Epidemiological Monitoring

流行病学监测
  • 文章类型: Journal Article
    甲型肝炎(HAV)是一个重要的全球健康问题,具有多种临床表现,主要通过粪便-口腔途径传播。强调卫生和水清洁在传输动力学中的关键作用。年龄相关的变化,特别是儿童的无症状表现,增加复杂性。世界卫生组织(WHO)的地方病分类有助于了解患病率和控制策略。这项研究检查了2023年南非HAV病例的流行病学数据,评估年龄分布,发病率,省差异。分析了来自国家监视系统和天气服务的数据。研究结果揭示了与年龄相关的明显趋势,在西开普省负担最重的5-9岁年龄组中,血清阳性率最高,夸祖鲁-纳塔尔省,和豪登省。此外,季节性降雨变化与西开普省和KZN的发病率增加有关。结果的合并表明潜在的流行病学转变,强调需要更新免疫策略。值得注意的模式,比如5-9岁的孩子,可能会受到学校集群和迁移等因素的影响。省级差异和气候事件的影响强调了动态疫苗接种策略和监测网络增强的必要性。这项研究强调了提高南非对HAV的理解和反应的紧迫性。
    Hepatitis A (HAV) presents a significant global health concern with diverse clinical manifestations primarily transmitted through fecal-oral routes, emphasizing the critical role of sanitation and water cleanliness in transmission dynamics. Age-related variations, notably asymptomatic presentation in children, add complexity. The World Health Organization\'s (WHO) endemicity classification aids in understanding prevalence and control strategies. This study examines 2023 South African epidemiological data on HAV cases, evaluating age distribution, incidence rates, and provincial disparities. Data from the national surveillance system and weather services were analyzed. Findings reveal distinct age-related trends, with the highest seroprevalence observed in the 5-9 age group with the most burdened areas located in the Western Cape, KwaZulu-Natal, and Gauteng provinces. Furthermore, seasonal rainfall variations correlate with increased incidence in Western Cape and KZN. The amalgamation of results suggest a potential epidemiological shift, emphasizing the need for updated immunization strategies. Noteworthy patterns, like the rise in 5-9-year-olds, may be influenced by factors such as school clustering and migration. Provincial disparities and the impact of climatic events underscore the necessity for dynamic vaccination strategies and surveillance network enhancements. This study highlights the urgency for improved understanding and response to HAV in South Africa.
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  • 文章类型: Journal Article
    澳大利亚轮状病毒监测计划的这份报告描述了在2022年1月1日至12月31日期间在儿童和成人中确定的循环轮状病毒基因型。在由于2019年冠状病毒病(COVID-19)大流行而收到的粪便样本数量减少两年后,本报告期是自2017年监测期以来收到的最高样本数量,从所有州和地区收到的样本。在此期间,1,379份粪便标本已被转诊用于轮状病毒G和P基因型分析,其中1,276例确诊为轮状病毒阳性。总的来说,1,119/1,276被鉴定为野生型轮状病毒,155/1,276被鉴定为Rotarix疫苗株,2/1,276由于测序失败而无法被确认为疫苗或野生型。虽然G12P[8]是全国野生型样本中的主要基因型(28.2%;315/1,119),以相似的频率鉴定出多种基因型,包括G9P[4](22.3%;249/1,119)和G2P[4](20.3%;227/1,119)。观察到基因型分布的地理差异,主要是由一些司法管辖区报告的疫情造成的。北领地报告了轮状病毒疾病的爆发和增加,昆士兰,和新南威尔士州。少数不寻常的基因型,自然界中潜在的人畜共患,被确认,其中:G8P[14];G10[14];犬状G3P[3];G6P[9];G11P[25]。持续的轮状病毒监测对于确定基因型模式的变化和通过报告野生型的发生率为诊断实验室提供质量保证至关重要。类似疫苗,或轮状病毒假阳性结果。
    UNASSIGNED: This report from the Australian Rotavirus Surveillance Program describes the circulating rotavirus genotypes identified in children and adults during the period 1 January to 31 December 2022. After two years of a lower number of stool samples received as a result of the coronavirus disease 2019 (COVID-19) pandemic, this reporting period saw the highest number of samples received since the 2017 surveillance period, with samples received from all states and territories. During this period, 1,379 faecal specimens had been referred for rotavirus G- and P- genotype analysis, of which 1,276 were confirmed as rotavirus positive. In total, 1,119/1,276 were identified as wildtype rotavirus, 155/1,276 identified as the Rotarix vaccine strain and 2/1,276 that could not be confirmed as vaccine or wildtype due to sequencing failure. Whilst G12P[8] was the dominant genotype nationally among wildtype samples (28.2%; 315/1,119), multiple genotypes were identified at similar frequencies including G9P[4] (22.3%; 249/1,119) and G2P[4] (20.3%; 227/1,119). Geographical differences in genotype distribution were observed, largely driven by outbreaks reported in some jurisdictions. Outbreaks and increased reports of rotavirus disease were reported in the Northern Territory, Queensland, and New South Wales. A small number of unusual genotypes, potentially zoonotic in nature, were identified, including: G8P[14]; G10[14]; caninelike G3P[3]; G6P[9]; and G11P[25]. Ongoing rotavirus surveillance is crucial to identify changes in genotypic patterns and to provide diagnostic laboratories with quality assurance by reporting incidences of wildtype, vaccine-like, or false positive rotavirus results.
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  • 文章类型: Journal Article
    背景:假伯克霍尔德菌,一种环境腐生菌,在人类和动物中引起类lioidosis。它在1967年至1976年之间在伊朗的小反刍动物中首次发现,马科,环境和人类。没有进行后续研究来确定该病原体在该国的存在和流行程度。
    目的:本研究旨在监测伊朗戈列斯坦省反刍动物种群中假单胞菌的存在,这在很大程度上取决于牧场。反刍动物可以作为哨兵,以指示环境中细菌的存在及其对人类健康的潜在影响。
    方法:家羊的肝和肺脓肿,对三个工业屠宰场和三个常规屠宰场中的牛和山羊进行了采样和分析,使用23S核糖体DNA聚合酶链反应(rDNAPCR),引物CVMP23-1和CVP-23-2用于假单胞菌,洋葱伯克霍尔德菌和越南伯克霍尔德菌,以及B.pseudomallei特异性TTS1实时PCR,以及微生物和生化检测。
    结果:在97只动物样本中,只有14人(15%)对23SrDNAPCR检测呈阳性。然而,使用TTS1实时PCR和微生物学和生化分析进行的随访评估未证实样本中是否存在假单胞菌.
    结论:尽管在当前的调查中没有检测到假双歧杆菌,进行基于屠宰场的反刍动物监测是一种具有成本效益的单一健康方法来监测致病性伯克霍尔德菌。制定伯克霍尔德氏菌感染的临床和实验室良好实践标准对于OneHealth监测至关重要。
    BACKGROUND: Burkholderia pseudomallei, an environmental saprophyte bacterium, causes melioidosis in humans and animals. It was first discovered in Iran between 1967 and 1976 in small ruminants, equines, environments and humans. No subsequent studies have been conducted to determine the existence and prevalence of this pathogen in the country.
    OBJECTIVE: The present study aims to monitor the presence of B. pseudomallei in the ruminant population of the Golestan province of Iran, which largely depends on pastures. The ruminants can serve as sentinels to indicate the presence of the bacteria in the environment and its potential impact on human health in the One Health triad.
    METHODS: Liver and lung abscesses from domestic sheep, cattle and goats in three industrial and three conventional slaughterhouses were sampled and analysed using 23S ribosomal DNA polymerase chain reaction (rDNA PCR) with primers CVMP 23-1 and CVP-23-2 for B. pseudomallei, Burkholderia cepacia and Burkholderia vietnamiensis, as well as B. pseudomallei-specific TTS1 real-time PCR, along with microbiological and biochemical assays.
    RESULTS: Out of the 97 animals sampled, only 14 (15%) tested positive for 23S rDNA PCR. However, the follow-up evaluation using TTS1 real-time PCR and microbiological and biochemical assays did not confirm the presence of B. pseudomallei in the samples.
    CONCLUSIONS: Although B. pseudomallei was not detected in the current survey, conducting abattoir-based surveillance of ruminants is a cost-effective One Health approach to monitor pathogenic Burkholderia. Developing standards of clinical and laboratory good practices for Burkholderia infections is crucial for One Health surveillance.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    自2019年非洲猪瘟(ASF)在韩国得到确认以来,其蔓延,主要是野猪,一直是一个重大问题。这种情况的一个关键因素是缺乏通过监测偏差识别风险因素。独特的地形,以高山为特征,使搜索工作复杂化,导致病例发现被忽视或延误,并对养猪业构成风险。此外,与邻国共享的河流持续存在病毒进入的威胁。本研究采用地理空间分析和统计方法,以1)确定发生ASF的高风险区域,但可能受到监视,和2)指出战略监测点,以监测ASF病毒通过水体和流域影响进入的风险。Pearsonrho检验表明,海拔(rho=-0.908,p值<0.001)和与道路的距离(rho=-0.979,p值<0.001)可能对限制监测活动产生重大影响。考虑到这些结果,创建了潜在的受监控区域图,并通过卡方拟合优度检验(X平方=208.03,df=1,p值<0.001)进行了验证。ASF阳性野猪与水源距离之间的强负相关(rho=-0.997,p值<0.001)强调了河流周围地区是监测的重点地区之一。随后的水文分析为监测病毒从邻国通过水进入的风险提供了重要的要点。这项研究旨在促进早期发现并防止ASF的进一步传播。
    Since the confirmation of African swine fever (ASF) in South Korea in 2019, its spread, predominantly in wild boars, has been a significant concern. A key factor in this situation is the lack of identification of risk factors by surveillance bias. The unique orography, characterized by high mountains, complicates search efforts, leading to overlooked or delayed case detection and posing risks to the swine industry. Additionally, shared rivers with neighboring country present a continual threat of virus entry. This study employs geospatial analysis and statistical methods to 1) identify areas at high risk of ASF occurrence but possibly under-surveilled, and 2) indicate strategic surveillance points for monitoring the risk of ASF virus entry through water bodies and basin influences. Pearson\'s rho test indicated that elevation (rho = -0.908, p-value < 0.001) and distance from roads (rho = -0.979, p-value < 0.001) may have a significant impact on limiting surveillance activities. A map of potential under-surveilled areas was created considering these results and was validated by a chi-square goodness-of-fit test (X-square = 208.03, df = 1, p-value < 0.001). The strong negative correlation (rho = -0.997, p-value <0.001) between ASF-positive wild boars and distance from water sources emphasizes that areas surrounding rivers are one of the priority areas for monitoring. The subsequent hydrological analyses provided important points for monitoring the risk of virus entry via water from the neighboring country. This research aims to facilitate early detection and prevent further spread of ASF.
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  • 文章类型: Journal Article
    有效繁殖数,[公式:见正文],是用于评估流行病状态的重要流行病学指标,以及为应对措施而采取的公共卫生干预措施的有效性。当[公式:见文本]高于1时,这表明新的感染正在增加,因此这种流行病正在加剧,虽然[公式:见正文]低于1表示新的感染正在减少,所以疫情得到了控制。有几种已建立的软件包可随时使用临床监测数据进行统计估计[公式:见正文]。然而,从病原体废水浓度估算[公式:见正文]的工具相对较少,在COVID-19大流行期间巩固其效用的监测数据流。我们提出了[公式:见文本]软件包,旨在以用户友好的方式从现实世界的废水或汇总的临床监测数据中估算有效的繁殖数量。
    The effective reproduction number, [Formula: see text], is an important epidemiological metric used to assess the state of an epidemic, as well as the effectiveness of public health interventions undertaken in response. When [Formula: see text] is above one, it indicates that new infections are increasing, and thus the epidemic is growing, while an [Formula: see text] is below one indicates that new infections are decreasing, and so the epidemic is under control. There are several established software packages that are readily available to statistically estimate [Formula: see text] using clinical surveillance data. However, there are comparatively few accessible tools for estimating [Formula: see text] from pathogen wastewater concentration, a surveillance data stream that cemented its utility during the COVID-19 pandemic. We present the [Formula: see text] package ern that aims to perform the estimation of the effective reproduction number from real-world wastewater or aggregated clinical surveillance data in a user-friendly way.
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  • 文章类型: Journal Article
    背景:初级卫生保健(PHC)在管理COVID-19大流行中起着至关重要的作用,只有8%的病例需要住院治疗。然而,PHCCOVID-19数据在欧洲政府仪表板和媒体讨论中经常被忽视。该项目旨在审查欧洲COVID-19大流行期间PHC患者护理的官方信息,具体目标:(1)描述PHC急性COVID-19病例的临床路径,包括长期护理设施,(2)描述PHCCOVID-19大流行指标,(3)制定COVID-19PHC活性指标,(4)解释PHC在疫苗接种策略中的作用,(5)为未来的流行病制定PHC应急计划。
    方法:一项混合方法研究将采用两份在线问卷,收集关于COVID-19管理和PHC参与疫苗接种策略的回顾性PHC数据。验证将通过与医疗和公共卫生(PH)专家的焦点小组讨论进行。Delphi的两波调查将为未来的流行病建立欧洲PHC指标仪表板。此外,涉及PHC的协调卫生系统行动计划,二级保健,PH将被设计为应对未来的大流行情景。
    方法:定量数据将使用STATAv16.0进行描述性和多变量分析。定性数据将通过同行评审问卷和焦点小组讨论的内容分析来收集。德尔菲调查和多个焦点小组将被用来就PHC指标达成共识,并为未来的流行病制定共同的欧洲卫生系统应对计划。来自28个欧洲国家的研究人员组成的Eurodata研究小组支持这一发展。
    结论:虽然PHC处理大多数COVID-19急性病例,许多欧洲国家的数据仍然有限。这项研究收集了来自许多国家的数据,全面了解PHC在欧洲大流行期间的作用。它率先开发了针对欧洲大流行疾病的PHC仪表板和卫生系统计划。这些结果可能在未来的大流行中被证明是无价的。然而,由于关键信息提供者的参与,数据可能存在偏差,并且可能无法完全代表所有欧洲GP实践。PHC在COVID-19大流行的管理中发挥着重要作用,因为大多数病例是轻度或中度的,只有8%需要住院治疗。然而,PHCCOVID-19活动数据在欧洲政府的每日仪表板上是不可见的,在媒体和公众辩论中经常被忽视。
    BACKGROUND: Primary Health Care (PHC) plays a crucial role in managing the COVID-19 pandemic, with only 8% of cases requiring hospitalization. However, PHC COVID-19 data often goes unnoticed on European government dashboards and in media discussions. This project aims to examine official information on PHC patient care during the COVID-19 pandemic in Europe, with specific objectives: (1) Describe PHC\'s clinical pathways for acute COVID-19 cases, including long-term care facilities, (2) Describe PHC COVID-19 pandemic indicators, (3) Develop COVID-19 PHC activity indicators, (4) Explain PHC\'s role in vaccination strategies, and (5) Create a PHC contingency plan for future pandemics.
    METHODS: A mixed-method study will employ two online questionnaires to gather retrospective PHC data on COVID-19 management and PHC involvement in vaccination strategies. Validation will occur through focus group discussions with medical and public health (PH) experts. A two-wave Delphi survey will establish a European PHC indicators dashboard for future pandemics. Additionally, a coordinated health system action plan involving PHC, secondary care, and PH will be devised to address future pandemic scenarios.
    METHODS: Quantitative data will be analysed using STATA v16.0 for descriptive and multivariate analyses. Qualitative data will be collected through peer-reviewed questionnaires and content analysis of focus group discussions. A Delphi survey and multiple focus groups will be employed to achieve consensus on PHC indicators and a common European health system response plan for future pandemics. The Eurodata research group involving researchers from 28 European countries support the development.
    CONCLUSIONS: While PHC manages most COVID-19 acute cases, data remains limited in many European countries. This study collects data from numerous countries, offering a comprehensive perspective on PHC\'s role during the pandemic in Europe. It pioneers the development of a PHC dashboard and health system plan for pandemics in Europe. These results may prove invaluable in future pandemics. However, data may have biases due to key informants\' involvement and may not fully represent all European GP practices. PHC has a significant role in the management of the COVID-19 pandemic, as most of the cases are mild or moderate and only 8% needed hospitalization. However, PHC COVID-19 activity data is invisible on governments\' daily dashboards in Europe, often overlooked in media and public debates.
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  • 文章类型: Journal Article
    正黄病毒(ILHV)是一种虫媒病毒,于1944年在黄热病的流行病学调查中首次在巴西分离。是黄病毒科的成员,属于Ntaya病毒组的抗原复合物。Psorophora是ILHV的主要载体,本研究提供了Ps库中ILHV的分离和系统发育分析。ferox于2021年在Goiás州收集。对Vero细胞和C6/36克隆进行病毒分离试验。使用间接免疫荧光测试(FI)来确认样品的阳性。阳性样本接受RT-qPCR,测序,测序和系统发育分析。这是该市ILHV循环的第一份报告,并介绍了该隔离物与贝伦市(PA)收集的另一种ILHV隔离物之间的密切关系。
    The Orthoflavivirus ilheusense (ILHV) is an arbovirus that was first isolated in Brazil in 1944 during an epidemiologic investigation of yellow fever. Is a member of the Flaviviridae family and it belongs to the antigenic complex of the Ntaya virus group. Psorophora ferox is the primary vector of ILHV and this study presents the isolation and phylogenetic analysis of ILHV in a pool of Ps. ferox collected in the state of Goiás in 2021. Viral isolation tests were performed on Vero cells and C6/36 clones. The indirect immunofluorescence test (IFI) was used to confirm the positivity of the sample. The positive sample underwent RT-qPCR, sequencing, and phylogenetic analysis. This is the first report of ILHV circulation in this municipality and presented close relationship between this isolate and another ILHV isolate collected in the city of Belém (PA).
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  • 文章类型: Journal Article
    克氏锥虫载体在城市地区的存在一直很频繁,随着家园的定殖和与水库动物的相关,增加了人类的风险,同时循环的载体和T.Cruzi。该研究旨在描述圣保罗都会区三叶草和T.cruzi的循环,以及评估风险情况。出于分析目的,使用了2016年1月至2023年7月的triatomine通知信息.而对于Didelphissp。在陷阱的帮助下收集,使用的通知信息是2019年至2023年。有关三原子的信息来自人口的自发需求,并且通知服务由州现场团队按照定义的协议进行。收到了202个通知,捕获了448个三原子。观察到的克氏虫阳性为60.5%。关于Didelphissp。,收集了416只动物,其中5.3%为克氏虫阳性。受感染的三叶草和Didelphissp存在重叠区域。,其离散分型单位(DTU)是T.cruziI。这项工作表明城市地区存在受感染的媒介,以及在Didelphiids中存在T.Cruzi的狂野循环,重申病媒监测工作的必要性和重要性,通过可以防止恰加斯病传播的行动。
    The presence of Trypanosoma cruzi vectors in urban areas has been frequent, with colonization of homes and associated with reservoir animals that increase risk to humans, with simultaneous circulation of vectors and T. cruzi. The study aimed to describe the circulation of triatomines and T. cruzi in the Metropolitan Region of São Paulo, as well as evaluate risk situations. For analysis purposes, the triatomine notification information from January 2016 to July 2023 was used. While for Didelphis sp. collection with the aid of traps, notification information used was from 2019 to 2023. Information about triatomines came from spontaneous demand by the population and notification services were carried out by state field teams following defined protocols. 202 notifications were received with the capture of 448 triatomines. The positivity for T. cruzi observed was 60.5%. Regarding Didelphis sp., 416 animals were collected, 5.3% of which were positive for T. cruzi. There was overlapping areas of presence of infected triatomines and Didelphis sp., whose Discrete Typing Unit (DTU) was T. cruzi I. This work indicates the presence of infected vectors in urban areas, and the presence of a wild cycle of T. cruzi in didelphiids, reaffirming the need for and importance of vector surveillance work, through actions that can prevent the transmission of Chagas disease.
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