Corrigendum: Disseminated tuberculosis and diagnosis delay during the COVID-19 era in a Western European country: a case series analysis.

[This corrects the article DOI: 10.3389/fpubh.2023.1175482.].

Disseminated tuberculosis and diagnosis delay during the COVID-19 era in a Western European country: a case series analysis.

Background: Disseminated tuberculosis is frequently associated with delayed diagnosis and a poorer prognosis. Objectives: To describe case series of disseminated TB and diagnosis delay in a low TB burden country during the COVID-19 period. Methodology: We consecutively included all patients with of disseminated TB reported from 2019 to 2021 in the reference hospital of the Northern Crown of the Metropolitan Area of Barcelona. We collected socio-demographic information, clinical, laboratory and radiological findings. Results: We included all 30 patients reported during the study period-5, 9, and 16 in 2019, 2020, and 2021 respectively-20 (66.7%) of whom were male and whose mean age was 41 years. Twenty-five (83.3%) were of non-EU origin. The most frequent system involvement was central nervous system (N = 8; 26.7%) followed by visceral (N = 7; 23.3%), gastro-intestinal (N = 6, 20.0%), musculoskeletal (N = 5; 16.7%), and pulmonary (N = 4; 13.3%). Hypoalbuminemia and anemia were highly prevalent (72 and 77%). The median of diagnostic delay was 6.5 months (IQR 1.8-30), which was higher among women (36.0 vs. 3.5 months; p = 0.002). Central nervous system involvement and pulmonary involvement were associated with diagnostic delay among women. We recorded 24 cured patients, two deaths, three patients with post-treatment sequelae, and one lost-to-follow up. We observed a clustering effect of patients in low-income neighborhoods (p < 0.001). Conclusion: There was a substantial delay in the diagnosis of disseminated TB in our study region, which might impacted the prognosis with women affected more negatively. Our results suggest that an increase in the occurrence of disseminated TB set in motion by diagnosis delay may have been a secondary effect of the COVID-19 pandemic.

Human Astrovirus Outbreak in a Daycare Center and Propagation among Household Contacts.

We investigated an outbreak of acute gastroenteritis due to human astrovirus in a daycare center, describing the transmission mechanism, the most affected age groups, conditioning factors and the extent of the outbreak among household contacts of the daycare center attenders. Data were collected from persons exposed at the daycare center and their home contacts. Fecal samples from affected and non-affected daycare center attenders were analyzed for viruses causing acute gastroenteritis by RT-PCR. The percentage of households affected and the attack rates (AR) were calculated. The attack rates were compared using the rate ratio (RR) with 95% confidence intervals. Information was obtained from 245 people (76 attenders and 169 contacts) of whom 49 were clinical cases. Five HAstV-4, two HAstV-8 and three non-typable HAstV cases were identified (six from clinical cases and four from asymptomatic infected people). The global AR was 20% (41.2% in children aged < 2 years). Data were obtained from 67 households: 20 households of affected attenders and 47 of non-affected attendees. Household contacts of affected attenders had a higher AR (74.3%) than that of non-affected attendees (2.4%). We found asymptomatic infections amongst daycare attendees. The transmission of HAstV during the outbreak was not limited to the daycare center but extended to household contacts of both affected and non-affected attenders.

Descriptive study of severe hospitalized cases of laboratory-confirmed influenza during five epidemic seasons (2010-2015).

OBJECTIVE: The Plan of Information on Acute Respiratory Infections in Catalonia (PIDIRAC) included the surveillance of severe hospitalized cases of laboratory-confirmed influenza (SHCLCI) in 2009. The objective of this study was to determine the clinical, epidemiological and virological features of SHCLCI recorded in 12 sentinel hospitals during five influenza seasons. RESULTS: From a sample of SHCLCI recorded during the 5 influenza epidemics seasons from 2010-2011 to 2014-2015, Cases were confirmed by PCR and/or viral isolation in cell cultures from respiratory samples. A total of 1400 SHCLCI were recorded, 33% required ICU admission and 12% died. The median age of cases was 61 years (range 0-101 years); 70.5% were unvaccinated; 80.4% received antiviral treatment (in 79.6 and 24% of cases within 48 h after hospital admission and the onset of symptoms, respectively); influenza virus A [37.9% A (H1N1)pdm09, 29.3% A (H3N2)] was identified in 87.7% of cases. Surveillance of SHCLCI provides an estimate of the severity of seasonal influenza epidemics and the identification and characterization of at-risk groups in order to facilitate preventive measures such as vaccination and early antiviral treatment.

Epidemiological analysis of severe hospitalized 2009 pandemic influenza A (H1N1) cases in Catalonia, Spain.

From 25th April 2009 to 20th January 2010, 771 laboratory confirmed cases of 2009 pandemic influenza A (H1N1) were admitted to intensive care units (ICU) or hospitalized in medical wards with clinical criteria of severe disease (hospitalized pneumonias, multiorganic failure, septic shock or admitted to ICU or death while hospitalized). 82% of cases were hospitalized between epidemiological week 43 and 48 (25th October - 5th December 2009). Median age of patients was 40 years (range 0-89 years) and 56% were males. 38.7% cases were in the 15-44 year age-group, 29.4% in the 45-64 and 21.8% were children under 15 years of age. 36.8% were admitted to an ICU and 48 died. Underlying conditions were absent in 29% of patients (up to 38% among those under 15 years old). Differences in the prevalence of underlying conditions were found between children and adults. In children less than 15 years old, asthma (16.2%), other respiratory diseases (12.7%), cognitive disorders (10.2%), epilepsy (8.7%) and neuromuscular disorders (7.1%) were the most frequent. In adults, chronic obstructive pulmonary disease (14.8%), cardiovascular diseases (12.6%), asthma (11.5%), diabetes (11.2%) and morbid obesity (10.6%) were the most frequent. Further surveillance is needed to better characterize the epidemiology of this pandemic.

Large outbreak of measles in a community with high vaccination coverage: implications for the vaccination schedule.

BACKGROUND: Attempts to eliminate measles from a country or region may be disrupted by an imported case that affects indigenous persons. The objective of this study was to analyze epidemiological and clinical characteristics of a measles outbreak in Catalonia, Spain, in 2006. METHODS: Data on cases of measles reported to the Department of Health, Generalitat of Catalonia, during the period 28 August 2006 through 8 July 2007 were collected. Suspected cases were confirmed by determination of measles-specific immunoglobulin M antibodies and/or detection of virus genome. Incidences were calculated using the estimated population of Catalonia for 2006, and 95% confidence intervals were determined assuming a Poisson distribution. The association between proportions was determined using the chi(2) test and Fisher's exact test. The level of statistical significance was set at alpha = .05. RESULTS: A total of 381 cases were confirmed, for an incidence of 6.6 cases per 100,000 persons. A total of 89.5% of cases occurred in nonvaccinated persons, mainly those aged < or =15 months (incidence, 278.2 cases per 100,000 persons; mean age of patients, 12 months). Indigenous subjects accounted for 89.8% of cases, and laboratory confirmation of results was obtained for 87.1%. Measles genotype D4 was identified in all sequenced samples. CONCLUSIONS: The age distribution of cases of measles among children aged <15 months suggests that the first dose of vaccine should be routinely administered at the age of 12 months.

Salud maternoinfantil. Evaluación de los objetivos del Plan de Salud de Cataluña para el año 2000 / Mother and child health. Evaluation of the objectives of the Health Plan for Catalonia for the year 2000

Fundamento y objetivos: El Plan de Salud de Cataluña del año 2000 incluye los objetivos generales de salud maternoinfantil y los elementos que permiten evaluar su consecución y evolución. El objetivo es presentar los resultados de la evaluación de los objetivos generales de salud maternoinfantil analizando los indicadores propuestos. Población y método: De las fuentes sistemáticas de información sanitaria se han obtenido los indicadores anuales propuestos y sus tendencias para la evaluación del mencionado plan de salud: mortalidad infantil por 1.000 nacidos vivos, mortalidad perinatal por 1.000 nacidos vivos y muertos, tasa de mortalidad materna (directa e indirecta) por 1.000 nacidos vivos, prevalencia de bajo peso al nacer por 100 nacidos vivos, prevalencia de prematuridad por 100 nacidos vivos y tasa de embarazos en mujeres de entre 14 y 17 años. Resultados: Tanto la mortalidad infantil como la perinatal y la materna han presentado una evolución favorable y con indicadores por debajo de los límites marcados. El bajo peso al nacer, la prematuridad y los embarazos en la adolescencia muestran indicadores con una evolución desfavorable y por encima de los límites marcados. Discusión: Se han alcanzado los objetivos de salud de mortalidad infantil, perinatal y materna, mientras que los de bajo peso al nacer, prematuridad y embarazos en adolescencia son objetivos de salud no alcanzados en el año 2000 (AU)

Background and objectives: The Health Plan for Catalonia for the year 2000 included general objectives of mother and child health and their respective indicators in order to evaluate them. The main objective of this paper is to present the results of the mother and child health objectives evaluation. Subjects and method: Rates and trends were obtained from health administrative sources of information: infant mortality per 1,000 alive births, perinatal mortality per 1,000 alive and stillbirths, maternal mortality (direct and indirect) per 1,000 alive births, prevalence of low birth weight per 100 alive births, prevalence of prematurity per 100 alive births and pregnancy rate in women between 14 and 17 years old. Results: Infant mortality, perinatal mortality and maternal mortality showed downward trends and figures under the established health objectives. Rates of low birth weight, prematurity and teenager pregnancy showed unfavorable trends and over the fixed health objectives. Discussion: Mother and child health objectives of infant, perinatal and maternal mortality were reached and low birth weight, prematurity and teenager pregnancy were not reached in the year 2000 (AU)