RESUMEN
BACKGROUND: The New York State Birth Defects Registry (BDR) has passive and active components. As part of statewide passive ascertainment, the BDR receives reports of International Classification of Diseases, Tenth Revision (ICD-10) codes and descriptive narratives on a wide range of birth defects. The BDR conducts enhanced active surveillance for selected birth defects in 14 counties, which includes medical record abstraction and clinician review. We sought to quantify agreement between the two surveillance approaches. METHODS: The analysis included live-born infants born with one of the 16 birth defects in 2018-2021 in the active surveillance counties (n = 1069 infants). We calculated positive predictive values (PPV) and 95% confidence intervals for each defect, defined as the percentage of cases confirmed in active surveillance among those in passive surveillance. Additionally, we calculated the percentage with each birth defect missed by passive surveillance. RESULTS: The PPV varied greatly by birth defect. The PPV was >90% for gastroschisis and cleft lip, but <70% for spina bifida, diaphragmatic hernia, truncus arteriosus, tricuspid atresia, hypoplastic left heart syndrome, coarctation of the aorta, and pulmonary atresia. The percentage missed by passive surveillance ranged from 2% for tetralogy of Fallot to 39% for tricuspid atresia. CONCLUSIONS: Active surveillance is an important strategy for ruling out false positive case reports for certain birth defects that we assessed, but not all of them. Passive surveillance programs can use our findings to develop targeted strategies for improving data quality of specific birth defects using active surveillance methods, thus optimizing limited resources.
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Anomalías Congénitas , Vigilancia de la Población , Sistema de Registros , Humanos , Anomalías Congénitas/epidemiología , New York/epidemiología , Vigilancia de la Población/métodos , Recién Nacido , Femenino , Masculino , Clasificación Internacional de Enfermedades , LactanteRESUMEN
Introduction: as part of the fight against malaria, epidemiological surveillance (ES) is one of the key pillars of the global technical strategy 2016-2030 to combat this disease. However, in the south-east of Senegal, where malaria poses a major public health problem, epidemiological surveillance has until recently been very neglected. To help reduce malaria-related morbidity and mortality in Senegal, an evaluation of the routine malaria ES system was conducted in the Tambacounda Health District in 2021. Methods: we conducted a cross-sectional, descriptive survey of 27 health structures in Tambacounda district from 20th February to 1st March 2022. Results: overall, the routine ES system in the district was acceptable according to its users, with satisfactory tool filling time in 96.3% of the structures in our study, a cumulative completeness of reports at 92% despite a 77% promptness. The data collected at the services delivery points (SDP) level allowed a representativeness of the ES system in 100% of health facilities. The ES system was also rated as simple by 74.1% of SDP managers even though only 55.6% of them were trained. However, the stability of the system was low because 55.6% of SDP had staff to ensure the continuity of ES service despite the availability of management tools (100%) and the telephone network (96.3%). The same was true for the usefulness of the ES because only 25.9% of SDP managers analyzed their produced data. The reported ES and malaria morbidity data were not adequate. On the other hand, the ES system was reactive with a speed of transmission of information at 96.3% and a possibility of rapid diagnosis and management of cases at 100%. Conclusion: the routine malaria ES system at the level of health facilities in Tambacounda District was acceptable, simple, flexible, representative, and responsive. However, an increase in qualified staff at the health posts, capacity strengthening of the ES staff and regular supervision of SDP are needed essentials to make the district's malaria surveillance system more efficient.
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Malaria , Humanos , Senegal/epidemiología , Malaria/epidemiología , Estudios Transversales , Monitoreo Epidemiológico , Instituciones de Salud/estadística & datos numéricos , Vigilancia de la Población/métodosRESUMEN
Background: India is facing triple epidemic of Non communicable diseases (NCDs) including high body mass index (BMI), high blood pressure and high blood glucose, contributing to more than half of deaths of all mortality, however, information in different demographics is limited, especially, in India. The aim of the study is to compare the prevalence of overweight, obesity, hypertension, and diabetes, along with the occurrence of multi-morbidity, across gender-specific populations in rural, suburban, and urban regions of India. Methods: This was a cross-sectional, population-based study including adults aged 20 and above in rural, suburban, and urban areas near Coimbatore, India. All participants were interviewed using a detailed questionnaire and had their anthropometric measurements, including height, weight, blood pressure, and blood samples collected. Gender specific and location specific prevalence of overweight, obesity, hypertension, diabetes, and multimorbidity were assessed. Results: This study included 2976 individuals, of which 865 were from rural areas, 1030 from sub-urban areas, and 1081 from metropolitan areas. The mean systolic and diastolic blood pressure were higher in rural participants than in sub-urban and urban participants, despite the fact that the prevalence of hypertension was higher in sub-urban (47.1%) than in rural (36.4%) and urban (39.7%, p < 0.001). In sub-group analysis, sub-urban areas had a greater prevalence of hypertension in both men and women (53.5% and 41.7%, p < 0.001) than rural areas (41.9% and 31.3%, p = 0.001) or urban areas (45.9% and 35.5%, p < 0.001). Compared to rural (16.1%) and urban (23%), sub-urban areas had a greater prevalence of diabetes (25.8%, p < 0.001). Urban residents (47.5%) had higher rates of overweight and obesity than rural (31.4%) and sub-urban (34.1%, p < 0.001) residents. The association between diabetes and hypertension was present in the unadjusted model and persisted even after age and BMI adjustments. Though not in men, higher levels of education were associated to a higher prevalence of diabetes in women. Diabetes was associated to being overweight or obese in women, however this association was significantly reduced once BMI was taken into account. The overall multimorbidity was 3.8%, however, women had a higher overlapping prevalence (2.8%) compared to men (1%, p < 0.001). Conclusions: Diabetes and hypertension were prevalent comorbidities across all demographics, with higher rates in suburban and urban areas. Women exhibited higher rates of multimorbidity than men, regardless of the demographic area.
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Diabetes Mellitus , Hipertensión , Obesidad , Sobrepeso , Humanos , India/epidemiología , Hipertensión/epidemiología , Estudios Transversales , Masculino , Femenino , Prevalencia , Adulto , Persona de Mediana Edad , Obesidad/epidemiología , Diabetes Mellitus/epidemiología , Sobrepeso/epidemiología , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Factores Sexuales , Anciano , Índice de Masa Corporal , Adulto Joven , Vigilancia de la Población/métodosRESUMEN
In the municipality of Rio de Janeiro, Brazil, the incorporation of the concept of epidemic intelligence and technological resources has supported new perspectives for the use of data by health surveillance, since the COVID-19 pandemic. This article presents the Epidemiological Intelligence Center (CIE) and the tools and products developed in its coordination. The CIE was inaugurated in March 2022, with a multiprofessional team, supported by the premises of transparency and integration of various data sources for early detection of changes in the trends of events of importance in Public Health. The initial acquisition of a data lake favored changes in the consumption, management and security processes for the data processed. This data lake currently stores the Carioca Base - a retrospective cohort of individuals with a history of COVID-19 vaccination and/or events related to the disease. Descriptive and analytical dashboards have been developed and made available, respectively for public use and for health surveillance administrators. An alert panel, aimed at monitoring trends in care in the urgency and emergency network, was implemented and subsidizes rapid response actions in the city's territories. The CIE developed the concept of epidemiological intelligence in the Brazilian Unified National Health System and this paradigm shift was made possible by investments in physical/human resources, the integration of epidemiological, statistical and data science methods, as well as the incorporation of different data sources in data analysis.
No Município do Rio de Janeiro, Brasil, a incorporação do conceito de inteligência epidêmica e de recursos tecnológicos sustentou novas perspectivas para a utilização de dados pela vigilância em saúde, a partir da pandemia de COVID-19. Neste artigo apresenta-se o Centro de Inteligência Epidemiológica (CIE), ferramentas e produtos desenvolvidos na coordenação. O CIE foi inaugurado em março de 2022, com equipe multiprofissional, apoiado nas premissas de transparência e integração de diversas fontes de dados para detecção precoce de mudanças nas tendências de eventos de importância em Saúde Pública. A aquisição inicial de um data lake favoreceu mudanças nos processos de consumo, gerenciamento e segurança para os dados processados. Esse data lake armazena, atualmente, a Base Carioca - uma coorte retrospectiva composta de indivíduos com histórico vacinal para COVID-19 e/ou eventos relacionados à doença. Painéis descritivos e analíticos foram desenvolvidos e disponibilizados, respectivamente, para uso público e para os gestores da vigilância em saúde. Um painel de alertas, voltado ao monitoramento de tendências nos atendimentos da rede de urgência e emergência municipal, foi implantado e subsidiou ações de resposta rápida nos territórios da cidade. O CIE desenvolveu o conceito de inteligência epidemiológica no Sistema Único de Saúde, e essa mudança de paradigma tornou-se possível em função de investimentos em recursos físicos/humanos, integração de métodos epidemiológicos, estatísticos e das ciências de dados, além de incorporação de fontes de dados diferenciadas nas análises de dados.
En el municipio de Río de Janeiro, Brasil, la inclusión del concepto de inteligencia epidémica y de recursos tecnológicos favoreció nuevas perspectivas en el uso de datos por parte de la vigilancia sanitaria desde la pandemia del COVID-19. Este artículo presenta el Centro de Inteligencia Epidemiológica (CIE), las herramientas y los productos desarrollados en coordinación. El CIE se creó en marzo de 2022 con un equipo multidisciplinar bajo las premisas de transparencia e integración de diversas fuentes de datos para la detección temprana de cambios en las tendencias a grandes eventos en Salud Pública. La adquisición inicial de un data lake promovió cambios en los procesos de consumo, gestión y seguridad de los datos procesados. Este data lake almacena actualmente la Base Carioca, una cohorte retrospectiva compuesta por individuos con antecedentes de vacunación contra el COVID-19 y/o eventos relacionados con la enfermedad. Se desarrollaron paneles descriptivos y analíticos, y se los pusieron a disposición, respectivamente, para uso público y para los gerentes de la vigilancia sanitaria. Se implementó un panel de alerta, dirigido a monitorear las tendencias a la asistencia en la red de urgencia y emergencia del municipio, el cual subvenciona acciones de pronta respuesta en los territorios de la ciudad. El CIE desarrolló el concepto de inteligencia epidemiológica en el Sistema Único de Salud, y este cambio de paradigma se hizo posible gracias a las inversiones en recursos físicos/humanos, la integración de métodos epidemiológicos, estadísticos y de ciencia de datos, además de la inclusión de fuentes de datos diferenciadas en el análisis de datos.
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COVID-19 , Humanos , Brasil/epidemiología , COVID-19/epidemiología , COVID-19/prevención & control , Tecnología de la Información , Pandemias , SARS-CoV-2 , Vigilancia de la Población/métodosRESUMEN
BACKGROUND: Mpox, is a zoonosis that is known to be endemic in several Central and West African countries. Recently, in 2022, it has emerged in Europe and United States, what raised the alarm to be declared in late June 2024 as a public health event of international concern. This study aimed to give insight about the recent spread of mpox in Sudan, and documents the epidemiologic situation. METHODS: Through a cross-sectional design, Sudan mpox data was extracted from the disease surveillance line-list at the national level at Sudan Federal Ministry of Health. the data was customized and then analyzed using Epi Info7 software. Analysis was done using frequencies and percentages and the results presented in tables and figures. Permission and ethical approval were obtained from the Health Emergency and Epidemic Control Directorate at the Federal Ministry of Health. RESULTS: The outbreak of mpox was confirmed after testing of initial specimens outside Sudan with positivity rate of 72%. Later the cases continued to be reported based on the clinical diagnosis and standard case definition. Out of 375 reported cases, 54.4% were males, while 45.6% were females. The age of cases ranged from one month to 78 years with majority (41.1%) of the cases were children under 5 years of age. Regarding the reported symptoms, all cases had the characteristic skin rash and 74.1% of them had fever. Other symptoms included, headache (31.5%), sore throat (30.9%) and lymphadenopathy (26.1%). For occupation, 35.7% were preschool and 10.4% were school children, 9% of cases were prisoners. Around 22 (5.8%) reported contact history with a confirmed case, while (5.6%) of the cases were imported cases. Cases were reported from 17 states with 42 affected localities (districts) with an overall attack rate of 2.36/ 100,000. The highest number of cases was reported from Gadaref (45.3%), West Darfur (25.9%), Khartoum (13.3%) and north Darfur (3.5%). In Gadaref, 146 (85.8%) of the cases were from a refugees' camp. Started in epi week 19, the outbreak peaked in week 38 and last in week 42. CONCLUSION: Mpox was confirmed in the new Sudan for the first time with cases reported in most of states. Although importation of the virus is hypothesized, internal hidden circulation is possible and more in-depth investigation is highly recommended. The higher rate of infection among preschool, school children and refugees, highlights the need to strengthen the prevention and control measures in schools and camps. More focus on the data completeness is required for better understanding of the disease and can be ensured by the surveillance directorate through training of staff and updating of reporting forms. Strengthening the lab capacity inside the country is a necessity to ensure testing of all the clinically diagnosed cases.
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Mpox , Humanos , Sudán/epidemiología , Femenino , Masculino , Niño , Adulto , Adolescente , Preescolar , Lactante , Persona de Mediana Edad , Adulto Joven , Estudios Transversales , Anciano , Mpox/epidemiología , Pandemias , Vigilancia de la Población/métodosRESUMEN
While more and more health-related data is being produced and published every day, few of it is being prepared in a way that would be beneficial for daily use outside the scientific realm. Interactive visualizations that can slice and condense enormous amounts of multi-dimensional data into easy-to-digest portions are a promising tool that has been under-utilized for health-related topics. Here we present two case studies for how interactive maps can be utilized to make raw health data accessible to different target audiences: i) the European Notifiable Diseases Interactive Geovisualization (ENDIG) which aims to communicate the implementation status of disease surveillance systems across the European Union to public health experts and decision makers, and ii) the Zoonotic Infection Risk in Twente-Achterhoek Map (ZIRTA map), which aims to communicate information about zoonotic diseases and their regional occurrence to general practitioners and other healthcare providers tasked with diagnosing infectious diseases on a daily basis. With these two examples, we demonstrate that relatively straight-forward interactive visualization approaches that are already widely used elsewhere can be of benefit for the realm of public health.
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Zoonosis , Humanos , Zoonosis/epidemiología , Animales , Análisis Espacio-Temporal , Salud Pública , Personal de Salud , Unión Europea , Mapeo Geográfico , Vigilancia de la Población/métodos , Difusión de la Información , Sistemas de Información GeográficaRESUMEN
The exposome approach, emphasizing lifelong environmental exposures, is a holistic framework exploring the intricate interplay between genetics and the environment in shaping health outcomes. Complementing this, the one health approach recognizes the interconnectedness of human and ecological health within a shared ecosystem, extending to planetary health, which encompasses the entire planet. Integrating Disease Surveillance Systems with exposome, one health, and planetary health signifies a paradigm shift in health management, fostering a comprehensive public health framework. This publication advocates for combining traditional health surveillance with exposome and one health/planetary health approach, proposing a three-step approach: ecological analysis, territorial intervention in identified issues, and an analytical phase for assessing interventions. Particularly relevant for Latin American countries facing a double burden of diseases, integrating the exposome into traditional health surveillance proves cost-effective by leveraging existing data and environmental measurements. In conclusion, the integration of exposome and one health approaches into traditional health surveillance presents a robust framework for monitoring population health, especially in regions like Latin America with complex health challenges. This innovative approach enables tailored interventions, disease outbreak predictions, and a holistic understanding of the intricate links between human health and the environment, offering substantial benefits for public health and disease prevention despite existing challenges.
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Exposoma , Salud Única , Humanos , América Latina , Exposición a Riesgos Ambientales/prevención & control , Salud Pública , Vigilancia de la Población/métodosRESUMEN
BACKGROUND: Infectious disease surveillance is difficult in many low- and middle-income countries. Information market (IM)-based participatory surveillance is a crowdsourcing method that encourages individuals to actively report health symptoms and observed trends by trading web-based virtual "stocks" with payoffs tied to a future event. OBJECTIVE: This study aims to assess the feasibility and acceptability of a tailored IM surveillance system to monitor population-level COVID-19 outcomes in Accra, Ghana. METHODS: We designed and evaluated a prediction markets IM system from October to December 2021 using a mixed methods study approach. Health care workers and community volunteers aged ≥18 years living in Accra participated in the pilot trading. Participants received 10,000 virtual credits to trade on 12 questions on COVID-19-related outcomes. Payoffs were tied to the cost estimation of new and cumulative cases in the region (Greater Accra) and nationwide (Ghana) at specified future time points. Questions included the number of new COVID-19 cases, the number of people likely to get the COVID-19 vaccination, and the total number of COVID-19 cases in Ghana by the end of the year. Phone credits were awarded based on the tally of virtual credits left and the participant's percentile ranking. Data collected included age, occupation, and trading frequency. In-depth interviews explored the reasons and factors associated with participants' user journey experience, barriers to system use, and willingness to use IM systems in the future. Trading frequency was assessed using trend analysis, and ordinary least squares regression analysis was conducted to determine the factors associated with trading at least once. RESULTS: Of the 105 eligible participants invited, 21 (84%) traded at least once on the platform. Questions estimating the national-level number of COVID-19 cases received 13 to 19 trades, and obtaining COVID-19-related information mainly from television and radio was associated with less likelihood of trading (marginal effect: -0.184). Individuals aged <30 years traded 7.5 times more and earned GH ¢134.1 (US $11.7) more in rewards than those aged >30 years (marginal effect: 0.0135). Implementing the IM surveillance was feasible; all 21 participants who traded found using IM for COVID-19 surveillance acceptable. Active trading by friends with communal discussion and a strong onboarding process facilitated participation. The lack of bidirectional communication on social media and technical difficulties were key barriers. CONCLUSIONS: Using an IM system for disease surveillance is feasible and acceptable in Ghana. This approach shows promise as a cost-effective source of information on disease trends in low- and middle-income countries where surveillance is underdeveloped, but further studies are needed to optimize its use.
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COVID-19 , Colaboración de las Masas , Humanos , Ghana/epidemiología , COVID-19/epidemiología , COVID-19/prevención & control , Proyectos Piloto , Adulto , Masculino , Femenino , Persona de Mediana Edad , Adulto Joven , Vigilancia de la Población/métodos , Estudios de FactibilidadRESUMEN
BACKGROUND: Children's mental health, including their well-being, is a major public health concern, as the burden of related disorders may last throughout one's life. Although epidemiological mental health surveillance systems for children and adolescents have been implemented in several countries, they are sorely lacking in France. OBJECTIVE: This study aims to describe the first step of the implementation of a novel surveillance system in France called Enabee (Etude nationale sur le bien-être des enfants), which focuses on the issue of mental health in children. The system aims to (1) describe the temporal trends in the population-based prevalence of the main mental health disorders and well-being in children aged 3 to 11 years, (2) explore their major determinants, and (3) assess mental health care use by this population. To do this, Enabee will rely on results from a recurrent national cross-sectional homonymous study. This paper presents the protocol for the first edition of this study (called Enabee 2022), as well as initial results regarding participation. METHODS: Enabee 2022 is a national cross-sectional study that was implemented in French schools in 2022. It used a probabilistic, multistage, stratified, and balanced sampling plan as follows: first, schools were randomly drawn and stratified according to the type of school. Up to 4 classes per school were then randomly drawn, and finally, all the pupils within each class were selected. The study covered children from preschool and kindergarten (aged 3 to 6 years, US grading system) to fifth grade (aged 6 to 11 years). Children from first to fifth grades provided a self-assessment of their mental health using 2 validated self-administered questionnaires: the Dominic Interactive (DI) and the KINDL. Parents and teachers completed a web-based questionnaire, including the Strengths and Difficulties Questionnaire. Parents also answered additional questions about their parenting attitudes; their own mental health; known social, economic, and environmental determinants of mental health in children; and their child's life habits. Health, education, and family stakeholders were involved in designing and implementing the study as part of a large consultation group. RESULTS: Data were collected from May 2, 2022, to July 31, 2022, in 399 schools across metropolitan France. Teachers completed questionnaires for 5721 pupils in preschool and kindergarten and for 15,263 pupils from first to fifth grades. Parents completed questionnaires for 3785 children in preschool and kindergarten and for 9227 children from first to fifth grades. Finally, 15,206 children from first to fifth grades completed the self-administered questionnaire. CONCLUSIONS: Enabee 2022 constitutes the first milestone in the development of a novel national epidemiological surveillance system, paving the way for improved children's mental health policies in France.
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Salud Mental , Humanos , Francia/epidemiología , Niño , Estudios Transversales , Preescolar , Masculino , Femenino , Salud Mental/estadística & datos numéricos , Trastornos Mentales/epidemiología , Vigilancia de la Población/métodos , Encuestas y CuestionariosRESUMEN
Background: Accurate and timely infectious disease surveillance is pivotal for effective public health responses. An important component of this is the disease surveillance tools used. Understanding views and experiences of users is crucial for informing policy decisions and ensuring the seamless functioning of surveillance systems. Objective: In this study, we aimed to assess the user perceptions of 3 disease surveillance tools used in Côte d'Ivoire, namely, MAGPI, District Health Information Software 2 (DHIS2), and Surveillance Outbreak Response Management and Analysis System (SORMAS), the latter was implemented in 2021 within a pilot scheme. Methods: We conducted interviews and a web-based survey distributed to users of the 3 surveillance tools. The survey assessed users' views of the surveillance tools' usefulness, ease of use, feelings toward the tool, conditions that may influence the use, and other characteristics. The descriptive analysis compared responses from SORMAS, MAGPI, and DHIS2 users, providing a comprehensive evaluation of their experiences. Results: Among the 159 respondents who actively use one of the systems, MAGPI was the most widely used surveillance tool among respondents (n=127, 79.9%), followed by DHIS2 (n=108, 67.9%), and SORMAS (n=25, 15.7%). In terms of users' perceptions, SORMAS, despite its limited implementation, emerged as a tool that allows for data analysis and had the most comprehensive set of functionalities. DHIS2 was appreciated for its frequency of report provision, although users reported occasional IT system failures. MAGPI was recognized for its ease of use but was reported to lack certain functionalities offered by the other surveillance systems. Conclusions: This study offers valuable insights into the perceptions of disease surveillance tools users in Côte d'Ivoire. While all systems were positively regarded, each exhibited strengths and weaknesses addressing different needs and functionalities. Policy makers and health officials can use these findings to enhance existing tools or consider a unified approach for infectious disease surveillance systems. Understanding users' perspectives allows them to optimize the choice of surveillance tools, ultimately strengthening public health responses in Côte d'Ivoire and potentially serving as a model for other countries facing similar decisions in their health care systems.
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Brotes de Enfermedades , Humanos , Côte d'Ivoire/epidemiología , Brotes de Enfermedades/prevención & control , Estudios Transversales , Masculino , Femenino , Adulto , Encuestas y Cuestionarios , Persona de Mediana Edad , Vigilancia de la Población/métodos , PercepciónRESUMEN
BACKGROUND: Tuberculosis (TB) burden and the underreporting of TB remain major health challenges in Indonesia. Interest in the internet is growing extensively, and the introduction of the TB mandatory electronic notification system in 2017 engaged the public's interest to leverage digital traces regarding TB information in Indonesia. OBJECTIVE: To quantify the correlation between Google Trends data and Indonesian TB surveillance data before and after the implementation of a mandatory TB notification system. METHODS: Google Trends searches on TB information were used. We used two sets of time series data, including before and after the launch of the TB notification system. Pearson's correlation was used to measure the correlation between TB search terms and official TB reports. RESULTS: The moving average graph showed a linear pattern of TB information with TB reports after 2017. Pearson's correlation estimated a high correlation for TB definition, TB symptoms, and official TB reports with an R-value range of 0.97 to -1.00 (p ≤ 0.05) and showed an increasing trend in TB information searching after 2016. CONCLUSION: Google Trends data can depict public interest in the TB epidemic. Validation of information-searching behavior is required to advocate the implementation of Google Trends for TB digital surveillance in Indonesia.
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Tuberculosis , Humanos , Indonesia/epidemiología , Tuberculosis/epidemiología , Tuberculosis/diagnóstico , Notificación de Enfermedades/estadística & datos numéricos , Motor de Búsqueda , Internet , Notificación Obligatoria , Vigilancia de la Población/métodosRESUMEN
Foot-and-mouth disease (FMD) is an ailment that causes serious damage to the productive chain, and its control through vaccination is of utmost importance for its eradication. Brazil initiated the National Foot-and-Mouth Disease Surveillance Program (PNEFA) with the aim of making the country FMD-free by 2026. As part of the program, notifications of vesicular lesions became mandatory for the Official Veterinary Service (OVS), which is responsible for verifying them. Due to its size, border areas with countries that do not have FMD-free status pose a risk to Brazil and require greater attention. This study described the profile of notifications of suspected outbreaks of vesicular syndrome in Brazil and analyzed the performance of the surveillance system. The results showed 7134 registered notifications of suspected vesicular syndrome outbreaks from 2018 to 2022, with 2022 having the highest number (n = 2343 or 32.85â¯%). The species that generated the most notifications were swine (90.99â¯%), cattle and buffaloes (7.54â¯%), goats and sheep (1.44â¯%), and others (0.03â¯%). The sources of notification were "Veterinary medicine professionals" (61.82â¯%), "Owners or employees" (13.66â¯%), "Third parties" (8.90â¯%), "OVS" (7.20â¯%), and "others" (2.66â¯%). 41.69â¯% of notifications originated from non-border municipalities, and 58.32â¯% from border areas. Only the state of Paraná account for 51.73â¯% of the total notifications. This state also accounted for 66.70â¯% of the 32.47â¯% of notifications with a final diagnosis of "absence of clinically compatible signs or susceptible animals", indicating a certain lack of knowledge in the area, leading to unnecessary notifications and system overload. The performance of the OVS was evaluated based on the service response time from notification registration trough Logistic and Negative binomial regressions. A total of 27.83â¯% of notifications did not meet the Brazilian legally specified time, and the zone related to the state of Parana needs improvements in performance. The presence and peaks of Senecavirus A cases may have influenced an increased number of swine notifications and led to a decrease in OVS response time. The results demonstrate better performance of surveillance in border areas. Given the vast territory of Brazil, it is not expected that 100â¯% of responses occur within the legal timeframe, however, the performance of the surveillance system proved to be adequate, with 86â¯% complied to the legislation. The performance indicators could be used as a monitoring tool, along with indicators to demonstrate system overload. Continued education actions are crucial for strengthening PNEFA.
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Enfermedades de los Bovinos , Brotes de Enfermedades , Fiebre Aftosa , Brasil/epidemiología , Animales , Fiebre Aftosa/epidemiología , Fiebre Aftosa/prevención & control , Brotes de Enfermedades/veterinaria , Brotes de Enfermedades/prevención & control , Bovinos , Enfermedades de los Bovinos/epidemiología , Enfermedades de los Bovinos/virología , Enfermedades de los Bovinos/prevención & control , Porcinos , Notificación de Enfermedades/estadística & datos numéricos , Ovinos , Enfermedades de los Porcinos/epidemiología , Enfermedades de los Porcinos/virología , Enfermedades de los Porcinos/prevención & control , Vigilancia de la Población/métodos , Enfermedades de las Ovejas/epidemiología , Enfermedades de las Ovejas/virología , Enfermedades de las Ovejas/prevención & control , Enfermedades de las Cabras/epidemiología , Enfermedades de las Cabras/virología , Enfermedades de las Cabras/prevención & control , Cabras , Búfalos , Monitoreo Epidemiológico/veterinariaRESUMEN
OBJECTIVES: To achieve malaria elimination by 2030, the Lao People's Democratic Republic (PDR) adopted a reactive surveillance and response (RASR) strategy of malaria case notification within 1 day, case investigation and classification within 3 days and foci investigation and response within 7 days. It is important to evaluate the performance and feasibility of RASR implementation in Lao PDR so that the strategy may be optimised and better contribute towards the goal of malaria elimination. DESIGN: A mixed-methods study comprising of secondary data analysis of routinely collected malaria surveillance data, quantitative surveys and qualitative consultations was conducted in 2022. SETTING: Primary data collections for quantitative surveys and qualitative consultations were conducted in Huaphan, Khammouane, Luangprabang and Savannakhet Provinces of Lao PDR. PARTICIPANTS: Quantitative surveys were conducted among malaria programme stakeholders and service providers. Qualitative interviews were conducted with malaria programme stakeholders, and focus group discussions with malaria programme stakeholders, service providers and mobile and migrant populations (MMPs). OUTCOME MEASURES: Outcomes of interests were awareness and acceptability of current RASR activities by different group of participants, implementation, performance and feasibility of RASR activities including enablers and barriers. RESULTS: In Lao PDR, malaria programme stakeholders and service providers were aware of RASR; however, these activities were not well known in MMPs. Respectively, the timeliness of case notification and case investigation was 0.0% and 15.6% in 2018 but increased to 98.0% and 98.6% in 2022. Implementation of RASR was acceptable to the malaria programme stakeholders and service providers, and continued implementation was perceived as feasible. Nevertheless, issues such as low level of community awareness, high level of migration and limitations in health system capacity were identified. CONCLUSION: Overall, the timeliness of case notification and investigation in Lao PDR was high, and malaria programme stakeholders and service providers had positive opinions on RASR. However, some operational and health system-related barriers were identified, which need to be addressed to improve the performance of RASR in Lao PDR.
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Malaria , Humanos , Laos/epidemiología , Malaria/prevención & control , Malaria/epidemiología , Grupos Focales , Vigilancia de la Población/métodos , Femenino , Erradicación de la Enfermedad/métodos , Masculino , Pueblos del Sudeste AsiáticoRESUMEN
BACKGROUND: While the new cardiovascular risk score (PREVENT) has improvements, its implementation may lead to significant changes in the distribution of atherosclerotic cardiovascular diseases (ASCVD) in the United States. We aimed to quantify and characterize the distribution of the 10-year predicted absolute ASCVD risk using the Pooled Cohorts Equation (PCE) and PREVENT. METHODS: We utilized the latest (2017-March 2020) round of the National Health and Nutrition Examination Survey (NHANES). Accounting for the complex survey design of the NHANES, we computed the mean predicted ASCVD risk overall and by sex, race, and education; similarly, we computed the prevalence of cardiovascular risk groups (<5%, 5%-7.4%, 7.5%-19.9%, and ≥ 20%). RESULTS: The study included 3845 observations, representing 109,692,509 people. Using the PREVENT calculator resulted in a reduction of the mean 10-year ASCVD absolute risk by half compared to the PCE: 9.1% vs 4.7%. Under the PCE, the high-risk category accounted for 12.5% of the population, whereas under PREVENT it fell to 0.4%. Among those previously classified as high-risk under the PCE, 3.5% would remain in this category with PREVENT, while 93% would be reclassified as intermediate risk. CONCLUSIONS: The adoption of the novel cardiovascular risk score, PREVENT, could lower the average predicted ASCVD risk and reduce the prevalence of high-risk individuals. While this shift might suggest improved cardiovascular health, it could also lead to complacency, potentially undermining ongoing public health efforts aimed at preventing cardiovascular disease.
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Enfermedades Cardiovasculares , Encuestas Nutricionales , Humanos , Masculino , Femenino , Persona de Mediana Edad , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Medición de Riesgo/métodos , Estados Unidos/epidemiología , Anciano , Adulto , Estudios de Cohortes , Factores de Riesgo de Enfermedad Cardiaca , Vigilancia de la Población/métodos , Factores de RiesgoRESUMEN
BACKGROUND: Remnant cholesterol (RC) is recognized as a residual risk factor for cardiovascular diseases (CVD). Most studies on the association between RC and CVD have focused on RC level at a single time point, typically during middle or older age. Limited data have characterized long-term RC exposures among young adult. Here we aimed to investigate the association of cumulative RC exposure during young adulthood and middle age with incident CVD later in life. METHODS: This cohort study enrolled 3416 CARDIA (Coronary Artery Risk Development in Young Adults) participants aged 18-30 years. Cumulative RC exposure was determined as cumulative RC and time-weighted average (TWA) RC during young adulthood and middle age. Multivariable Cox proportional hazards models were employed to examine the association between cumulative RC exposure and incident CVD. RESULTS: Of the 3416 included participants, 193 (5.6%) primary CVD outcomes occurred with a median 30.4-year follow-up. In multivariable Cox proportional hazards regression models that adjusted for LDL-C level, the most recent RC level and other CVD risk factors, the hazard ratios for primary CVD ourtcomes were as follows: 2.01 (95% CI, 1.23-3.27; P for trend = 0.021) for cumulative RC, and 2.11 (95% CI, 1.28-3.47; P for trend = 0.011) for TWA RC. Similar results were observed in other secondary outcomes. CONCLUSIONS: Greater exposures to cumulative RC and TWA RC during young adulthood and middle age were independently associated with an increased risk of cardiovascular events, suggesting that maintaining low RC levels early in life may reduce the lifetime CVD risk.
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Enfermedades Cardiovasculares , Colesterol , Humanos , Femenino , Masculino , Adulto , Enfermedades Cardiovasculares/epidemiología , Adulto Joven , Estudios de Cohortes , Adolescente , Colesterol/sangre , Persona de Mediana Edad , Estudios de Seguimiento , Factores de Riesgo , Vigilancia de la Población/métodos , IncidenciaRESUMEN
BackgroundA new respiratory virus surveillance platform, based on nationwide hospital laboratory data, was established in Israel during the COVID-19 pandemic.AimWe aimed to evaluate the performance of this platform with respect to the detection of influenza and respiratory syncytial virus (RSV) from week 36 in 2020 to week 15 in 2023, and how it fits with the World Health Organization (WHO) mosaic surveillance framework.MethodsData of respiratory samples from hospitalised patients sent for laboratory confirmation of influenza virus or RSV from 25 general hospital laboratories nationwide were collected. We analysed the weekly number and percentage of samples positive for influenza virus or RSV vis-à-vis SARS-CoV-2 activity and compared data from the new surveillance platform with existing surveillance platforms. Using data in the new surveillance platform, we analysed early stages of a 2021 out-of-season RSV outbreak and evaluated the capabilities of the new surveillance system with respect to objectives and domains of the WHO mosaic framework.ResultsThe new hospital-laboratory surveillance platform captured the activity of influenza virus and RSV, provided crucial data when outpatient sentinel surveillance was not operational and supported an out-of-season RSV outbreak investigation. The new surveillance platform fulfilled important objectives in all three domains of the mosaic framework and could serve for gathering additional information to fulfil more domain objectives.ConclusionThe new hospital laboratory surveillance platform provided essential data during the COVID-19 pandemic and beyond, fulfilled important domain objectives of the mosaic framework and could be adapted for the surveillance of other viruses.
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COVID-19 , Gripe Humana , Pandemias , Infecciones por Virus Sincitial Respiratorio , SARS-CoV-2 , Organización Mundial de la Salud , Humanos , COVID-19/epidemiología , Israel/epidemiología , Infecciones por Virus Sincitial Respiratorio/epidemiología , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Gripe Humana/epidemiología , Gripe Humana/diagnóstico , Vigilancia de Guardia , Laboratorios de Hospital/estadística & datos numéricos , Virus Sincitial Respiratorio Humano/aislamiento & purificación , Vigilancia de la Población/métodosRESUMEN
BACKGROUND: Track PCC includes five geographic surveillance sites to conduct standardized population-based surveillance to estimate and track Post-COVID Conditions (PCC) by age, sex, race/ethnicity, geographic area, severity of initial infection, and risk factors among persons with evidence of SARS-CoV-2 infection (based on the Council of State and Territorial Epidemiologist [CSTE] case definitions for confirmed cases or laboratory-confirmed evidence of infection). METHODS: The study will estimate the incidence, prevalence, including temporal trends, and duration and severity of PCC symptoms, among children, adolescents, and adults. PCCs include a broad range of symptoms and conditions that continue or develop after acute SARS-CoV-2 infection or COVID-19 illness. Surveillance includes both passive and active components for diverse populations in Arizona, Indiana, and Utah as well as the Bronx Borough, NY, and part of Philadelphia County, PA. Passive surveillance will utilize electronic health records and health information exchanges within each site catchment area to longitudinally follow persons with COVID-19 to estimate PCC occurring at least 30 days after acute COVID-19 illness. Active surveillance will utilize self-report of PCCs from detailed surveys of persons ages 7 years and older with evidence of SARS-CoV-2 infection in the past 3 months. Respondents will complete follow-up surveys at 6-, 12- and 18-months post-infection. DISCUSSION: These data can help identify which groups are most affected by PCC, and what health differences among demographic groups exist, as well as indicate potential barriers to care. These additional levels of granularity can inform public health action and help direct needed clinical care for patients.
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COVID-19 , Vigilancia de la Población , Humanos , COVID-19/epidemiología , Adolescente , Niño , Adulto , Masculino , Femenino , Vigilancia de la Población/métodos , Síndrome Post Agudo de COVID-19 , Estados Unidos/epidemiología , Adulto Joven , SARS-CoV-2 , Incidencia , Prevalencia , Preescolar , Costo de EnfermedadRESUMEN
Open surveys complementing surveillance programs often yield opportunistically sampled data characterised by spatio-temporal imbalance. We set up our study to understand to what extent spatio-temporal statistical models using such data achieve in describing epidemiological trends. We used self-reported symptomatic COVID-19 data from two Belgian regions, Flanders and the Brussels-Capital Region. These data were collected in a large-scale open survey with spatio-temporally imbalanced participation rates. We compared incidence estimates of both self-reported symptoms and test-confirmed COVID-19 cases obtained through generalised linear mixed models correcting for spatio-temporal correlation. We additionally simulated symptom incidences under different sampling strategies to explore the impact of sample imbalance, sample size and disease incidence, on trend detection. Our study shows that spatio-temporal sample imbalance generally does not lead to bad model performances in spatio-temporal trend estimation and high-risk area detection. Except for low-incidence diseases, collecting large samples will often be more essential than ensuring spatio-temporally sample balance.
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COVID-19 , SARS-CoV-2 , Autoinforme , Análisis Espacio-Temporal , Humanos , COVID-19/epidemiología , Bélgica/epidemiología , Incidencia , Masculino , Femenino , Adulto , Persona de Mediana Edad , Monitoreo Epidemiológico , Vigilancia de la Población/métodosRESUMEN
BACKGROUND: Lymphatic filariasis (LF), a mosquito-borne helminth infection, is an important cause of chronic disability globally. The World Health Organization has validated eight Pacific Island countries as having eliminated lymphatic filariasis (LF) as a public health problem, but there are limited data to support an evidence-based approach to post-validation surveillance (PVS). Tonga was validated as having eliminated LF in 2017 but no surveillance has been conducted since 2015. This paper describes a protocol for an operational research project investigating different PVS methods in Tonga to provide an evidence base for national and regional PVS strategies. METHODS: Programmatic baseline surveys and Transmission Assessment Surveys conducted between 2000-2015 were reviewed to identify historically 'high-risk' and 'low-risk' schools and communities. 'High-risk' were those with LF antigen (Ag)-positive individuals recorded in more than one survey, whilst 'low-risk' were those with no recorded Ag-positives. The outcome measure for ongoing LF transmission will be Ag-positivity, diagnosed using Alere™ Filariasis Test Strips. A targeted study will be conducted in May-July 2024 including: (i) high and low-risk schools and communities, (ii) boarding schools, and (iii) patients attending a chronic-disease clinic. We estimate a total sample size of 2,010 participants. CONCLUSIONS: Our methodology for targeted surveillance of suspected 'high-risk' populations using historical survey data can be adopted by countries when designing their PVS strategies. The results of this study will allow us to understand the current status of LF in Tonga and will be used to develop the next phase of activities.