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Zoonotic Tuberculosis in Humans: Control, Surveillance, and the One Health Approach. 人类人畜共患结核病:控制、监测和同一个健康方法。
IF 5.5 2区 医学 Q1 Medicine Pub Date : 2019-01-31 DOI: 10.1093/epirev/mxz002
Rodrigo Macedo Couto, Otavio T Ranzani, Eliseu Alves Waldman

Zoonotic tuberculosis is a reemerging infectious disease in high-income countries and a neglected one in low- and middle-income countries. Despite major advances in its control as a result of milk pasteurization, its global burden is unknown, especially due the lack of surveillance data. Additionally, very little is known about control strategies. The purpose of this review was to contextualize the current knowledge about the epidemiology of zoonotic tuberculosis and to describe the available evidence regarding surveillance and control strategies in high-, middle-, and low-income countries. We conducted this review enriched by a One Health perspective, encompassing its inherent multifaceted characteristics. We found that the burden of zoonotic tuberculosis is likely to be underreported worldwide, with higher incidence in low-income countries, where the surveillance systems are even more fragile. Together with the lack of specific political commitment, surveillance data is affected by lack of a case definition and limitations of diagnostic methods. Control measures were dependent on risk factors and varied greatly between countries. This review supports the claim that a One Health approach is the most valuable concept to build capable surveillance systems, resulting in effective control measures. The disease characteristics and suggestions to implement surveillance and control programs are discussed.

人畜共患结核病在高收入国家是一种重新出现的传染病,在低收入和中等收入国家是一种被忽视的传染病。尽管由于牛奶巴氏消毒在控制其方面取得了重大进展,但其全球负担尚不清楚,特别是由于缺乏监测数据。此外,我们对控制策略知之甚少。本综述的目的是将目前关于人畜共患结核病流行病学的知识置于背景下,并描述有关高、中、低收入国家监测和控制策略的现有证据。我们进行了这一综述,丰富了一个健康的观点,包括其固有的多方面的特点。我们发现,人畜共患结核病的负担可能在世界范围内被低估,在监测系统更加脆弱的低收入国家发病率更高。由于缺乏病例定义和诊断方法的局限性,加上缺乏具体的政治承诺,监测数据受到影响。控制措施取决于风险因素,各国之间差异很大。这篇综述支持这样一种说法,即“同一个健康”方针是建立有能力的监测系统、产生有效控制措施的最有价值的概念。讨论了该病的特点和实施监测控制方案的建议。
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引用次数: 12
Emerging Evidence for Infectious Causes of Cancer in the United States. 美国癌症感染原因的新证据。
IF 5.5 2区 医学 Q1 Medicine Pub Date : 2019-01-31 DOI: 10.1093/epirev/mxz003
Heidi E Brown, Leslie K Dennis, Priscilla Lauro, Purva Jain, Erin Pelley, Eyal Oren

Worldwide, infectious agents currently contribute to an estimated 15% of new cancer cases. Most of these (92%, or 2 million new cancer cases) are attributable to 4 infectious agents: Helicobacter pylori, human papillomavirus, and hepatitis B and C viruses. A better understanding of how infectious agents relate to the US cancer burden may assist new diagnostic and treatment efforts. We review US-specific crude mortality rates from infection-associated cancers and describe temporal and spatial trends since 1999. We review the US-specific evidence for infection-cancer associations by reporting available estimates for attributable fractions for the infection-cancer associations. Death due to cancers with established infectious associations varies geographically, but estimates for the US attributable fraction are limited to a few observational studies. To describe the burden of infection-associated cancer in the United States, additional observational studies are necessary to estimate the prevalence of infection nationally and within subpopulations. As infectious associations emerge to explain cancer etiologies, new opportunities and challenges to reducing the burden arise. Improved estimates for the United States would help target interventions to higher-risk subpopulations.

在世界范围内,目前估计有15%的新癌症病例是由传染性病原体造成的。其中大多数(92%,即200万新发癌症病例)可归因于4种感染因子:幽门螺杆菌、人乳头瘤病毒、乙型和丙型肝炎病毒。更好地了解感染因子与美国癌症负担的关系可能有助于新的诊断和治疗工作。我们回顾了美国特定的感染相关癌症的粗死亡率,并描述了自1999年以来的时间和空间趋势。我们通过报告感染-癌症关联的可归因分数的现有估计,回顾了美国特定的感染-癌症关联的证据。与已确定的感染相关的癌症导致的死亡因地理位置而异,但对美国可归因比例的估计仅限于少数观察性研究。为了描述美国感染相关癌症的负担,需要额外的观察性研究来估计全国和亚人群内感染的患病率。随着解释癌症病因的传染性关联的出现,减轻负担的新机会和挑战出现了。改善对美国的估计将有助于针对高风险亚人群进行干预。
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引用次数: 6
Hepatitis C Virus Infection in Indigenous Populations in the United States and Canada. 土著居民丙型肝炎病毒感染:美国和加拿大的系统综述。
IF 5.5 2区 医学 Q1 Medicine Pub Date : 2019-01-31 DOI: 10.1093/epirev/mxz015
Veronica Bruce, Jonathan Eldredge, Yuridia Leyva, Jorge Mera, Kevin English, Kimberly Page

American Indian/Alaska Native (AI/AN) and Canadian Indigenous people are disproportionally affected by hepatitis C virus (HCV) infection yet are frequently underrepresented in epidemiologic studies and surveys often used to inform public health efforts. We performed a systematic review of published and unpublished literature and summarized our findings on HCV prevalence in these Indigenous populations. We found a disparity of epidemiologic literature of HCV prevalence among AI/AN in the United States and Indigenous people in Canada. The limited data available, which date from 1995, demonstrate a wide range of HCV prevalence in AI/AN (1.49%-67.60%) and Indigenous populations (2.28%-90.24%). The highest HCV prevalence in both countries was reported in studies that either included or specifically targeted people who inject drugs. Lower prevalence was reported in studies of general Indigenous populations, although in Canada, the lowest prevalence was up to 3-fold higher in Aboriginal people compared with general population estimates. The disparity of available data on HCV prevalence and need for consistent and enhanced HCV surveillance and reporting among Indigenous people are highlighted. HCV affects Indigenous peoples to a greater degree than the general population; thus we recommend tribal and community leaders be engaged in enhanced surveillance efforts and that funds benefitting all Indigenous persons be expanded to help prevent and cover health care expenses to help stop this epidemic.

美国印第安人/阿拉斯加原住民(AI/AN)和加拿大原住民受到丙型肝炎病毒(HCV)感染的影响不成比例,但在流行病学研究和调查中的代表性往往不足,这些研究和调查通常用于为公共卫生工作提供信息。为了解决这个问题,我们对已发表和未发表的文献进行了系统综述,并总结了我们对这些土著人群中丙型肝炎流行率的研究结果。我们发现,美国AI/AN人群和加拿大土著人群中丙型肝炎流行率的流行病学文献存在差异。从1995年开始的有限数据表明,在AI/AN(1.49%至67.60%)和土著人群(2.28%至90.24%)中,HCV的患病率范围很广。由于注射药物的使用会导致更高的感染风险,包括或专门针对注射药物的人的研究报告称,这两个国家的HCV患病率最高。在对一般土著人口的研究中,报告的患病率较低,尽管在加拿大,本次审查中发现的最低患病率比一般人口估计高出三倍。这篇综述强调了有关丙型肝炎流行率的现有数据的差异,并强调了在土著人中持续和加强丙型肝炎监测和报告的必要性。此外,研究结果支持了以前的报告,即这种疾病对土著人民的影响比普通人群更大。建议部落和社区领导人加强监测工作,并扩大惠及所有土著人的资金,以帮助预防和支付医疗费用,帮助阻止这一流行病。
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引用次数: 7
Incubation Period of Shiga Toxin–Producing Escherichia coli 产志贺毒素大肠杆菌的培养期
IF 5.5 2区 医学 Q1 Medicine Pub Date : 2019-01-31 DOI: 10.1093/epirev/mxz001
A. Awofisayo-Okuyelu, J. Brainard, I. Hall, N. McCarthy
Abstract Shiga toxin–producing Escherichia coli are pathogenic bacteria found in the gastrointestinal tract of humans. Severe infections could lead to life-threatening complications, especially in young children and the elderly. Understanding the distribution of the incubation period, which is currently inconsistent and ambiguous, can help in controlling the burden of disease. We conducted a systematic review of outbreak investigation reports, extracted individual incubation data and summary estimates, tested for heterogeneity, classified studies into subgroups with limited heterogeneity, and undertook a meta-analysis to identify factors that may contribute to the distribution of the pathogen’s incubation period. Twenty-eight studies were identified for inclusion in the review (1 of which included information on 2 outbreaks), and the resulting I2 value was 77%, indicating high heterogeneity. Studies were classified into 5 subgroups, with the mean incubation period ranging from 3.5 to 8.1 days. The length of the incubation period increased with patient age and decreased by 7.2 hours with every 10% increase in attack rate.
摘要志贺毒素产生的大肠杆菌是在人类胃肠道中发现的致病菌。严重感染可能导致危及生命的并发症,尤其是在幼儿和老年人中。了解目前不一致和不明确的潜伏期分布,有助于控制疾病负担。我们对疫情调查报告进行了系统审查,提取了个体潜伏期数据和总结估计,测试了异质性,将研究分为异质性有限的亚组,并进行了荟萃分析,以确定可能导致病原体潜伏期分布的因素。28项研究被确定纳入综述(其中1项包括2次疫情的信息),结果I2值为77%,表明高度异质性。研究分为5个亚组,平均潜伏期为3.5至8.1天。潜伏期随着患者年龄的增长而增加,发病率每增加10%,潜伏期就减少7.2小时。
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引用次数: 4
Advances in Data Driven Responses to Preventing Spread of Antibiotic Resistance across Healthcare Settings. 预防抗生素耐药性在医疗保健环境中传播的数据驱动反应进展。
IF 5.5 2区 医学 Q1 Medicine Pub Date : 2019-01-31 DOI: 10.1093/epirev/mxz010
S. Fridkin
Among the most urgent and serious antibiotic resistant threats to public health, seven are bacteria predominately acquired during health care delivery. There is an emerging field of healthcare epidemiology focused on preventing healthcare-associated infections with antibiotic resistant bacteria incorporating data from patient transfers or patient movements both within and between facilities; this analytic field is being used to help public health professionals identify best opportunities for prevention. Different analytic approaches drawing on uses of big data is being explored to help target the use of limited public health resources, leverage expertise, and enact effective policy to maximize an impact on a population-level health. This paper will summarize recent advances in data driven responses to preventing spread of antibiotic resistance across healthcare settings: leveraging big data for machine learning, integration or advances in tracking patient movement, and highlighting the value of coordinating response across institutions within a region.
在对公共健康最紧迫和最严重的抗生素耐药性威胁中,有七种是主要在医疗保健过程中获得的细菌。医疗流行病学的一个新兴领域专注于预防与医疗保健相关的抗生素耐药性细菌感染,该领域结合了患者在设施内和设施之间转移或患者流动的数据;这一分析领域正被用来帮助公共卫生专业人员确定预防的最佳机会。正在探索利用大数据的不同分析方法,以帮助确定有限公共卫生资源的使用目标,利用专业知识,并制定有效的政策,最大限度地提高对人口健康的影响。本文将总结数据驱动的应对措施的最新进展,以防止抗生素耐药性在医疗环境中的传播:利用大数据进行机器学习、整合或跟踪患者运动的进展,并强调协调一个地区内各机构应对措施的价值。
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引用次数: 2
The Many Faces of Emerging and Re-emerging Infectious Disease. 新出现和重新出现的传染病的多方面。
IF 5.5 2区 医学 Q1 Medicine Pub Date : 2019-01-31 DOI: 10.1093/epirev/mxz011
J. Lessler, W. Orenstein
The emergence of disease threats can take many forms, from the adaptation of a traditionally zoonotic pathogen for efficient spread in humans, to the development of antibiotic resistance in well-known pathogens, to the creation of new niches for established disease through social and societal changes. In this commentary, the authors explore these various facets of disease emergence through the lens of the papers included in this issue of Epidemiologic Reviews. The authors explore multiple aspects of emergence, and the ways in which emergent pathogens can be controlled with the limited tools available. In doing so they put the papers in this issue in the context of the broader research agenda around understanding and combatting emergent pathogens.
疾病威胁的出现可以采取多种形式,从传统的人畜共患病原体适应在人类中有效传播,到众所周知的病原体产生抗生素耐药性,以及通过社会和社会变化为现有疾病创造新的生态位。在这篇评论中,作者通过本期《流行病学评论》中收录的论文,探讨了疾病出现的这些不同方面。作者探索了涌现的多个方面,以及利用有限的可用工具控制涌现病原体的方法。在这样做的过程中,他们把发表在这个问题上的论文放在了更广泛的研究议程的背景下,围绕着理解和对抗突发病原体。
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引用次数: 5
Postexposure Effects of Vaccines on Infectious Diseases. 疫苗对传染病的暴露后影响。
IF 5.5 2区 医学 Q1 Medicine Pub Date : 2019-01-31 DOI: 10.1093/epirev/mxz014
Tara Gallagher, Marc Lipsitch

We searched the PubMed database for clinical trials and observational human studies about postexposure vaccination effects, targeting infections with approved vaccines and vaccines licensed outside the United States against dengue, hepatitis E, malaria, and tick-borne encephalitis. Studies of animal models, serologic testing, and pipeline vaccines were excluded. Eligible studies were evaluated by definition of exposure; attempts to distinguish pre- and postexposure effects were rated on a scale of 1 to 4. We screened 4,518 articles and ultimately identified for this review 14 clinical trials and 31 observational studies spanning 7 of the 28 vaccine-preventable diseases. For secondary attack rate, the following medians were found for postexposure vaccination effectiveness: hepatitis A, 85% (interquartile range (IQR), 28; n = 5 sources); hepatitis B, 85% (IQR, 22; n = 5 sources); measles, 83% (IQR, 21; n = 8 sources); varicella, 67% (IQR: 48; n = 9 sources); smallpox, 45% (IQR, 39; n = 4 sources); and mumps, 38% (IQR, 7; n = 2 sources). For case fatality proportions resulting from rabies and smallpox, the median vaccine postexposure efficacies were 100% (IQR, 0; n = 6 sources) and 63% (IQR, 50; n = 8 sources), respectively. Many available vaccines can modify or preclude disease if administered after exposure. This postexposure effectiveness could be important to consider during vaccine trials and while developing new vaccines.

我们在PubMed数据库中搜索了关于暴露后疫苗接种效果的临床试验和观察性人体研究,针对的是使用已批准的疫苗和美国境外许可的登革热、戊型肝炎、疟疾和蜱传脑炎疫苗的感染。排除了动物模型、血清学测试和管道疫苗的研究。符合条件的研究通过暴露定义进行评估;区分暴露前和暴露后影响的尝试按1-4分。我们筛选了4518篇文章,最终确定了14项临床试验和31项观察性研究,涵盖28种疫苗可预防疾病中的7种。对于二次发病率,暴露后疫苗接种有效性的中位数如下:甲型肝炎,85%(四分位数间距(IQR),28;n=5个来源);乙型肝炎,85%(IQR,22;n=5来源);麻疹,83%(IQR,21;n=8个来源);水痘,67%(IQR:48;n=9个来源);天花,45%(IQR,39;n=4个来源);腮腺炎,38%(IQR,7;n=2来源)。对于狂犬病和天花引起的病死率,疫苗暴露后的中位有效性分别为100%(IQR,0;n=6个来源)和63%(IQR;50;n=8个来源)。许多可用的疫苗如果在暴露后接种,可以改变或预防疾病。这种暴露后的有效性在疫苗试验和开发新疫苗时可能很重要。
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引用次数: 0
RE: "PREVALENCE OF POSTTRAUMATIC STRESS DISORDER IN PRISONERS". 回复:“囚犯中创伤后应激障碍的患病率”。
IF 5.5 2区 医学 Q1 Medicine Pub Date : 2018-06-01 DOI: 10.1093/epirev/mxy007
In the article “Prevalence of Posttraumatic Stress Disorder in Prisoners” by Baranyi et al. (1), there was an error in the version of the corrected proof that published online ahead of print. In the tenth sentence of the abstract, the number of smaller studies was listed as “n< 100.” The correct number is n≤ 200. This has been updated in the print and online versions of the article. The authors regret this error. REFERENCE
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引用次数: 81
Active Case Finding for Communicable Diseases in Prison Settings: Increasing Testing Coverage and Uptake Among the Prison Population in the European Union/European Economic Area. 在监狱环境中积极寻找传染病病例:增加欧洲联盟/欧洲经济区监狱人口的检测覆盖率和接受度。
IF 5.5 2区 医学 Q1 Medicine Pub Date : 2018-06-01 DOI: 10.1093/epirev/mxy001
Lara Tavoschi, Hilde Vroling, Giordano Madeddu, Sergio Babudieri, Roberto Monarca, Marije Vonk Noordegraaf-Schouten, Netta Beer, Joana Gomes Dias, Éamonn O'Moore, Dagmar Hedrich, Anouk Oordt-Speets

Prison populations are disproportionally affected by communicable diseases when compared with the general community because of a complex mix of socioeconomic determinants and environmental factors. Tailored and adequate health care provision in prisons has the potential to reach vulnerable and underserved groups and address their complex needs. We investigated the available evidence on modalities and effectiveness of active case-finding interventions in prisons by searching PubMed, Embase, and the Cochrane Library for records on prison and active case finding with no language limit. Conference abstracts and unpublished research reports also were retrieved. We analyzed the findings by testing modality, outcomes, and study quality. The included 90 records-63 peer-reviewed, 26 from gray literature, and 1 systematic review-reported variously on viral hepatitis, human immunodeficiency virus, sexually transmitted infections, and tuberculosis. No records were retrieved for other communicable diseases. Provider-initiated opt-in testing was the most frequently investigated modality. Testing at entry and provider-initiated testing were reported to result in comparatively higher uptake ranges. However, no comparative studies were identified that reported statistically significant differences between testing modalities. Positivity rates among tested inmates ranged broadly but were generally high for all diseases. The evidence on active case finding in correctional facilities is limited, heterogeneous, and of low quality, making it challenging to draw conclusions on the effect of different testing modalities. Scale-up of provider-initiated testing in European correctional facilities could substantially reduce the undiagnosed fraction and, hence, prevent additional disease transmission in both prison settings and the community at large.

由于社会经济决定因素和环境因素的复杂组合,与一般社区相比,监狱人口受到传染病的影响不成比例。在监狱提供有针对性和充分的保健服务,有可能惠及弱势群体和服务不足群体,并解决他们的复杂需求。我们通过检索PubMed、Embase和Cochrane图书馆关于监狱和主动病例发现的记录(没有语言限制),调查了有关监狱主动病例发现干预方式和有效性的现有证据。还检索了会议摘要和未发表的研究报告。我们通过测试方式、结果和研究质量来分析研究结果。其中包括90条记录——63条同行评议,26条灰色文献,1条系统综述——报道了病毒性肝炎、人类免疫缺陷病毒、性传播感染和结核病。没有检索到其他传染病的记录。提供者发起的选择加入测试是最常被调查的模式。据报道,在入门测试和提供者发起的测试导致相对较高的吸收范围。然而,没有比较研究被确定报告统计显著差异的检测方式。接受检测的囚犯的阳性率差别很大,但所有疾病的阳性率总体上都很高。在教养设施中主动发现病例的证据是有限的、异质性的和低质量的,这使得对不同检测方式的效果得出结论具有挑战性。在欧洲惩教设施中扩大由提供者发起的检测可以大大减少未确诊的部分,从而在监狱环境和整个社区中预防更多的疾病传播。
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引用次数: 34
Health Outcomes for Clients of Needle and Syringe Programs in Prisons. 监狱针头和注射器项目客户的健康结果。
IF 5.5 2区 医学 Q1 Medicine Pub Date : 2018-06-01 DOI: 10.1093/epirev/mxx019
Jeffrey V Lazarus, Kelly Safreed-Harmon, Kristina L Hetherington, Daniel J Bromberg, Denise Ocampo, Niels Graf, Anna Dichtl, Heino Stöver, Hans Wolff

High levels of drug dependence have been observed in the prison population globally, and the sharing of injecting drug equipment in prisons has contributed to higher prevalence of bloodborne diseases in prisoners than in the general population. Few prison needle and syringe programs (PNSPs) exist. We conducted a systematic review to assess evidence regarding health outcomes of PNSPs. We searched peer-reviewed databases for data relating to needle and syringe programs in prisons. The search methodology was conducted in accordance with accepted guidelines. Five studies met review inclusion criteria, and all presented evidence associating PNSPs with one or more health benefits, but the strength of the evidence was low. The outcomes for which the studies collectively demonstrated the strongest evidence were prevention of human immunodeficiency virus and viral hepatitis. Few negative consequences from PNSPs were observed, consistent with previous evidence assessments. More research is needed on PNSP effectiveness, and innovative study designs are needed to overcome methodological limitations of previous research. Until stronger evidence becomes available, policymakers are urged to recognize that not implementing PNSPs has the potential to cause considerable harm, in light of what is currently known about the risks and benefits of needle and syringe programs and PNSPs and about the high prevalence of human immunodeficiency virus and viral hepatitis in prisons.

在全球监狱人口中观察到高度的药物依赖,监狱内共用注射毒品设备导致囚犯中血液传播疾病的流行率高于一般人口。很少有监狱针头和注射器项目存在。我们进行了一项系统综述,以评估有关pnsp健康结果的证据。我们在同行评议的数据库中搜索有关监狱中针头和注射器项目的数据。搜索方法是按照公认的准则进行的。5项研究符合综述纳入标准,所有研究都提出了PNSPs与一种或多种健康益处相关的证据,但证据的强度较低。这些研究共同证明了最有力证据的结果是预防人类免疫缺陷病毒和病毒性肝炎。没有观察到PNSPs的负面影响,这与之前的证据评估一致。需要对PNSP的有效性进行更多的研究,并需要创新的研究设计来克服以往研究的方法局限性。在获得更有力的证据之前,我们敦促政策制定者认识到,鉴于目前已知的针头和注射器项目和PNSPs的风险和益处,以及监狱中人类免疫缺陷病毒和病毒性肝炎的高流行率,不实施PNSPs可能会造成相当大的伤害。
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引用次数: 29
期刊
Epidemiologic Reviews
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