Search

Groundwater level (GWL) simulations allow the generation of reconstructions for exploring the past temporal variability of groundwater resources or provide the means for generating projections under climate change on decadal scales. In this context, analyzing GWLs affected by low-frequency variations is crucial. In this study, we assess the capabilities of three deep learning (DL) models (long short-term memory (LSTM), gated recurrent unit (GRU), and bidirectional LSTM (BiLSTM)) in simulating three types of GWLs affected by varying low-frequency behavior: inertial (dominated by low-frequency), annual (dominated by annual cyclicity) and mixed (in which both annual and low-frequency variations have high amplitude). We also tested if maximal overlap discrete wavelet transform pre-processing (MODWT) of input variables helps to better identify the frequency content most relevant for the models (MODWT-DL models). Only external variables (i.e., precipitation, air temperature as raw data, and effective precipitation (EP)) were used as input. Results indicate that for inertial-type GWLs, MODWT-DL models with raw data were notably more accurate than standalone models. However, DL models performed well for annual-type GWLs, while using EP as input, with MODWT-DL models exhibiting only minor improvements. Using raw data as input improved MODWT-DL models compared to standalone models; nevertheless, all models using EP performed better for annual-type GWLs. For mixed-type GWLs, while using EP as input, MODWT-DL models performed well, with substantial improvements over standalone models. Using raw data as input, improvement of MODWT-DL models is marginal compared to that of standalone models; nevertheless, they perform better than standalone models with EP. The Shapley Additive exPlanations (SHAP) approach used to interpret models highlighted that they preferentially learned from low-frequency in precipitation data to achieve the best simulations for inertial and mixed GWLs. This study showed that MODWT-based input pre-processing is highly suitable to better simulate low-frequency varying GWLs.

SUMMARY In general, the inverse problem of electrical resistivity tomography (ERT) is treated using a deterministic algorithm to find a model of subsurface resistivity that can numerically match the apparent resistivity data acquired at the ground surface and has a smooth distribution that has been introduced as prior information. In this paper, we propose a new deep learning algorithm for processing the 3-D reconstruction of ERT. This approach relies on the approximation of the inverse operator considered as a nonlinear function linking the section of apparent resistivity as input and the underground distribution of electrical resistivity as output. This approximation is performed with a large amount of known data to obtain an accurate generalization of the inverse operator by identifying during the learning process a set of parameters assigned to the neural networks. To train the network, the subsurface resistivity models are theoretically generated by a geostatistical anisotropic Gaussian generator, and their corresponding apparent resistivity by solving numerically 3-D Poisson's equation. These data are formed in a way to have the same size and trained on the convolutional neural networks with SegNet architecture containing a three-level encoder and decoder network ending with a regression layer. The encoders including the convolutional, max-pooling and nonlinear activation operations are sequentially performed to extract the main features of input data in lower resolution maps. On the other side, the decoders are dedicated to upsampling operations in concatenating with feature maps transferred from encoders to compensate the loss of resolution. The tool has been successfully validated on different synthetic cases and with particular attention to how data quality in terms of resolution and noise affects the effectiveness of the approach.

Highlights • P323L (94.7%) is the most common mutation, followed by D614G (92.6%) Spike protein mutation. • A unique mutation, I280V, was first reported in Oman and was associated with a rare lineage, B.1.113 (10.6%). • The study revealed a good agreement between genetic and epidemiological data. • Oman’s robust surveillance system was very efficient to guide the outbreak investigation processes in the country, • The study illustrates the future importance of molecular epidemiology to lead the national response to outbreaks and pandemics., Background Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been proven to be lethal to human health, which affects almost every corner of the world. The objectives of this study were to add context to the global data and international genomic consortiums, and to give insight into the efficiency of the contact tracing system in Oman. Methods We combined epidemiological data and whole-genome sequence data from 94 samples of SARS-CoV-2 in Oman to understand the origins, genetic variation, and transmissibility. The whole-genome size of sequence data was obtained through a customized SARS-COV-2 research panel. Amplifier methods ranged from 26 Kbp to 30 Kbp and were submitted to GISAID. Findings The study found that P323L (94.7%) is the most common mutation, followed by D614G (92.6%) Spike protein mutation. A unique mutation, I280V, was first reported in Oman and was associated with a rare lineage, B.1.113 (10.6%). In addition, the study revealed a good agreement between genetic and epidemiological data. Interpretation Oman’s robust surveillance system was very efficient in guiding the outbreak investigation processes in the country, the study illustrates the future importance of molecular epidemiology in leading the national response to outbreaks and pandemics.

Objetivo: Avaliar a acessibilidade de tecnologia assistiva sobre câncer de próstata e de mama por deficientes visuais de dois países lusófonos. Métodos: Estudo metodológico de avaliação de tecnologia assistiva em saúde. Dados coletados com instrumento validado, constituído por 17 itens distribuídos nos atributos objetivos, acesso, clareza, estruturação e apresentação, relevância e eficácia e interatividade. Na análise, aplicaram-se Teste Qui-quadrado de Pearson, Teste Exato de Fisher ou Razão de Verossimilhança de acordo com os pressupostos dos testes. Os aspectos éticos foram respeitados. Resultados: A amostra foi de 62 participantes. As variáveis que tiveram diferenças estatísticas significantes foram escolaridade (p=0,006), tipos de deficiência (p=0,010) e desenvolvimento da deficiência (p= 0,005). Todas os atributos e itens obtiveram boas avaliações com alguns tópicos que não houve diferença estatística em ambos os países. Conclusão: As tecnologias assistivas sobre câncer de mama e próstata foram bem avaliadas, independente do país, brasileiros e portugueses as consideraram adequadas.ABSTRACTObjective: To evaluate the accessibility of assistive technology about prostate and breast cancer by visually impaired persons in two Portuguese-speaking countries. Methods: Methodological study of an assess assistive health technology. Data were collected from a validated instrument, comprising of 17 items distributed in the attributes, objective, access, clarity, structure and presentation, relevance and effectiveness and interactivity. In the analysis, the Pearson’s Chi-squared test and the Fisher’s exact test or likelihood ratios were applied according to the assumptions of the tests. The ethical aspects involved in the research were respected. Results: The sample was of 62 participants. The variables that exhibited any statistical diferences ware: schooling (p = 0.006); types of disabilities (p = 0.010) and; disabilities development (p = 0.005). All attributes and items had good evaluations, with some topics that there was no statistical difference among the countries. Conclusion: Assistive technology about prostate and breast cancer were well evaluated, regardless of the country, were considered adequate by brazilians and portuguese.RESUMENObjetivo: Evaluar la accesibilidad de la tecnología de asistencia en el cáncer de próstata y mama por personas con daño visual de dos países de habla portuguesa. Métodos: Estudio metodológico para evaluar la tecnología asistencial sanitaria. Datos recolectados con un instrumento validado, compuesto por 17 ítems distribuidos en los atributos objetivos, acceso, claridad, estructuración y presentación, relevancia y efectividad e interactividad. En el análisis se aplicó la prueba de chi-cuadrado de Pearson, la prueba exacta de Fisher o razón de verosimilitud según los supuestos de las pruebas. Se respetaron los aspectos éticos. Resultados: La muestra estuvo formada por 62 participantes. Las variables que presentaron diferencias estadísticamente significativas fueron educación (p = 0,006), tipos de discapacidad (p = 0,010) y desarrollo de la discapacidad (p = 0,005). Todos los atributos e ítems obtuvieron buenas evaluaciones con algunos temas que no hubo diferencia estadística en ambos países. Conclusion: Las tecnologías de asistencia en cáncer de mama y próstata fueron bien evaluadas, independientemente del país, brasileños y portugueses las consideraron apropiadas.

Effective Tuberculosis (TB) control measures in Oman have reduced the annual incidence of tuberculosis cases by 92% between 1981 and 2016. However, the current incidence remains above the program control target oflt;1 TB case per 100,000 population. This has been partly attributed to a high influx of migrants from countries with high TB burdens. The present study aimed to elucidate

PulseNet International (PNI) is a global network of 88 countries who work together through their regional and national public health laboratories to track foodborne disease around the world. The vision of PNI is to implement globally standardized surveillance using whole genome sequencing (WGS) for real-time identification and subtyping of foodborne pathogens to strengthen preparedness and response and lower the burden of disease. Several countries in North America and Europe have experienced significant benefits in disease mitigation after implementing WGS. To broaden the routine use of WGS around the world, challenges and barriers must be overcome. We conducted this study to determine the challenges and barriers countries are encountering in their attempts to implement WGS and to identify how PNI can provide support to improve and become a better integrated system overall. A survey was designed with a set of qualitative questions to capture the status, challenges, barriers, and successes of countries in the implementation of WGS and was administered to laboratories in Africa, Asia-Pacific, Latin America and the Caribbean, and Middle East. One-third of respondents do not use WGS, and only 8% reported using WGS for routine, real-time surveillance. The main barriers for implementation of WGS were lack of funding, gaps in expertise, and training, especially for data analysis and interpretation. Features of an ideal system to facilitate implementation and global surveillance were identified as an all-in-one software that is free, accessible, standardized and validated. This survey highlights the minimal use of WGS for foodborne disease surveillance outside the United States, Canada, and Europe to date. Although funding remains a major barrier to WGS-based surveillance, critical gaps in expertise and availability of tools must be overcome. Opportunities to seek sustainable funding, provide training, and identify solutions for a globally standardized surveillance platform will accelerate implementation of WGS worldwide.

Since 2007, national public health laboratories in the WHO Eastern Mediterranean Region (EMR) have participated in a regional external quality assessment scheme in bacteriology to improve testing proficiency.To assess laboratory performance in bacteriology in the EMR between 2011 and 2019 using the regional external quality assessment scheme.We analysed the accuracy of participant-reported data in bacterial identification, Gram stain microscopy, and antimicrobial susceptibility testing. For each category, we assessed the performance over time, the performance on multiple organisms, and whether a laboratory repeatedly failed to attain satisfactory results.Between 2011 and 2019, 70% of laboratories achieved satisfactory performance for bacterial identification and antimicrobial susceptibility testing, and 85% performed satisfactory Gram stain microscopy. Testing did not improve on multiple organisms and results were consistently low for some pathogens and test categories. Twenty-nine percent of laboratories underperformed throughout the study period.The unchanged performance over time and underperformance of laboratories highlight the need for improvements in the regional external quality assessment scheme. Participating laboratories and WHO need to work more actively to strengthen the problem areas.التقييم الخارجي لجودة أداء المختبرات المتخصصة في علم الجراثيم في إقليم شرق المتوسط، 2011–2019.همايون أصغر، كارين نهابتيان، أماني غنيم، فرانك كونينجز، أمينة الجرداني.منذ عام 2007 ، شاركت مختبرات الصحة العامة الوطنية في إقليم شرق المتوسط في مخطط إقليمي للتقييم الخارجي للجودة في علم الجراثيم لتحسين كفاءة الاختبارات.هدفت هذه الدراسة الى تقييم أداء المختبرات في مجال علم الجراثيم في إقليم شرق المتوسط بين عامَي 2011 و 2019 ، باستخدام النظام الإقليمي للتقييم الخارجي للجودة.حللنا دقة البيانات التي أبلغ بها المشاركون فيما يخص تحديد الجراثيم، والفحص المجهري لصبغة جرام، واختبار الحساسية لمضادات الميكروبات. وبالنسبة إلى كل فئة، قيمنا الأداء مع مرور الزمن، والأداء على كائنات حية متعددة، وما إذا كان المختبر قد فشل مرارًا في تحقيق نتائج مُرضية.بين عامَي 2011 و 2019 ، حقق 70 ٪ من المختبرات أداءً مُرضيًا في التعرف على الجراثيم وتحديدها واختبار الحساسية لمضادات الميكروبات، ونفذ 85 ٪ منها الفحصَ المجهري لصبغة جرام تنفيذًا مُرضيًا. ولم يتحسن مستوى الاختبار على كائنات حية متعددة، وكانت النتائج منخفضة باستمرار فيما يخص بعض مسببات الأمراض وفئات الاختبارات. وكان أداء 29 ٪ من المختبرات دون المستوى خلال فترة الدراسة.إن عدم تغيُُّّر الأداء بمرور الوقت والأداء القاصر للمختبرات يبرزان الحاجة إلى إدخال تحسينات على الخطة الإقليمية للتقييم الخارجي للجودة. لذا، يتعيََّّن على المختبرات المشارِكة و المختبرات المشاركة ومنظمة الصحة العالمية بحاجة إلى العمل بشكل أكثر نشاطا لتقوية مناطق المشاكل.Évaluation externe de la qualité des performances des laboratoires en bactériologie dans la Région de la Méditerranée orientale, 2011-2019.Depuis 2007, les laboratoires de santé publique nationaux de la Région OMS de la Méditerranée orientale ont participé à un système régional d'évaluation externe de la qualité en bactériologie afin d'améliorer la bonne exécution des analyses.Évaluer les performances des laboratoires en bactériologie dans la Région de la Méditerranée orientale entre 2011 et 2019 à l'aide du système régional d'évaluation externe de la qualité.Nous avons analysé l'exactitude des données communiquées par les participants concernant l'identification bactérienne, la microscopie après coloration de Gram et les tests de sensibilité aux antimicrobiens. Pour chaque catégorie, nous avons évalué la performance au fil du temps, la performance sur plusieurs micro-organismes et avons vérifié si un laboratoire n'a pas obtenu des résultats satisfaisants à plusieurs reprises.Entre 2011 et 2019, 70 % des laboratoires ont obtenu des résultats satisfaisants pour l'identification bactérienne et les tests de sensibilité aux antimicrobiens, et 85 % ont effectué une microscopie après coloration de Gram satisfaisante. Les tests ne se sont pas améliorés sur plusieurs micro-organismes et les résultats étaient systématiquement faibles pour certains agents pathogènes et certaines catégories de tests. Vingt-neuf pour cent des laboratoires ont eu des résultats insuffisants tout au long de la période d'étude.Les performances inchangées au cours du temps et les résultats insuffisants des laboratoires soulignent la nécessité d'améliorer le système régional d'évaluation externe de la qualité. Les laboratoires participants et l'OMS doivent collaborer plus activement pour renforcer les domaines qui posent problème.

Imaging characterization of a heterogeneous alluvial aquifer at a decametric scale is presented. The characterization relies on responses to oscillatory pumping tests led in two different wells and at two different periods of oscillation (5 and 10 min). These specific oscillatory responses are extracted from the hydraulic pressure values, measured in 13 boreholes during the pumping tests, through a data processing procedure. Then, a deterministic inversion process, led with a two-dimensional hydraulic properties model, aims to reproduce this set of oscillatory responses, in a frequency domain, by optimizing the distribution of the property values in the model. Two inversion processes are led separately with each set of responses corresponding to the two periods of oscillation used, and one joint inversion is led with the set of all responses together. The inversion results image the heterogeneities in the distribution of the field properties. The results suggest that longer periods of oscillation (in this case 10 min) permit characterization of larger areas around the pumping wells. In contrast, shorter periods (in this case 5 min) propagate more readily in the conductive zones near the pump and provide less information for the less conductive areas. Therefore, it appeared that performing a joint inversion, combining the information carried by the responses to both periods, provided more information on the heterogeneous distribution of the field properties and resulted in better constrained property maps than the ones obtained from separate inversions.

The hydraulic characterization of a highly anthropized coastal aquifer in France is presented. The current industrial operations of the study site prevent the use of standard ‘active’ hydrogeological investigation methods (pumping, slug tests). However, the studied field is bordered on its north-western side by a channel directly connected to the sea, which allows for characterization of the hydraulic properties of the aquifer from its natural responses to the channel’s tidal signal. Piezometers (37) were monitored, from which oscillatory water-level responses (amplitude and phase-offset) to the tidal signal were extracted through linear regression and fast Fourier transform. A two-dimensional (2D) numerical model in the frequency domain was built to simulate the oscillations. The anthropic buried walls and barriers existing at the site are represented as 1D elements in a 2D model representing the properties of the aquifer. A deterministic inversion process optimizes the spatial distribution of aquifer properties and anthropic-structure properties in the model, in order to minimize the differences between the responses simulated with the model and those measured in the field. The results of the characterization on this complex study case (flows highly constrained by hydraulic barriers or buildings, and the impossibility to perform pumping tests) generate simulations able to reproduce the observed responses. The property and simulation maps generated make it possible to take into account the impact of the anthropic structures on the groundwater flows and to localize the parts of the hydraulic barriers where most exchanges between the channel and the aquifer occur.

RESUMEN Al considerar el auge que actualmente experimenta el turismo en desiertos y sus efectos, se presenta una propuesta de indicadores para conocer la valoración ambiental en 2019, expresada a través de un índice sintético denominado índice ambiental para el turismo sostenible (IATS) en el desierto de la Tatacoa. La metodología consiste en seleccionar un conjunto de indicadores que toman como referencia la propuesta de indicadores para el turismo sostenible de la Organización Mundial del Turismo, algunos criterios de selección de indicadores y las características específicas del territorio. El resultado es una propuesta que se compone de veintiocho indicadores, de los cuales ocho fueron calculados para la construcción del IATS, el cual permite valorar el estado ambiental del destino turístico como bueno. CLASIFICACIÓN JEL: L83, Q51, Q01 CONTENIDO: Introducción; 1. Turismo sostenible e indicadores en entornos desérticos; 2. Metodología; 3. Resultados; 4. Conclusiones; Bibliografía. ABSTRACT By considering the boom in which deserts tourism currently is and its effects, here we present an indicators proposal to know the environmental values of 2019, expressed through an index known as sustainable tourism index (STI) in the Tatacoa desert. The methodology employed consists in selecting a group of indicators that take as a reference the sustainable tourism index of the World Tourism Organization, some of the criteria for selecting indicators and the specific features of the territory. The result is a proposal composed by 28th indicators from which eight were calculated for the construction of the STI, which allows the assessment of the environmental status of the tourist site as good. JEL CLASSIFICATION: L83, Q51, Q01 CONTENT: Introduction; 1. Sustainable tourism and indicators in desert environments; 2. Methodology; 3. Results; 4. Conclusions; Bibliography. RESUMO Ao considerar o auge atual do turismo em desertos e seus efeitos, é apresentada uma proposta de indicadores para conhecer a avaliação ambiental em 2019, expressa pelo índice sintético denominado “índice ambiental para o turismo sustentável” (IATS) no deserto da Tatacoa. A metodologia consiste em selecionar um conjunto de indicadores que tomam como referência a proposta de indicadores para o turismo sustentável da Organização Mundial do Turismo, alguns critérios de seleção de indicadores e das características específicas do território. O resultado é uma proposta composta de 28 indicadores, dos quais 8 foram calculados para a construção do IATS, o que permite avaliar o estado ambiental do destino turístico como bom. JEL RATING: L83, Q51, Q01 CONTEÚDO: Introdução; 1. Turismo sustentável e indicadores em ambientes desérticos; 2. Metodologia; 3. Resultados; 4. Conclusões; Bibliografia.

HIV prevalence in Oman is low (5 %). HIV screening is performed at regional public health laboratories as part of a medical fitness programme for residency applicants. We conducted a retrospective evaluation of indeterminate serology results from 11 females of African origin, aged 21–43 years. Serology testing for HIV was conducted according to the national Oman algorithm: fourth-generation immunoassays (Bio-Rad GS HIV Combo Ag/Ab EIA, Siemens Enzygnost HIV Integral 4, Abbott ARCHITECT HIV Ag/Ab Combo, Roche Elecsys HIV Combi PT, bioMérieux VIDAS HIV DUO QUICK), confirmatory assays (Geenius HIV 1/2 Confirmatory, INNO-LIA HIV I/II Score) and PCR testing. Confirmatory testing to resolve indeterminate results was conducted with available samples for five patients using a combination of immunoassays, confirmatory assays, PCR/PERT and pro-viral DNA levels, at three external laboratories; Roche Diagnostics (Germany), Swiss National Laboratory (Switzerland) and Barts Health NHS Trust (UK). Nineteen serum, 15 plasma and two whole-blood samples were analysed. Nine of ten patients analysed on Bio-Rad and Siemens immunoassays were highly reactive; seven were highly reactive on the Abbott assay. Eight of nine patients tested with the Roche assay were negative. Three of four patients tested on the bioMérieux assay were negative. Five patients underwent confirmatory testing at external laboratories; all were negative by HIV-RNA or pro-viral DNA testing. In conclusion, HIV-RNA and pro-viral DNA testing is recommended for HIV screening of individuals from high-prevalence regions coming to low-prevalence regions.

SUMMARY We present an inversion algorithm to reconstruct the spatial distribution of the electrical conductivity from the analysis of magnetometric resistivity (MMR) data acquired at the ground surface. We first review the theoretical background of MMR connecting the generation of a magnetic field in response to the injection of a low-frequency current source and sink in the ground given a known distribution of electrical conductivity in the subsurface of the Earth. The forward modelling is based on sequentially solving the Poisson equation for the electrical potential distribution and the magnetostatic (Biot and Savart) equation for the magnetic field. Then, we introduce a Gauss–Newton inversion algorithm in which the logarithm of the electrical conductivity field is parametrized by using the chaos polynomial expansion in order to reduce the number of model parameters. To illustrate how the method works, the algorithm is successfully applied on four synthetic models with 3-D heterogeneous distribution of the electrical conductivity. Finally, we apply our algorithm to a field case study in which seepage was known to be occurring along an embankment of a headrace channel to a power station.

Following the detection of the first human case of avian influenza A subtype H9N2 in 1998, more than 40 cases were diagnosed worldwide. However, the spread of the virus has been more remarkable and significant in global poultry populations, causing notable economic losses despite its low pathogenicity. Many surveillance studies and activities conducted in several countries have shown the predominance of this virus subtype. We present the case of a 14-month-old female in Oman with an A(H9N2) virus infection. This is the first human case of A(H9N2) reported from Oman and the Gulf Cooperation Countries, and Oman is the second country outside of southern and eastern Asia to report a case (cases have also been detected in Egypt). The patient had bronchial asthma and presented with a high-grade temperature and symptoms of lower respiratory tract infection that necessitated admission to a high dependency unit in a tertiary care hospital. It is of urgency that a multisector One Health approach be established to combat the threat of avian influenza at the animal–human interface. In addition to enhancements of surveillance and control in poultry, there is a need to develop screening and preventive programs for high-risk occupations. Keywords: Avian influenza A, One Health, A(H9N2), Virus infection, Oman

Resumo Objetivo Avaliar o conhecimento de agentes comunitários de saúde sobre pessoas com deficiência visual antes e após capacitação acerca da temática. Métodos Estudo descritivo e longitudinal, desenvolvido em três Unidades Básicas de Saúde em um município do interior do Ceará, entre os meses de dezembro de 2019 e maio de 2020. Participaram 13 agentes comunitários de saúde que trabalhavam nas referidas instituições. Os dados obtidos pela aplicação do questionário foram analisados pelo programa Statistical Package for the Social Sciences e Epi-Info. Resultados Os agentes comunitários de saúde eram, em sua maioria, mulheres com idade entre 41 e 50 anos (46,15%) e casados (69,23%). Mais da metade dos participantes estudaram apenas até o ensino médio (61,54%), e o mesmo número participou de curso técnico para agentes comunitários de saúde. Em relação ao tempo de trabalho como agentes comunitários de saúde, poucos exerciam essa função há mais de 20 anos (38,46%) e aproximadamente metade trabalhava na zona rural (53,85%). Foi observada aprendizagem após realização da capacitação, pois ocorreu acréscimo de respostas adequadas sobre termos comuns à temática, uma vez que os participantes da pesquisa passaram a compreender os conceitos de pessoa com deficiência, inclusão e acessibilidade. Foi possível observar que nenhum participante tinha treinamento sobre a temática, sendo relevante a capacitação ofertada por esse estudo. Conclusão Após realização da capacitação, foi possível observar aumento no número de respostas corretas, sensibilização e conscientização sobre a importância da temática, já que possuíam pessoas com deficiência em suas áreas de atuação. Resumen Objetivo Evaluar los conocimientos de agentes comunitarios de salud sobre personas con discapacidad visual antes y después de una capacitación acerca del tema. Métodos Estudio descriptivo y longitudinal, llevado a cabo en tres Unidades Básicas de Salud en un municipio del interior del estado de Ceará, entre los meses de diciembre de 2019 y mayo de 2020. Participaron 13 agentes comunitarios de salud que trabajaban en las instituciones mencionadas. Los datos obtenidos tras la aplicación del cuestionario fueron analizados con el programa Statistical Package for the Social Sciences y Epi-Info. Resultados Los agentes comunitarios de salud eran mayormente mujeres entre 41 y 50 años de edad (46,15 %) y casados (69,23 %). Más de la mitad de los participantes estudiaron solamente hasta la educación secundaria (61,54 %) y el mismo número participó en un curso técnico para agentes comunitarios de salud. Con relación al tiempo de trabajo como agentes comunitarios de salud, pocos ejercían esa función hace más de 20 años (38,46 %) y aproximadamente la mitad trabajaba en la zona rural (53,85 %). Se observó el aprendizaje luego de la capacitación, pues hubo un incremento de respuestas correctas sobre términos comunes del tema, dado que los participantes del estudio comenzaron a comprender los conceptos sobre personas con discapacidad, inclusión y accesibilidad. Fue posible verificar que ningún participante había sido capacitado sobre el tema, por lo que la capacitación ofrecida por este estudio resultó relevante. Conclusión Luego de realizar la capacitación, fue posible observar un aumento en el número de respuestas correctas, sensibilización y concientización sobre la importancia de la temática, ya que en sus áreas de actuación había personas con discapacidad. Abstract Objective Evaluate community health agents’ knowledge about visually impaired people before and after training on the topic. Methods Descriptive and longitudinal study, developed in three primary health care services in a city in the interior of Ceará, between December 2019 and May 2020. The participants were 13 community health agents who worked at these institutions. The data obtained by applying the questionnaire were analyzed using Statistical Package for the Social Sciences and Epi-Info. Results most community health agents were women between 41 and 50 years of age (46.15%) and married (69.23%). More than half of the participants had only obtained a high school degree (61.54%), and the same number had taken a technical course for community health agents. As for their length of experience as community health agents, few had been working in this function for more than 20 years (38.46%) and about half worked in rural areas (53.85%). Learning was observed after the training, as the number of correct answers on common terms related to the topic increased, considering that the research participants began to understand the concepts of disabled people, inclusion and accessibility. It could be observed that none of the participants had been trained on the subject, showing the relevance of the training offered in this study. Conclusion After the training, an increase in the number of correct answers could be observed, as well as increased awareness about the importance of the topic, as there were people with disabilities in their activity areas.

Despite the apparent challenges inflicted by COVID-19 globally, the pandemic provided an opportunity to utilize and expand existing public health capacities for a more adaptive and resilient system during and after each wave of the disease. This paper provides a narrative review of Oman's public health response to the COVID-19 pandemic from January 2020 to July 2021, and the challenges it faced for a more rapid and efficient response. The review demonstrates that the three main pillars influencing the direction of the pandemic and aiding the control are Oman's unified governmental leadership, the move to expand the capacity of the health care system at all levels, and community partnership in all stages of the response including the COVID-19 vaccination campaign. The opportunities identified during response stages in the harmonization of the multisectoral response, streamlining communication channels, addressing vulnerable communities (dormitories, residences at border regions), and providing professional technical leadership provide an excellent precursor for expediting the transformation of Oman's health care system to one with a multisectoral holistic approach. Some of the major challenges faced are the shortage of the public health cadre, lack of a fully integrated digital platform for surveillance, and the scarcity of experts in risk communication and community engagement. A future health system where the center for diseases surveillance and control acts as a nucleus for multisectoral expertise and leadership, which includes community representatives, is crucial to attain optimum health. The destruction inflicted by this prolong COVID-19 pandemic at all levels of human life had valued the importance of investing on preventive and preparedness strategies.

Objective The primary objective of our study was to estimate the prevalence of hepatitis B infection among pregnant women in Oman. The secondary objectives were to test for other hepatitis B virus (HBV) serological markers and to determine hepatitis B viral load. Methods In this cross-sectional study conducted from June 2019 to December 2020, we randomly selected 2210 Omani women who attended antenatal clinics across the country. Pregnant women were tested for HBV surface antigen (HBsAg) using a commercial enzyme immunoassay; those who tested positive were further analyzed for other HBV serological markers: HBV core total antibody (anti-HBc), HBV core antibody IgM (immunoglobulin M) (anti-HBc IgM), hepatitis B virus e antigen (HBeAg) and hepatitis B virus e antibody (anti-HBe). They were also tested for hepatitis B viral load. Results This study included 2210 women with a mean age of 39 years. Ninety-five percent of the women who were invited to participate consented and were included in the study. Thirty-three (1.49%) tested positive for HBsAg. All participants tested negative for HBeAg and anti-HBc IgM and positive for anti-HBc and anti-HBe, and 30 (90.9%) women had their hepatitis B viral load measured. Three (10.0%) had undetectable viral loads, 23 (76.7%) had low viral loads of Conclusion Our study shows that the HBV prevalence in pregnant women is 1.49%, which is lower than what was reported earlier. Nevertheless, antenatal screening is still warranted, as there are vital interventions for the newborn and the mother.

Background: Non-pharmaceutical interventions (NPIs), particularly mobility restrictions, are mainstay measures for the COVID-19 pandemic worldwide. We evaluated the effects of Oman’s mobility restriction strategies to highlight their efficacy in controlling the pandemic. Methods: Accessible national data of daily admissions and deaths were collected from 1 April 2020 to 22 May 2021. Google Community Mobility Report (CMR) data were downloaded for the same period. Among six CMR categories, three were used and reduced to one index—the community mobility index (CMI). We used a generalised linear model with a negative binomial distribution combined with a non-linear distributed lag model to investigate the short-term effects of CMI on the number of admitted PCR-confirmed COVID-19 cases and deaths, controlling for public holidays, day of the week, and Eid/Ramadan days. Results: We demonstrated the feasibility of using CMRs in the evaluation and monitoring of different NPIs, particularly those related to movement restriction. The best movement restriction strategy was a curfew from 7 p.m. to 5 a.m. (level 3 of CMI = 8), which had a total reduction of 35% (95% confidence interval (CI), 25–44%) in new COVID-19 admissions in the following two weeks, and a fatality reduction in the following four weeks by 52% (95% CI, 11–75%). Conclusion: Evening lockdown significantly affected the course of the pandemic in Oman which lines up with similar studies throughout the world.

In response to the current COVID-19 pandemic, numerous commercial assays have been developed for the detection of SARS-CoV-2 for use in the clinical diagnostic laboratories. To date, there is limited comparison of testing methods performed in different hospital laboratory sites. The aims of the study were to evaluate the analytical performance of Cepheid Xpert Xpress SARS-CoV-2 when compared to RT-PCR. This is a cross-sectional study. A total of 155 nasopharyngeal swabs were taken in duplicate from patients presenting with suspected COVID-19 to 8 hospitals in Oman. One swab was tested by the hospital laboratory and the duplicate swab was sent to the national Central Public Health Laboratory (CPHL) for testing. We compared the analytical performance of the commercially available point of care Cepheid Xpert Xpress SARS-CoV-2 assay which was used in the 8 different hospitals with assays including Liferiver, Sansure, TIB MOL BIOL, Kingfisher and COBAS 6800 by Roche which were performed at the CPHL. Testing of the duplicate swabs revealed excellent agreement of results with the viral loads of Ct values ranging from 16-43 for the E gene, 18-44 for the N gene and 17-44 for the ORF gene using the Liferiver assay. The overall sample sensitivity and specificity of the Cepheid Xpert Xpress SARS-CoV-2 assay were both 100% and there was 100% agreement across specimens. We conclude that the rapid GeneXpert and RT-PCR kits assessed in this study may be used for routine diagnostic testing of COVID-19 patients by experienced clinical microbiology diagnostic laboratories. Our results highlight the importance of rapid molecular testing at different sites within a country in a public health emergency.

To highlight the importance of molecular testing in characterizing extensively drug-resistant (XDR)Our study reports three travel-related typhoid fever cases caused by XDRLaboratory testing revealed resistance to all first-line antibiotics (i.e ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole), as well as to quinolones and third-generation cephalosporins, leading to a change in the patients' therapy to the use of carbapenems. Classical MLST (cMLST) revealed that the strains were of sequence type 1 (ST1) and the core genome sequence (cgWGS) analysis closely clustered our strains with internationally reported strains from Pakistan, India, and the UK. The strains were found to carry aOur report alerts clinicians to the use of appropriate empirical treatments in such scenarios, and highlights the significance of the global spread of XDR

We describe the case of a 47 years old Sri Lankan man living in Oman with melioidosis and the resultant occupational risk of exposure to 5 laboratory staff members to the causative agent, Burkholderia pseudomallei. Widely reported as an endemic disease in tropical and subtropical areas, B. pseudomallei was imported to Oman by our patient who had risk factors of diabetes mellitus and alcoholic cirrhotic liver disease. Microbiological and biochemical tests identified the gram negative bacillus, B. pseudomallei, in the patient’s blood sample. Five laboratory workers had occupational exposure to Burkholderia pseudomallei and received post-exposure prophylaxis. Our report highlights the importance of early suspicion of the infection and managing the patient with the correct international protocols for melioidosis especially for patients with severe sepsis and septic shock in the Intensive Care Unit (ICU). Furthermore, the importance of increased awareness among laboratory personnel and the need for good laboratory practices is reported. Furthermore, improved surveillance is essential to guide early diagnosis and prompt treatment.

Objective: This study was undertaken to determine the serotype distribution and drug susceptibility patterns in pneumococcal isolates recovered from patients with invasive pneumococcal disease (IPD). Methods: All invasive pneumococcal isolates received between June 2014 and June 2016 were included in the study as part of a national laboratory-based IPD surveillance program. Isolates recovered from clinical specimens of normally sterile body sites were included. Results: A total of 41 different serotypes were identified among the 132 pneumococcal isolates included in this study. The most prevalent serotypes/serogroups were 12 (8.3%), 15 (8.3%), 19 F (7.6%), 3 (6.1%), and 19A (6.1%);. It was observed that overall vaccine coverage rates for pneumococcal conjugate vaccines (PCV), PCV7, PCV10 and PCV13 were 15.9%, 24.2% and 37.1% respectively. 56.8% (n = 75) of the isolates were non-susceptible to at least one antibiotic and 40.9% (n = 54) of the isolates were resistant to PEN (M). 18.9% (n = 25) of the isolates were multi-drug resistant (MDR).The case fatality rate was 15.9%. Conclusion: Our study results call for broader vaccine coverage, emphasizes the need to introduce the conjugate pneumococcal vaccine for the high risk adult population and stress the importance of continuous surveillance of serotypes and antimicrobial resistance to guide vaccine development and antimicrobial stewardship activities. Keywords: Streptococcus pneumoniae, IPD, Serotype, Antibiotic resistance, Oman, Vaccination

RESUMEN Hacer un análisis sobre la opinión que los hogares tienen de la gestión de los residuos sólidos en su ciudad, permite enfocar las estrategias de intervención para lograr los objetivos de política. Este documento presenta los hallazgos sobre la opinión de los hogares localizados en la zona que operaba hasta inicios de 2018 la empresa Aguas de Bogotá S. A. ESP, sobre la gestión de los residuos sólidos domiciliarios. Se utiliza la estadística descriptiva, se aplicaron 384 encuestas. Se concluye que hay una tendencia en la ciudad a la falta de gobernanza ambiental y se hace necesaria una masificación de la sensibilización sobre la importancia de hacer separación en fuente y el uso adecuado de los contenedores y de las bolsas plásticas. CLASIFICACIÓN JEL: Q53, P48, Q01. CONTENIDO: Introducción; 1. Desarrollo sostenible y residuos sólidos; 2. Gestión de los residuos sólidos domiciliarios en Bogotá; 3. Metodología; 4. Resultados; 5. Conclusiones; Bibliografía. ABSTRACT Analyzing the opinion at homes on the management of solid residues in your city allows the narrowing of the intervention strategies for the achieving of political goals. This document presents the findings on the opinion about the management of solid home residues of homes located in the areas in which the company Aguas de Bogotá S. A. ESP operated until the beginnings of 2018. This article concludes that in the city there is a tendency inclined towards the lack of environmental governance and that a massification of the sensitization about the importance of separating in the source is necessary, as well as adequate use of bags and containers. JEL CODE: Q53, P48, Q01. CONTENTS: Introduction; 1. Sustainable development and solid residues; 2. Management of home solid residues in Bogota; 3. Methodology; 4. Results; 5. Conclusions; Bibliography RESUMO A análise da opinião advinda dos lares quanto à gestão dos resíduos sólidos em sua cidade permite elaborar estratégias de intervenção para atingir objetivos de política. Este documento apresenta os achados sobre a opinião da população de moradias localizadas na área que a empresa Aguas de Bogotá S. A. ESP. operava até o início de 2018 sobre a gestão dos resíduos residenciais. É utilizada a estatística descritiva e aplicado questionário a 384 participantes. Conclui-se que há uma tendência na cidade para a falta de governança ambiental e que é necessária uma massificação da sensibilização acerca da importância de fazer a separação do lixo na fonte, além do uso adequado das lixeiras e dos sacos plásticos. CLASSIFICAÇÃO JEL: Q53, P48, Q01. CONTEÚDO: Introdução; 1. Desenvolvimento sustentável e resíduos sólidos; 2. Gestão dos resíduos sólidos residenciais em Bogotá; 3. Metodologia; 4. Resultados; 5. Conclusões; Bibliografia.

OBJECTIVE: To determine the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in healthcare workers (HCWs) based on risk of exposure to COVID-19 patients. METHOD: This was a SARS-CoV-2 seroprevalence cross-sectional study in risk-stratified HCWs randomly selected from three main district hospitals in Oman. RESULTS: 1078 HCWs were included, with an overall SARS-CoV-2 seroprevalence of 21%. The seropositivity rates in low-, variable-, and high-risk groups were 29%, 18%, and 17%, respectively (p-value < 0.001). The study found higher positivity in males (crude odds ratio [COR] 1.71, 95% confidence interval [CI] 1.28-2.3), and workers residing in high-prevalence areas (COR 2.09, 95% CI 1.42-3.07). Compared with doctors, workers from supporting services, administration staff, and nurses were more likely to test positive for SARS-CoV-2 antibodies (COR 9.81, 95% CI 5.26-18.27; 2.37, 95% CI 1.23-4.58; 2.08 95% CI 1.14-3.81). The overall rate of previously undetected infection was 12%, with higher values in low-risk HCWs. High district prevalence was a driving factor for seropositivity in the low-risk group (adjusted odds ratio [AOR] 2.36, 95% CI 1.0-5.59). CONCLUSION: Low-risk supporting services workers can drive SARS-CoV-2 transmission in hospitals. More attention and innovation within this area will enhance the safety of health care during epidemics/pandemics.

In this paper, we present a multicentre record-based descriptive study used to estimate the incidence and characterize the spectrum of confirmed bacille Calmette–Guérin (BCG) vaccine-related disease among children in Oman. This study included all children (age ≤ 14 years) who had culture and/or polymerase chain reaction (PCR)-confirmed BCG disease from January 2006 to December 2018, as identified from Central Public Health Laboratory data and International Classification of Diseases coding of an electronic patient information system. In total, 88 children confirmed to have BCG disease were included in the study, making an average incidence of 9.2 cases per 100,000 vaccinated neonates. The males comprised 65.9%, Omanis 93.2%, and the median age of presentation was 4 months in children with BCG disease. The most common type of disease was BCG abscesses (72.4%). Children with immunodeficiency and those presenting within 6 months were found to have a more severe and disseminated disease. In total, 28 children had immunodeficiency. The age of presentation and type of BCG disease was significantly associated with immunodeficiency status. The majority of cases required therapy (both medical and surgical) and recovered well. The incidence of laboratory-confirmed BCG vaccine-related disease was low in Oman supporting continuing the use of the BCG vaccination practice at birth.