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Leishmaniasis is an infectious disease caused by a protozoan of the genus Leishmania. Leishmaniasis constitutes a significant health problem for various regions of Latin America. The social isolation imposed because of the COVID-19 pandemic favored a decrease in the incidence of this entity. However, regular social activities were gradually resumed, imposing the corresponding monitoring and control measures., La leishmaniasis resulta una enfermedad infectocontagiosa causada por un protozoo del género Leishmania. Esta constituye un problema de salud importante para diversas regiones de América Latina. El aislamiento social impuesta a raíz de la pandemia de COVID-19 favoreció que disminuyera la incidencia de esta entidad, pero las actividades sociales de la normalidad se retomaron paulatinamente, imponiéndose que se retomen las medidas de seguimiento y control correspondientes.

Background: Public health surveillance data do not always capture all cases, due in part to test availability and health care seeking behaviour. Our study aimed to estimate under-ascertainment multipliers for each step in the reporting chain for COVID-19 in Toronto, Canada. Design and methods: We applied stochastic modeling to estimate these proportions for the period from March 2020 (the beginning of the pandemic) through to May 23, 2020, and for three distinct windows with different laboratory testing criteria within this period. Results: For each laboratory-confirmed symptomatic case reported to Toronto Public Health during the entire period, the estimated number of COVID-19 infections in the community was 18 (5th and 95th percentile: 12, 29). The factor most associated with under-reporting was the proportion of those who sought care that received a test. Conclusions: Public health officials should use improved estimates to better understand the burden of COVID-19 and other similar infections.

Background: Despite agreement among policymakers, funders, consumers and researchers about the value of public reporting of health information, limited attention has been paid to how it can be used to understand the performance of rural hospitals. Objective: To determine whether publicly available information can be used to measure health service performance in a rural hospital. Method: The study used performance data routinely reported for public consumption in Australia. Data across four domains, multiple measures and time periods were collected to examine access and equity; efficiency and sustainability; quality, safety and patient orientation; and employee engagement. Performance of the rural hospital was examined using a visualisation tool. Results: Visualisation of multiple measures of performance over time was achievable but required a high degree of health information management skills. Conclusion and implications: Publicly reported data can be used to represent performance for a rural hospital. Timeliness, level of detail available and peer groupings of data limits optimal utility. Consumers, clinicians and health service managers wanting to understand the performance of rural hospitals will need to use significant health information management skills to gain a picture of performance. Further research in the applied use of publicly available performance data and relevant dashboards for rural hospitals is suggested.

Funding: Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) - grant numbers 115293/2019-1 and 162996/2019-5; Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG) - grant number APQ-00208-20; and Liver Center at Universidade Federal de Minas Gerais., BACKGROUND: Since February 2020, data on the clinical features of patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and their clinical evolution have been gathered and intensively discussed, especially in countries with dramatic dissemination of this disease. OBJECTIVE: To assess the clinical features of Brazilian patients with SARS-CoV-2 and analyze its local epidemiological features. DESIGN AND SETTING: Observational retrospective study conducted using data from an official electronic platform for recording confirmed SARS-CoV-2 cases. METHODS: We extracted data from patients based in the state of Pernambuco who were registered on the platform of the Center for Strategic Health Surveillance Information, between February 26 and May 25, 2020. Clinical signs/symptoms, case evolution over time, distribution of confirmed, recovered and fatal cases and relationship between age group and gender were assessed. RESULTS: We included 28,854 patients who were positive for SARS-CoV-2 (56.13% females), of median age 44.18 years. SARS-CoV-2 infection was most frequent among adults aged 30-39 years. Among cases that progressed to death, the most frequent age range was 70-79 years. Overall, the mortality rate in the cohort was 8.06%; recovery rate, 30.7%; and hospital admission rate (up to the end of follow-up), 17.3%. The average length of time between symptom onset and death was 10.3 days. The most commonly reported symptoms were coughing (42.39%), fever (38.03%) and dyspnea/respiratory distress with oxygen saturation < 95% (30.98%). CONCLUSION: Coughing, fever and dyspnea/respiratory distress with oxygen saturation < 95% were the commonest symptoms. The case-fatality rate was 8.06% and the hospitalization rate, 17.3%.

Background: Decision making in hospitals, and especially in their own healthcare services, is hardly referenced in the literature. During the pandemic period, healthcare services have put in place contingency plans to minimize the consequences of the coronavirus on professionals and patients. However, the deployment of contingency plans and results are hardly shared, depriving other services of references to refute, compare or emulate the aforementioned plans. The objective of this work was the description of the implementation and evaluation of Contingency Plans in the Covid-19 pandemic in a unit of inflammatory bowel disease of a Digestive Service in the Sanitary Area of Pontevedra and O Salnés. Methods: A team of managers and professionals adapted the 10 measures recommended by Deloitte to face a pandemic to the healthcare environment. The measures were then formulated as a checklist. From the Plan-Do- Check-Act improvement cycle, they were grouped into categories: risk management, organizational management and decision-making. Finally, an external team carried out a qualitative evaluation of the implementation of the contingency plan carried out. Results: The Intestinal Inflammatory Disease Unit of the Digestive Service has obtained an assessment of compliance with the 10 recommended measures to confidently face a pandemic. Conclusions: Sharing the deployment of the contingency plan and its results is useful to identify good practices. This article shows a method to evaluate decision-making in pandemic situations. The outcomes faces the The Intestinal Inflammatory Disease Unit in an excelent position. Key words: COVID-19, Pandemic, Coronavirus Infections Gastroenterology, Inflammatory bowel disease, Contingency Plans, Revisión de Utilización de Recursos Learning Health System, Public Reporting of Healthcare Data., Fundamentos: La toma de decisiones en los hospitales y en sus propios servicios asistenciales apenas está referenciada en la literatura. Durante el período de pandemia por Covid-19, los servicios asistenciales han puesto en marcha planes de contingencia para minimizar las consecuencias del coronavirus en los profesionales y pacientes. Sin embargo, apenas se comparte el despliegue de esos planes de contingencia, ni sus resultados, privando de referencias para refutar, comparar o emular los citados planes a otros servicios asistenciales u hospitales. El objetivo del trabajo fue la descripción de la puesta en marcha de dichos planes ante la pandemia de Covid-19 en la Unidad de Enfermedad Inflamatoria Intestinal de un Servicio de Digestivo en el Área Sanitaria de Pontevedra e O Salnés (Galicia). Métodos: Un equipo de directivos y profesionales adaptaron al entorno sanitario las 10 medidas recomendadas por Deloitte para afrontar una pandemia. A continuación, se formularon las medidas como listado de comprobación. A partir del ciclo de mejora Plan-Do-Check-Act, se agruparon las 10 medidas en las siguientes categorías: gestión del riesgo, gestión organizacional y toma de decisiones. Por último, un equipo externo realizó una evaluación cualitativa de la puesta en marcha del plan de contingencia realizado. Resultados: La Unidad de Enfermedad Inflamatoria Intestinal del Servicio de Digestivo realizó un plan de contingencia que presenta un cumplimiento de las 10 medidas recomendadas para hacer frente a la pandemia de Covid-19 con garantías. Conclusiones: Compartir el despliegue del plan de contingencia y sus resultados es útil para identificar buenas prácticas. Este trabajo ofrece un método para evaluar las tomas de decisiones en los plantes de contingencia en situaciones de pandemia. Los resultados sitúan a la Unidad de Enfermedad Inflamatoria Intestinal en el rango de la excelencia.