为了评估由位于医院的医生和护士组成的监测网络获得的结果,以及接受过识别培训的初级保健,诊断确认和临床管理。
在一个日历年中,巴塞罗那北部都市区(1,400万居民;加泰罗尼亚;西班牙)。
7名初级保健和10名医院医生以及4名初级保健护士。
一项前瞻性观察性研究。
人口统计学,流行病学(本地/进口,可疑/可能/确诊病例)和医疗保健变量(症状,血清学概况,病毒期)被定义。
在确定的34名患者中,26(76.5%)符合研究标准。其中,在14例(53.8%)中确认了任何树病:13登革热加1基孔肯雅热。没有寨卡热病例。有前往流行地区的历史23(88.4%),但在3例(11.6%)中没有考虑到土著传播的可能性;其中,确诊了一例登革热。估计白病的发病率为0.4(95CI:0.33-0.51)例×10,000hab/年,与2009-2013年期间同一地理区域的估计发病率相比(0.19例×10,000hab/年;95CI:0.07-0.31),发现显着增加(P=.044)。首次就诊时在病毒血症期内的患者为11例(42.3%)。
在初级保健和医院层面定义的强化流行病学监测计划能够检测出明显更多的输入性和自源性树病病例。可能我们正在目睹进口树病的发病率增加,因此,应加强旨在对其进行识别和确认的措施。
To evaluate the results obtained by a surveillance network on arbovirosis composed by doctors and nurses located at hospitals and Primary Care trained in their identification, diagnostic confirmation and clinical management.
North Metropolitan Area of Barcelona (1,400,000 inhabitants; Catalonia; Spain) during a calendar year.
Seven Primary Care and 10 hospital physicians plus 4 Primary Care nurses.
A prospective observational study.
Demographic, epidemiological (autochthonous/imported, suspect/probable/confirmed
case) and healthcare variables (symptoms, serological profile, viral period) were defined.
Of the 34 patients identified, 26 (76.5%) met study criteria. Among them, any arbovirosis was confirmed in 14 (53.8%): 13 dengue plus 1chikungunya fever. There were no cases of
Zika fever. There was a history of travel to endemic areas 23 (88.4%), but not in 3cases (11.6%) in which the possibility of an indigenous transmission was considered; of them, a
case of dengue was confirmed. The estimated incidence of arbovirosis was 0.4 (95%CI: 0.33-0.51) cases ×10,000hab/year which, when compared to the estimated incidence in the same geographical area during the period 2009-2013 (0.19cases ×10,000hab/year; 95%CI: 0.07-0.31), a significant increase was found (P=.044). Patients within viremia period at the time of their first medical visit were 11 (42.3%).
An intensified epidemiological surveillance program defined at Primary Care and hospital levels is able to detect significantly more cases of imported and autochthonous arbovirosis. Possibly we are witnessing an increase in the incidence of imported arbovirosis and, thus, measures aimed at their identification and confirmation should be reinforced.