Trending on Social Media: Integrating Social Media into Infectious Disease Dynamics.

Social media plays an important role in alerting and educating the public during disease outbreaks. By increasing awareness of the disease and its prevention, it can lead to a modification of behaviour which then affects contact/incidence rates. Social media data may also be used when formulating, developing and parameterising models. As mobile technology continues to evolve and proliferate, social media is expected to occupy an increasingly prominent role in the field of infectious disease modelling to improve their predictive power. This article presents a review of existing models incorporating media in general and highlights opportunities for social media to enhance traditional compartmental models so as to make the best use of this resource in controlling the spread of disease.

La columna infame de Milán en tiempos de pandemia / Milan's infamous column in times of pandemic

Las épocas de pandemia han despertado y despiertan miedo en individuos y pánico en sus comunidades. En este artículo el autor repasa brevemente los hechos históricos ocurridos durante La Gran Plaga (pandemia de peste bubónica) que dieron lugar a la denominada Columna Infame de Milán, haciendo un paralelismo con algunas situaciones de criminalización de los enfermos e individuos afectados por la actual pandemia de SARS-Cov-2. (AU)

The Role of Risk Proximity in the Beliefs and Behaviors Related to Mosquito-Borne Diseases: The Case of Chikungunya in French Guiana.

Human behaviors are increasingly recognized to play a key role in the spread of infectious diseases. Although a set of social and cognitive determinants has been consistently found to affect the adoption of health protective behaviors aiming to control and prevent a variety of infections, little is currently known about the ecological drivers of these behaviors in epidemic settings. In this article, we took advantage of the outbreak of chikungunya, a reemerging mosquito-borne disease, that occurred in French Guiana in 2014-15 to test empirically the assumption proposed by Zielinski-Gutierrez and Hayden that the proximity of the disease and perceptions of the natural environment may considerably shape public response to an emerging health threat. To achieve this, a cross-sectional survey was conducted among high school students of the region (N = 1462) at an early stage of the epidemic. Surprisingly, spatial analysis of the collected data leads to counterintuitive results as the participants who lived in the most affected area expressed less concern about the disease and practiced preventive behaviors less frequently than did other participants. These paradoxical results may be attributed to the possible activation of risk denial processes which have previously been observed in the risk perception literature, and described by several social and psychological defensiveness theories.

Community perceptions of health and rodent-borne diseases along the Inter-Oceanic Highway in Madre de Dios, Peru.

BACKGROUND: Madre de Dios is located in the southeastern Amazonian region of Peru. Rodents have been estimated to be the reservoirs for up to 50 % of emerging zoonotic pathogens, including a host of viruses, bacteria, and parasites. As part of a larger study involving both human and animal research, this study serves to obtain a broader understanding of the key challenges and concerns related to health and rodent-borne illnesses from the perspective of the people living in these communities. METHODS: We used a mixed methods approach, which comprised of 12 focus group discussions, 34 key informant interviews and the application of a survey (n = 522) in four communities along the Inter-Oceanic Highway (IOH) in Madre de Dios, Peru over a two-year period. RESULTS: Although 90 % of survey respondents answered that rodents can transmit diseases and had seen rodents in their homes and immediate surroundings, most could not name specific rodent-borne diseases and, when probed, described rodents as pests or nuisance animals, but were not concerned about acquiring illnesses from them. Key informant interview data suggests that there has been a perceived increase in the amount of rodents in the communities since the construction of the IOH, however this potential increase was not coupled with increased knowledge about diseases or perceived risks among these key informants. Health providers also mentioned a lack of diagnostic tools specific for rodent-borne illnesses. This may be related to the fact that although a common rodent-borne disease like leptospirosis is frequently detected in the region, it is not routinely and readily diagnosed, therefore the real burden of the disease and exposure risk can be underestimated. If rodent-borne diseases are not on the radar of health professionals, they may not consider presumptive treatment, which could result in unnecessary morbidity and mortality. CONCLUSION: Awareness of rodent-borne diseases is still lacking in the area, even among health care professionals within the communities, despite the known burden of diseases like leptospirosis. We expect to report further findings as we obtain more information from all the study components.

A Cross-Sectional Study of Prisoners in Mexico City Comparing Prevalence of Transmissible Infections and Chronic Diseases with That in the General Population.

OBJECTIVES: To describe patterns of transmissible infections, chronic illnesses, socio-demographic characteristics and risk behaviors in Mexico City prisons, including in comparison to the general population, to identify those currently needing healthcare and inform policy. MATERIALS AND METHODS: A cross-sectional study among 17,000 prisoners at 4 Mexico City prisons (June to December 2010). Participation was voluntary, confidential and based on informed consent. Participants were tested for HIV, Hepatitis B & C, syphilis, hypertension, obesity, and, if at risk, glucose and cholesterol. A subset completed a questionnaire on socio-demographic characteristics and risk behaviors. Positive results were delivered with counseling and treatment or referral. RESULTS: 76.8% (15,517/20,196) of men and 92.9% (1,779/1,914) of women participated. Complete data sets were available for 98.8%. The following prevalence data were established for transmissible infections: HIV 0.7%; syphilis: Anti-TP+/VDRL+ 2.0%; Hepatitis B: HBcAb 2.8%, HBsAg 0.15%; Anti-HCV 3.2%. Obesity: 9.5% men, 33.8% women. Compared with national age- and sex-matched data, the relative prevalence was greater for HIV and syphilis among women, HIV and Hepatitis C in men, and all infections in younger participants. Obesity prevalence was similar for women and lower among male participants. The prevalence of previously diagnosed diabetes and hypertension was lower. Questionnaire data (1,934 men, 520 women) demonstrated lower educational levels, increased smoking and substance use compared to national data. High levels of non-sterile tattooing, physical abuse and histories of sexual violence were found. CONCLUSION: The study identified that health screening is acceptable to Mexico City prisoners and feasible on a large-scale. It demonstrated higher prevalence of HIV and other infections compared to national data, though low rates compared to international data. Individual participants benefited from earlier diagnosis, treatment and support. The data collected will also enable the formulation of improved policy for this vulnerable group.

La lepra en Colombia: estigma, identidad y resistencia en los siglos XX y XXI / Leprosy in Colombia: stigma, identity and resistance in XX and XXI centuries

Este artículo analiza la historia de la lepra o enfermedad de Hansen como un concepto reelaborado a lo largo de la historia por los discursos científicos, políticos, religiosos y por los saberes populares, puesto en relación al problema de la estigmatización. Buscamos realizar un análisis desde la teoría del estigma como un proceso social, que produce el aislamiento, la exclusión, discriminación y rechazo al enfermo y su familia, deteriorando la identidad de los mismos. Encontramos y analizamos cómo se produce en la interacción social la estigmatización, y a su vez, cómo los enfermos reelaboran su identidad, generando una serie de estrategias de afrontamiento y ocultamiento del estigma, estrategias de resistencia con las que reconstruyen su tejido social. Las categorías de análisis de la información fueron percepciones y creencias sobre la enfermedad, relaciones sociales y familiares, construcción de la imagen del enfermo y las metáforas de la enfermedad, actos de discriminación y rechazo, y actos de ocultamiento y afrontamiento del estigma. En este trabajo de carácter cualitativo, analítico y diacrónico, se utilizaron metodologías de investigación cualitativa, consistentes en entrevistas, observación etnográfica, trabajos de memoria y cartografía social, y revisión y análisis de fuentes primarias y secundarias, recolectando información de Colombia, específicamente los municipios de Agua de Dios, Cundinamarca y Contratación, Santander, considerando como marco temporal los siglos XX y XXI.

This article analyzes the history of leprosy or hansens disease as a concept that has been re elaborated throughout history by popular opinion and political, religious and scientific influence, all in relation with the problem of stigmatizing. Here we seek to make an analysis of the theory of stigma as social process that produces isolation, exclusion, discrimination and rejection of the sick and his family, reducing their own identity. We find and analyze how social interaction in stigmatization works, and how those with the disease recreate their identity, generating a series of coping strategies, ways of hiding the cause of stigma, and resilience strategy with which they rebuild their social network. The information was analyzed through the categories of perceptions and believes of the disease, social and family relations, self image construction of the sick and the metaphors of the disease, acts of discrimination and rejection, acts of hiding and confronting the stigma. In this work of analytic, qualitative and diachronic characteristics, we used qualitative investigation methodologies, consisting in interviews, ethnographic observation, social cartography and memory exercises, and reviews and analysis of primary and secondary sources. Information was collected from Colombia, specifically the towns of Agua de Dios, Cundinamarca and Contratacion, Santander, taking into account the XX and XXI century as the time frame.

Neuroimmunomodulation during infectious diseases: mechanisms, causes and consequences for the host.

In this special issue of Neuroimmunomodulation, the reader will find reviewed some of the hottest topics in the field of neuroendocrine-immune interactions, with emphasis on infectious diseases. For instance, the role that immunoendocrine alterations have during human tuberculosis, a chronic infectious disease, is discussed, and it is concluded that these immunoendocrine interactions may play a detrimental role during the disease, in terms of the development of protective immune responses, control of tissue damage and metabolic disorders. Also, the role that neuroimmunomodulation plays in parasitic diseases is presented, and emphasizes the importance of the host-parasite neuroimmunoendocrine network during helminth infection. Moreover, the influence of beta-androstenes on resistance to viral and bacterial infections is discussed, as well as the impact of infectious diseases upon neuroendocrine circuits. Also, the reader will find contributions to the study of sex hormones and modulation of immunity against leishmaniasis, as well as recent work on the immune mechanisms associated with resistance or susceptibility to parasitic diseases during pregnancy. We hope that our readers will find the first ever special issue devoted to neuroimmunomodulation and infectious diseases fascinating and enticing.

Asociación entre el estrés y las enfermedades infecciosas, autoinmunes, neoplásicas y cardiovasculares / Association between stress and the infectious, autoimmune, neoplastic and cardiovascular diseases

Desde hace mucho tiempo, se ha pensado que los factores psicológicos desempeñan un papel contribuyente en la predisposición, el comienzo o el curso de varias enfermedades físicas. Estudios recientes demuestran claramente una unión entre el estrés y el desarrollo y curso de muchas enfermedades. El estrés es definido como una condición que ocurre cuando un individuo percibe las demandas de una situación que excede sus recursos y puede incrementar la vulnerabilidad del organismo a ciertas enfermedades ejerciendo un efecto inmunosupresor. Se realiza una actualización acerca de las influencias del estrés psicológico en aquellas enfermedades que están conectadas directamente con los mecanismos inmunológicos tales como las infecciones, las enfermedades autoinmunes y las neoplasias, así como también su efecto sobre las enfermedades cardiovasculares. Se señala que intervenciones psicológicas oportunas pueden contribuir a modular la respuesta al estrés y mejorar el comportamiento de la salud, enseñando a los individuos métodos más adaptativos para interpretar los desafíos de la vida con respuestas más efectivas(AU)

Tuberculosis y afectividad / Tuberculosis and affectivity

Se investigaron las percepciones, actitudes, prejuicios y comportamientos asociados a la tuberculosis y diferencias debidas al género, porque esta presenta un fuerte estigma social con matices culturales según la sociedad. La conducta más reportada resultó tratar de ocultarla. Se realizaron entrevistas grupales y una encuesta a 147 enfermos de La Habana. Se comprobó la persistencia del estigma y las conductas asociadas fueron: seguimiento del tratamiento lejos del lugar de residencia, ocultamiento activo y el motivo predominante declarado, en mayor proporción por las mujeres fue evitar el rechazo social. No se encontraron afectaciones a la búsqueda de atención médica ni al seguimiento del tratamiento. Apreciaciones asociadas a la enfermedad fueron sentir vergüenza por padecerla, que se les trata con temor, que para hacer una vida normal hay que ocultarla y más de la tercera parte lo aconsejaría. Se recomendó diseñar una estrategia de comunicación social(AU)

[Hospital leaflets and the dynamics of constructing their meanings: the perspective of health professionals]. / Impressos hospitalares e a dinâmica de construção de seus sentidos: o ponto de vista dos profissionais de saúde.

Based on interviews in a hospital in Rio de Janeiro, the authors analyze strategies, interests, assumptions, and concerns among producers of patient information leaflets on infectious diseases. Most such publications followed a linear communications model, according to which health messages produce a sole and single effect on their audience. Visual communications are seen as a field of knowledge over which physicians have no "command", but which raises great expectations on their part, principally in light of the limits of written language for an illiterate patient population. The most frequent concerns relate to the "adequacy of the language" (a denotative, non-semantic function of language) and on the increase in "dissemination". Leaflets are generally linked to the professional experience of providing health care, but the lack of pertinent research prior to the production of such publications leads to simplifications and generalizations concerning the patients' most common doubts and questions, reinforcing the stereotyping of the clientele based on their lacks and needs. In two exceptional leaflets, interaction with the clientele appears and expands the relationship between the health care professionals and the values and decisions made in distinct sociocultural contexts.

Encuesta sobre comportamientos sexuales riesgosos y enfermedades de transmisión sexual en estudiantes adolescentes de Ciudad de La Habana, 1996 / It interviews on risky sexual behaviors and illnesses of sexual transmission in adolescent students of City of Havana, 1996

En Cuba, se ha observado un incremento de las enfermedades de transmisión sexual (ETS) en los adolescentes, lo cual motivó el interés de realizar un estudio con el objetivo de expolorar los comportamientos y actitudes sexuales riesgosos y el antecedente de ETS. Se realizó un estudio descriptivo transversal con una muestra aleatoria tomada del universo de estudiantes adolescentes de Ciudad de La Habana del curso escolar 1995-1996. La muestra estuvo constituida por 2 793 adolescentes entre 11 y 19 años de edad (1 370 hembras y 1 423 varones). La información se recogió por especialistas vinculados con la actividad previo entrenamiento mediante una entrevista estructurada con un instrumento elaborado para tales fines. Se constató que más de la mitad de adolescentes no usaban preservativos en las relaciones sexuales; 57,0; 40,0 y 35 por ciento respectivamente, tuvieron más de una pareja al año, creyeron que era difícil mantener la pareja o tenían más de una pareja sexual. Fueron referidos hábitos sexuales riesgosos sin protección en el 39 por ciento para el hábito oro-genital y 21,4 por ciento para el genito-anal. Refirieron antecedentes de ETS el 22 por ciento de los entrevistados(AU)

[Expectations of hospitalized patients as to their relationship with the nursing team]. / Expectativas dos clientes hospitalizados frente ao relacionamento com a equipe de enfermagem.

This research has been made in infectious-parasitary disease sector of a public university hospital in Rio de Janeiro on the first semester of 1995. The logbook research has been introduced to 5 adult clients, from both sexes, who had been interned in the construction of two categories, which are: a) Category I: Feelings and expectations of the client and; b) Category II: Communication and relationship between client and nurse. The results found in the first category were: 1) Lack of affection; 2) Affection, fear and anxiety; 3) Loneliness and depression; 4) Reflection; 5) Insecurity; 6) Worry about the equipment, to be cut, to be impersonally treated, lose self-control and physical dependence. The results found in the second category were: 1) Doubts and interests in information about their disease, its evolution and how long they will stay in hospital: 2) Opportunity to express feelings and ideas; 3) Comprehension of the message given by the nurse. We emphasize the increase of interchange of information, ideas, beliefs, feelings and acts in nurse-client interaction to develop the therapeutic relationship aiming at helping the client to fulfill his basic needs.

[Attitudes, beliefs, and motivations in blood donors and non-donors]. / Actitudes, creencias y motivaciones en donantes y no donantes de sangre.

OBJECTIVE: To know and compare the beliefs, attitudes and motivations of donors and non-donors in relation with blood donation. MATERIAL AND METHODS: Transversal study by questionnaires administered to 197 blood donors and 303 non-donors. The questionnaires gathered: sociodemographic data, beliefs and attitudes (using a Likert scale), and motivations and demotivations (using upon questions). The responses were analysed using different descriptive analyses and bivariant tests, and factorial analysis and discriminant analysis were performed as multivariant analyses. RESULTS: The donor group had a mean age of 37.8 years, were 58.4 female and 41.6% male, and had made 6.02 donations. The non-donor group had a mean age of 39.8 years and were 53.8% female and 46.2 male. Regarding attitudes and beliefs, the donor group showed more confidence in the good conditions in which donations are performed, had less fears about the possibility that donation can affect health, their attitudes were generally less egotistical, and they had less fears about possible commercialisation of the blood. Both groups believed that blood banks and society itself give inadequate compensation to donors, but this belief was significantly greater among non-donors. Regarding the motivations of donors, the highest proportion were related with a sense of solidarity or duty (26.4%), followed by issues related with information or pressure (23.4%), and the possible personal or family benefits that donation might bring (21.8%). The initial motivations of most donors (75.9%) had not varied with the passage of time, and the factors found to be most demotivating for donation had to do with problems of access and comfort (74.6%). We would highlight that most non-donors denied any worries about blood donation (70.9%) and did not agree that those who need blood should be those who pay for it (92.8%). For non-donors, lack of information (43.6%) and different fears (32.3%) were the principal factors discouraging them from donating. Finally, discriminant analysis selected 11 of the items as providing 75.6% of correct discrimination between the one population and the other. CONCLUSIONS: Donors and non-donors reveal very different beliefs, attitudes and motivations towards blood donation, and the questionnaire employed in this study permits a high degree of discrimination between the two groups. The attitudes of non-donors towards donation are generally less favourable, but allow us to think that a high percentage of these could be changed with the right conditions.

SIDA y cirugía (parte I) / AIDS and Surgery (Part I)

El SIDA es una enfermedad de identificación reciente, de progresión geométrica y hasta el momento irremisiblemente mortal. Como consecuencia del mismo se han alterado los patrones sexuales y de conducta, lo que trae alteraciones de las relaciones interpersonales y que afectan los derechos humanos del individuo. El mayor peligro lo representa la ignorancia de la historia natural de la enfermedad, de las medidas de prevención y las formas de contagio. Los trabajadores de la salud pueden infectarse con el virus del SIDA durante la realización de procedimientos invasivos al tratar enfermos que sufren de este padecimiento, esta situación debe considerarse como una enfermedad profesional y se debe proteger al trabajador de la salud así infectado y a su familia en todos los aspectos. La relación entre un trabajador de la salud y/o pacientes infectados con SIDA afectan los derechos de cada uno de ellos y es motivo de controversia. Se mencionan los cuadros agudos suceptibles de tratamiento quirúrgico que se presentan en el enfermo con SIDA y que requieren manejo urgente, indicando la conducta a seguir. Se insiste en las medidas de protección universales que deben observar los trabajadores de la salud para evitar el contagio con microorganismos que residan en la sangre y las que deben seguirse en casos de inoculación con los virus del SIDA y la hepatitis B

O ser com AIDS em sua dimensäo existencial / The being a person with AIDS of their existential dimension

A inquietaçäo sobre o significado de estar com AIDS, sob a perspectiva da pessoa que vivencia a doença, levou as autoras a uma pesquisa que as norteie para uma assistência de enfermagem que contemple o doente em sua dimensäo existencial. Desta forma, utilizando os passos de uma investigaçäo fenomenológica, puderam, a partir dos discursos das pessoas sobre as suas experiências vividas de um ser com AIDS, desvelar facetas que integram a essência desse vivenciar e que o afetam enquanto um ser histórico. O momento crítico de revelaçäo do diagnóstico, o conviver com a doença e com os sintomas a ela inerentes, a perspectiva de finitude próxima, a configuraçäo de seu horizonte existencial face ao que lhes está acontecendo, foram facetas que emergiram e que säo analisadas. Esses resultados contribuem, efetivamente, para uma assistência de enfermagem que assegure aos doentes o exercício de sua condiçäo primordial de ser humano: a sua dimensäo existencial.

[The preoccupations manifested by nursing students in relation to the discipline of nursing and transmissible diseases]. / Preocupações manifestadas por graduandos de enfermagem em relação à disciplina enfermagem e doenças transmissíveis.

Reactions like flight, anxiety, aggressiveness, and aversion are usually observed among students of nursing when they attend transmissible Disease subject, in Nursing Course. This symptoms are caused by the chance of contagion. The objectives of this study are to identify the students preoccupation of being infected or being a transmission vehicle of any transmissible disease, to their family or community and to verify what kind of diseases they are fear of being infected.