Western Pacific Surveillance and Response最新文献

The aim of this study was to assess the effectiveness of safety regulations governing traditional Mongolian horse racing on the frequency and severity of injuries among child jockeys. Regulations introduced in 2019 mandate the wearing of helmets and protective clothing, prohibit the participation of jockeys aged < 7 years, and ban horse racing during the cold season (November-April). National injury surveillance data were used to compare the profile of injuries that occurred among children aged < 15 years in the 4-year periods before and after the introduction of the regulations (2015-2018 and 2019-2022) and to investigate whether injuries continued to occur among underage children and during the banned season. The proportion of head injuries among injured children was calculated before and after the regulations were introduced. During the study periods, 6309 animal-riding injuries were recorded among children aged 3-14 years; 2539 occurred before the regulations were introduced and 3770 occurred after. Following the introduction of the regulations, the proportion of injured children aged < 7 years decreased slightly. However, during 2019-2022, 294 animal-riding injuries were observed among underage children and 855 during the banned season. The proportion of head injuries among children with animal-riding injuries remained unchanged before and after the regulations were implemented (33.7% and 34.6%, respectively). The regulations have been ineffective. To reduce the burden of injuries among child jockeys, safety regulations need to be enforced throughout the year, and more stringent penalties for noncompliance should be imposed.

Antimicrobial resistance (AMR) is a global concern. However, in Cambodia, as in other countries in the World Health Organization's Western Pacific Region, the magnitude of the problem is largely unknown. Thus, this study aimed to determine the prevalence of AMR in common pathogens, namely Escherichia coli and Staphylococcus aureus, isolated from blood cultures at one provincial hospital, a national sentinel site for AMR surveillance, during a 3-year period. Sample processing and analysis were conducted at the hospital's on-site microbiology laboratory. Blood cultures were processed manually, and conventional methods were used for bacterial identification. Antibiotic susceptibility testing (AST) was performed by disk diffusion and Etest minimum inhibitory concentration measurement, in accordance with current Clinical and Laboratory Standards Institute guidelines. Blood culture data from 1 January 2020 to 31 December 2022 were extracted from the hospital's microbiology database and, for the AST analysis, deduplicated to include results only for the first isolate per patient per year. Of 6102 blood cultures collected, 529 (9%) were positive. The most common blood culture pathogens found were E. coli (150, 28% of positive isolates) and S. aureus (65, 12% of positive isolates). For E. coli, resistance to ceftriaxone was detected in 110/148 (74%) isolates and resistance to imipenem in 3/147 (2%). For S. aureus, 18/56 (32%) isolates were methicillin-resistant, but vancomycin resistance was not detected. These rates of resistance to first-line treatments are of concern and have the potential to negatively impact patient outcomes.

Objective: Lamongan District Health Office received a report of a suspected measles outbreak from a community health centre and two hospitals in Brondong subdistrict, Lamongan district, Indonesia. An outbreak investigation team was deployed to verify the diagnosis and to determine the magnitude of the outbreak.

Methods: This retrospective, 1:1 matched case-control study involved 51 suspected or laboratory-confirmed measles cases and 51 controls selected from household contacts and/or playmates within the same village who did not have measles. Data on case characteristics, clinical symptoms, vaccination status, as well as contact and travel histories were collected via interview. Blood specimens were collected from 25 of the children for laboratory confirmation. Univariate and multivariable logistic regression analyses were conducted to investigate risk factors for measles infection.

Results: Nineteen of the 51 measles cases (37.3%) were laboratory-confirmed. All 51 cases exhibited fever and rash (100%) and ranged in age from 11 months to 12 years; 29 (56.9%) were female, and 32 (62.7%) were hospitalized. Over half of the cases occurred in Sedayulawas village (31/51, 60.8%), showing a propagated epidemic pattern. The index case was a 2-year-old girl. Transmission predominantly occurred within the same village through household or playmate contacts. Immunization status and contact history were significantly associated with measles infection.

Discussion: The measles outbreak was attributed to a decline in immunization coverage, particularly for the second dose of the measles-rubella vaccine. This decrease was driven by multiple factors, including the impact of the COVID-19 pandemic, misconceptions related to religious beliefs, and the long interval between the first and second vaccine doses, which contributed to the patients who were lost to follow-up. Collectively, these factors increased the vulnerability of children to measles infection.

The COVID-19 pandemic impacted tuberculosis epidemiology worldwide, and Japan was no exception. This report analysed Japan's national tuberculosis surveillance data to explore the potential impact of COVID-19 on tuberculosis, by age group and place of birth, and to explore possible reasons behind the impact, if any. Overall since 2019, the observed number of notified cases was significantly lower than the number of expected cases. However, closer examination revealed that among Japan-born patients, this was true only for those aged 35-54 years and ≥ 65 years, while among those aged 25-34 years, the observed number of notified cases significantly exceeded the expected cases. Among foreign-born patients, the observed number of notified cases was significantly lower than that of expected cases for those aged 0-24 years and ≥ 65 years. Examination of changes in the modes of detection during the pre- and post-COVID-19 periods revealed that the impact of COVID-19 affected screening opportunities for tuberculosis among various populations differently, which in turn may partially explain the discrepancies between the observed and expected cases among those in different age groups and with different places of birth. A detailed study may be helpful in further understanding the interaction between the impact of COVID-19 on tuberculosis in the short and long-term.

Since its inception in April 2000, the Global Outbreak Alert and Response Network has played a pivotal role in coordinating the rapid deployment of technical experts to support countries, when requested, during public health emergencies. This paper presents a regional analysis of the Network's deployments within, to and from the World Health Organization Western Pacific Region over the past 24 years. The findings emphasize the critical importance of a well coordinated surge workforce and advocate for enhanced partner engagement with strategic utilization of regional and global expertise to strengthen future outbreak responses.

Objective: To outline the management of an outbreak of invasive group A Streptococcus (iGAS) in a residential aged-care facility in rural Queensland, Australia, comparing outbreak management with the newly released Australian Series of National Guidelines (SoNG) for this disease and exploring unique aspects of rural iGAS outbreak management.

Methods: An outbreak of iGAS was identified in a rural Queensland residential facility, where two cases occurred within 24 hours. A confirmed case was defined as any individual linked to the facility who had laboratory evidence of group A Streptococcus (GAS) in a sterile site. Whole genome sequencing was performed on all confirmed cases. The public health management of this outbreak was conducted according to the Queensland Communicable Disease Control guidelines and was compared with the new SoNG.

Results: A phylogenetic tree confirmed that the two samples clustered closely together with a single allele difference. Chemoprophylaxis was offered to all residents and staff in the affected part of the facility; 95% (42/44) of residents consented to chemoprophylaxis. Increased surveillance for GAS and increased facility cleaning were recommended by the public health unit. No additional cases were identified after 30 days of surveillance. Management of the outbreak largely aligned with the SoNG except for post-outbreak surveillance, which would have been extended under the new guidelines.Discussion: This paper highlights factors unique to managing iGAS outbreaks in rural areas. Rural workforce factors and access to pathology services impact rural outbreak management, and thus involving local services and considering the local context are vital. The use of chemoprophylaxis continues to be recommended by the SoNG, and in this case was considered to be an important adjunct to other management strategies.