Revista Panamericana De Salud Publica-pan American Journal of Public Health最新文献

Objective: Identify the challenges that Mexico faced during the measles outbreak during the COVID-19 pandemic and describe the interventions to interrupt measles virus circulation.

Methods: Descriptive, retrospective study of actions taken during the measles outbreak during the COVID-19 pandemic.

Results: Epidemiological surveillance of febrile exanthematous diseases has been carried out continuously in the country since 1992. This measles outbreak demonstrated the limitations and strengths of the health system with respect to measles control in the context of a pandemic.

Conclusions: A very important factor in controlling the outbreak was to strengthen the training and coordination of rapid response teams belonging to local health districts, states, the national network of government-operated public health laboratories, and the national laboratory supporting epidemiological surveillance (LAVE). On 31 August 2020, after 90 days of active surveillance and reports of negative test results from the network of health units and laboratory units, it was concluded that the country remained free of measles transmission.

Objective: To describe Mexico's experience of a high-quality follow-up vaccination campaign against measles and rubella in children aged 1 to 4 years, and actions taken to recover the coverage of other biologics during the COVID-19 health emergency.

Method: Use of a microplanning tool in the design and implementation of a follow-up campaign to protect 8 604 781 girls and boys aged 1 to 4 years and to complete other vaccination schedules, followed by the implementation of rapid vaccination monitoring.

Results: A total of 8 026 184 doses of MR vaccine were administered to children aged 1 to 4 years, with a coverage rate of 93.3%. In addition, 3 058 201 doses of MMR vaccine and 2 361 021 doses of hexavalent vaccine were administered. Rapid vaccination monitoring was carried out 78 times in selected municipalities in the country, where 30% (18 692) of 62 308 children aged 1-4 years contacted were found to be unvaccinated. The reasons for not vaccinating were "not knowing it was necessary" (28.5%), "not having time" (21.2%), "other reasons" (mainly fear of getting sick from COVID-19 in health centers) (12.9%), "believing they had received two doses of MMR vaccine" (9.1%), or "not knowing where to get vaccinated" (8.7%); 19.6% did not respond.

Conclusions: The high-quality vaccination campaign was successful, favoring the sustainability of measles, rubella, and polio elimination, as well as the control of other vaccine-preventable diseases, and demonstrating the relevance of microplanning.

Objective: To determine measles and rubella IgG seropositivity in the post-elimination era, based on data generated by the Costa Rican National Reference Center for Virology laboratory at Inciensa from 2012 to 2023.

Methods: Cross-sectional, descriptive, observational study analyzing the frequency of measles IgG and rubella IgG reactivity by enzyme-linked immunofluorescence (ELISA) in 877 subjects.

Results: The average age of the studied individuals was 36 years; 51.8% were women. Measles and rubella IgG seropositivity was slightly higher in females. The average seropositivity over the study period was 74.8% for measles IgG antibodies and 84.5% for rubella. The age group 50 years and older exhibited the highest positivity for the both measles and rubella IgG, while the 20-to-39 age group had the lowest protective humoral response.

Conclusions: Descriptive studies of measles and rubella IgG seropositivity can identify age groups susceptible to these infections, which in turn can guide health authorities in directing supplementary immunization campaigns to strengthen the immune response of the population and prevent outbreaks of both diseases.

The widespread digitization of information, advances in data processing and the emergence of internet-connected devices have led to a proliferation of data, often loosely referred to as big data. With this digital transformation, offering open data - that is, data freely available for modification and reuse - has emerged as a key strategy for encouraging transparency and innovation. Data reuse holds particular importance in the small island developing states of the Caribbean, which have a limited resource pool from which to tackle the landscape of social priorities. Efforts made towards data-sharing must consider privacy, security and the ethical use of information, and the tension between data as a social good and data for commercial gain can be a determinant of data-sharing decisions. A multidisciplinary approach is needed to realize the potential of data-sharing. In this article, we describe techniques (or pathways) for growing the Caribbean's stock of open data, classifying these into four types. Initiative pathways are techniques to broaden the range of data producers that share data. Infrastructure pathways deal with the practicalities of making data publicly available. Governance pathways are regulations and frameworks that guide data producers, including in meeting their legal data obligations. Training and communication pathways are efforts to raise awareness and knowledge about the benefits and practices of data-sharing. Data-sharing can offer a cost-effective evidence base for the Caribbean's continuing digital transformation. Sustainable sharing is key, and it must include robust technical infrastructure and governance, and ongoing communication.

In Honduras, health systems have been faced with a duty and a need to establish surveillance mechanisms in order to understand the pathways of health and disease in the population. The objective of this article is to describe the process of analysis and the strategies used during development of a robust information system for vaccine safety surveillance, which can also be replicated for other forms of surveillance. For this purpose, agile development methods and open-source tools were used to design and develop a baseline monitoring system, incorporating recognized standards for information coding, validation, and verification. This successful implementation of a reliable, stable, and scalable information system that will be used for the surveillance of events supposedly attributable to vaccination and immunization (ESAVI) and adverse events of special interest (AESI) should allow the timely and agile capture of surveillance data and facilitate data analysis.

In the face of growing health challenges, nontraditional sources of data, such as open data, have the potential to transform how decisions are made and used to inform public health policies. Focusing on the COVID-19 pandemic, this article presents a case study employing sentiment analysis on unstructured social media data from Twitter (now X) to gauge public sentiment regarding pandemic-related restrictions. Our study aims to uncover and analyze Jamaican citizens' emotions and opinions surrounding COVID-19 restrictions following an outbreak at a call center in April 2020. Machine learning sentiment analysis was used to analyze tweets from Twitter related to the lockdown. A total of 1 609 tweets were retrieved and analyzed, 76% of which expressed negative sentiments, suggesting that the majority of citizens were not in favor of the restrictions. The low compliance with the government-mandated policy may be related to the high percentage of negative sentiments expressed. Insights from citizens' sentiments derived from open data sources such as Twitter can serve as valuable indicators for public health policymakers, providing critical input that will aid in tailoring interventions that align with public sentiments, thereby enhancing the effectiveness of and compliance with public health policies. This type of analysis can be useful to the health community and more generally to governments, as it allows for a more scientific assessment of public response to public health intervention techniques in real time. This study contributes to the emerging discourse on the integration of nontraditional data into public health policy-making, highlighting the growing potential for the use of these novel analytic techniques in addressing complex public health challenges.

This study searched grey literature and PubMed for strategies to sustain the elimination of measles, rubella, and congenital rubella syndrome and prevent their reintroduction in the Caribbean. Strategies were categorized at the macro, meso, and micro health levels. Macro strategies include: strong, clear, unified political and technical leadership and support; country ownership and subregional coordination of resources, policies, and programs; government investment in national immunization programs; and timely payment to the Pan American Health Organization Revolving Fund for affordable, good-quality vaccines. Including the private health sector and health workers in the tourism industry to identify and manage suspected imported cases, and finding and vaccinating every unvaccinated child, university student or frontline worker are key meso strategies. Strong social and communication programs are the key micro strategies needed to promote vaccine confidence and gain public trust. Priority macro strategies include a strengthened legislative framework supporting immunization, and policies to ring-fence the immunization budget, mitigate the rapid turnover of staff, and train new immunization managers. Establishing infrastructure to vaccinate adolescents and adults, including through the private sector, increasing the capacity to test for measles and rubella, and updating digital surveillance systems for timely decision-making are also critical meso strategies to prevent the reintroduction of these diseases. Partnerships, commitment, and collaborative efforts that contribute to elimination must be sustained, and health strategies strengthened to keep the Caribbean free of endemic transmission of measles, rubella, and congenital rubella syndrome.

Objective: To describe the comprehensive activities implemented in the Bolivarian Republic of Venezuela to achieve reverification of measles elimination by 2023.

Methods: Descriptive study of the procedures implemented to achieve reverification of measles elimination by 2023 according to the components set forth in the Regional Framework for the Monitoring and Re-verification of Measles, Rubella, and Congenital Rubella Syndrome Elimination in the Americas, published in 2022.

Results: Due to a measles outbreak that began in epidemiological week (EW) 26 of 2017, Venezuela lost the elimination status which had been conferred in 2016 by the Expert Committee. Endemic transmission of the virus was reestablished in EW26 of 2018, after 12 months of circulation. After 111 weeks, 7054 confirmed cases and 80 deaths, endemic transmission was interrupted in EW33 2019; this prompted vaccination activities and intensified surveillance, in addition to securing financial resources for procurement of vaccines and supplies. Evidence of these activities was provided to the Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission (RVC), which enabled the country to be reverified as measles-free by 2023.

Conclusions: Venezuela achieved interruption of endemic measles transmission in 2019, and then carried out activities which enabled it to meet the core criteria for reverification of elimination as established in the Regional Framework.

Objective: To determine the distribution of human papillomavirus (HPV) genotypes in invasive cervical cancer samples from Ecuadorian women who attended the Cancer Institute (Sociedad de Lucha Contra el Cáncer - SOLCA).

Methods: Archived formalin-fixed paraffin-embedded (FFPE) cervical cancer tissue samples collected during 2017-2021 were deparaffinized, and nucleic acid extraction and purification was performed using silica columns. The obtained nucleic acids were analyzed using INNO-LiPA® HPV Genotyping Extra II per the manufacturer's specifications. Data were retrieved from records, and HPV genotypes were determined from the FFPE samples.

Results: The study included samples from 190 women diagnosed with invasive cervical cancer, with a median age of 52.78 years. Squamous cell carcinoma accounted for 78.94% of the cases, while 21.05% had adenocarcinoma. Among the 190 samples, 80.53% tested positive for HPV DNA, while 19.47% were negative. The most common genotypes detected were HPV 16 (64.05%), 18 (16.99%), and 58 (6.54%). HPV infection frequency was higher in samples from patients with elementary level education (p < 0.05).

Conclusions: This study provides valuable insights into the distribution of HPV genotypes in invasive cervical cancer samples from Ecuadorian women. The results indicate an elevated presence of HPV 16, HPV 18, and HPV 58, which are vaccine-preventable genotypes.

Objective: To estimate the effect of the COVID-19 pandemic on the supply, uptake, coverage, and timeliness of vaccination in children under 5 years of age in Ecuador.

Methods: Concurrent mixed-methods design with two rapid evaluation cycles. In each cycle, questionnaires and semi-structured interviews were administered to health personnel and mothers of children under 5. The instruments explored the immunization program in terms of supply (availability of material and personnel) and uptake (demand and access). To estimate vaccination coverage, we randomly sampled children under 5 in five provinces and analyzed monthly administrative program records for the period 2017-2020.

Results: Approximately 50% of respondents perceived a reduction in personnel and supplies for the program. The demand for care declined 26% between 2020 and 2021, mainly due to fear of contracting COVID-19 in health facilities. Access to program services was affected by changes in schedules, ventilated spaces, and the provision of virtual care, none of which were well accepted by the population. Only 50% of children under 1 year of age completed their full vaccination schedule, and most vaccines were not administered in a timely manner.

Conclusions: The COVID-19 pandemic had a negative impact on the immunization program in terms of supply and uptake. This led to a precipitous decline in the coverage and timeliness of vaccination, which have fallen to suboptimal levels in children under 5 in Ecuador. This has increased the risk of children contracting vaccine-preventable diseases.