communicable disease control

传染病控制
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  • 文章类型: Journal Article
    COVID-19大流行和相关的非药物干预措施(NPI)导致全球多个国家的传染病病例数量大幅减少。随着NPI逐渐被取消,报告了呼吸道和胃肠道疾病的强烈或反季节爆发,提出了感染潜在追赶效应的假设。通过分析来自联邦报告系统的应报告传染病的监测数据,我们旨在评估解除COVID-19相关NPI对巴伐利亚州选定传染病通知的潜在影响,2022年。
    我们比较了流感,水痘,诺如病毒胃肠炎,使用两种时间序列分析方法,在大流行前(2016-2019)和2022年的轮状病毒胃肠炎每周病例数:(i)基于2016-2019年数据,预测2020-2022年大流行年度的每周病例数的预测模型,(二)中断时间序列模型,根据2016-2022年的数据,包括每个大流行期间的一个术语。
    2022年,流感(IRR=3.47,95CI:1.49-7.94)和轮状病毒胃肠炎(IRR=1.36,95CI:0.95-1.93)的发病率高于大流行前。虽然对轮状病毒胃肠炎并不重要。相反,水痘(IRR=0.52,95CI:0.41-0.65)和诺如病毒胃肠炎(IRR=0.59,95CI:0.42-0.82)的病例数仍显著低于大流行前水平.季节性变化尤其是流感,与大流行前相比,显示出更早的流感浪潮。
    根据所选疾病,NPI的解除与异源性流行病学模式相关。只有继续监测和评估潜在的其他影响因素,NPI及其终止的全部影响才可能变得清晰。
    UNASSIGNED: The COVID-19 pandemic and associated non-pharmaceutical interventions (NPIs) have led to substantial decreases in case numbers of infectious diseases in several countries worldwide. As NPIs were gradually lifted, intense or out-of-season outbreaks of respiratory and gastrointestinal diseases were reported, raising the hypothesis of a potential catch-up effect of infections. By analysing surveillance data from the federal reporting system for notifiable infectious diseases, we aimed to assess the potential impact of lifting COVID-19 associated NPIs on notifications of selected infectious diseases in Bavaria, 2022.
    UNASSIGNED: We compared influenza, chickenpox, norovirus gastroenteritis, rotavirus gastroenteritis weekly case numbers in a pre-pandemic period (2016-2019) and 2022 using two time series analyses approaches: (i) a predictive model forecasting weekly case numbers for the pandemic years 2020-2022, based on 2016-2019 data, (ii) interrupted time series model, based on 2016-2022 data, including a term per pandemic period.
    UNASSIGNED: In 2022, incidence rates were higher compared to pre-pandemic period for influenza (IRR = 3.47, 95%CI: 1.49-7.94) and rotavirus gastroenteritis (IRR = 1.36, 95%CI: 0.95-1.93), though not significant for rotavirus gastroenteritis. Conversely, case numbers remained significantly below pre-pandemic levels for chickenpox (IRR = 0.52, 95%CI: 0.41-0.65) and norovirus gastroenteritis (IRR = 0.59, 95%CI: 0.42-0.82). Seasonality changed notably for influenza, showing an earlier influenza wave compared to pre-pandemic periods.
    UNASSIGNED: The lifting of NPIs was associated with heterogenic epidemiological patterns depending on the selected disease. The full impact of NPIs and their discontinuation may only become clear with continued monitoring and assessment of potential additional contributing factors.
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  • 文章类型: Journal Article
    2020年底,全球抗击COVID-19大流行的重点集中在疫苗的开发上,当来自丹麦的1700万养殖水貂的SARS-CoV-2病毒变异的报道来自丹麦,威胁要危及这一努力。人们担心水貂和人类之间新变种的溢出感染会威胁到即将到来的疫苗的功效。在这项研究中,分析了在98个国家中的7个城市实施的短暂但严格的封锁措施,以减少SARS-CoV-2感染的有效性。使用严格措施未针对的其余城市的加权平均组合为每个城市创建综合反事实。这可以清楚地概述测试阳性率的发展,公民流动行为和最后的每日感染人数,以应对这些限制。研究结果表明,这些目标,短期封锁显著减少了进一步的感染,显示出明显的下降,首先是公民的流动性,然后是与他们的合成反事实相比的日常情况。总的来说,估计显示感染人数平均减少约31%。这项研究强调了严格,然而,在打破持续的感染动态方面进行了严重的封锁,通过利用罕见的准实验设计案例,避免了通过治疗选择引入的偏见。
    In late 2020, the focus of the global effort against the COVID-19 pandemic centered around the development of a vaccine, when reports of a mutated SARS-CoV-2 virus variant in a population of 17 million farmed mink came from Denmark, threatening to jeopardize this effort. Spillover infections of the new variant between mink and humans were feared to threaten the efficacy of upcoming vaccines. In this study the ensuing short-lived yet stringent lockdowns imposed in 7 of the countries 98 municipalities are analysed for their effectiveness to reduce SARS-CoV-2 infections. Synthetic counterfactuals are created for each of these municipalities using a weighted average combination of the remaining municipalities not targeted by the stringent measures. This allows for a clear overview regarding the development of test-positivity rates, citizen mobility behaviours and lastly daily infection numbers in response to the restrictions. The findings show that these targeted, short-term lockdowns significantly curtailed further infections, demonstrating a marked decrease, first in citizens mobility and then in daily cases when compared to their synthetic counterfactuals. Overall, the estimates indicate average reductions to infection numbers to be around 31%. This study underscores the potential of strict, yet severe lockdowns in breaking ongoing infection dynamics, by utilising a rare quasi-experimental design case that avoids bias introduced through treatment selection.
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  • 文章类型: Journal Article
    2019年冠状病毒病意外发生在2019年12月下旬,在疫情爆发的早期阶段很难立即开发出有效的疫苗或提出有针对性的医疗干预措施。在这一点上,非药物干预措施(NPIs)是对COVID-19的公共卫生反应的重要组成部分。如何在疫情爆发初期对不同的NPI进行组合,控制疫情的传播,确保政策组合不产生高昂的社会经济成本,成为本次研究的重点。
    我们主要使用模糊集定性比较分析来评估不同NPI组合对COVID-19大流行早期控制效果的影响,使用包含案例编号的开放数据集,国家人口和政策对策。
    我们表明,高发病率结果的配置包括一个,这是非严格的面部覆盖的组合,社会隔离和旅行限制。非高发病率结果的配置包括三个,一是严格的口罩佩戴措施,这本身就构成了解释结果的充分条件;二是严格的测试和接触者追踪,社会隔离;第三是严格的测试和接触者追踪,旅行限制。稳健性检验的结果表明,更改最小情况频率后,配置的组件和一致性没有改变,证明了分析结果的可靠性。
    在流行病的早期阶段,高发病率的原因与非高发病率的原因不对称。严格的面部覆盖是预防和控制流行病所需的最基本措施,不严格的面部覆盖和围堵相结合是导致防控不力的最重要因素,严格遏制和主动追求相结合是实现卓越防控的途径,及时积极的遏制策略有更好的预防和控制,并应动员公众合作。
    UNASSIGNED: Coronavirus disease 2019 occurred unexpectedly in late December 2019, it was difficult to immediately develop an effective vaccine or propose targeted medical interventions in the early stages of the outbreak. At this point, non-pharmaceutical interventions (NPIs) are essential components of the public health response to COVID-19. How to combine different NPIs in the early stages of an outbreak to control the spread of epidemics and ensure that the policy combination does not incur high socio-economic costs became the focus of this study.
    UNASSIGNED: We mainly used the fuzzy set qualitative comparative analysis to assess the impact of different combinations of NPIs on the effectiveness of control in the COVID-19 pandemic early stage, using open datasets containing case numbers, country populations and policy responses.
    UNASSIGNED: We showed that the configuration of high morbidity results includes one, which is the combination of non-strict face covering, social isolation and travel restrictions. The configuration of non-high morbidity results includes three, one is strict mask wearing measures, which alone constitute sufficient conditions for interpreting the results; the second is strict testing and contact tracing, social isolation; the third is strict testing and contact tracing, travel restriction. The results of the robustness test showed that the number, components and consistency of the configurations have not changed after changing the minimum case frequency, which proved that the analysis results are reliable.
    UNASSIGNED: In the early stages of the epidemic, the causes of high morbidity are not symmetrical with the causes of non-high morbidity. Strict face covering is the most basic measure required to prevent and control epidemics, and the combination of non-strict face covering and containment is the most important factor leading to poor prevention and control, and the combination of strict containment and proactive pursuit is the way to achieve superior prevention and control, timely and proactive containment strategies have better prevention and control, and should mobilize the public to cooperate.
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  • 文章类型: Journal Article
    适当的传染病特异性健康素养(IDSHL)有利于居民应对传染病。本研究旨在探讨居民获取传染病防治知识(IDPC知识)的方法,以寻求有效的健康教育方法,以提高居民的IDSHL水平。2022年,山东省进行了一项横断面研究,中国。通过多阶段抽样从农村地区招募参与者。IDPC知识认知问卷,作为一个可靠和有效的工具,应用于数据收集和调查参与者的IDPC知识。采用卡方分析法分析不同亚组间IDSHL占有水平的差异。还通过卡方分析检查了人口统计学因素与获取IDPC知识的方法之间的关系。在总共2283名参与者中,IDSHL的持有率为31.80%。IDSHL水平与社会人口因素之间存在显着关联,包括年龄(P<.001),性别(P=0.02),教育(P<.001),职业(P<.001),家庭年收入(P<.001),是否使用智能手机(P<.001),是否在智能手机上浏览微信(P<.001),以及是否在智能手机上浏览除微信以外的应用程序(P<.001)。单因素分析表明,是否采用特定的方法,包括电视(P=0.02),智能手机上的微信(P<.001),传染病防控宣传(P<.001),获得IDPC知识的医生建议(P<.001)与IDSHL水平显著相关。年龄(P<.001),教育(P<0.05),职业(P<0.05),和家庭年收入(P<.01)与获取IDPC知识的方法相关。山东省农村居民充足的IDSHL,中国,并不乐观。传统方法与互联网宣传平台的结合,应该为农村人群中的IDSHL健康教育承担更大的责任。
    Adequate infectious disease-specific health literacy (IDSHL) is of benefit to residents in dealing with infectious diseases. This study aimed to investigate the methods by which residents acquire knowledge about infectious disease prevention and control (IDPC knowledge) so as to find effective health education methods used to improve residents\' IDSHL level. In 2022, a cross-sectional study was conducted in Shandong Province, China. Participants were recruited from rural areas by multistage sampling. The IDPC knowledge cognitive questionnaire, as a reliable and valid tool, was applied to data collection and to investigate the participants\' IDPC knowledge. Chi-square analysis was utilized to analyze the differences in possession level of IDSHL between different subgroups. The relationship between demographic factors and methods to acquire IDPC knowledge was also examined by chi-square analysis. The possession rate of adequate IDSHL among the total 2283 participants was 31.80%. There was a significant association between IDSHL level and socio-demographic factors, including age (P < .001), sex (P = .02), education (P < .001), occupation (P < .001), annual family income (P < .001), whether to use smartphones (P < .001), whether to browse WeChat on smartphones (P < .001), and whether to browse apps on smartphones except WeChat (P < .001). Univariate analysis showed that whether to adopt specific methods, including television (P = .02), WeChat on smartphones (P < .001), propaganda of infectious disease prevention and control (P < .001), and doctor\'s advice (P < .001) to acquire IDPC knowledge had significant associations with IDSHL level. Age (P < .001), education (P < .05), occupation (P < .05), and annual family income (P < .01) were associated with methods to acquire IDPC knowledge. The rural residents\' adequate IDSHL in Shandong Province, China, was not optimistic. The combination of traditional methods and Internet publicity platforms should take greater responsibility for IDSHL health education among rural populations.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:COVID-19大流行导致非接触式支付和政府现金转移计划的数字金融服务空前普及,以减轻大流行的经济影响。大流行对低收入和中等收入国家使用数字金融服务促进健康的影响,然而,知之甚少。
    目的:本研究旨在评估首次COVID-19封锁对使用移动孕产妇健康钱包的影响,特别侧重于描述年龄相关的差异效应,并就封锁措施对数字医疗服务使用的影响得出结论。
    方法:我们分析了来自塔那那利佛25家公共部门初级保健机构和4家医院的3416名女性的819,840人日健康钱包使用数据,马达加斯加,2020年1月1日至8月27日。我们收集了储蓄数据,付款,和凭证在护理点使用。为了评估马达加斯加首次COVID-19封锁的影响,我们在2020年3月23日首次COVID-19封锁开始日前后使用了回归不连续性分析。我们使用数据驱动方法确定带宽,用于无偏带宽选择,并使用改进的泊松回归用于二元变量,以估计锁定效应大小的风险比。
    结果:我们记录了3719个保存事件,1572个付款事件,和3144使用事件的电子凭证。马达加斯加的首次COVID-19封锁将移动货币节省减少了58.5%(P<.001),付款量为45.8%(P<.001),凭证使用率下降49.6%(P<.001)。214天后,凭单使用恢复到推断的锁定前反事实,而储蓄和付款并没有超过推断的封锁前的反事实。封锁后的恢复时间因年龄组而异。年龄>30岁的妇女恢复得更快,在34、226和77天后恢复到提前封锁率,以节省资金,付款,和优惠券使用,分别。年龄<25岁的年轻女性没有恢复到基线值。在使用±20天的最佳带宽的灵敏度分析中,结果保持稳健。
    结论:COVID-19的封锁大大减少了移动货币在卫生部门的使用,影响储蓄,付款,和代金券使用。储蓄减少的幅度最大,这意味着封锁影响了女性对未来医疗保健使用的期望。付款和代金券使用的下降表明,封锁导致实际医疗保健使用减少。这些影响至关重要,因为许多妇幼保健服务不能延迟,因为潜在的利益将丢失或减少。为了减轻封锁对孕产妇保健服务使用的不利影响,可以利用数字医疗服务来提供远程医疗服务,并通过有关可用医疗服务访问选项和遵守安全协议的明确信息来增强用户通信。
    BACKGROUND: The COVID-19 pandemic resulted in the unprecedented popularity of digital financial services for contactless payments and government cash transfer programs to mitigate the economic effects of the pandemic. The effect of the pandemic on the use of digital financial services for health in low- and middle-income countries, however, is poorly understood.
    OBJECTIVE: This study aimed to assess the effect of the first COVID-19 lockdown on the use of a mobile maternal health wallet, with a particular focus on delineating the age-dependent differential effects, and draw conclusions on the effect of lockdown measures on the use of digital health services.
    METHODS: We analyzed 819,840 person-days of health wallet use data from 3416 women who used health care at 25 public sector primary care facilities and 4 hospitals in Antananarivo, Madagascar, between January 1 and August 27, 2020. We collected data on savings, payments, and voucher use at the point of care. To estimate the effects of the first COVID-19 lockdown in Madagascar, we used regression discontinuity analysis around the starting day of the first COVID-19 lockdown on March 23, 2020. We determined the bandwidth using a data-driven method for unbiased bandwidth selection and used modified Poisson regression for binary variables to estimate risk ratios as lockdown effect sizes.
    RESULTS: We recorded 3719 saving events, 1572 payment events, and 3144 use events of electronic vouchers. The first COVID-19 lockdown in Madagascar reduced mobile money savings by 58.5% (P<.001), payments by 45.8% (P<.001), and voucher use by 49.6% (P<.001). Voucher use recovered to the extrapolated prelockdown counterfactual after 214 days, while savings and payments did not cross the extrapolated prelockdown counterfactual. The recovery duration after the lockdown differed by age group. Women aged >30 years recovered substantially faster, returning to prelockdown rates after 34, 226, and 77 days for savings, payments, and voucher use, respectively. Younger women aged <25 years did not return to baseline values. The results remained robust in sensitivity analyses using ±20 days of the optimal bandwidth.
    CONCLUSIONS: The COVID-19 lockdown greatly reduced the use of mobile money in the health sector, affecting savings, payments, and voucher use. Savings were the most significantly reduced, implying that the lockdown affected women\'s expectations of future health care use. Declines in payments and voucher use indicated decreased actual health care use caused by the lockdown. These effects are crucial since many maternal and child health care services cannot be delayed, as the potential benefits will be lost or diminished. To mitigate the adverse impacts of lockdowns on maternal health service use, digital health services could be leveraged to provide access to telemedicine and enhance user communication with clear information on available health care access options and adherence to safety protocols.
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  • 文章类型: Journal Article
    During the late Qing Dynasty, Tianjin Customs gradually established the seaport quarantine system to prevent the spread of epidemics from Japan, Hong Kong, and the Northeast. The major infectious diseases inspected by the quarantine institution of Tianjin Port include cholera, plague, smallpox, typhus and yellow fever, of which cholera is the most frequent and influential infectious disease in modern Tianjin, followed by plague and smallpox, and no large-scale epidemics of typhus and yellow fever have been found.In the process of preventing the spreading of foreign infectious diseases, the quarantine institution of Tianjin Port has gradually developing. A set of business system has been established, which is based on ship inspection and takes preventive injection, rat flea research and disease diagnosis and treatment as the core.In conclusion,the seaport quarantine institutions in Tianjin played an active role in the prevention, detection, and response to major infectious diseases ,opened up a precedent for Chinese people to independently handle border health quarantine.Its historical practice and quarantine mode are a window for understanding the development history of quarantine infectious diseases in modern China, which has very important reference value.
    晚清时期,为防止日本、香港、东北等地的疫情传入天津,天津海关逐步建立起天津海港检疫制度。天津海港检疫机构施检的重大传染病包括霍乱、鼠疫、天花、斑疹伤寒和黄热病,其中霍乱是近代天津地区爆发最频繁、影响力最大的传染病,鼠疫、天花次之,未发现斑疹伤寒和黄热病大规模流行的记载。天津海港检疫机构在抵制外来传染病入侵的过程中逐渐成熟,建立起以船舶检验为基础,以预防注射、鼠蚤研究和疾病诊疗为核心的业务体系。天津海港检疫机构在重大传染病预防、检测与应对方面发挥了积极的作用,开辟了国人自主办理国境卫生检疫的先河,其历史实践和检疫模式是认识和了解近代中国检疫传染病发展史的一个窗口,具有十分重要的借鉴价值。.
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