Przeglad epidemiologiczny最新文献

Background: Mumps is a viral disease primarily transmitted by infected individuals. A milestone in controlling mumps in Poland was the introduction of mandatory MMR vaccination in 2003, protecting against measles, mumps, and rubella. Since then, the incidence has decreased substantially, and complications have become rare.

Objective: The aim of the study was to conduct an epidemiological assessment of the incidence of mumps in Poland in 2023 compared to previous years, taking into account the impact of the COVID-19 pandemic.

Material and methods: The analysis of the epidemiological situation of swine fever in Poland in 2023 was conducted based on the interpretation of data from the nationwide epidemiological surveillance system. The percentage of those vaccinated with the first dose was determined based on data for the 2021 cohort (children aged 3 years), and the percentage of those vaccinated with two doses was determined based on data for the 2017 cohort (children aged 6 years). Vaccination effectiveness was estimated using the screening method.

Results: In 2023, 966 cases of swine fever were registered in Poland. This represented a 4.8% increase in the number of cases compared to 2022, when 922 cases were reported. The overall incidence rate was 2.6 per 100,000 inhabitants, which was 5.3% higher than in 2022. The highest incidence rate, 3.6 per 100,000 inhabitants, was recorded in the Śląskie voivodeship, and the lowest, as in previous years, of 1.2 per 100,000 inhabitants in Dolnośląskie voivodeship. The highest incidence(13.7/100,000) was recorded in children aged 0-4 and 5-9 (17.3/100,000). The incidence in men (3.0/100,000) was higher than in women (2.1/100,000). In 2023, the number of hospitalisations due to mumps in Poland was 12, a decrease of 40% compared to 2022, when 20 people were hospitalized.

Conclusions: In 2023, there was an increase in the number of registered cases of mumps, indicating a general upward trend. The decline in cases in2020-2021was the result of the COVID-19 pandemic, which was accompanied by restrictions significantly limiting the transmission of diseases spread by droplets, including mumps. Despite the increase in the number of cases in 2023, the level remains below that observed in the period before the COVID-19 pandemic.

Adverse drug reactions (ADRs) remain a major, yet largely preventable, global public health challenge, causing significant morbidity, mortality, and healthcare costs. This review synthesises evidence on the global burden, pharmacovigilance systems, and prevention strategies for ADRs, integrating data from multiple regions, healthcare settings, and drug classes. Epidemiological findings reveal wide variability in incidence and mortality, with older adults, low-resource settings, and exposure to high-risk medicines-such as antibiotics, antiretrovirals, and cardiovascular agents-representing key vulnerabilities. Despite advances in surveillance, underreporting, data quality issues, and methodological biases persist, particularly in low- and middle-income countries. Comparative analyses of pharmacovigilance platforms, including World Health Organization's (WHO's) VigiBase, EudraVigilance, and EU-ADR, highlight complementary strengths and the value of integrating spontaneous reporting with electronic health record analytics. Emerging statistical methods, including machine learning and federated analytics, offer improved signal detection timeliness and precision. Prevention strategies span prescriber-level, system-level, and patient engagement interventions. These include clinical decision support systems, pharmacogenomic-guided therapy, deprescribing protocols, mobile reporting applications, and wearable biosensors. Evidence shows that active surveillance and automated alerts outperform voluntary reporting, while digital tools can enhance detection and risk communication. However, implementation remains uneven due to infrastructure, workforce, and policy gaps. Looking forward, achieving the World Health Organization's goal of halving severe medication-related harm by 2030 will require embedding ADR surveillance and prevention into universal health coverage frameworks. Policy priorities include mandating interoperable safety systems, harmonising international safety indicators, investing in capacity building for resource-limited settings, and aligning incentives with safer prescribing. Coordinated global action can bridge surveillance gaps, strengthen prevention, and build resilient, equitable pharmacovigilance systems, advancing both patient safety and sustainable health systems worldwide.

Background: Cardiovascular disease (CVD) complicates pregnancies worldwide and remains a major contributor to maternal mortality, particularly in low- and middle-income countries (LMICs).

Objective: This study aimed to evaluate the prevalence, clinical profiles, and outcomes of heart disease (HD) among pregnant women referred to the Joint Clinic of Pregnancy and Heart Disease at Al-Zahra Hospital and assess the utility and limitations of the modified World Health Organization (mWHO) risk classification system.

Material and methods: We analyzed a retrospective cohort of 389 pregnant women with confirmed heart disease managed at the Joint Clinic of Pregnancy and Heart Disease, a tertiary referral center, Al-Zahra Hospital (Isfahan, Iran), between March 2017 and March 2023. Participants were followed until hospital discharge after delivery or pregnancy termination. Patients were stratified into mWHO risk classes and categorized by disease type, including congenital heart disease (CHD), valvular heart disease (VHD), cardiomyopathy, and other conditions. Clinical outcomes, including maternal mortality, abortion and delivery methods were examined.

Results: VHD was the most prevalent condition (35.99%), followed by CHD (20.82%). Severe mitral stenosis and prosthetic heart valves were the most common VHD subtypes. Among CHD cases, atrial septal defect was predominant. Class IV mWHO patients comprised 21.85%, highlighting the high-risk population. Cesarean deliveries were common (53%). Maternal mortality was 1.0%, with four deaths mostly due to pulmonary hypertension.

Conclusions: The observed outcomes in this high-risk cohort compare favorably to those reported in similar LMIC settings, suggesting that structured multidisciplinary care and mWHO-based risk assessment may contribute to improved maternal and fetal management. However, overlapping and unclassified conditions highlight the need to refine current risk stratification frameworks for pregnancy in cardiac patients.

Advanced HIV infection leads to profound immunosuppression and increased susceptibility to opportunistic infections. Resumption of antiretroviral therapy (ART) may result in immune reconstitution inflammatory syndrome (IRIS), which manifests as a worsening of an existing infection or the emergence of new ones. Disseminated mycobacteriosis caused by Mycobacterium avium complex (MAC) is one of the most severe opportunistic infections in the course of AIDS. The aim of this paper is to present the diagnostic and therapeutic difficulties in a AIDS patient who developed IRIS with generalized MAC infection and numerous metabolic and infectious complications following the resumption of ART, ultimately leading to treatment failure. We describe the case of a 34-year-old HIV-positive patient who had discontinued ART for several years. Clinical, laboratory, imaging, and psychiatric data collected during several months of hospitalization were analyzed. A multidisciplinary approach was employed, including antiretroviral, antimycobacterial, antifungal, nutritional, and psychiatric treatment. After ART was resumed, the patient developed IRIS in the form of disseminated MAC infection, confirmed in sputum, blood, and bone marrow. He developed refeeding syndrome, multidrug-resistant sepsis, and fungal and bacterial infections. Despite improved immunological parameters (increased CD4 and decreased HIV viral load), treatment was ineffective due to the patient's lack of compliance and worsening cachexia. This case illustrates the complexity of caring for patients with advanced AIDS and IRIS. Effective treatment requires a multidisciplinary approach, early diagnosis of IRIS, and consideration of psychosocial factors that can significantly complicate treatment and prognosis. .

Background: The epidemiological situation of chickenpox in Poland has been stable in recent years, with no significant increase in the number of cases observed. Between 2016 and 2023, the incidence rate ranged from 389.4 to 506.2 cases per 100,000 population, except for 2020 and 2021, when the incidence rate decreased to 186.6 per 100,000 in 2020 and 151.1 per 100,000 in 2021, due to the COVID-19 pandemic. In 2022, an increase in the incidence rate was recorded, reaching 453.9 per 100,000.

Objective: The aim of this study was to assess the epidemiological situation of chickenpox in Poland in 2023 compared to previous years.

Material and methods: To assess the epidemiological situation of chickenpox in Poland, data submitted to the National Institute of Public Health NIH - National Research Institute by District Sanitary and Epidemiological Stations and published in the annual bulletin "Infectious diseases and poisonings in Poland in 2023" and data published in the annual bulletin "Vaccinations in Poland in 2023" were used.

Results: A total of 190,825 cases of chickenpox were registered in 2023, which was 11.13% more than in 2022, and 27.59% more than the median number of cases for the years 2017-2021. The overall incidence was 506.2/100,000 population. In terms of age, the highest incidence was among children in the age groups 0-4 years (4,741.4/100,000) and 5-9 years (4,155.1/100,000), while in adults, the incidence did not exceed 100 cases per 100,000. In 2023, a total of 123,743 people were vaccinated against chickenpox, of whom 95.49% were children under 11 years of age (118,163 people).

Conclusions: The slowdown in the increase in incidence in 2023 (compared to 2022) may indicate a stabilization of the chickenpox situation, but the increase in the overall incidence rate above 500 per 100,000 is concerning and requires monitoring in next years.

Background: Rubella is a viral childhood disease, usually mild, but infection during pregnancy can cause severe congenital defects. In Poland, mandatory vaccination was introduced in 1989 for girls, and since 2003 as part of the MMR vaccine for both sexes. In 2022-2023, Poland recorded the highest number of rubella cases in the WHO European Region.

Objective: To assess the epidemiological situation of rubella in Poland in 2022-2023, with emphasis on vaccination coverage and the impact of the COVID-19 pandemic.

Material and methods: Data for the analysis of the epidemiological situation of rubella in Poland were obtained from reports submitted to the NIPH NIH - NRI by the Voivodeship Sanitary and Epidemiological Stations and published in the annual bulletins Infectious Diseases and Poisonings in Poland for 2022-2023 and Protective Vaccinations in Poland for 2022-2023, as well as from individual epidemiological case investigations recorded in the EpiBaza system. Case classification was based on the definition used in surveillance in 2022-2023.

Results: In 2022, 147 rubella cases were reported (0.39/100,000), rising to 246 in 2023 (0.65/100,000), a 67% year-on-year increase and nearly a fivefold rise compared to 2021. Compared to 2019, case numbers were 13.7% lower. The highest incidence was observed in children aged 0-4 and 5-9 years. Vaccination coverage among 3-year-olds was around 91%, below the elimination threshold (≥95%). Laboratory confirmation accounted for only about 2% of notifications.

Conclusions: Analysis of epidemiological data from 2022-2023 indicates a marked increase in rubella cases in Poland compared to the COVID-19 pandemic period. In 2023, the number of reported cases was nearly five times higher than in 2021. Although the 2023 total remained below that of 2019, the last pre-pandemic year, the observed upward trend may be associated with increased virus transmission following a period of reduced exposure due to sanitary restrictions implemented during the pandemic.

Background: Measles remains one of the most contagious viral diseases, spreading rapidly in populations with insufficient vaccination coverage. Despite the availability of an effective vaccine, cases continue to occur worldwide. The World Health Organization (WHO) has set goals of regional elimination and, ultimately, global eradication. Essential elements include ≥95% vaccination coverage, sensitive epidemiological surveillance, and laboratory confirmation. In Poland, these functions are coordinated by the National Institute of Public Health NIH - National Research Institute (NIPH NIH - NRI).

Objective: To assess the epidemiological situation of measles in Poland in 2022-2023, with particular focus on vaccination coverage, progress in implementing the WHO elimination programme, and the impact of the COVID-19 pandemic.

Material and methods: The analysis was based on case reports submitted to NIPH-NIH by Provincial Sanitary and Epidemiological Stations, data from the national bulletins Infectious diseases and poisoning in Poland (2022-2023) and Vaccinations in Poland (2022-2023), and individual epidemiological interviews registered in the EpiBaza system.

Results: In 2022, 27 cases of measles were reported (incidence 0.07/100,000), and in 2023 - 35 cases (0.09/100,000). Compared to 2021 (13 cases, 0.03/100,000), this represented a 107.7% increase, although the incidence remained 97.7% lower than in 2019 (1,502 cases, 3.31/100,000). The highest rates were recorded among children: in 2022 in the 0-4 age group (0.61/100,000) and in 2023 in the 5-9 group (0.61/100,000). Hospitalisations increased from 7 patients in 2022 (25.9%) to 11 in 2023 (31.4%). No deaths were reported.

Conclusions: In 2022-2023, Poland saw a rise in measles cases compared to 2021, but incidence remained much lower than in the pre-pandemic period. The predominance of cases among children and suboptimal vaccination coverage (<95%) highlight the ongoing risk of outbreaks. Strengthening epidemiological surveillance, systematic monitoring of vaccination rates, and public education are key to meeting WHO elimination targets.

Tularemia, caused by the bacterium Francisella tularensis, is a zoonotic disease that has been reported in many countries across the globe. It may manifest in many forms, like pneumonic, oropharyngeal, glandular, ulceroglandular, or oculoglandular. In Poland, one of the most common types of tularemia is ulceroglandular. Typical symptoms of ulceroglandular tularemia include painful ulcers at the site of the insect or animal bite, along with systemic flu-like symptoms. Tularemia is generally effectively treated with appropriate antibiotics, however, frequent misdiagnosis and subsequent improper treatment remain significant clinical challenges. We present a case of a 54-year-old patient diagnosed with the ulceroglandular form of tularemia. Physicians in endemic areas are obliged to be aware of a high index of suspicion for tularemia. It should be included in the differential diagnosis when evaluating patients presenting with flu-like symptoms, lymphadenopathy, and non-healing ulcers.

Background: Both in Poland and worldwide, an increase in the number of smartphone users has been observed. It is estimated that two-thirds of the global population uses them. Smartphones significantly enhance many aspects of daily life. However, it is important to be aware that improper use of these devices can lead to negative health effects, both mental and physical. Adhering to digital hygiene principles can greatly reduce the risk of various ailments, which will undoubtedly improve users' quality of life.

Objective: The aim of the study was to assess behaviors related to smartphone use in the context of digital hygiene among medical students.

Material and methods: The study was conducted with a diagnostic survey method. The technique used was a questionnaire, and the tool was a validated Digital Hygiene Self-Assessment Questionnaire developed by Bigaj and Woynarowska. The study group consisted of 71 individuals. Data analysis was conducted using Google Sheets, MS Excel, and SPSS software. Statistical analysis included Spearman's rho correlation coefficient and the Mann-Whitney test.

Results: Most respondents described their daily smartphone usage time as long. Just over 73% of those surveyed reported experiencing negative effects from using the device (n=52). The most common behaviors related to digital hygiene included limiting the number of notifications (n=28, 39.4%), deleting unused apps (n=25, 35.2%), and avoiding keeping the phone with them all the time (n=17, 23.9%).

Conclusions: Extensive daily smartphone usage may have negative health implications. Respondents are aware of the fact that they use smartphones too frequently, and their digital hygiene habits pose health risks. Systematic educational initiatives are necessary to not only raise awareness of the issue but also provide users with practical methods for implementing digital hygiene principles related to mobile device use.

Background: Over the past 10 years the number of newly diagnosed HIV infections per year in Poland has been increasing. International data shows that in-school education about prevention of HIV leads to improved knowledge, increased condom use and safer sex attitudes. Data about HIV knowledge in polish schools is lacking.

Objective: The aim of the study was to assess the knowledge of polish secondary school students regarding HIV/AIDS, and how it changes after one training in this topic.

Material and methods: An online questionnaire with 30 questions about HIV/AIDS and sources of knowledge was given to students in two secondary schools in Warsaw, Poland. After completing the questionnaire an educational training was conducted. The same online questionnaire was distributed to the same classes after a year from the first survey and training. Numbers of correct answers were counted and the change of correct answers between first and second questionnaire was calculated.

Results: In the first part of the study n=364 students filled in the questionnaire and in the second part n=257. The majority of students self-assessed their knowledge as not sufficient (84.3%). Questions answered incorrectly by most of the respondents concerned routes of transmission, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). In 16/20 yes/no questions an improvement in knowledge was noted in the second survey.

Conclusions: This study showed some knowledge gaps about HIV/AIDS of surveyed students. More education about prevention of HIV/AIDS should be included in the school programme. A one-time educational training can be beneficial.