolution was analyzed. Results: 20,813 cases of pneumococcal disease were registered (annual average incidence 41.87/100,000 inhabitants). Incidence was 40.65 for pneumoniae and 0.77 for meningitis. People over 64 years old (185.04) and under 1 year of age (67.22) showed the highest incidence. Lethality was 10.1% (15.8% for meningitis). Incidence in 2004-2006 was lower than 1998-2000 (before the introduction of conjugate vaccine). Incidence trend has declined slightly. Conclusions: The incidence is higher than that shown by other studies. Selected source of data can explain this difference, since our data included suspected cases. However, pneumococcal meningitis incidence is similar to that described by others
Subject(s)
Humans , Pneumococcal Infections/epidemiology , Streptococcus pneumoniae/pathogenicity , Cohort Studies , Pneumococcal Vaccines , Retrospective Studies , Pneumonia, Pneumococcal/epidemiology , Meningitis, Pneumococcal/epidemiologyABSTRACT
Fundamento: La inmigración desde países de alta prevalenciade tuberculosis hacia otros más desarrollados afecta a la evoluciónglobal de la tuberculosis en los últimos años. El objetivode este estudio fue describir la influencia de los casos de tuberculosisen personas extranjeras sobre la incidencia de la enfermedaden la Comunidad de Madrid en el período 1996 a 2004.Métodos: Los datos procedían del Registro Regional deCasos de Tuberculosis, y del padrón de 1996 y los padronescontinuos de 1998 a 2004. Se estimó la incidencia de tuberculosissegún país de origen desde 1996 a 2004, por sexo y gruposde edad. Se calcularon c2 para tendencia lineal, razones deincidencia y proporción de casos en personas extranjeras.Resultados: La incidencia de tuberculosis pasó de 34,3casos por 105 habitantes en 1996 a 16,9 casos por 105 habitantesen 2004. Para los nacidos en España cambió de 33,2 casospor 105 habitantes en 1996 a 12,7 casos por 105 habitantes en2004, y para los extranjeros de 50,5 casos por 105 habitantesen 1996 a 42,9 casos por 105 habitantes en 2004. La razón dela incidencia entre extranjeros y españoles fue superior a 1 entodos los años, con valor máximo en 2003, en el que se detectaron4,2 casos en extranjeros por cada caso en españoles (IC95% 3,7-4,7). El porcentaje de casos extranjeros pasó del 5,2%en 1996 al 35,1% en 2004.Conclusiones: La incidencia de tuberculosis en extranjerosfue mayor que entre los españoles y no disminuyó significativamenteen el período 1996-2004, lo que está contribuyendoa que la tuberculosis se haya estabilizado. Esta situación ylas características de esta población han de ser tenidas en cuentaen los esfuerzos para el control de esta enfermedad(AU)
Backgound: Immigration from countries having a highprevalence of tuberculosis to other more highly-developedcountries has a bearing on the overall evolution of tuberculosisin the latter. This study is aimed at describing the influenceof the cases of tuberculosis among foreign individuals onthe incidence of this disease in the Autonomous Community ofMadrid during the 1996-2004 period.Methods: The data was taken from the Regional TuberculosisCase Registry and from the 1996 census and the continuouscensuses from 1998 to 2004. The tuberculosis incidencewas estimated by country of origin from 1996 to 2004, bygender and by age groups. A calculation was made of the c2for the linear trend, reasons for incidence and proportion ofcases among foreign individuals.Results: The incidence of tuberculosis went from 34.3cases per105 inhabitants in 1996 to 16.9 cases per105 inhabitantsin 2004. For those born in Spain, it changed from 33.2cases per 105 inhabitants in 1996 to 12.7 cases per 105 inhabitantsin 2004; and for foreign individuals, from 50.5 casesper 105 inhabitants in 1996 to 42.9 cases per 105 inhabitantsin 2004. The reason for the incidence between foreign andSpanish individuals was greater than 1 for all years, the maximumfigure having been in 2003, when 4.2 cases were detectedamong foreigners for every case among Spanish individuals(95% CI 3.7-4.7). The percentage of foreign cases wentfrom 5.2% in 1996 to 35.1% in 2004.Conclusions: The incidence of tuberculosis among foreignerswas greater than among Spanish individuals and did notsignificantly decrease in the 1996-2004 period, which is contributingto tuberculosis having stabilized. This situation andthe characteristics of this population must be taken intoaccount in the efforts for controlling this disease(AU)
Subject(s)
Humans , Tuberculosis/epidemiology , Communicable Disease Control/methods , Emigrants and Immigrants/statistics & numerical data , Spain/epidemiology , Mandatory Reporting , Disease PreventionABSTRACT
OBJECTIVE: The aim of this study was to assess the seroprevalence of Toscana virus (TOSV) in the Community of Madrid. METHODS: Samples from two serosurveys obtained during 1993-1994 (2262 individuals) and 1999-2000 (1945 individuals) were studied. Samples were tested by ELISA for TOSV IgG detection. RESULTS: The seroprevalence of TOSV IgG was significantly higher in 1993-1994 (7.2%; 95% CI 6.2-8.4) than in 1999-2000 (5.7%; 95% CI 4.7-6.9) (chi-square, p < 0.05). In both periods, the prevalence increased significantly with age. CONCLUSION: These results confirm that TOSV has been circulating in the Community of Madrid over the last years.
Subject(s)
Antibodies, Viral/blood , Phlebotomus Fever/epidemiology , Sandfly fever Naples virus/immunology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Child , Child, Preschool , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunoglobulin G/blood , Male , Middle Aged , Morbidity/trends , Retrospective Studies , Seroepidemiologic Studies , Urban Population/statistics & numerical dataABSTRACT
Este trabajo ha sido presentado en parte en el XII Congreso de la Sociedad Española de Microbiología Clínica y Enfermedades Infecciosas (Valencia del 10 al 13 de mayo de 2006). Objetivo. Valorar la seroprevalencia frente a virus Toscana (VTOS) en la Comunidad de Madrid. Métodos. Se estudiaron muestras de dos encuestas de serovigilancia obtenidas durante 1993-1994 (2.262 individuos) y 1999-2000 (1.945 individuos). Las muestras se procesaron mediante análisis inmunoenzimático (ELISA) para la detección de IgG frente a VTOS. Resultados. La seroprevalencia en 1993-1994 (7,2%; IC 95%: 6,2-8,4) resultó significativamente mayor (x2; p < 0,05) que en 1999-2000 (5,7%; IC 95%: 4,7-6,9). En ambos períodos la prevalencia aumentó significativamente según la edad. Conclusión. Estos resultados confirman la circulación de VTOS en la Comunidad de Madrid durante los últimos años (AU)
Objective. The aim of this study was to assess the seroprevalence of Toscana virus (TOSV) in the Community of Madrid. Methods. Samples from two serosurveys obtained during 1993-1994 (2262 individuals) and 1999-2000 (1945 individuals) were studied. Samples were tested by ELISA for TOSV IgG detection. Results. The seroprevalence of TOSV IgG was significantly higher in 1993-1994 (7.2%; 95% CI 6.2-8.4) than in 1999-2000 (5.7%; 95% CI 4.7-6.9) (chi-square, p < 0.05). In both periods, the prevalence increased significantly with age. Conclusion. These results confirm that TOSV has been circulating in the Community of Madrid over the last years (AU)
Subject(s)
Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Humans , Antibodies, Viral/blood , Sandfly fever Naples virus/immunology , Phlebotomus Fever/epidemiology , Age Distribution , Immunoglobulin G/blood , Morbidity/trends , Retrospective Studies , Seroepidemiologic Studies , Urban Population/statistics & numerical data , Enzyme-Linked Immunosorbent AssayABSTRACT
BACKGROUND: Immigration from countries having a high prevalence of tuberculosis to other more highly-developed countries has a bearing on the overall evolution of tuberculosis in the latter. This study is aimed at describing the influence of the cases of tuberculosis among foreign individuals on the incidence of this disease in the Autonomous Community of Madrid during the 1996-2004 period. METHODS: The data was taken from the Regional Tuberculosis Case Registry and from the 1996 census and the continuous censuses from 1998 to 2004. The tuberculosis incidence was estimated by country of origin from 1996 to 2004, by gender and by age groups. A calculation was made of the c2 for the linear trend, reasons for incidence and proportion of cases among foreign individuals. RESULTS: The incidence of tuberculosis went from 34.3 cases per 105 inhabitants in 1996 to 16.9 cases per 105 inhabitants in 2004. For those born in Spain, it changed from 33.2 cases per 105 inhabitants in 1996 to 12.7 cases per 105 inhabitants in 2004; and for foreign individuals, from 50.5 cases per 105 inhabitants in 1996 to 42.9 cases per 105 inhabitants in 2004. The reason for the incidence between foreign and Spanish individuals was greater than 1 for all years, the maximum figure having been in 2003, when 4.2 cases were detected among foreigners for every case among Spanish individuals (95% CI 3.7-4.7). The percentage of foreign cases went from 5.2% in 1996 to 35.1% in 2004. CONCLUSIONS: The incidence of tuberculosis among foreigners was greater than among Spanish individuals and did not significantly decrease in the 1996-2004 period, which is contributing to tuberculosis having stabilized. This situation and the characteristics of this population must be taken into account in the efforts for controlling this disease.
Subject(s)
Emigrants and Immigrants , Tuberculosis/epidemiology , Adolescent , Adult , Age Factors , Aged , Female , Humans , Incidence , Male , Middle Aged , Risk , Sex Factors , Spain/epidemiology , Tuberculosis/prevention & controlABSTRACT
No disponible
Subject(s)
Humans , Population Surveillance , Communicable Diseases/epidemiology , Environmental Monitoring , European Union , Health Surveys , Information Systems , Public Health Administration , Risk Factors , Spain/epidemiologySubject(s)
Disease Outbreaks , Emigration and Immigration , Rubella/epidemiology , Adult , Diagnosis, Differential , Female , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Immunoglobulin M/blood , Immunoglobulin M/immunology , Latin America/ethnology , Male , Measles/diagnosis , Measles/epidemiology , Rubella/diagnosis , Rubella virus/immunology , Spain/epidemiologyABSTRACT
BACKGROUND: The Autonomous Community of Madrid Epidemiological Bulletin is the main communications link between epidemiological monitoring system and health care professionals. The purpose of this study is that of ascertaining the dissemination and opinion of this Autonomous Community of Madrid Epidemiological Bulletin among primary care physicians for the purpose of adapting this publication to its readers' interests. METHOD: A telephone survey among primary care physicians in the Autonomous Community of Madrid, asking how often they read the Bulletin, the interest and usefulness of the information included in it. The sample size was estimated at 346 physicians. A two-stage sampling process was carried out-by cluster sampling in the first stage, randomly selecting 125 health care centers and 2.7 physicians per center, 17% being primary care team coordinators. A comparison is made of the results among physicians and coordinators by means of the Chi-square and Fisher's Exact Test method, with Epi-Info v.6. RESULTS: A total of 305 surveys were conducted (245 physicians and 60 coordinators). There was an awareness of the existence of the Autonomous Community of Madrid Epidemiological Bulletin on the part of 91.5% (CI 95%: 88.1-94.8), and 27.2% (CI 95%: 21.9-32.5) were familiar with more than 50% of the last issues published. A total of 92.4% (CI 95%: 89.4-95.8) considered the Bulletin to be interesting or highly interesting, grading its usefulness an average of 3.5 on a maximum scale of 5. Of the permanent sections, the most highly-valued was Epidemic Outbreaks, those reports related to meningococcal infection, tuberculosis and HIV/AIDS being the most highly-valued. CONCLUSIONS: The Autonomous Community of Madrid Epidemiological Bulletin is a publication which, although not widely-known by the primary care physicians in the Community, is well-valued when it is read, thus being a useful feedback tool within the Epidemiological Monitoring System.
Subject(s)
Information Services , Primary Health Care , Public Opinion , Surveys and Questionnaires , Adult , Humans , SpainABSTRACT
Fundamento:. El objetivo es conocer la difusión y percepción del Boletín Epidemiológico de la Comunidad de Madrid (BECAM) entre los médicos de atención primaria, con el fin de adaptar la publicación al interés de sus lectores. Método: Encuesta telefónica entre los médicos de primaria de la Comunidad de Madrid, preguntando por la frecuencia de lectura, interés y utilidad de la información contenida El tamaño muestral se estimó en 346 médicos. Se realizó un muestreo bietápico por conglomerados en la primera etapa, con selección aleatoria de 125 centros de salud y 2,7 médicos por centro, siendo el 17 per cent coordinadores de equipo. Se comparan los resultados entre médicos y coordinadores mediante Chi-cuadrado y test exacto de Fisher, con Epi-Info v.6. Resultados: Se realizó un total de 305 entrevistas: 245 médicos y 60 coordinadores. Sabían de la existencia del BECAM el 91,5 per cent (IC 95 per cent: 88,1-94,8), y el 27,2 per cent (IC 95 per cent: 21,9-32,5) conocía más del 50 per cent de los números editados durante el año. El 92,4 per cent (IC 95 per cent: 89,4-95,8) lo consideraba interesante o muy interesante, puntuando con una media de 3,5 sobre 5 su utilidad. De las secciones fijas, la mejor valorada es Brotes Epidémicos, y de los informes, los relacionados con enfermedad meningocócia, tuberculosis y VIH/Sida. Conclusiones: El BECAM es una publicación que, aunque no es conocida ampliamente entre los médicos de primaria de nuestra Comunidad, cuando se lee es bien valorada; siendo así un instrumento útil de retroalimentación en la Red de Vigilancia Epidemiológico (AU)
Background: The Autonomous Community of Madrid Epidemiological Bulletin is the main communications link between epidemiological monitoring system and health care professionals. The purpose of this study is that of ascertaining the dissemination and opinion of this Autonomous Community of Madrid Epidemiological Bulletin among primary care physicians for the purpose of adapting this publication to its readers’ interests. Method: A telephone survey among primary care physicians in the Autonomous Community of Madrid, asking how often they read the Bulletin, the interest and usefulness of the information included in it. The sample size was estimated at 346 physicians. A two-stage sampling process was carried out - by cluster sampling in the first stage, randomly selecting 125 health care centers and 2.7 physicians per center, 17% being primary care team coordinators. A comparison is made of the results among physicians and coordinators by means of the Chi-square and Fisher’s Exact Test method, with Epi-Info v.6. Results: A total of 305 surveys were conducted (245 physicians and 60 coordinators). There was an awareness of the existence of the Autonomous Community of Madrid Epidemiological Bulletin on the part of 91.5% (CI 95%: 88.1-94.8), and 27.2% (CI 95%: 21.9-32.5) were familiar with more than 50% of the last issues published. A total of 92.4% (CI 95%: 89.4-95.8) considered the Bulletin to be interesting or highly interesting, grading its usefulness an average of 3.5 on a maximum scale of 5. Of the permanent sections, the most highly-valued was Epidemic Outbreaks, those reports related to meningococcal infection, tuberculosis and HIV/AIDS being the most highly-valued. Conclusions: The Autonomous Community of Madrid Epidemiological Bulletin is a publication which, although not widely-known by the primary care physicians in the Community, is well-valued when it is read, thus being a useful feedback tool within the Epidemiological Monitoring System (AU)
Subject(s)
Adult , Humans , Public Opinion , Primary Health Care , Surveys and Questionnaires , Information Services , SpainABSTRACT
Fundamento: La infección por citomegalovirus (CMV) es frecuentemente asintomática. Sin embargo, constituye una importante causa de infección congénita y de patología severa en sujetos inmunodeprimidos, por lo que representa un problema en Salud Pública. El objeto de este trabajo fue conocer la prevalencia de IgG frente a CMV (IgG-CMV) en la población general madrileña. Métodos: Estudio transversal en el que se detectó IgG-CMV en una muestra representativa de la población general de la Comunidad de Madrid entre 2 y 60 años (n=2030). Se realizó un muestro bietápico estratificado por conglomerados (octubre de 1993 y febrero de 1994). Para el análisis estadístico se emplearon los test de c2 y c2 de tendencia lineal y se calcularon los porcentajes de seroprevalencia y los odds ratios con intervalos de confianza del 95 por ciento. Resultados: La seroprevalencia global fue del 62,8 por ciento (IC95 por ciento: 60,6-64,9); 66,7 por ciento (IC95 por ciento: 63,7-69,5) en mujeres y del 58,4 por ciento (IC95 por ciento: 55,2-61,5) en hombres. Se observó una asociación significativa entre el aumento de la edad y el incremento de la seroprevalencia. Fueron factores significativos de riesgo la consulta al dentista, antecedentes de cirugía, acupuntura y tatuajes. Los estudios superiores constituyeron un factor protector. Conclusión: Aunque los factores de riesgo detectados indican una posible transmisión vía sanguínea, la elevada prevalencia apunta a la existencia de otras vías mas comunes. El aumento de la seroprevalencia dependiente de la edad sugiere que se produce un número importante de infecciones en la edad adulta. No se puede excluir, sin embargo, que este aumento responda a un efecto cohorte debido a mejoras socioeconómicas similar al detectado para otros virus (AU)
Subject(s)
Middle Aged , Child , Child, Preschool , Adolescent , Adult , Male , Female , Humans , Risk Factors , Spain , Seroepidemiologic Studies , Age Distribution , Sex Distribution , Antibodies, Viral , Cross-Sectional Studies , Cytomegalovirus , Cytomegalovirus InfectionsABSTRACT
FUNDAMENTO: En el año 1997 (entre el 22 de septiembre y el 14 de noviembre) se efectuó una campaña de vacunación antimeningocócica A+C en la Comunidad de Madrid, en el grupo de edad de 18 meses a 19 años, ante el aumento del número de casos de enfermedad meningocócica por serogrupo C presentado en la temporada 1996-97. Este estudio forma parte de la evaluación de dicha campaña. MÉTODOS: Se ha valorado la evolución de la incidencia de la enfermedad meningocócica, mediante la comparación de tasas; y se ha determinado la efectividad de la vacunación al año (temporada 1997-98) y a los dos años (temporadas 1997-98 y 1998-99) de seguimiento. La efectividad vacunal se ha calculado como (1-(Tasa en vacunados/Tasa en no vacunados))*100. RESULTADOS: Se ha producido un descenso significativo en la incidencia de enfermedad meningocócica por serogrupo C al comparar las temporadas 1997-98 y 1998-99 con la temporada epidémica (1996-97). La efectividad vacunal a los dos años de seguimiento tras la campaña de vacunación ha sido de un 76,9 por ciento para la población global de 18 meses a 19 años y de un 88,5 por ciento en el grupo de vacunados entre 15 y 19 años. CONCLUSIONES: La efectividad vacunal obtenida es compatible con lo descrito en la literatura. La disminución significativa de la incidencia de enfermedad meningocócica por serogrupo C ha sido debida a la efectividad vacunal obtenida (AU)
Subject(s)
Child , Child, Preschool , Adolescent , Adult , Infant , Humans , Disease Outbreaks , Spain , Incidence , Age Distribution , Neisseria meningitidis , Meningococcal Infections , Meningococcal VaccinesABSTRACT
FUNDAMENTO: La Comunidad de Madrid detectó a partir de 1995 un incremento del número de casos de enfermedad meningocócica por serogrupo C. En 1997 se realizó una campaña de inmunización masiva sobre la población de 18 meses a 19 años. El objetivo de este estudio es conocer la respuesta inmunitaria producida por la vacuna y su relación con la edad. MÉTODOS: Se seleccionó una muestra de 1.003 niños vacunados durante la campaña. Se extrajo una muestra de sangre antes de la vacunación y tras uno, seis (solo <5a) y doce meses. Para valorar la respuesta inmune se midieron niveles de anticuerpos bactericidas y totales. RESULTADOS: La prevalencia de seroconversión medida por anticuerpos bactericidas es 89,6 por ciento. La respuesta es baja en menores de 3 años (34,8 por ciento), aumenta con la edad y a partir de los 7 años supera el 90 por ciento. A los 6 meses, la prevalencia de niveles protectores en menores de 5 años desciende notablemente (31,3 por ciento). Al año, la prevalencia desciende notablemente, especialmente en menores de 7 años. La proporción de individuos con respuesta de anticuerpos totales al mes supera el 90 por ciento y se mantiene elevada al año en todos los grupos edad (97,5 por ciento). CONCLUSIONES: La respuesta medida mediante anticuerpos totales entra en contradicción con la respuesta clínica a la vacunación y la medida mediante anticuerpos bactericidas infraestima la protección si se compara con los resultados de efectividad vacunal, por lo que es necesario buscar indicadores biológicos que se correlacionen de manera adecuada con la respuesta clínica tras la vacunación (AU)
