Przeglad epidemiologiczny最新文献

Background: In 2022, gonorrhoea incidence in Poland returned to its pre-pandemic upward trajectory after a temporary decline.

Objective: This study aims to describe the epidemiological situation of gonorrhoea in Poland in 2023 based on national surveillance data.

Material and methods: The analysis was based on case-based data from gonorrhoea notifications in 2023, supplemented by aggregated data from MZ-56 forms (2014-2022) and treatment data from dermatology-venereology clinics reported via MZ-14 forms (2019-2023).

Results: In 2023, gonorrhoea incidence doubled to 3.5/100,000 (1322 cases), the highest rate ever reported in Poland. Despite the rise, rates stayed far below the EU/EEA level (25/100,000). An improvement in reporting timeliness was observed. Most cases (87.4%) were among Polish nationals, and the male-to-female ratio was 11:1 (1,210 vs. 111 cases). Among individuals aged 15-24, the proportion of female cases increased (15-19 years: 18%; 20-24 years: 10%). Extragenital infections remained stable for rectal (9%) and pharyngeal (8%) sites, while conjunctival in adults increased (1% vs. 0.3% in 2022). Five cases occurred in children under 14 years, including two neonates with conjunctivitis - the first such reports in a decade. Nearly one-third of 2023 notifications (29.8%) related to diagnoses made between 2020 and 2022. These delayed notifications revealed that the upward trend began in 2021 (525 cases vs. 522 in 2019), intensified in 2022 (723), and peaked in 2023 (928).

Conclusions: 1) The rise in gonorrhoea cases since 2021, along with better reporting in 2023, suggests partial recovery of STI surveillance post-COVID-19, while exposing gaps in epidemiological monitoring. 2) Increasing cases among young women, children, and migrants underscore the need for tailored prevention and access to services. 3) Poland's limited involvement in the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) underscores the urgent need to enhance domestic microbiological monitoring of N. gonorrhoeae to support regular antimicrobial susceptibility reporting and timely public health response.

Background: Advances in dental technology have improved treatment quality but increased costs. In Poland, where the scope of services reimbursed by the National Health Fund (NFZ) is limited, the cost of dental treatment can be a financial barrier - especially for lower-income patients, particularly for older adults.

Objective: The aim of this study was to analyze how income levels affect patients' awareness of dental treatment costs and their decisions regarding available treatment options.

Material and methods: A cross-sectional survey of 282 participants (dental patients, medical students, healthcare and education professionals, and their families) was conducted from late 2023 to early 2024. Data from a self administered questionnaire were analyzed in Python using chi-square tests, Cramér's V, and phi coefficients (p < 0.05). Income was dichotomized (PLN 3,500) when necessary.

Results: Lower-income patients (

Conclusions: Income significantly affects dental care utilization, influencing check-up postponement and treatment choices. However, weak correlations suggest other factors - such as health awareness, service quality and appointment availability - also play key roles.

Non-tuberculous mycobacteria encompass various Mycobacterium species, which are pathogens that can cause diverse cutaneous manifestations due to their ability to infect different tissues. These infections are increasingly recognised, particularly in immunocompromised individuals or those with predisposing factors like trauma, surgery, or environmental exposure. Non-tuberculous mycobacteria skin infections can present as ulcers, necrosis, nodules, sarcoidosis-like lesions, patchy alopecia, or limb oedema. In this case, we present a 37-year-old patient who had cutaneous involvement of the left breast.

European sexually transmitted infections (STIs) diagnostic and therapeutic guideline were firstly published in 2001. They are updated on regular bases in line with the progress of scientific medical knowledge and changes in the epidemiological situation. The evolution of antimicrobial resistance in bacterial microorganisms is also of major concern. We present the latest, since 2020, Guideline regarding diagnostics, treatment, principles of after-treatment follow-up and partners' management in four bacterial STIs, namely: syphilis, gonorrhoea, infections with Mycoplasma genitalium and, published in 2025, Chlamydia trachomatis. In addition, the statement of International Union against Sexually Transmitted Infections-Europe on prophylactic doxycycline use in bacterial STIs is briefly discussed.

Background: COVID-19 has an uncharacteristic course in immunodeficient patients, often contributing to diagnostic and therapeutic difficulties and the reactivation of latent infections.

Objective: To describe the clinical course and therapeutic outcomes in immunocompromised patients with persistent COVID-19 who were found to have concurrent cytomegalovirus (CMV) reactivation, and to assess the potential impact of anti-CMV therapy on SARS-CoV-2 clearance.

Material and methods: Four different cases of COVID-19 pneumonia and immune disorders were evaluated, and the intended effect was not achieved, despite multidirectional treatment aimed at SARS-CoV-2. This prompted further virological research to investigate the features of CMV reactivation.

Results: Multidirectional treatment of COVID-19 in immunodeficient patients did not contribute to viral eradication. In all patients, high CMV viremia was observed with the use of ganciclovir/valganciclovir, which suppressed CMV replication and contributed to the elimination of SARS-CoV-2.

Conclusions: This case series highlights the complex relationship between SARS-CoV-2 and CMV, emphasizing the need for a comprehensive virological evaluation of persistent COVID-19 cases. As the global medical landscape has grappled with the evolving challenges of the pandemic, incorporating such multifaceted clinical insights remains paramount.

Background: Immunizations represent a critical component of contemporary preventive measures. Their primary function is to safeguard against the development of diseases and the ensuing complications.

Objective: The objective of this study is to evaluate the effects of the measles, mumps, and rubella immunization program on the population of children in Poland from 2014 to 2021.

Material and methods: The vaccination rate against measles, mumps and rubella in the population aged 1-19 years was calculated. The numerator was the number of children vaccinated in a given year and the denominator was the number of children born in a given year. The rate of missed vaccinations was calculated, where the numerator was the difference between the number of children born in a given year and the number of children vaccinated in a given year, and the denominator was the number of children born in a given year. The incidence rate was calculated for the vaccinated and unvaccinated populations (per 1 million population). The numerator constituted the number of reported cases in a given calendar year, whilst the denominator represented the number of individuals in the vaccinated or unvaccinated population in an age group.

Results: In the subsequent years a gradual decrease in vaccination coverage was observed among the youngest age groups: 1-year-olds (from 77.8% to 70.7%) and 2-year-olds (from 94.8% to 89.5%). In the population vaccinated against measles, the highest incidence of the disease was observed among 1-year-olds. A decline in the incidence of rubella can be observed in subsequent years, both in the vaccinated and unvaccinated populations. A lower incidence of diseases was observed in 2020 and 2021 in all age groups.

Conclusions: A significant decrease in the incidence of measles, mumps and rubella has been observed between 2014-2021 in the vaccinated population in comparison to the unvaccinated population.

Diphtheria is a forgotten disease that, despite advances in medicine and vaccination, is increasingly re-emerging in various parts of the world, including developed countries. It is caused by the bacterium Corynebacterium diphtheriae, which produces diphtheria toxin responsible for the severe course of the disease. However, only toxigenic strains-those carrying the tox gene, are capable of producing this toxin. The majority of C. diphtheriae strains isolated in Poland do not contain this gene, which is why infections caused by them are usually milder. Depending on the site of infection, symptoms most commonly involve the upper respiratory tract, with the hallmark sign being the presence of pseudomembranes. Rapid diagnosis and accurate confirmation of the pathogen are essential not only for implementing proper preventive measures, but above all for initiating timely treatment and preventing serious organ complications. Vaccination plays a key role in diphtheria prevention, offering effective protection against infection and transmission. Despite the availability of both preventive and therapeutic measures, diphtheria is becoming an increasing threat in countries with low vaccination rates. The growing number of cases particularly among children, highlights the urgent need for education and improvement in both prevention and treatment strategies.

Background: Lyme borreliosis (LB) is one of the most commonly diagnosed tick-borne diseases globally, caused by Borrelia spirochetes. Despite advances in laboratory diagnostics, both overdiagnosis and underdiagnosis of LB remain significant issues. Nonspecific symptoms such as chronic fatigue or musculoskeletal complaints are often misattributed to LB, creating controversy and delaying appropriate diagnosis and treatment.

Objective: To analyze clinical data and diagnostic results of patients referred to the Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, with suspected LB, and to assess the frequency of its clinical forms.

Material and methods: A retrospective analysis was conducted on medical records of patients hospitalized with suspected early or late LB at the Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, from January 2018 to June 2023. Diagnostics included ELISA and Western blot tests for IgM and IgG antibodies against Borrelia. Initial diagnoses were based on tick exposure and clinical presentation.

Results: Records of 819 hospitalized patients were analyzed: 497 (60.7%) men and 322 (39.3%) women, mean age 55.7 ± 14.8 years. LB was diagnosed in 426 (52%) patients, including 24 (5.6%) with neuroborreliosis and 7 (1.7%) with erythema migrans. In 395 cases, symptoms and results did not clearly confirm LB, yet antibiotics were used to assess response. In 393 patients (48%), LB was excluded; the most common alternative diagnoses were osteoarthritis (31.3%) and other musculoskeletal disorders (25.1%).

Conclusions: Overdiagnosis of LB may result in unwarranted antibiotic use, while delayed treatment can lead to late-stage disease. A key issue is the lack of differential diagnostics, delaying proper management of serious conditions like MS, rheumatoid arthritis, or cancer. Notably, many patients received empirical antibiotics despite not meeting clinical-serological criteria, distorting disease incidence. The current LB reporting system also requires revision, as it promotes overdiagnosis.

Background: Leptospirosis is one of the most common bacterial zoonoses in the world. However, there is scarce available literature on public awareness of the infection and the main clinical symptoms of leptospirosis.

Objective: The aim of this study was to assess the level of leptospirosis awareness among the general population and individuals with occupational risk of the disease in Lviv Region, Ukraine.

Material and methods: A leptospirosis questionnaire on potential risk factors, routes of transmission and ways of protection along with the demographic data was prepared, posted on Facebook and distributed as a printed version. The statistical analysis was performed using Fisher's two-sided test.

Results: A total of 446 individuals completed the questionnaire. Of these, 364 persons had no occupational risk of acquiring leptospirosis, while 82 of them had it. The study showed the following levels of leptospirosis awareness among the participants: 193 out of 446 (43.3%) individuals knew what leptospirosis was, with 158/364 (43.4%) representing general population (Group 1) and 35/82 (42.7%) representing individuals with an occupational risk of acquiring leptospirosis (Group 2), p>0.05. Furthermore, a total of 55.8% of all the participants knew how they could contract leptospirosis: 194/364 (53.3%) in Group 1 and 55/82 (67.1%) in Group 2, p<0.05. The most common risk factors of acquiring leptospirosis observed in both groups were as follows: swimming in ponds and lakes with stagnant water (57.69% in Group 1and 79.26% in Group 2, p<0.01), and the presence of rodents in houses, basements and utility rooms as well as periodic visits to these premises by respondents (45.6% of the respondents in Group 1 and 58.53% of the respondents in Group 2, p<0.01).

Conclusions: Outreach campaigns should be implemented to raise the awareness of leptospirosis, both among the general population and among the individuals at increased risk of exposure.

Background: In 2022, global oral squamous cell carcinoma (OSCC) incidence was 389,846 cases, with 188,438 deaths (GLOBOCAN). In India, it ranked 2nd with 143,759 cases and 79,979 deaths, and a 5-year prevalence of 370,106 cases. High OSCC rates are associated with oral leukoplakia, erythroplakia, and oral submucous fibrosis (OSMF), with malignant conversion rates of 1.1%-40.8% for leukoplakia, 19.9%-45% for erythroplakia, and 6% for OSMF. Central India has the highest oral cancer incidence, 19.2% in males and 7.6% in females. Limited research highlights the need for public health interventions; our study offers key epidemiological insights from a tertiary care center.

Objective: The study investigates the prevalence and epidemiology of oral leukoplakia, erythroplakia, and OSMF among tobacco and areca nut users.

Material and methods: This prospective observational study was conducted at the Govt Dental Institute, of Central India, from September 2022 to March 2023, with ethical clearance (No. 161/IEC/SS/2022). A purposive sampling approach targeted individuals with smokeless tobacco, smoking, or areca nut consumption. Oral cavity screenings were conducted, classifying leukoplakia, erythroplakia, and OSMF using established clinical criteria. The data were analyzed using SPSS 25.0, with significance set at p < 0.05.

Results: Among 28,736 patients, 5,428 had a history of tobacco or areca nut consumption, and 411 were diagnosed with OPMDs (Oral Potentially Malignant Disorders), yielding an overall prevalence of 7.57%. OSMF was the most common disorder (5.30%), followed by oral leukoplakia (2.22%) and erythroplakia (0.036%). The most prevalent habit was areca nut and smokeless tobacco consumption (71.53%). OSMF Grade IV had the highest prevalence (36.79%).

Conclusions: The prevalence of Oral Potentially Malignant Disorders in this study (7.57%) exceeds global averages, highlighting the impact of tobacco and areca nut consumption in Central India. OSMF, particularly Grade IV, is more prevalent, underscoring the need for targeted public health interventions and rigorous screening for early detection and management.