Communicable disease control

传染病控制
  • 文章类型: Journal Article
    青春期是出现心理健康问题的时期。研究表明,COVID-19封锁可能使情绪和行为健康恶化。
    研究在COVID-19大流行期间,社会经济地位是否与青少年的心理健康结果相关。
    青少年大脑认知发育(ABCD)研究是一项针对美国青少年神经认知发育的多站点10年纵向研究。招募是交错的,基线访问(9至10岁)发生在2016年至2018年,并且每年进行一次访问。在为期2年的随访(年龄11至12岁)期间,COVID-19封锁停止了研究收集,但最终恢复。由于一些年轻人在封锁前已经接受了两年的探访,这就允许了类似自然实验设计来比较流行前和流行内的组.因此,数据来自1年的随访(所有年轻人在COVID-19之前被封锁)和2年的随访,其中一部分年轻人在封锁开始后收集了数据,比较接近社会隔离的时期是否与年轻人的心理健康症状有关。大流行组由在2020年3月11日之前收集的2年随访的年轻人组成,大流行组在解除封锁限制后进行了2年随访。
    评估包括收入与需求比率(INR;来自家庭总收入),儿童行为检查表(一种心理健康症状学的衡量标准),和家庭环境规模。
    最终样本包括10399名年轻人;3947(52.3%)为男性;2084(20.3%)为拉丁裔/西班牙裔;6765(66.0%)为白人;4600(44.2%)报告的看护者教育水平低于4年制大学学位;2475(26.2%)的INR低于100%(表明贫困)或在100%和以下(接近贫困在大流行群体的年轻人中,更糟糕的心理健康症状(例如,更多的问题,更大的抑郁,和更大的焦虑)随着时间的推移与来自社会经济地位较高的家庭有关(例如,在比较1年至2年随访期间,在流行前和流行内组之间INR差异为1个单位的个体时,他们在总问题评分中的预期差异为0.79[95%CI,0.37-1.22];错误发现率校正P<.001).
    这项队列研究发现,在具有较高社会经济地位背景的年轻人中,COVID-19封锁与不成比例的负面心理健康结果相关。虽然这项研究没有揭示驱动这些关联的直接机制,它确实为年轻人的积极成果提供了一些支持。未来的研究需要了解这些关联是否会持续更长的时间。
    UNASSIGNED: Adolescence is a period in which mental health problems emerge. Research suggests that the COVID-19 lockdown may have worsened emotional and behavioral health.
    UNASSIGNED: To examine whether socioeconomic status was associated with mental health outcomes among youths during the COVID-19 pandemic.
    UNASSIGNED: The Adolescent Brain Cognitive Development (ABCD) Study is a multisite 10-year longitudinal study of youth neurocognitive development in the US. Recruitment was staggered where the baseline visit (ages 9 to 10 years) occurred from 2016 to 2018, and visits occurred yearly. The COVID-19 lockdown halted research collection during the 2-year follow-up visits (ages 11 to 12 years), but eventually resumed. As some youths already underwent their 2-year visits prior to lockdown, this allowed for a natural experiment-like design to compare prepandemic and intrapandemic groups. Thus, data were gathered from the 1-year follow-up (pre-COVID-19 lockdown for all youths) and the 2-year follow-up, of which a portion of youths had data collected after the lockdown began, to compare whether a period of near social isolation was associated with mental health symptoms in youths. The prepandemic group consisted of youths with a 2-year follow-up visit collected prior to March 11, 2020, and the intrapandemic group had their 2-year follow-up visit after lockdown restrictions were lifted.
    UNASSIGNED: Assessments included measures on income-to-needs ratio (INR; derived from total household income), the Child Behavior Checklist (a measure of mental health symptomology), and the Family Environmental Scale.
    UNASSIGNED: The final sample included 10 399 youths; 3947 (52.3%) were male; 2084 (20.3%) were Latinx/Hispanic; 6765 (66.0%) were White; 4600 (44.2%) reported caregiver education levels below a 4-year college degree; and 2475 (26.2%) had INR either below 100% (indicating poverty) or between 100% and less than 200% (near poverty). Among youths in the intrapandemic group, worse mental health symptoms (eg, more total problems, greater depression, and greater anxiety) over time were associated with being from a household with higher socioeconomic status (eg, when comparing individuals who differed by 1 unit on INR between prepandemic and intrapandemic groups from 1-year to 2-year follow-up, their expected difference in total problems score was 0.79 [95% CI, 0.37-1.22]; false discovery rate-corrected P < .001).
    UNASSIGNED: This cohort study found that the COVID-19 lockdown was associated with disproportionately negative mental health outcomes among youths from higher socioeconomic status backgrounds. Although this study does not shed light on the direct mechanisms driving these associations, it does provide some support for positive outcomes for youths. Future studies are needed to understand whether these associations persist over longer periods of time.
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  • 文章类型: English Abstract
    To understand the progress of national schistosomiasis elimination program of China in 2023 and summarize the lessons and experiences, data on the endemic status of schistosomiasis and national schistosomiasis surveillance results in the People\'s Republic of China were collected and analyzed at a national level. By the end of 2023, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to consolidate the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan and Hubei provinces were identified to achieve the criteria of transmission interruption in 2020, and Anhui, Jiangxi and Hunan provinces achieved the criteria of transmission interruption in 2023. A total of 451 counties (cites, districts) were found to be endemic for schistosomiasis in China in 2023, including 26 250 endemic villages covering 73 034 500 residents at risk of infections. Among the 451 endemic counties (cities, districts), 78.49% (354/451) achieved the criteria of schistosomiasis elimination and 21.51% (97/451) achieved the criteria of transmission interruption, respectively. In 2023, a total of 4 216 643 individuals received immunological tests, with 47 794 sero-positives identified, and a total of 184 216 individuals received parasitological examinations, with 4 egg-positives detected. A total of 27 768 cases with advanced schistosomiasis were documented in China by the end of 2023. In 2023, 539 548 bovines were raised in schistosomiasis-endemic areas of China, and 125 440 bovines received immunological tests, with 124 sero-positives detected, while no egg-positives were identified among the 133 508 bovines receiving parasitological examinations. In 2023, snail survey was performed at an area of 641 339.53 hm2 and 184 819.77 hm2 snail habitats were identified, including 51.53 hm2 emerging snail habitats and 642.25 hm2 reemerging snail habitats. In 2023, there were 20 198 schistosomiasis patients receiving praziquantel chemotherapy, and 598 183 person-time individuals and 283 954 herdtime bovines were given expanded chemotherapy. In 2023, snail control with chemical treatment was performed in 116 347.95 hm2 snail habitats, and the actual area of chemical treatment was 65 690.89 hm2, while environmental improvements were performed in snail habitats covering an area of 1 334.62 hm2. The national schistosomiasis surveillance results showed that the mean prevalence of Schistosoma japonicum infections were both zero among humans and bovines in 2023, and no S. japonicum infection was detected in snails. These data demonstrated that transmission interruption of schistosomiasis had been achieved across all endemic provinces in China in 2023, and the endemic status of schistosomiasis tended to be stable, while advanced cases were predominant among all schistosomiasis cases. However, the areas of snail habitats remained high and cattle re-raising was very common in some regions. Intensified schistosomiasis surveillance and forecast and snail control in high-risk areas are needed.
    [摘要] 为了解全国血吸虫病消除工作进展、总结防治经验及存 在的问题, 本文对2023年全国血吸虫病疫情和监测结果进行了概 括分析。截至2023年底, 上海、浙江、福建、广东、广西等5个省 (直辖市、自治区) 继续维持血吸虫病消除状态, 四川、江苏省继续 维持传播阻断标准, 云南、湖北省于2020年达到传播阻断标准, 安 徽、江西、湖南省于2023年新达到传播阻断标准。2023年, 全国 共有451个血吸虫病流行县 (市、区) 、26 250个流行村, 流行村总 人口7 303.45万人; 451个流行县 (市、区) 中, 354个 (78.49%) 已达 到血吸虫病消除标准、97个 (21.51%) 已达到传播阻断标准。2023 年全国共开展居民血吸虫病免疫学检查4 216 643例, 阳性47 794 例; 开展病原学检查184 216例, 阳性4例; 全国尚存晚期血吸虫病 患者27 768例。2023年全国血吸虫病流行村现有存栏牛539 548 头, 累计开展免疫学检查查病125 440头, 阳性124头; 病原学检查查病133 508头, 未发现阳性。全国累计开展钉螺调查 641 339.53 hm2, 查出有螺面积184 819.77 hm2, 其中新发现有螺面积51.53 hm2、复现有螺面积642.25 hm2。2023年, 全国 累计治疗血吸虫病患者20 198例, 人群病原学扩大治疗598 183例·次, 牛病原学扩大治疗283 954头·次; 全国累计开展 药物灭螺116 347.95 hm2, 实际药物灭螺65 690.89 hm2, 环境改造灭螺1 334.62 hm2。2023年, 全国血吸虫病监测结果显 示人、畜血吸虫感染率均为0, 未发现感染性钉螺。疫情数据分析显示, 2023年全国所有流行省份均达到血吸虫病传播 阻断标准、疫情趋于稳定, 血吸虫病病例以晚期病例为主; 但钉螺面积居高不下, 部分地区牛复养现象严重。需继续加强 血吸虫病监测预警, 做好重点地区钉螺控制工作。.
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  • 文章类型: Journal Article
    人们普遍认为,COVID-19封锁期间日常活动表现的中断影响了健康,但是需要更好地了解特定活动的受限表现如何与健康相关。这项横断面研究回答了以下问题:在COVID-19封锁期间,16项日常活动的表现与健康相关的变化如何?共有116名参与者完成了一项在线调查,对他们在COVID-19封锁之前和期间的健康状况进行了评估,并将他们对COVID-19之前16项活动的表现与封锁期间的表现进行了比较。使用多元逐步线性回归分析来估计封锁期间自我报告的活动变化与同时(封锁期间)健康状况之间的关系。同时控制前COVID-19的健康状况。最终模型中只保留了与锁定健康状况唯一且显著相关的活动变化。COVID-19之前的健康状况占COVID-19封锁期间健康状况差异的3.7%(P=0.039)。在控制COVID-19之前的健康状况后,五种类型的活动对封锁期间的健康状况有显著和独特的预测作用,合计占差异的48.3%。这些活动和它们所占的差异是休息和睡眠(29.5%,P<0.001),游戏和娱乐活动(8%,P<0.001),工作(4.8%,P=0.002),个人卫生(3.2%,P=0.01),和健康饮食(2.8%,P=0.013)。研究表明,当活动的参与受到封锁或类似因素的限制时,应在政策或干预措施中优先考虑这五种类型的活动。
    The disruption in daily activity performance during COVID-19 lockdowns is widely understood to have impacted health, but a better understanding of how restricted performance of specific activities are associated with health is needed. This cross-sectional study answers the following question: How were changes in the performance of 16 daily activities associated with health during COVID-19 lockdowns? A total of 116 participants completed an online survey rating their health before and during COVID-19 lockdowns and comparing their recollection of the performance of 16 activities before COVID-19 with their performance during lockdowns. Multiple stepwise linear regression analysis was used to estimate the relationship between self-reported changes in activities during lockdowns and concurrent (during-lockdown) health status, while controlling for pre-COVID-19 health status. Only changes in activities that were uniquely and significantly associated with lockdown health status were retained in the final model. Health before COVID-19 accounted for 3.7% (P = 0.039) of the variance in health during COVID-19 lockdowns. After controlling for health before COVID-19, five types of activity were significantly and uniquely predictive of health during lockdowns, together accounting for 48.3% of the variance. These activities and the variances they accounted for were rest and sleep (29.5%, P < 0.001), play and recreational activities (8%, P < 0.001), work (4.8%, P = 0.002), personal hygiene (3.2%, P = 0.01), and healthy eating (2.8%, P = 0.013). The study suggests that these five types of activity should be prioritized in policy or interventions when participation in activity is constrained by lockdowns or comparable factors.
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  • 文章类型: Journal Article
    2020年3月21日,第一例COVID-19在乌干达确诊。3月30日开始全面封锁,5月5日至6月30日逐步解除封锁。3月25日,坎帕拉首都城市管理局组织了一个免费呼叫中心,以回应公众对COVID-19和封锁的担忧。我们记录了呼叫中心的设置和使用情况,并分析了公众提出的关键问题。
    通过大坎帕拉的媒体平台建立并传播了两条热线。呼叫中心每天24小时开放,每周7天。我们抽象了2020年3月25日至6月30日的来电数据。我们将呼叫数据分为几类,并对封锁期间提出的公众担忧进行了描述性分析。
    在10,167个电话中,三分之二(6,578;64.7%)涉及获得卫生服务,1,565(15.4%)是关于社会服务,1,375人(13.5%)涉及与COVID-19相关的问题。大约三分之一(2152;32.7%)的关于获得医疗服务的电话是非新冠肺炎相关紧急情况患者的救护车请求。关于社会服务的电话中约有四分之三是食品和救济物品的请求(1,184;75.7%)。关于COVID-19的电话中有一半(730;53.1%)寻求疾病相关信息。
    在坎帕拉的COVID-19封锁期间,公众使用了免费呼叫中心。来电者更关心获得基本卫生服务,与COVID-19疾病无关。在与公共卫生紧急情况有关的封锁之前,重要的是要计划基本服务的连续性。
    UNASSIGNED: on March 21, 2020, the first case of COVID-19 was confirmed in Uganda. A total lockdown was initiated on March 30 which was gradually lifted May 5-June 30. On March 25, a toll-free call center was organized at the Kampala Capital City Authority to respond to public concerns about COVID-19 and the lockdown. We documented the set-up and use of the call center and analyzed key concerns raised by the public.
    UNASSIGNED: two hotlines were established and disseminated through media platforms in Greater Kampala. The call center was open 24 hours a day and 7 days a week. We abstracted data on incoming calls from March 25 to June 30, 2020. We summarized call data into categories and conducted descriptive analyses of public concerns raised during the lockdown.
    UNASSIGNED: among 10,167 calls, two-thirds (6,578; 64.7%) involved access to health services, 1,565 (15.4%) were about social services, and 1,375 (13.5%) involved COVID-19-related issues. Approximately one-third (2,152; 32.7%) of calls about access to health services were requests for ambulances for patients with non-COVID-19-related emergencies. About three-quarters of calls about social services were requests for food and relief items (1,184; 75.7%). Half of the calls about COVID-19 (730; 53.1%) sought disease-related information.
    UNASSIGNED: the toll-free call center was used by the public during the COVID-19 lockdown in Kampala. Callers were more concerned about access to essential health services, non-related to COVID-19 disease. It is important to plan for continuity of essential services before a public health emergency-related lockdown.
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  • 文章类型: Journal Article
    创新数字健康技术在公共卫生领域的应用正在迅速扩大,包括在疫情应对中使用这些工具。将数字健康创新转化为有效的公共卫生实践是一个复杂的过程,需要不同的推动者。process,和技术领域。本文介绍了一种新颖的基于Web的应用程序,该应用程序由地区级公共卫生机构设计和实施,以协助老年护理机构进行流感和COVID-19爆发的检测和响应。它讨论了一些挑战,启用者,以及从承担该项目的公共卫生从业人员(作者)的角度设计和实施此类新颖应用程序的关键经验教训。
    UNASSIGNED: The use of innovative digital health technologies in public health is expanding quickly, including the use of these tools in outbreak response. The translation of a digital health innovation into effective public health practice is a complex process requiring diverse enablers across the people, process, and technology domains. This paper describes a novel web-based application that was designed and implemented by a district-level public health authority to assist residential aged care facilities in influenza and COVID-19 outbreak detection and response. It discusses some of the challenges, enablers, and key lessons learned in designing and implementing such a novel application from the perspectives of the public health practitioners (the authors) that undertook this project.
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  • 文章类型: Journal Article
    这项研究使用强加的控制技术和疫苗接种博弈论来研究具有暂时性或逐渐减弱的免疫力的疾病动力学。我们的模型使用ABC分数阶导数机制来显示非药物干预的效果,例如个人保护或意识,检疫,和隔离,以模拟针对在无限且均匀分布的人群中传播的传染病的基本控制策略。一项全面的进化博弈论研究量化了人们疫苗接种选择的重大影响,政府部队参与疫苗接种计划,以改善强制性控制措施,以减少疫情传播。该模型使用上述干预选项作为控制策略,以减少人类社会中的疾病患病率。再一次,我们的模拟结果表明,当疾病传播得更快时,组合控制策略会非常有效。缓慢的传播速度减缓了流行病的爆发,但是适度的控制技术可以重建无病平衡。预防接种调节三个阶段之间的边界,在个人保护的同时,检疫,隔离方法减少了现有场所的疾病传播。因此,成功地将这三种干预措施结合起来,减少了流行病或大流行的规模,由线图和3D表面图表示。第一次,我们使用分数阶导数来显示阶段描绘的轨迹图,以显示模型的动力学,如果免疫以特定的速度减弱,考虑各种疫苗接种成本和有效性设置。
    This study uses imposed control techniques and vaccination game theory to study disease dynamics with transitory or diminishing immunity. Our model uses the ABC fractional-order derivative mechanism to show the effect of non-pharmaceutical interventions such as personal protection or awareness, quarantine, and isolation to simulate the essential control strategies against an infectious disease spread in an infinite and uniformly distributed population. A comprehensive evolutionary game theory study quantified the significant influence of people\'s vaccination choices, with government forces participating in vaccination programs to improve obligatory control measures to reduce epidemic spread. This model uses the intervention options described above as a control strategy to reduce disease prevalence in human societies. Again, our simulated results show that a combined control strategy works exquisitely when the disease spreads even faster. A sluggish dissemination rate slows an epidemic outbreak, but modest control techniques can reestablish a disease-free equilibrium. Preventive vaccination regulates the border between the three phases, while personal protection, quarantine, and isolation methods reduce disease transmission in existing places. Thus, successfully combining these three intervention measures reduces epidemic or pandemic size, as represented by line graphs and 3D surface diagrams. For the first time, we use a fractional-order derivate to display the phase-portrayed trajectory graph to show the model\'s dynamics if immunity wanes at a specific pace, considering various vaccination cost and effectiveness settings.
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  • 文章类型: Journal Article
    面对传染病的爆发,社会的集体行为会对流行病的进程产生深远的影响。这项研究调查了个人对疫苗行为的态度所表现出的瞬时社会困境及其对社会距离的影响,这是疾病控制策略的关键组成部分。这项研究采用了多方面的方法,结合建模技术和模拟,以全面评估疾病爆发期间社会距离态度和疫苗摄取之间的动态。关于建模,我们引入了一个新的疫苗接种游戏(VG),与传统的VG模型不同,2-玩家和2-策略的回报结构被恰当地嵌入到个人行为动态中。个人愿意坚持社会疏远措施,比如戴口罩和身体上的距离,与他们接受疫苗的倾向密切相关。研究表明,对社交距离的积极态度倾向于与疫苗接受的可能性更高。最终有助于更有效的疾病控制。正如COVID-19大流行所表明的那样,迅速和协调的公共卫生措施对于遏制传染病的传播至关重要。这项研究强调了解决个人态度所带来的瞬时社会困境的紧迫性。通过了解这些因素之间的复杂关系,政策制定者,医疗保健专业人员可以制定量身定制的策略,以促进社会距离合规性和疫苗接受度,从而增强我们控制和减轻未来疾病爆发影响的能力。
    In the face of infectious disease outbreaks, the collective behavior of a society can has a profound impact on the course of the epidemic. This study investigates the instantaneous social dilemma presented by individuals\' attitudes toward vaccine behavior and its influence on social distancing as a critical component in disease control strategies. The research employs a multifaceted approach, combining modeling techniques and simulation to comprehensively assess the dynamics between social distancing attitudes and vaccine uptake during disease outbreaks. With respect to modeling, we introduce a new vaccination game (VG) where, unlike conventional VG models, a 2-player and 2-strategy payoff structure is aptly embedded in the individual behavior dynamics. Individuals\' willingness to adhere to social distancing measures, such as mask-wearing and physical distancing, is strongly associated with their inclination to receive vaccines. The study reveals that a positive attitude towards social distancing tends to align with a higher likelihood of vaccine acceptance, ultimately contributing to more effective disease control. As the COVID-19 pandemic has demonstrated, swift and coordinated public health measures are essential to curbing the spread of infectious diseases. This study underscores the urgency of addressing the instantaneous social dilemma posed by individuals\' attitudes. By understanding the intricate relationship between these factors, policymakers, and healthcare professionals can develop tailored strategies to promote both social distancing compliance and vaccine acceptance, thereby enhancing our ability to control and mitigate the impact of disease outbreaks in the future.
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  • 文章类型: Journal Article
    COVID-19大流行不仅带来了重大的全球公共卫生和社会经济危机,但也显著影响了人类遵守(或缺乏)全球社区实施的公共卫生干预和缓解措施的行为。这项研究是基于使用数学建模方法来评估SARS-CoV-2传播动态受到人类行为的人口水平变化的影响程度,这些因素包括(a)传播的严重程度(例如疾病引起的死亡率和症状性传播的水平),(b)由于实施缓解干预措施而导致的疲劳(例如,封锁)在很长一段时间内,(c)社会同伴压力,在其他人中。一种新的行为流行病学模型,它采用非线性微分方程确定性系统的形式,是使用美国第一波期间观察到的累积SARS-CoV-2死亡率数据开发和拟合的。该模型拟合了观测数据,以及对第一波(2020年3月至2020年6月)期间观察到的每日SARS-CoV-2死亡率进行更准确的预测,与没有明确说明人类行为变化的等效模型相比。这项研究表明,随着越来越多的新感染者变得无传染性,积极行为改变的总体水平可以预期会显著下降(而新病例可能会上升,特别是如果无症状的个体有更高的接触率,与有症状的个体相比)。
    The COVID-19 pandemic has not only presented a major global public health and socio-economic crisis, but has also significantly impacted human behavior towards adherence (or lack thereof) to public health intervention and mitigation measures implemented in communities worldwide. This study is based on the use of mathematical modeling approaches to assess the extent to which SARS-CoV-2 transmission dynamics is impacted by population-level changes of human behavior due to factors such as (a) the severity of transmission (such as disease-induced mortality and level of symptomatic transmission), (b) fatigue due to the implementation of mitigation interventions measures (e.g., lockdowns) over a long (extended) period of time, (c) social peer-pressure, among others. A novel behavior-epidemiology model, which takes the form of a deterministic system of nonlinear differential equations, is developed and fitted using observed cumulative SARS-CoV-2 mortality data during the first wave in the United States. The model fits the observed data, as well as makes a more accurate prediction of the observed daily SARS-CoV-2 mortality during the first wave (March 2020-June 2020), in comparison to the equivalent model which does not explicitly account for changes in human behavior. This study suggests that, as more newly-infected individuals become asymptomatically-infectious, the overall level of positive behavior change can be expected to significantly decrease (while new cases may rise, particularly if asymptomatic individuals have higher contact rate, in comparison to symptomatic individuals).
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  • 文章类型: Journal Article
    这项研究的目的是总结四个东亚国家对COVID-19的卫生系统反应,分析他们的卫生系统反应的有效性,并为其他国家控制疫情和优化卫生系统应对措施提供经验教训。
    这项研究调查并总结了四个东亚国家的COVID-19数据和卫生系统反应,中国,Japan,蒙古,和韩国的国家政府和卫生部,世卫组织国家办事处,和国际组织的官方网站,评估卫生系统措施的有效性。
    截至2022年6月30日,这四个国家的COVID-19比例都在下降。中国有两个浪潮,新病例缓慢增加,每百万病例总数保持在4个以内,表明水平较低。日本经历了六次浪潮,随着病例增长达到历史最高水平,每百万病例总数为250.994。蒙古后来开始流行,但也经历了四次浪潮,每百万病例总数为632.658,是四个国家中最高的。韩国每波新病例数量不断增加,总病例为473.759。
    在中国和蒙古采取的遏制战略中,以及日本和韩国采取的缓解策略,卫生系统在COVID-19的预防和控制中发挥了重要作用。在推广疫苗接种的同时,各国应重视非药物卫生系统措施,这证明了:侧重于引导公众思想的公共宣传运动;加强早期发现和识别的检测能力;使用技术方法参与接触者追踪,促进精确判断隔离。
    UNASSIGNED: The purpose of this study is to summarize the health system response to COVID-19 in four East Asian countries, analyze the effectiveness of their health system response, and provide lessons for other countries to control the epidemic and optimize their health system response.
    UNASSIGNED: This study investigated and summarized COVID-19 data and health system response in four East Asian countries, China, Japan, Mongolia, and South Korea from national governments and ministries of health, WHO country offices, and official websites of international organizations, to assess the effectiveness of health system measures.
    UNASSIGNED: As of June 30, 2022, all four countries are in a declining portion of COVID-19. China has two waves, and new cases increased slowly, with the total cases per million remaining within 4, indicating a low level. Japan has experienced six waves, with case growth at an all-time high, total cases per million of 250.994. Mongolia started the epidemic later, but also experienced four waves, with total cases per million of 632.658, the highest of the four countries. South Korea has seen an increasing number of new cases per wave, with a total case per million of 473.759.
    UNASSIGNED: In containment strategies adopted by China and Mongolia, and mitigation strategies adopted by Japan and South Korea, health systems have played important roles in COVID-19 prevention and control. While promoting vaccination, countries should pay attention to non-pharmaceutical health system measures, as evidenced by: focusing on public information campaigns to lead public minds; strengthening detection capabilities for early detection and identification; using technical ways to participate in contact tracing, and promoting precise judging isolation.
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  • 文章类型: Systematic Review
    背景:SARS-CoV-2大流行强调了大流行准备的必要性,与呼吸道传播的病毒被认为是一个重大的风险。在大流行中,长期护理设施(LTCF)是一个高风险环境,具有严重的暴发和疾病负担.当药物干预不可用时,非药物干预(NPI)构成主要防御机制。然而,关于LTCF中实施NPI有效性的证据仍不清楚.
    方法:我们进行了一项系统评价,评估了在LTCF中实施NPI的有效性,以保护居民和工作人员免受具有大流行潜力的病毒性呼吸道病原体的影响。我们搜查了Medline,Embase,CINAHL,和2022年9月2日的两个COVID-19登记册。筛选和数据提取由两名经验丰富的研究人员独立进行。我们纳入了随机对照试验和干预效果的非随机观察性研究。使用ROBINS-I和RoB2进行质量评价。主要结果包括爆发次数,感染,住院治疗,和死亡。我们叙述地综合了研究结果,专注于效果的方向。使用等级评估证据确定性(CoE)。
    结果:我们分析了13项观察性研究和3项(成组)随机对照试验。所有研究都是在高收入国家进行的,除三个人以外,其他所有人都集中在SARS-CoV-2上,其余的则集中在流感或上呼吸道感染上。证据表明,不同措施和手部卫生干预措施的组合可以有效地保护居民和工作人员免受感染相关结果的影响(中度CoE)。员工与居民的自我约束,LTCF工作人员的分工,以及对LTCF中的居民和/或工作人员的常规测试,其中,可能是有效的(低CoE)。其他措施,比如限制共享空间,在房间里用餐,队列感染和未感染的居民可能是有效的(非常低的CoE)。证据差距图突出了重要干预措施缺乏证据,包括访问限制,进入前测试,和空气过滤系统。
    结论:尽管大多数结局的干预措施CoE较低或非常低,在本次审查中确定为潜在有效的NPI的实施通常是唯一可行的选择,特别是在接种疫苗之前。我们的证据差距图强调了进一步研究几种干预措施的必要性。需要解决这些差距,以便为未来的流行病做好准备。
    背景:CRD42022344149.
    BACKGROUND: The SARS-CoV-2 pandemic underscored the need for pandemic preparedness, with respiratory-transmitted viruses considered as a substantial risk. In pandemics, long-term care facilities (LTCFs) are a high-risk setting with severe outbreaks and burden of disease. Non-pharmacological interventions (NPIs) constitute the primary defence mechanism when pharmacological interventions are not available. However, evidence on the effectiveness of NPIs implemented in LTCFs remains unclear.
    METHODS: We conducted a systematic review assessing the effectiveness of NPIs implemented in LTCFs to protect residents and staff from viral respiratory pathogens with pandemic potential. We searched Medline, Embase, CINAHL, and two COVID-19 registries in 09/2022. Screening and data extraction was conducted independently by two experienced researchers. We included randomized controlled trials and non-randomized observational studies of intervention effects. Quality appraisal was conducted using ROBINS-I and RoB2. Primary outcomes encompassed number of outbreaks, infections, hospitalizations, and deaths. We synthesized findings narratively, focusing on the direction of effect. Certainty of evidence (CoE) was assessed using GRADE.
    RESULTS: We analysed 13 observational studies and three (cluster) randomized controlled trials. All studies were conducted in high-income countries, all but three focused on SARS-CoV-2 with the rest focusing on influenza or upper-respiratory tract infections. The evidence indicates that a combination of different measures and hand hygiene interventions can be effective in protecting residents and staff from infection-related outcomes (moderate CoE). Self-confinement of staff with residents, compartmentalization of staff in the LTCF, and the routine testing of residents and/or staff in LTCFs, among others, may be effective (low CoE). Other measures, such as restricting shared spaces, serving meals in room, cohorting infected and non-infected residents may be effective (very low CoE). An evidence gap map highlights the lack of evidence on important interventions, encompassing visiting restrictions, pre-entry testing, and air filtration systems.
    CONCLUSIONS: Although CoE of interventions was low or very low for most outcomes, the implementation of NPIs identified as potentially effective in this review often constitutes the sole viable option, particularly prior to the availability of vaccinations. Our evidence-gap map underscores the imperative for further research on several interventions. These gaps need to be addressed to prepare LTCFs for future pandemics.
    BACKGROUND: CRD42022344149.
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