Journal of Infection and Public Health最新文献_第3页

Impact of education on knowledge, attitudes, and practices for gestational toxoplasmosis 教育对妊娠弓形虫病知识、态度和做法的影响

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health

Pub Date : 2024-08-10 DOI: 10.1016/j.jiph.2024.102516

Background

Toxoplasmosis is potentially avoidable, treatable, and curable by simple and direct preventive measures. Knowledge, attitudes, and practices (KAP) assessments concerning gestational toxoplasmosis were evaluated in a cohort of pregnant women from Armenia-Quindío (Colombia, South America).

Methods

This cross-sectional descriptive KAP-type study was performed with informed consent between October 2021 and March 2022. The intervention involved a ten-minute talk administered by prenatal clinic nurses to pregnant women. This took place in the public health clinic RedSalud and the private clinic Happy Maternity with a post-KAP survey after pregnancy.

Results

The findings of the initial KAP survey revealed that approximately 42.8 % of the 250 mothers surveyed had IgG anti-T. gondii antibodies present. A strong correlation was observed between a lower frequency of antibodies and a higher level of education. Following an educational intervention, 73 seronegative women demonstrated a significant improvement in their knowledge and behavior. Among the 111 mothers who received the intervention, 42 (37 %) were followed until delivery. Unfortunately, their level of compliance with prenatal serological follow-up was lower compared to previous historical records of cohort of mothers in the same health center during pre-pandemic periods. No seroconversion occurred, although the small number of cases makes the outcome inconclusive with respect to statistical significance.

Conclusions

Education plays a crucial role in imparting valuable knowledge and fostering effective practices. It holds significant potential to prevent toxoplasmosis in pregnant seronegative mothers. Prenatal check-ups have proven to be a critical determinant in leveraging the benefits of education for seronegative mothers. Reporting and observed behaviors differed, identifying areas for improvement.

背景弓形虫病通过简单直接的预防措施是可以避免、治疗和治愈的。方法这项横断面描述性 KAP 型研究是在知情同意的情况下于 2021 年 10 月至 2022 年 3 月间进行的。干预措施包括由产前诊所护士对孕妇进行十分钟的谈话。最初的 KAP 调查结果显示，在接受调查的 250 名母亲中，约有 42.8% 的人体内存在 IgG 抗淋巴结核抗体。据观察，抗体出现频率较低与受教育程度较高密切相关。经过教育干预后，73 名血清阴性的妇女在知识和行为方面都有了显著改善。在接受干预的 111 位母亲中，有 42 位（37%）一直被跟踪到分娩。遗憾的是，与疫情流行前同一医疗中心的产妇队列的历史记录相比，她们对产前血清学随访的依从性较低。尽管由于病例较少，结果在统计意义上并不确定，但没有发生血清转换。它在预防血清反应阴性孕妇感染弓形虫病方面具有巨大潜力。事实证明，产前检查是血清反应阴性母亲从教育中获益的关键因素。报告和观察到的行为各不相同，这就确定了需要改进的地方。

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引用次数: 0

The emergence of Oropouche virus in Cuba – A wake-up call for global health 古巴出现奥罗普切病毒--为全球健康敲响警钟

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health

Pub Date : 2024-08-09 DOI: 10.1016/j.jiph.2024.102513

引用次数: 0

Evaluation of an influenza-like illness sentinel surveillance system in South Korea, 2017-2023 2017-2023 年韩国流感样疾病哨点监测系统评估。

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health

Pub Date : 2024-08-09 DOI: 10.1016/j.jiph.2024.102515

Background

Guided by the data from the surveillance system, public health efforts have contributed to reducing the burden of influenza in many countries. During the COVID-19 pandemic, many surveillance resources were directed at tracking the severe acute respiratory syndrome-Coronavirus 2. However, most countries have not reported surveillance evaluations during the COVID-19 pandemic.

Methods

Using the U.S. CDC surveillance evaluation method, we evaluated the influenza-like illness (ILI) sentinel surveillance performance in South Korea between January 2017 and September 2023. For the timeliness, we measured the mean time lag between the reports from the sentinel sites to the Korea Disease Control and Prevention Agency (KDCA) and surveillance result dissemination from KDCA. For the completeness, we measured the submission rate of complete reports per overall number of reports from each sentinel site to the KDCA. For the sensitivity, we calculated the correlation coefficient between the monthly number of ILI reports and the patients with ILI from the Korea national reimbursement data by either Pearson’s or Spearman’s test. For the representativeness, we compared the age-specific distribution of ILI between the surveillance data and the national reimbursement data using a chi-squared test.

Results

We found that the surveillance performance of timeliness (less than 2 weeks) and completeness (97 %−98 %) was stable during the study period. However, we found a reduced surveillance sensitivity (correlation coefficient: 0.73 in 2020, and 0.84 in 2021) compared to that of 2017–2019 (0.96–0.99), and it recovered in 2022–2023 (0.93–0.97). We found no statistical difference across the proportion of age groups between the surveillance and reimbursement data during the study period (all P-values > 0.05).

Conclusions

Ongoing surveillance performance monitoring is necessary to maintain efficient policy decision-making for the control of the influenza epidemic. Additional research is needed to assess the overall influenza surveillance system including laboratory and hospital-based surveillance in the country.

背景：在监测系统数据的指导下，公共卫生工作为减轻许多国家的流感负担做出了贡献。在 COVID-19 大流行期间，许多监测资源被用于追踪严重急性呼吸系统综合征--冠状病毒 2。然而，大多数国家并未报告 COVID-19 大流行期间的监测评估情况：我们采用美国疾病预防控制中心的监测评估方法，对 2017 年 1 月至 2023 年 9 月期间韩国的流感样疾病（ILI）哨点监测绩效进行了评估。在及时性方面，我们测量了哨点向韩国疾病预防控制机构（KDCA）报告与KDCA发布监测结果之间的平均时滞。在完整性方面，我们测量了每个哨点向韩国疾病预防控制机构提交的报告总数中完整报告的提交率。在灵敏度方面，我们通过皮尔逊检验或斯皮尔曼检验计算了每月 ILI 报告数与韩国全国报销数据中 ILI 患者之间的相关系数。在代表性方面，我们使用卡方检验比较了监测数据和国家报销数据中 ILI 患者的年龄分布：我们发现，在研究期间，监测的及时性（少于 2 周）和完整性（97%-98%）保持稳定。然而，我们发现与 2017-2019 年（0.96-0.99）相比，监测灵敏度有所下降（相关系数：2020 年为 0.73，2021 年为 0.84），2022-2023 年有所恢复（0.93-0.97）。我们发现，在研究期间，监测数据和报销数据在各年龄组比例上没有统计学差异（所有 P 值均大于 0.05）：结论：为了保持控制流感疫情的决策效率，有必要对监测绩效进行持续监测。需要开展更多研究，以评估该国的整体流感监测系统，包括实验室和医院监测。

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引用次数: 0

Present outlooks on the prevalence of minimal and subclinical tuberculosis and current diagnostic tests: A systematic review and meta-analysis 目前对轻微和亚临床结核病发病率的展望以及当前的诊断测试：系统回顾和荟萃分析。

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health

Pub Date : 2024-08-08 DOI: 10.1016/j.jiph.2024.102517

Background

Tuberculosis (TB) is a major global health issue, particularly in its minimal and subclinical forms, which often go undetected and contribute to transmission. Accurate prevalence assessment of these forms and the effectiveness of diagnostic tests are crucial for improving TB control, especially in high-risk populations such as those with HIV.

Objectives

This study aimed to determine the prevalence of minimal and subclinical TB and evaluate the positivity rates of current diagnostic tests. Methods: We conducted a meta-analysis of studies published from January 2000 to December 2022. Prevalence rates and diagnostic test results, including sputum culture, smear microscopy, TST/IGRA, and chest X-ray, were analyzed, with pooled prevalence calculated and comparisons made between geographic regions.

Results

Minimal TB prevalence ranged from 0.9 % to 22.9 % in the general population, while subclinical TB prevalence was 0.05 % to 0.64 %, and 1.57 % to 14.63 % among individuals with HIV. The overall pooled prevalence of minimal TB was 7 % (95 % CI: 5–9 %), with higher rates in Asia (8 %, 95 % CI: 5–12 %) compared to Africa (6 %, 95 % CI: 4–8 %). Subclinical TB had a pooled prevalence of 0.2 % (95 % CI: 0.2–0.3 %) overall and 52 % (95 % CI: 46–58 %) among TB cases, with higher rates in Asia (60 %) compared to Africa (44 %). Diagnostic test positivity was 77 % (sputum culture), 15 % (smear microscopy), 64 % (TST/IGRA), and 53 % (chest X-ray).

Conclusions

This study reveals significant variability in the prevalence of minimal and subclinical TB. The findings highlight the need for improved diagnostic methods to reduce undetected cases, especially in high-risk populations.

背景：结核病（TB）是一个重大的全球健康问题，尤其是其微小和亚临床形式，这些形式的结核病往往未被发现并造成传播。对这些形式的结核病进行准确的患病率评估并提高诊断检测的有效性，对于改善结核病控制至关重要，尤其是在艾滋病毒感染者等高危人群中：本研究旨在确定极少数和亚临床结核病的患病率，并评估当前诊断检测的阳性率：我们对 2000 年 1 月至 2022 年 12 月期间发表的研究进行了荟萃分析。方法：我们对 2000 年 1 月至 2022 年 12 月发表的研究进行了荟萃分析，分析了患病率和诊断检测结果，包括痰培养、涂片显微镜检查、TST/IGRA 和胸部 X 光检查，计算了汇总患病率，并对不同地理区域进行了比较：结果：在普通人群中，轻度肺结核发病率为 0.9% 至 22.9%，而在艾滋病毒感染者中，亚临床肺结核发病率为 0.05% 至 0.64%，发病率为 1.57% 至 14.63%。最小肺结核的总发病率为 7%（95% CI：5%-9%），与非洲（6%，95% CI：4%-8%）相比，亚洲的发病率更高（8%，95% CI：5%-12%）。亚临床肺结核的总发病率为 0.2 %（95 % CI：0.2-0.3 %），在肺结核病例中的发病率为 52 %（95 % CI：46-58 %），亚洲的发病率（60 %）高于非洲（44 %）。诊断测试阳性率为 77%（痰培养）、15%（涂片显微镜检查）、64%（TST/IGRA）和 53%（胸部 X 光检查）：这项研究揭示了轻度和亚临床结核病发病率的巨大差异。研究结果凸显了改进诊断方法的必要性，以减少未发现的病例，尤其是在高危人群中。

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引用次数: 0

Sotrovimab lost neutralization efficacy against SARS-CoV-2 subvariants but remained clinically effective: Were monoclonal antibodies against COVID-19 rejected too early? 索托维单抗失去了对SARS-CoV-2亚变种的中和效力，但仍有临床疗效：针对 COVID-19 的单克隆抗体被过早拒绝了吗？

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health

Pub Date : 2024-08-07 DOI: 10.1016/j.jiph.2024.102512

引用次数: 0

Enhanced event-based surveillance: Epidemic Intelligence from Open Sources (EIOS) during FIFA World Cup 2022 Qatar 加强基于事件的监控：2022 年卡塔尔国际足联世界杯期间的开放源流行病情报 (EIOS)

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health

Pub Date : 2024-08-03 DOI: 10.1016/j.jiph.2024.102514

Background

Public health threats can significantly impact mass gatherings and enhancing surveillance systems would thus be crucial. Epidemic Intelligence from Open Sources (EIOS) was introduced to Qatar to complement the existing surveillance measures in preparation to the FIFA World Cup Qatar 2022 (FWC22). This study estimated the empirical probability of EIOS detecting signals of public health relevance. It also looked at the factors responsible for discerning a moderate-high risk signal during a mass gathering event.

Methods

This cross-sectional descriptive study used data collected between November 8th and December 25th, 2022, through an EIOS dashboard that filtered open-source articles using specific keywords. Triage criteria and scoring scheme were developed to capture signals and these were maintained in MS Excel. EIOS’ contribution to epidemic intelligence was assessed by the empirical probability estimation of relevant public health signals. Chi-squared tests of independence were performed to check for associations between various hazard categories and other independent variables. A multivariate logistic regression evaluated the predictors of moderate-high risk signals that required prompt action.

Results

The probability of EIOS capturing a signal relevant to public health was estimated at 0.85 % (95 % confidence interval (CI) [0.82 %−0.88 %]) with three signals requiring a national response. The hazard category of the signal had significant association to the region of occurrence (χ² (5, N = 2543) = 1021.6, p < .001). The hazard category also showed significant association to its detection during matchdays of the tournament (χ² (5, N = 2543) = 11.2, p < .05). The triage criteria developed was able to discern between low and moderate-high risk signals with an acceptable discrimination (Area Under the Curve=0.79).

Conclusion

EIOS proved useful in the early warning of public health threats.

背景公共卫生威胁会对大规模集会产生重大影响，因此加强监测系统至关重要。为迎接 2022 年卡塔尔国际足联世界杯（FWC22），卡塔尔引入了开放源流行病情报系统（EIOS），以补充现有的监控措施。这项研究估算了 EIOS 检测到公共卫生相关信号的经验概率。这项横断面描述性研究使用了 2022 年 11 月 8 日至 12 月 25 日期间通过 EIOS 面板收集的数据，该面板使用特定关键词过滤开源文章。为捕捉信号制定了分流标准和评分计划，并将其保存在 MS Excel 中。通过对相关公共卫生信号的经验概率估计，评估了 EIOS 对流行病情报的贡献。对独立性进行了卡方检验，以检查各种危害类别与其他独立变量之间是否存在关联。结果据估计，监督厅捕捉到与公共卫生有关的信号的概率为 0.85%（95% 置信区间 (CI) [0.82%-0.88%]），其中有三个信号需要国家做出反应。信号的危害类别与发生地区有显著关联（χ2 (5, N = 2543) = 1021.6, p <.001）。危险类别还与在比赛日期间的检测结果有明显关联（χ2 (5, N = 2543) = 11.2, p <.05）。所制定的分流标准能够以可接受的区分度（曲线下面积=0.79）区分低风险和中高风险信号。

{"title":"Enhanced event-based surveillance: Epidemic Intelligence from Open Sources (EIOS) during FIFA World Cup 2022 Qatar","authors":"","doi":"10.1016/j.jiph.2024.102514","DOIUrl":"10.1016/j.jiph.2024.102514","url":null,"abstract":"<div><h3>Background</h3><p>Public health threats can significantly impact mass gatherings and enhancing surveillance systems would thus be crucial. Epidemic Intelligence from Open Sources (EIOS) was introduced to Qatar to complement the existing surveillance measures in preparation to the FIFA World Cup Qatar 2022 (FWC22). This study estimated the empirical probability of EIOS detecting signals of public health relevance. It also looked at the factors responsible for discerning a moderate-high risk signal during a mass gathering event.</p></div><div><h3>Methods</h3><p>This cross-sectional descriptive study used data collected between November 8th and December 25th, 2022, through an EIOS dashboard that filtered open-source articles using specific keywords. Triage criteria and scoring scheme were developed to capture signals and these were maintained in MS Excel. EIOS’ contribution to epidemic intelligence was assessed by the empirical probability estimation of relevant public health signals. Chi-squared tests of independence were performed to check for associations between various hazard categories and other independent variables. A multivariate logistic regression evaluated the predictors of moderate-high risk signals that required prompt action.</p></div><div><h3>Results</h3><p>The probability of EIOS capturing a signal relevant to public health was estimated at 0.85 % (95 % confidence interval (CI) [0.82 %−0.88 %]) with three signals requiring a national response. The hazard category of the signal had significant association to the region of occurrence (χ<sup>2</sup> (5, N = 2543) = 1021.6, <em>p</em> < .001). The hazard category also showed significant association to its detection during matchdays of the tournament (χ<sup>2</sup> (5, N = 2543) = 11.2, <em>p</em> < .05). The triage criteria developed was able to discern between low and moderate-high risk signals with an acceptable discrimination (Area Under the Curve=0.79).</p></div><div><h3>Conclusion</h3><p>EIOS proved useful in the early warning of public health threats.</p></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S187603412400248X/pdfft?md5=1a4e943d3f36de683a065d02e876c5de&pid=1-s2.0-S187603412400248X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141978613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effect of silver nanoparticles on the antimicrobial activity of cloned nisin against extensively drug-resistant Acinetobacter baumannii” 银纳米粒子对克隆尼生素对广泛耐药鲍曼不动杆菌抗菌活性的影响"。

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health

Pub Date : 2024-07-30 DOI: 10.1016/j.jiph.2024.102501

Background

Antibiotic resistance is a global threat to human health that leads to disasters. Acinetobacter baumannii cannot be controlled by the existing antibiotics, and it became challenging. Therefore, novel antibacterial agents are required to combat such threats. The aim of this project is to find a novel antimicrobial agent to treat this multi-drug resistant bacterium.

Methods

The NisA gene was isolated from Lactococcus lactis spp. lactis and cloned into the pET-3a plasmid using Gibson cloning assembly. Purified Nisin from cloning was conjugated with silver nanoparticles. Finally, an assessment of antibacterial activity for each of the purified Nisin, Silver nanoparticles, and Nisin-Silver nanoparticles conjugate against the extensively drug-resistant A. baumannii was performed.

Results

Nisin was successfully purified from cloned bacteria, and the concentration was 416 µg/ml. The conjugation of nisin and silver nanoparticles was analyzed by electron microscopy. The minimum inhibitory concentration of Nisin and silver nanoparticles against A. baumannii were 104 µg/ml and 125 µg/ml, respectively. While Nisin-silver nanoparticle conjugates showed potent antimicrobial activity with MIC 125–52 µg/ml in which silver nanoparticles increased the antimicrobial activity of nisin beyond its optimum concentration (104 µg/ml). ‎

Conclusion

The development of new antibacterial agents is necessary to control extensively drug-resistant bacteria. Nisin-silver conjugates showed more potent antimicrobial activity than when applied separately and gave hope to combat the multi-drug resistant A. baumannii.

背景：抗生素耐药性是对人类健康的全球性威胁，会导致灾难。现有的抗生素无法控制鲍曼不动杆菌，这已成为一项挑战。因此，需要新型抗菌剂来应对此类威胁。本项目旨在寻找一种新型抗菌剂来治疗这种具有多重耐药性的细菌：方法：从乳酸乳球菌中分离出 NisA 基因，并使用 Gibson 克隆组装法将其克隆到 pET-3a 质粒中。将克隆纯化的 Nisin 与纳米银颗粒连接。最后，对纯化的 Nisin、银纳米颗粒和 Nisin-银纳米颗粒共轭物对广泛耐药的鲍曼尼氏菌的抗菌活性进行了评估：结果：从克隆细菌中成功纯化出 Nisin，浓度为 416 µg/ml。电子显微镜分析了尼生素和银纳米颗粒的共轭情况。尼生素和纳米银颗粒对鲍曼尼氏菌的最小抑菌浓度分别为 104 µg/ml 和 125 µg/ml。尼生素-银纳米颗粒共轭物显示出强大的抗菌活性，MIC 为 125-52 µg/ml，其中银纳米颗粒提高了尼生素的抗菌活性，超过了其最佳浓度（104 µg/ml）。结论：开发新的抗菌剂对控制广泛耐药细菌很有必要。与单独使用相比，尼生素-银共轭物显示出更强的抗菌活性，为抗击多重耐药鲍曼不动杆菌带来了希望。

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引用次数: 0

Changes in the incidence, clinical features and outcomes of tuberculosis during COVID-19 pandemic COVID-19 大流行期间结核病发病率、临床特征和结果的变化。

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health

Pub Date : 2024-07-25 DOI: 10.1016/j.jiph.2024.102511

Background

COVID-19 pandemic has disrupted tuberculosis (TB) services in many countries, but the impacts on sites of involvement, drug susceptibility, smear positivity and clinical outcomes, and clinical outcomes of co-infection with influenza and COVID-19 remain unclear.

Methods

Descriptive epidemiological study using episode-based and patient unique data of tuberculosis from Hospital Authority’s territory-wide electronic medical record database, comparing baseline (January 2015-December 2019) and COVID-19 period (January 2020-December 2022), followed by univariate and multivariate analyses. Effects of co-infection with influenza and COVID-19 were investigated.

Results

The study included 10,473 episodes of laboratory-confirmed TB, with 6818 in baseline period and 3655 during COVID-19 period. During COVID-19 period, TB patients had a lower proportion of smear positivity (49.2 % vs 54.7 %, P < 0.001), and fewer cases of extrapulmonary TB (7.0 % vs 8.0 %, P = 0.078) and multidrug resistant TB (1.0 % vs 1.6 %, P = 0.020). Mortality was higher in TB patients with COVID-19 coinfection (OR 1.7, P = 0.003) and influenza coinfection (OR 2.6, P = 0.004). During COVID-19 period, there were higher rates of treatment delay (20.5 % vs 15.5 %, P < 0.001) and episodic death (15.1 % vs 13.3 %, P = 0.006). Factors associated with higher mortality included age ≥ 70 years (OR 7.24), treatment delay (OR 2.16), extrapulmonary TB (OR 2.13). smear positivity (OR 1.71) and Charlson comorbidity index score ≥ 3 (OR 1.37). Higher mortality was observed with co-infection by influenza (OR 1.18) and COVID-19 (OR 1.7).

Conclusions

The epidemiology and outcomes of TB were changed during COVID-19 period. Mortality was higher during COVID-19 period and with co-infection by influenza and COVID-19.

背景：COVID-19大流行扰乱了许多国家的结核病（TB）服务，但对涉及部位、药物敏感性、涂片阳性率和临床结果的影响，以及流感和COVID-19合并感染的临床结果仍不清楚：描述性流行病学研究使用医院管理局全港电子病历数据库中结核病的病例数据和病人唯一数据，比较基线（2015年1月至2019年12月）和COVID-19期间（2020年1月至2022年12月），然后进行单变量和多变量分析。研究还调查了流感和COVID-19合并感染的影响：研究纳入了 10,473 例经实验室确诊的结核病，其中基线期为 6818 例，COVID-19 期间为 3655 例。在 COVID-19 期间，肺结核病人涂片阳性的比例较低（49.2% 对 54.7%，P）：在 COVID-19 期间，结核病的流行病学和结果都发生了变化。COVID-19 期间的死亡率较高，同时感染流感和 COVID-19 的死亡率也较高。

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引用次数: 0

Severity outcomes of SARS-CoV-2 infection in the Omicron and pre-Omicron periods, in unvaccinated first-time test positive adults less than 65 years old without comorbidity, in Sweden 瑞典 65 岁以下未接种疫苗的首次检测呈阳性且无合并症的成年人在 Omicron 和 Omicron 前感染 SARS-CoV-2 的严重程度。

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health

Pub Date : 2024-07-23 DOI: 10.1016/j.jiph.2024.102502

Background

The COVID-19 pandemic has had several phases with varying characteristics. We aimed to compare severity outcomes in different phases in a population with limited bias from risk factors.

Methods

In a nationwide observational study of all unvaccinated first-time COVID-19 test positive individuals in Sweden aged 18–64 years without comorbidity, from week 45 of 2020 to week 5 of 2022, variant periods with certain variants constituting ≥ 92 % of all whole genome-sequenced cases nationwide, were compared regarding hospitalisation (with main discharge code of COVID-19), severe illness (use of high-flow nasal oxygen or admission to intensive care unit), and death due to COVID-19. Logistic regression was used to estimate odds ratios (ORs) for comparison of these outcomes between variant periods, using adjustments for variant period, age, sex, country of birth, place of residence, income, and education.

Findings

The study included 789,133 individuals, including 15,145 hospitalised individuals. Among all individuals, the adjusted ORs for hospitalisation were 1.7 for the Alpha period vs the Pre-variant period (week 45–52 2020), 1.8 for the Delta period vs the Alpha period, and 0.1 for the Omicron period vs the Delta period (all comparisons significant). Among hospitalised individuals, the adjusted ORs for severe illness were 1.4 for the Alpha period vs the Pre-variant period, 1.7 for the Delta period vs the Alpha period, and 0.5 for the Omicron period vs the Delta period (all comparisons significant), and the adjusted ORs for death were 1.1 for the Alpha period vs the Pre-variant period (non-significant), 1.8 for the Delta period vs the Alpha period (significant), and 0.1 for the Omicron period vs the Delta period (non-significant).

Interpretation

In this population with limited bias from risk factors, vaccination, and previous infection, disease severity increased from the pre-variant to the Delta period and then decreased with the Omicron period, among all individuals and among hospitalised individuals. These severity outcome differences should be considered when the pandemic is evaluated.

背景：COVID-19大流行分为几个阶段，其特征各不相同。我们旨在比较不同阶段人群的严重程度结果，因为风险因素造成的偏差有限：在一项全国范围的观察性研究中，我们对瑞典所有 18-64 岁首次 COVID-19 检测呈阳性且无合并症的未接种者进行了研究，研究时间为 2020 年第 45 周至 2022 年第 5 周，比较了因 COVID-19 而住院（主要出院代码为 COVID-19）、重症（使用高流量鼻氧或入住重症监护室）和死亡的变异期，其中某些变异占全国所有全基因组测序病例的比例≥ 92%。通过对不同时期、年龄、性别、出生国、居住地、收入和教育程度等因素进行调整，采用逻辑回归法估算出这些结果在不同时期间比较的几率比（ORs）：研究共纳入 789 133 人，包括 15 145 名住院患者。在所有患者中，阿尔法期与变异前期（2020 年第 45-52 周）的住院调整 OR 值分别为 1.7、德尔塔期与阿尔法期的调整 OR 值分别为 1.8、奥米克隆期与德尔塔期的调整 OR 值分别为 0.1（所有比较均显著）。在住院患者中，阿尔法期与变异前期相比，重症的调整OR为1.4，德尔塔期与阿尔法期相比，重症的调整OR为1.7，奥克隆期与德尔塔期相比，重症的调整OR为0.5（所有比较均显著），阿尔法期与变异前期相比，死亡的调整OR为1.1（不显著），德尔塔期与阿尔法期相比，死亡的调整OR为1.8（显著），奥克隆期与德尔塔期相比，死亡的调整OR为0.1（不显著）：在这一受风险因素、疫苗接种和既往感染影响有限的人群中，从变异前到德尔塔期，所有个体和住院个体的疾病严重程度均有所上升，然后随着奥米克伦期的到来而下降。在对大流行进行评估时，应考虑到这些严重程度结果的差异。

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引用次数: 0

Unexpected arboviruses found in an epidemiological surveillance of acute tropical febrile syndrome in the department of Meta, Eastern Colombia 在哥伦比亚东部梅塔省急性热带发热综合征流行病学监测中发现的意外虫媒病毒

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health

Pub Date : 2024-07-23 DOI: 10.1016/j.jiph.2024.102510

Background

Nonspecific acute tropical febrile illnesses (NEATFI) are common in the Latin American tropics. Dengue, Chikungunya, Zika, Mayaro, and Usutu, among others, can coexist in the American tropics. This study aimed to surveil the arboviruses that cause| acute febrile syndrome in patients in the Meta department, Colombia.

Methods

Between June 2021 and February 2023, an epidemiological surveillance study was conducted in the Llanos of the Meta department in Eastern Colombia.

Results

One hundred patients in the acute phase with typical prodromal symptoms of NEATFI infection who attended the emergency department of the Villavicencio Departmental Hospital were included. ELISA tests were performed for Dengue, Usutu, Chikungunya, and Mayaro. RT-qPCR was performed to detect the arboviruses Usutu, Dengue, Zika, Mayaro, and Oropouche. The seroprevalence for the Chikungunya, Mayaro, and Usutu viruses was 41 % (28/68), 40 % (27/67), and 62 % (47/75), respectively. Seroconversion for Chikungunya was observed in one patient; two seroconverted to Mayaro and one to Usutu. The NS5 gene fragment of the Usutu virus was detected in nine febrile patients. RT-qPCR of the remaining arboviruses was negative. The clinical symptoms of the nine Usutu-positive patients were very similar to those of Dengue, Chikungunya, Zika, and Mayaro infections.

Conclusions

The pervasive detection of unexpected viruses such as Usutu and Mayaro demonstrated the importance of searching for other viruses different from Dengue. Because Usutu infection and Mayaro fever have clinical features like Dengue, a new algorithm should be proposed to improve the accuracy of acute tropical fevers.

背景拉丁美洲热带地区常见非特异性急性热带发热疾病（NEATFI）。登革热、基孔肯雅热、寨卡病毒、马雅罗病毒和乌苏图病毒等可在美洲热带地区共存。本研究旨在调查引起哥伦比亚梅塔省患者急性发热综合征的虫媒病毒。研究方法在 2021 年 6 月至 2023 年 2 月期间，在哥伦比亚东部梅塔省的拉诺斯地区开展了一项流行病学监测研究。对登革热、乌苏图、基孔肯雅和马雅罗病毒进行了 ELISA 检测。对乌苏图、登革热、寨卡、马亚罗和奥罗普切虫媒病毒进行了 RT-qPCR 检测。基孔肯雅病毒、马亚罗病毒和乌苏图病毒的血清流行率分别为 41%（28/68）、40%（27/67）和 62%（47/75）。一名患者出现了基孔肯雅病毒血清转换；两名患者出现了玛雅罗病毒血清转换，一名患者出现了乌苏图病毒血清转换。在九名发热患者中检测到了乌苏图病毒的 NS5 基因片段。其余虫媒病毒的 RT-qPCR 检测结果均为阴性。九名乌苏图病毒阳性患者的临床症状与登革热、基孔肯雅病毒、寨卡病毒和马雅洛病毒感染的症状非常相似。由于Usutu感染和Mayaro热具有类似登革热的临床特征，因此应提出一种新的算法来提高急性热带热病的准确性。

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