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Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: According to the World Health Organisation (WHO) global Tuberculosis (TB) report in 2019, 10 million new cases of Tuberculosis were detected worldwide, with India being one of the significant contributors. After achieving some milestones in TB control, the Government of India launched the National Tuberculosis Elimination Program (NTEP) to end TB by 2025. The role of private practitioners in the success of national health programs in India cannot be overemphasised, considering they cater to three times more population than the public sector. Aim: To understand the knowledge and perceived bottlenecks of private practitioners in achieving the goals of NTEP. Materials and Methods: A web-based cross-sectional survey was conducted by Community Medicine Department of Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India, using a semi-structured questionnaire among randomly selected 110 doctors affiliated with the Indian Medical Association (IMA) from October 2020 to December 2020. The survey questionnaire was prepared by an experienced TB Chest expert and consensually validated. It covered all aspects of the Revised National TB Control Program (RNTCP) training modules. Descriptive statistics (Mean, SD, Frequency (%), etc.,) along with independent t-test and Analysis of Variance (ANOVA) were used to present the profile of the participants as well as associated factors with the knowledge score. A p-value of less than 0.05 was considered statistically significant. Results: Out of 110 invitations, 97 (88%) doctors responded. Most of the respondents were males 71 (73%), specialists (81, 83.5%), and had been practicing for more than 20 years (66, 68%). The mean (SD) score was 3.31±1.27 out of six for Multiple Choice Questions and 8.05±3.77 out of 15 for True/False questions. Only 37 (38%) participants scored above the passing benchmark of 60%, indicating a substantial knowledge gap. A higher Outpatient Department (OPD) strength (>50 patients per day) and attending a TB training program by the Government were associated with a higher total score (p=0.018). Conclusion: The knowledge of private practitioners about the diagnosis and management of Tuberculosis was found to be suboptimal. Participants also expressed a few systemic challenges like poor communication and the complexity of the system in the notification of Tuberculosis cases. Innovative training programs, proper communication, and supportive supervision will help in engaging the private practitioners to achieve TB elimination goals.

Introduction: According to the World Health Organisation (WHO) global Tuberculosis (TB) report in 2019, 10 million new cases of Tuberculosis were detected worldwide, with India being one of the significant contributors. After achieving some milestones in TB control, the Government of India launched the National Tuberculosis Elimination Program (NTEP) to end TB by 2025. The role of private practitioners in the success of national health programs in India cannot be overemphasised, considering they cater to three times more population than the public sector. Aim: To understand the knowledge and perceived bottlenecks of private practitioners in achieving the goals of NTEP. Materials and Methods: A web-based cross-sectional survey was conducted by Community Medicine Department of Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India, using a semi-structured questionnaire among randomly selected 110 doctors affiliated with the Indian Medical Association (IMA) from October 2020 to December 2020. The survey questionnaire was prepared by an experienced TB Chest expert and consensually validated. It covered all aspects of the Revised National TB Control Program (RNTCP) training modules. Descriptive statistics (Mean, SD, Frequency (%), etc.,) along with independent t-test and Analysis of Variance (ANOVA) were used to present the profile of the participants as well as associated factors with the knowledge score. A p-value of less than 0.05 was considered statistically significant. Results: Out of 110 invitations, 97 (88%) doctors responded. Most of the respondents were males 71 (73%), specialists (81, 83.5%), and had been practicing for more than 20 years (66, 68%). The mean (SD) score was 3.31±1.27 out of six for Multiple Choice Questions and 8.05±3.77 out of 15 for True/False questions. Only 37 (38%) participants scored above the passing benchmark of 60%, indicating a substantial knowledge gap. A higher Outpatient Department (OPD) strength (>50 patients per day) and attending a TB training program by the Government were associated with a higher total score (p=0.018). Conclusion: The knowledge of private practitioners about the diagnosis and management of Tuberculosis was found to be suboptimal. Participants also expressed a few systemic challenges like poor communication and the complexity of the system in the notification of Tuberculosis cases. Innovative training programs, proper communication, and supportive supervision will help in engaging the private practitioners to achieve TB elimination goals. [ABSTRACT FROM AUTHOR]

BACKGROUND: To analyze the influence of the COVID-19 pandemic on the process of diagnosis and monitoring of drug-resistant pulmonary tuberculosis (TB) cases reported in the state of Paraná, Brazil, from 2015 to 2020. METHODS: Ecological study with quantitative approach. This study was based on diagnosed cases of pulmonary TB reported in the Notifiable Disease Information System in residents of Paraná; as well as through the number of confirmed cases of COVID-19 in the state epidemiological bulletin for the year 2020. The study data were analyzed using descriptive statistics. RESULTS: It was found that, although the number of reported pulmonary TB cases (drug-resistant and general) increased between 2015 and 2019, there was a drop in notification in 2020, the first year of the COVID-19 pandemic. The notification of TB cases was also influenced monthly during the year according to the increase in the number of COVID-19 cases. For cases of drug-resistant pulmonary TB, the provision of diagnostic tests and Directly Observed Treatment decreased by more than half in 2020, especially when compared to 2019. CONCLUSIONS: In view of these findings, the influence of COVID-19 on the diagnosis and monitoring of drug-resistant and general pulmonary TB cases is evident, showing that the pandemic has compromised the advances of recent decades in achieving the goals established for its eradication by 2035.

Abstract Background Health information systems (HIS) are a pivotal element in epidemiological surveillance. In Brazil, malaria persists as a public health challenge, with 99% of its occurrences concentrated in the Amazon region, where cases are reported through the HIS Sivep-Malaria. Recent technological advancements indicate that case notifications can be expedited through more efficient systems with broader coverage. The objective of this study is to analyse opportunities for notification within Sivep-Malaria and explore the implementation of mobile electronic devices and applications to enhance the performance of malaria case notifications and use. Methods This descriptive study analyses data on malaria-positive cases in the Brazilian Amazon from 2004 to 2022. Malaria Epidemiological Surveillance System (Sivep-Malaria) data were used. The Brazilian Amazon region area is approximately 5 million km2 across nine different states in Brazil. Data entry opportunities were assessed by considering the time difference between the 'date of data entry' and the 'date of notification.' Descriptive statistics, including analyses of means and medians, were conducted across the entire Amazon region, and for indigenous population villages and gold mining areas. Results Between 2004 and 2022, 6,176,878 new malaria cases were recorded in Brazil. The average data entry opportunity throughout the period was 17.9 days, with a median of 8 days. The most frequently occurring value was 1 day, and 99% of all notifications were entered within 138 days, with 75.0% entered within 20 days after notification. The states with the poorest data entry opportunities were Roraima and Tocantins, with averages of 31.3 and 31.0 days, respectively. For indigenous population villages and gold mining areas, the median data entry opportunities were 23 and 15 days, respectively. Conclusions In malaria elimination, where surveillance is a primary strategy for evaluating each reported case, reducing notification time, enhancing data quality and being able to follow-up cases through computerized reports offer significant benefits for cases investigation. Technological improvements in Sivep-Malaria could yield substantial benefits for malaria control in Brazil, aiding the country in achieving disease elimination and fulfilling the Sustainable Development Goals.

Hepatitis E virus (HEV) is an important cause of acute hepatitis, however, is highly neglected and largely underreported. This study aimed to describe the detailed epidemiology of hepatitis E (HE) through a 10-year surveillance. A community-based active hepatitis surveillance was conducted between November 2007 and October 2017 in 11 townships of Dongtai City in China, involving 355,673 residents. Serum samples were obtained from patients presenting with hepatitis symptoms for more than 3 days. Serum alanine aminotransferase (ALT) levels greater than 2.5 times the upper limit of normal (ULN) were considered acute hepatitis. Samples were subsequently tested for IgG and IgM anti-HEV antibodies, HEV RNA, and hepatitis B surface antigen (HBsAg). The data indicated the incidence of HE fluctuated downward from 2007 to 2017, with an average annual age-standardized incidence of 17.50 per 100,000, exceeding the 10.26 per 100,000 in the National Notifiable Disease Report System (NNDRS). The incidence was notably higher among males (20.95 per 100,000) and individuals aged 50–69 years (37.47 per 100,000). Genotype 4 (HEV-4) was the predominantly circulating genotype during the study period. Furthermore, the study revealed the incidence of hepatitis with HEV and hepatitis B virus (HBV) co-infection was 4.99 per 100,000. The active surveillance system identified a higher incidence of HE compared to NNDRS, with a decreased prevalence over a 10-year period. While efforts are still needed to prevent HE in high-risk populations, including individuals with hepatitis B and the elderly.

PURPOSE: Digital methods to augment traditional contact tracing approaches were developed and deployed globally during the COVID-19 pandemic. These Exposure Notification (EN) systems present new opportunities to support public health interventions. To date, there have been attempts to model the impact of such systems, yet no reports have explored the value of real-time system data for predictive epidemiological modeling. METHODS: We investigated the potential to short-term forecast COVID-19 caseloads using data from Californias implementation of the Google Apple Exposure Notification (GAEN) platform, branded as CA Notify. CA Notify is a digital public health intervention leveraging residents smartphones for anonymous EN. We extended a published statistical model that uses prior case counts to investigate the possibility of predicting short-term future case counts and then added EN activity to test for improved forecast performance. Additional predictive value was assessed by comparing the pandemic forecasting models with and without EN activity to the actual reported caseloads from 1-7 days in the future. RESULTS: Observation of time series presents noticeable evidence for temporal association of system activity and caseloads. Incorporating earlier ENs in our model improved prediction of the caseload counts. Using Bayesian inference, we found nonzero influence of EN terms with probability one. Furthermore, we found a reduction in both the mean absolute percentage error and the mean squared prediction error, the latter of at least 5% and up to 32% when using ENs over the model without. CONCLUSIONS: This preliminary investigation suggests smartphone based ENs can significantly improve the accuracy of short-term forecasting. These predictive models can be readily deployed as local early warning systems to triage resources and interventions.

Background: Health information systems (HIS) are a pivotal element in epidemiological surveillance. In Brazil, malaria persists as a public health challenge, with 99% of its occurrences concentrated in the Amazon region, where cases are reported through the HIS Sivep-Malaria. Recent technological advancements indicate that case notifications can be expedited through more efficient systems with broader coverage. The objective of this study is to analyse opportunities for notification within Sivep-Malaria and explore the implementation of mobile electronic devices and applications to enhance the performance of malaria case notifications and use. Methods: This descriptive study analyses data on malaria-positive cases in the Brazilian Amazon from 2004 to 2022. Malaria Epidemiological Surveillance System (Sivep-Malaria) data were used. The Brazilian Amazon region area is approximately 5 million km2 across nine different states in Brazil. Data entry opportunities were assessed by considering the time difference between the 'date of data entry' and the 'date of notification.' Descriptive statistics, including analyses of means and medians, were conducted across the entire Amazon region, and for indigenous population villages and gold mining areas. Results: Between 2004 and 2022, 6,176,878 new malaria cases were recorded in Brazil. The average data entry opportunity throughout the period was 17.9 days, with a median of 8 days. The most frequently occurring value was 1 day, and 99% of all notifications were entered within 138 days, with 75.0% entered within 20 days after notification. The states with the poorest data entry opportunities were Roraima and Tocantins, with averages of 31.3 and 31.0 days, respectively. For indigenous population villages and gold mining areas, the median data entry opportunities were 23 and 15 days, respectively. Conclusions: In malaria elimination, where surveillance is a primary strategy for evaluating each reported case, reducing notification time, enhancing data quality and being able to follow-up cases through computerized reports offer significant benefits for cases investigation. Technological improvements in Sivep-Malaria could yield substantial benefits for malaria control in Brazil, aiding the country in achieving disease elimination and fulfilling the Sustainable Development Goals. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ObjectivesToward common methods for system monitoring and evaluation, we proposed a key performance indicator framework and discussed lessons learned while implementing a statewide exposure notification (EN) system in California during the COVID-19 epidemic.Materials and methodsCalifornia deployed the Google Apple Exposure Notification framework, branded CA Notify, on December 10, 2020, to supplement traditional COVID-19 contact tracing programs. For system evaluation, we defined 6 key performance indicators: adoption, retention, sharing of unique codes, identification of potential contacts, behavior change, and impact. We aggregated and analyzed data from December 10, 2020, to July 1, 2021, in compliance with the CA Notify privacy policy.ResultsWe estimated CA Notify adoption at nearly 11 million smartphone activations during the study period. Among 1 654 201 CA Notify users who received a positive test result for SARS-CoV-2, 446 634 (27%) shared their unique code, leading to ENs for other CA Notify users who were in close proximity to the SARS-CoV-2-positive individual. We identified at least 122 970 CA Notify users as contacts through this process. Contact identification occurred a median of 4 days after symptom onset or specimen collection date of the user who received a positive test result for SARS-CoV-2.Practice implicationsSmartphone-based EN systems are promising new tools to supplement traditional contact tracing and public health interventions, particularly when efficient scaling is not feasible for other approaches. Methods to collect and interpret appropriate measures of system performance must be refined while maintaining trust and privacy.

ABSTRACT Objective To analyze epidemiological characteristics, temporal trends and spatial distribution of leprosy cases and indicators in the state of Piauí, 2007-2021. Methods This was an ecological time-series study using data from the Notifiable Health Conditions Information System, describing the spatial distribution and the temporal trend of leprosy using Prais-Winsten regression. Results A total of 17,075 new cases of leprosy were reported. There was a falling trend in the overall detection rate [annual percentage change (APC) = -6.3; 95%CI -8.1;-4.5)], detection in children under 15 years of age (APC = -8,6; 95%CI -12,7;-4,3) and detection of cases with grade 2 physical disability (APC = -4,4; 95%CI -7,0;-1,8). There was a rising trend in the proportion of multibacillary cases. Spatial distribution of the average detection rate identified hyperendemic areas in the Carnaubais, Entre Rios, Vale dos Rios Piauí e Itaueiras regions. Conclusion High leprosy detection rates were found, despite the falling trend of indicators, except the proportion of multibacillary cases.

• The proportion of fully vaccinated measles cases increases with age, reflecting higher vaccination coverage. • Vaccine effectiveness (VE) for two-dose measles vaccine is high in all ages. • Considering natural immunity absent, two-dose measles vaccine VE in the 26–31 age group is 91%, lower than in younger groups. • Accounting for natural immunity, two-dose measles VE is 96.8 % in 26–31 age group. • Two-dose measles VE decreases at a yearly rate of 0.22% after early life vaccination. From 2008 to 2019, France has experienced a resurgence of measles epidemics. Surveillance data have shown that the proportion of cases vaccinated with two doses of measles-containing vaccine (MCV) increased with age, raising concerns about the duration of vaccine protection. Our objectives were to investigate age-stratified vaccine effectiveness (VE) for the second dose of MCV (MCV2) and to quantify protection levels over time. We analyzed data on measles cases aged 2–31 years, reported via mandatory notification to the French measles surveillance system from October 2017 to September 2019. We estimated an age-stratified VE for MCV2 using the screening method, which compares the vaccination status of cases with that of the general population. We improved this method by accounting for natural immunity, exploring four scenarios with four possible levels of natural immunity in the population. In addition, we quantified the decay rate of protection over time, by fitting an exponential decay model among individuals vaccinated in early life. In the baseline analysis (absence of natural immunity), VE estimates were high in all age groups and decreased with age, from 99.6 % (95 % confidence interval: 99.3–99.8) in 2–5 years old to 91.4 % (85.1–95.0) in 26–31 years old. Accounting for natural immunity increased VE in the older age group to 93.2–99.2 % depending on the scenario. We estimated that VE was slowly decreasing over time, with an exponential decay rate of 0.0022/year (0.0017–0.0028), leading to VE of 96.7 % (96.0–97.4) 16 years after MCV2 vaccination. This decline was most compatible with scenario 2, a scenario of 4.4 % naturally immunized, non-vaccinated individuals in the 26–31 years old. Our study confirms the continued high effectiveness of two doses of MCV with only slight degradation, decades after immunization. These findings support the importance of achieving a very high vaccination coverage with 2 doses of MCV. [ABSTRACT FROM AUTHOR]

BackgroundLeishmaniasis is a neglected tropical vector-borne disease, which is on the rise in Sri Lanka. Spatiotemporal and risk factor analyses are useful for understanding transmission dynamics, spatial clustering and predicting future disease distribution and trends to facilitate effective infection control.MethodsThe nationwide clinically confirmed cutaneous leishmaniasis and climatic data were collected from 2001 to 2019. Hierarchical clustering and spatiotemporal cross-correlation analysis were used to measure the region-wide and local (between neighboring districts) synchrony of transmission. A mixed spatiotemporal regression-autoregression model was built to study the effects of climatic, neighboring-district dispersal, and infection carryover variables on leishmaniasis dynamics and spatial distribution. Same model without climatic variables was used to predict the future distribution and trends of leishmaniasis cases in Sri Lanka.ResultsA total of 19,361 clinically confirmed leishmaniasis cases have been reported in Sri Lanka from 2001-2019. There were three phases identified: low-transmission phase (2001-2010), parasite population buildup phase (2011-2017), and outbreak phase (2018-2019). Spatially, the districts were divided into three groups based on similarity in temporal dynamics. The global mean correlation among district incidence dynamics was 0.30 (95% CI 0.25-0.35), and the localized mean correlation between neighboring districts was 0.58 (95% CI 0.42-0.73). Risk analysis for the seven districts with the highest incidence rates indicated that precipitation, neighboring-district effect, and infection carryover effect exhibited significant correlation with district-level incidence dynamics. Model-predicted incidence dynamics and case distribution matched well with observed results, except for the outbreak in 2018. The model-predicted 2020 case number is about 5,400 cases, with intensified transmission and expansion of high-transmission area. The predicted case number will be 9115 in 2022 and 19212 in 2025.ConclusionsThe drastic upsurge in leishmaniasis cases in Sri Lanka in the last few year was unprecedented and it was strongly linked to precipitation, high burden of localized infections and inter-district dispersal. Targeted interventions are urgently needed to arrest an uncontrollable disease spread.

When Words Matter Most: Conveying Serious Health Information to Parents

ABSTRACT Objectives: to describe the epidemiological profile of suspected, confirmed, and probable cases of monkeypox in the state of Minas Gerais, Brazil. Methods: a descriptive, retrospective study of reported suspected, confirmed, and probable cases of monkeypox infection in the state of Minas Gerais, Brazil. The study period was from the first notification, on June 11, to September 7, 2022. Results: a total of 759 suspected, confirmed, and probable cases of monkeypox infection were reported, with 35.44% suspected, 53.75% confirmed, and 10.81% probable cases, respectively. As for the coexisting diseases within confirmed cases, 38.79% were related to people living with human immunodeficiency virus, and 13.74% had some active sexually transmitted infection. Regarding the evolution of confirmed cases, 47.43% were cured. Conclusions: the results contribute to greater knowledge and control of the infection by allowing better disease management and care offered in health services.

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Beriberi is the clinical manifestation of severe and prolonged thiamine (vitamin B1) deficiency. It is a neglected disease that affects low-income populations facing food and nutrition insecurity. The aim of this study was to compare cases of beriberi among indigenous and non-indigenous people in Brazil. We conducted a cross-sectional study using data on cases of beriberi during the period July 2013-September 2018 derived from beriberi notification forms available on the FormSUS platform. Cases in indigenous and non-indigenous patients were compared using the chi-squared test or Fisher's exact test, adopting a significance level of 0.05. A total of 414 cases of beriberi were reported in the country during the study period, 210 of which (50.7%) were among indigenous people. Alcohol consumption was reported by 58.1% of the indigenous patients and 71.6% of the non-indigenous patients (p = 0.004); 71.0% of the indigenous patients reported that they consumed caxiri, a traditional alcoholic drink. Daily physical exertion was reported by 76.1% of the indigenous patients and 40.2% of the non-indigenous patients (p < 0.001). It is concluded that beriberi disproportionately affects indigenous people and is associated with alcohol consumption and physical exertion. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The coronavirus disease pandemic was declared in March 2020, as the southern hemispheres winter approached. Australia expected co-circulation of severe acute respiratory syndrome coronavirus 2, influenza and other seasonal respiratory viruses. However, influenza notifications were 7,029 (March-September) compared with an average 149,832 for the same period in 2015-2019 [corrected], despite substantial testing. Restrictions on movement within and into Australia may have temporarily eliminated influenza. Other respiratory pathogens also showed remarkably changed activity in 2020.

BackgroundWith its epicenter in Wuhan, China, the COVID-19 outbreak was declared a pandemic by the World Health Organization (WHO). While many countries have implemented flight restrictions to China, an increasing number of cases with or without travel background to China are confirmed daily. These developments support concerns on possible unidentified and unreported international COVID-19 cases, which could lead to new local disease epicenters.MethodsWe have analyzed all available data on the development of international COVID-19 cases from January 20th, 2020 until February 18th, 2020. COVID-19 cases with and without travel history to China were divided into cohorts according to the Healthcare Access and Quality Index (HAQ-Index) of each country. Chi-square and Post-hoc testing were performed.ResultsWhile COVID-19 cases with travel history to China seem to peak for each HAQ-cohort, the number of non-travel related COVID-19 cases seem to continuously increase in the HAQ-cohort of countries with higher medical standards. Further analyses demonstrate a significantly lower proportion of reported COVID-19 cases without travel history to China in countries with lower HAQ (HAQ I vs. HAQ II, posthoc p

BACKGROUND:Dengue is the most prevalent mosquito-borne disease in the world, with China affected seriously in recent years. 65.8% of dengue cases identified in mainland China since 2005 were reported from the city of Guangzhou. METHODS:In this study, we described the incidence rate and distribution of dengue cases using data collected form National Notifiable Infectious Disease Reporting Information System data in Guangzhou for 2001 to 2016. All dengue cases were investigated using standardized questionnaire. RESULTS:A total of 42,469 dengue cases were reported, with an average annual incidence rate of 20.99 per 100,000 resident population. Over this time period, the incidence rate of indigenous cases increased. Dengue affected areas also expanded sharply geographically from 58.1% of communities affected during 2001-2005 to 96.4% of communities affected in 2011-2016. Overall 95.30% of the overseas imported cases were reported during March and December, while 99.79% of indigenous cases were reported during July and November. All four dengue virus serotypes were identified both in imported cases and indigenous cases. The Aedes albopictus mosquito was the only vector for dengue transmission in the area. CONCLUSIONS:Guangzhou has become the dengue epicenter in mainland China. Control strategies for dengue should be adjusted to the epidemiological characteristics above and intensive study need to be conducted to explore the factors that driving the rapid increase of dengue.

Abstract Objective: to evaluate the completeness and timeliness of notifications of cases of spotted fever (SF) held on the Notifiable Health Conditions Information System (SINAN) in São Paulo State, Brazil, from 2007 to 2017. Methods: this was a descriptive and ecological study of confirmed human cases of SF regarding completeness and timeliness of ten fields of the notification form (good if ≥ 90% for most variables); time series analysis was performed using the Prais-Winsten technique. Results: we analyzed 736 records; among essential fields, only “Discharge date” showed poor completeness (68.5%). Timeliness was good for the “Investigation” and “Closure” fields; other time lapses were not adequate. Conclusion: in São Paulo state, data completeness was good for most variables, whereas timeliness was not adequate (except for “Closure” and “Investigation”), pointing to the need for health education and communication actions about SF.

BackgroundInterseasonal influenza outbreaks are not unusual in countries with temperate climates and well-defined influenza seasons. Usually, these are small and diminish before the main influenza season begins. However, the 2018/19 summer-autumn interseasonal influenza period in Australia saw unprecedented large and widespread influenza outbreaks.AimOur objective was to determine the extent of the intense 2018/19 interseasonal influenza outbreaks in Australia epidemiologically and examine the genetic, antigenic and structural properties of the viruses responsible for these outbreaks.MethodsThis observational study combined the epidemiological and virological surveillance data obtained from the Australian Government Department of Health, the New South Wales Ministry of Health, sentinel outpatient surveillance, public health laboratories and data generated by the World Health Organization Collaborating Centre for Reference and Research on Influenza in Melbourne and the Singapore Agency for Science, Technology and Research.ResultsThere was a record number of laboratory-confirmed influenza cases during the interseasonal period November 2018 to May 2019 (n= 85,286; 5 times the previous 3-year average) and also more institutional outbreaks, hospitalisations and deaths, than what is normally seen.ConclusionsThe unusually large interseasonal influenza outbreaks in 2018/19 followed a mild 2018 influenza season and resulted in a very early start to the 2019 influenza season across Australia. The reasons for this unusual event have yet to be fully elucidated but are likely to be a complex mix of climatic, virological and host immunity-related factors. These outbreaks reinforce the need for year-round surveillance of influenza, even in temperate climates with strong seasonality patterns.

An HIV diagnosis may be associated with severe emotional and psychological distress, which can contribute to delays in care or poor self-management. Few studies have explored the emotional, psychological, and psychosocial impacts of an HIV diagnosis on women in low-resource settings. We conducted in-depth interviews with 30 women living with HIV in the Dominican Republic. Interviews were audio-recorded, transcribed, and analyzed using the biographical disruption framework. Three disruption phases emerged (impacts of a diagnosis, postdiagnosis turning points, and integration). Nearly all respondents described the news as deeply distressful and feelings of depression and loss of self-worth were common. Several reported struggling with the decision to disclose-worrying about stigma. Postdiagnosis turning points consisted of a focus on survival and motherhood; social support (family members, friends, HIV community) promoted integration. The findings suggest a need for psychological resources and social support interventions to mitigate the negative impacts of an HIV diagnosis.

Abstract Background In the State of Mato Grosso do Sul, Brazil, sand flies and cases of visceral (VL) and cutaneous (CL) leishmaniases have been reported in almost all municipalities. The aim of this study was to analyze the geographic distribution of VL and CL in relation the sand fly species found in the municipalities of Mato Grosso do Sul. Methods We analyzed VL and CL cases from 2001 to 2018 using data from the Notifiable Diseases Information System (SINAN). Data collected since 2003 on the presence of sand fly vectors (proven or suspected) were provided by the State Health Secretariat. Results A total of 3566 and 3030 cases of VL and CL, respectively, were reported from 2001 to 2018. The municipalities with the most reported cases of VL were Campo Grande (2495), Três Lagoas (442), Corumbá (140) and Aquidauana (136); and those for CL were Campo Grande (635) and Bodoquena (197). The following sand fly species with vector potential were found in 59 municipalities (74.7%): Lutzomyia longipalpis, Lutzomyia cruzi, Nyssomyia whitmani, Migonemyia migonei, Nyssomyia neivai, Pintomyia pessoai, Bichromomyia flaviscutellata and Pintomyia fischeri. Sand flies were present in six municipalities where no cases of VL were reported and in two municipalities where no cases of CL were reported. Conclusions Our results indicate that the geographical distribution of VL and CL in Mato Grosso do Sul expanded during the study period, and highlight the presence of sand fly vectors in municipalities where these diseases are currently considered to be non-endemic. Graphical Abstract

ABSTRACT Background: Rabies is an anthropozoonosis that greatly impacts public health and is transmitted by infected mammals. Aggression by animals is notifiable and may result in anti-rabies post-exposure prophylaxis (PEP). This study aimed to characterize anti-rabies PEP notifications in São Paulo state, Brazil. Methods: A descriptive study was conducted using data provided by the SINAN between 2013 and 2017. Results: A total of 572,889 aggressions were recorded during the study period, characterized mostly by dogs (83.5%), single wounds (56.9%), superficial wounds (58.6%), and hands/feet (34.6%). Conclusions: Animal observation was the most frequent recommendation, even in cases of attacks from non-domestic animals.

Abstract Objective: to analyze the profile of violence against the elderly and the degree of completeness of event notification forms in Niterói, Rio de Janeiro, Brazil. Methods: this was a descriptive study having as its data source violence notification forms held on the Notifiable Health Conditions Information System for the period 2011-2020; analysis of form completeness was performed according to criteria proposed by the Ministry of Health. Results: of the 486 registered cases, physical violence was the most reported type of violence (48.1%), followed by psychological violence (22.2%) and self-harm (21.4%); the fields with the highest degree of incompleteness were victim’s level of schooling (32.8%) and repeat violence (41.5%). Conclusion: despite the increase in notifications in the period, predominantly of physical violence, completeness of some of the form fields continues to be poor, which reinforces the importance of training professionals to improve the reporting process and data quality.

Several chemical substances cause toxicological damage to individuals, triggering Exogenous Intoxication (EI) with relevant fatal potential. It is, therefore, essential to describe and compare the epidemiological profile of EI cases reported in Bahia before and during the COVID-19 pandemic. A quantitative analytical approach was used, and secondary data were extracted, in August 2022, from the Notifiable Diseases Information System, cases of EI between January 2018 and December 2021, Bahia. Age, sex, color, circumstance, and causative agent were analyzed and described in frequency and proportions, 12,838 cases of EI were reported between 2018-2019. The highest incidence occurred in individuals aged 20-59 years (57.8%), females (59%), and browns (48.8%). Among toxic agents, medication (40.3%) stood out, followed by food and beverages (10%), rodenticides (6.8%), and drugs of abuse (6%). Among the circumstances: suicide attempt was highlighted (33.5%). In 2020 and 2021, there were 11,279 cases, higher incidence in individuals aged 20-59 years (59.5%), females (58%), and browns (55%). The toxic agent medication (41.9%) stood out, followed by drugs (10.2%), food and beverages (7.8%), and household products (5.7%). Similar to the previous period, suicide led among circumstances (36.5%). The pandemic did not seem to affect epidemiology significantly. However, the almost 50% increase in the frequency of EI cases due to drug abuse, reinforces the World Report on Drugs (2021), which pointed to a worldwide growth of drugs consumption during the pandemic and alerts attention to mental health of Brazilians. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Pesquisa: Cuidado é Fundamental is the property of Revista de Pesquisa: Cuidado e Fundamental Online and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To identify the publications that discussed COVID-19 as an occupational injury and its notification by health workers. Methods: The search for this scoping review explored national and international literature, between 2020 and 2021, in English, Portuguese and Spanish, in the databases of the Regional Portal of the Virtual Health Library, in MEDLINE through PubMed and in Capes Journal Portal used: Embase, Scopus, Web of Science, CINAHL. The texts were imported into EndNote, duplicates were removed and exported to the Rayyan application, and the articles were included in an Excel spreadsheet with the labels: COVID-19 as injuries at work and Notification of COVID-19. Results: A total of 5665 studies were identified, excluding 2088 duplicates, resulting in 3577 publications, selected by title and abstract. Of these, 3280 did not meet the inclusion criteria, resulting in 297 articles. Of these, 10 were selected for full text analysis because they dealt with COVID-19 as an injury at work and/or notification of this condition by health workers. Two articles were excluded because they were a literature review, remaining 8 as the study's corpus. Conclusion: Although certain countries already recognize COVID-19 as an occupational injury, some workers still have difficulties in relating the SARS-CoV-2 infection with work in health care, characterizing it as an occupational injured. Everyone should be guided and trained regarding the recognition of COVID-19 as an occupational injury and notify its occurrence, since the definition of the infection as a notifiable disease already exists. [ABSTRACT FROM AUTHOR]

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Espaço Para a Saúde is the property of Faculdades Pequeno Principe and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Portuguese Journal of Mental Health Nursing / Revista Portuguesa de Enfermagem de Saúde Mental is the property of Portuguese Society of Mental Health Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective Digital exposure notifications (DEN) systems were an emergency response to the coronavirus disease 2019 (COVID-19) pandemic, harnessing smartphone-based technology to enhance conventional pandemic response strategies such as contact tracing. We identify and describe performance measurement constructs relevant to the implementation of DEN tools: (1) reach (number of users enrolled in the intervention); (2) engagement (utilization of the intervention); and (3) effectiveness in preventing transmissions of COVID-19 (impact of the intervention). We also describe WA State's experience utilizing these constructs to design data-driven evaluation approaches. Methods We conducted an environmental scan of DEN documentation and relevant publications. Participation in multidisciplinary collaborative environments facilitated shared learning. Compilation of available data sources and their relevance to implementation and operation workflows were synthesized to develop implementation evaluation constructs. Results We identified 8 useful performance indicators within reach, engagement, and effectiveness constructs. Discussion We use implementation science to frame the evaluation of DEN tools by linking the theoretical constructs with the metrics available in the underlying disparate, deidentified, and aggregate data infrastructure. Our challenges in developing meaningful metrics include limited data science competencies in public health, validation of analytic methodologies in the complex and evolving pandemic environment, and the lack of integration with the public health infrastructure. Conclusion Continued collaboration and multidisciplinary consensus activities can improve the utility of DEN tools for future public health emergencies. [ABSTRACT FROM AUTHOR]

Objectives: To understand the perceptions of the private HIV physicians regarding HIV case management and reporting practices followed by the National AIDS Control Programme, India. Methods: We conducted this cross-sectional study among 142 private practitioners attending Chennai ART Symposium 2017, from five south Indian states. We used a pre-structured questionnaire to collect information on demography, qualification, the number of HIV patients treated, ART regimen, and the reporting practices. EpiInfo 7.2 was used for data analysis. Results: Out of the 142 private practitioners, 89 (63%) responded. All respondents had diagnosed and/or treated at least 10 HIV patients in the past 12 months. About 42% of respondents reported attending an orientation program on ART by the State AIDS Control Society (SACS). Seventy percent of respondents were aware of the National AIDS Control Organization's (NACO) Public Private Partnership (PPP) initiative for private clinics, and 44% (39) reported sharing monthly reports with SACS. However, 77% of physicians were not interested to enroll due to increased paperwork and complicated reporting mechanisms. Conclusion: Private sector physicians treating People Living with HIV (PLHIV) are aware of NACO guidelines and reporting mechanisms. A simplified reporting process and an engaging platform are needed to facilitate reporting.

Introduction: India accounts for one-fourth of global incidence of Tuberculosis (TB) with 2.79 million estimated cases annually. To improve and intensify case finding, the Government of India declared TB a notifiable disease in May 2012. It is now mandatory that all public and private health providers notify TB cases to the designated public health authorities. To facilitate notification, the central government has created a web-based, case-based notification system called NIKSHAY. Notification also provides support to the private sector in adherence to standards of TB care which helps in the monitoring of the patients, contact screening and adherence to the treatment. Aim: To assess the knowledge, opinion and barriers regarding TB notification and its processes amongst private practitioners offering TB services. Materials and Methods: This was a cross-sectional study with both analytical and descriptive components which was conducted on the private practitioners of urban Chennai for a period of three months from April 2021 to June 2021. Study was done on a convenient sample of 150 private practitioners in Urban Chennai. Any registered medical practitioner with a bachelor degree in medicine (MBBS) with private practice in Urban Chennai with a minimum of 1 year practice was included in the study. The knowledge, attitude and practice of notification of TB among private practitioners and other proportions were summarised into percentages and 95% confidence intervals were calculated. The categorical data was analysed by Chi-square (χ2) test. Strength of associations was assessed through odds ratio and 95% confidence intervals. Tha analysis of the data was done using Statistical Package for Social Sciences (SPSS) version 28.0.1.1. Results: Amongst the total sample of 150 study participants, 90% had said that TB notification was mandatory, of whom 80% said that they had prior sensitisation on the notification procedures. Only 46% were aware of the honorarium given after notification. Attitude of the study participants towards notification though 100% of the study participants agreed that TB notification was necessary, while 56.7% said that government should do more towards the sensitisation of the notification procedures. Only 5.3% of the study participants had initiated treatment on their own and 4% had started treatment based on clinical suspicion Nikshay registration was more among those whose duration of practice was more than or equal to 5 years (p=0.03), those who had prior sensitisation on TB notification procedures (p

Objectives: To understand the perceptions of the private HIV physicians regarding HIV case management and reporting practices followed by the National AIDS Control Programme, India. Methods: We conducted this cross-sectional study among 142 private practitioners attending Chennai ART Symposium 2017, from five south Indian states. We used a pre-structured questionnaire to collect information on demography, qualification, the number of HIV patients treated, ART regimen, and the reporting practices. EpiInfo 7.2 was used for data analysis. Results: Out of the 142 private practitioners, 89 (63%) responded. All respondents had diagnosed and/or treated at least 10 HIV patients in the past 12 months. About 42% of respondents reported attending an orientation program on ART by the State AIDS Control Society (SACS). Seventy percent of respondents were aware of the National AIDS Control Organization's (NACO) Public Private Partnership (PPP) initiative for private clinics, and 44% (39) reported sharing monthly reports with SACS. However, 77% of physicians were not interested to enroll due to increased paperwork and complicated reporting mechanisms. Conclusion: Private sector physicians treating People Living with HIV (PLHIV) are aware of NACO guidelines and reporting mechanisms. A simplified reporting process and an engaging platform are needed to facilitate reporting. [ABSTRACT FROM AUTHOR]

Background: Despite several global interventions, tuberculosis (TB) remains a leading cause of death affecting millions of people globally. Many TB patients either have no access to quality care or go undetected by national health systems. Several multilevel factors account for under-detection of persons with TB. This study sought to explore patient-related software, community and health systems software and hardware factors influencing time to notification of TB in Lusaka District, Zambia., Methods: This was an exploratory qualitative case study that adopted a software and hardware lens of conceptualizing health systems. Data were collected from across three sites - urban and peri-urban areas: Chongwe, Kafue, and Lusaka - within Lusaka Province, Zambia. Sixteen key informants - TB corner nurses, community TB treatment supporters, and TB program managers - were interviewed. Six focus groups were held with TB patients. Data were analyzed using thematic analysis., Results: The study identified factors influencing timely TB notification, categorized into software and hardware elements. Patient-related software elements, including TB knowledge and awareness, and health-seeking behavior, are crucial for prompt notification among TB patients. In the community health system, software elements like social stigma and undesirable community attitudes towards contact tracing, and hardware elements such as unbalanced schedules, excessive workload and limited capacity of community TB treatment supporters contribute to delayed TB notification. In the formal health system, software elements like negative attitudes of health providers towards TB patients and demotivation of TB staff, and hardware elements such as high diagnostics and transportation costs, outdated diagnostics in primary care facilities, and slow referral mechanisms, can also delay TB notification., Conclusion: Delays in time to TB notification are influenced by a combination of software (attitudinal and behavioral) and hardware (resource-related) elements across TB patients, community health systems, community TB treatment supporters, health providers, and TB staff. Addressing these factors, particularly social stigma, negative attitudes, and resource constraints, is crucial to improving timely TB detection and treatment., (© 2024. The Author(s).)

Alphavirus infections are transmitted by mosquitoes, but the mode of transmission for Mycobacterium ulcerans, which causes Buruli ulcer, is contested. Using notification data for Victoria, Australia, during 2017-2022, adjusted for incubation period, we show close alignment between alphavirus and Buruli ulcer seasons, supporting the hypothesis of mosquito transmission of M. ulcerans.

Background: Covid-19 is the disease caused by coronavirus-2 of severe acute respiratory syndrome (SARS-Cov-2) recognized as a pandemic with community transmission in Brazil. Knowing the potential occupational exposure and transmission mechanisms are essentials to define preventive and protective strategies. Objective: This article presents a proposal to systematize the recognition, characterization and notification of covid-19 as a work-related disease (WDR). Method: Literature review on the subject to systematize the qualitative assessment of occupational risks and the potential relationship between covid-19 and work. Results: A matrix was proposed indicating that covid-19 can be: presumably workrelated for high or very high exposure to the virus; probably work-related for medium exposure; or possibly work-related for lower exposure to the virus. Conclusion: The characterization and notification of work-related covid-19 in the information systems allows the analysis of the epidemiological profile, which is essential to plan actions of comprehensive health care for workers, and to contribute to the inseparability between assistance and health surveillance. [ABSTRACT FROM AUTHOR]

Background: In the State of Mato Grosso do Sul, Brazil, sand flies and cases of visceral (VL) and cutaneous (CL) leishmaniases have been reported in almost all municipalities. The aim of this study was to analyze the geographic distribution of VL and CL in relation the sand fly species found in the municipalities of Mato Grosso do Sul. Methods: We analyzed VL and CL cases from 2001 to 2018 using data from the Notifiable Diseases Information System (SINAN). Data collected since 2003 on the presence of sand fly vectors (proven or suspected) were provided by the State Health Secretariat. Results: A total of 3566 and 3030 cases of VL and CL, respectively, were reported from 2001 to 2018. The municipalities with the most reported cases of VL were Campo Grande (2495), Três Lagoas (442), Corumbá (140) and Aquidauana (136); and those for CL were Campo Grande (635) and Bodoquena (197). The following sand fly species with vector potential were found in 59 municipalities (74.7%): Lutzomyia longipalpis, Lutzomyia cruzi, Nyssomyia whitmani, Migonemyia migonei, Nyssomyia neivai, Pintomyia pessoai, Bichromomyia flaviscutellata and Pintomyia fischeri. Sand flies were present in six municipalities where no cases of VL were reported and in two municipalities where no cases of CL were reported. Conclusions: Our results indicate that the geographical distribution of VL and CL in Mato Grosso do Sul expanded during the study period, and highlight the presence of sand fly vectors in municipalities where these diseases are currently considered to be non-endemic. [ABSTRACT FROM AUTHOR]

BackgroundTB patients co-infected with HIV have worse treatment outcomes than non-coinfected patients. How clinical characteristics of TB and socioeconomic characteristics influence these outcomes is poorly understood. Here, we use polytomous regression analysis to identify clinical and epidemiological characteristics associated with unfavorable treatment outcomes among TB-HIV co-infected patients in Brazil.MethodsTB-HIV cases reported in the Brazilian information system (SINAN) between January 1, 2001 and December 31, 2011 were identified and categorized by TB treatment outcome (cure, default, death, and development of MDR TB). We modeled treatment outcome as a function of clinical characteristics of TB and patient socioeconomic characteristics by polytomous regression analysis. For each treatment outcome, we used cure as the reference outcome.ResultsBetween 2001 and 2011, 990,017 cases of TB were reported in SINAN, of which 93,147 (9.4%) were HIV co-infected. Patients aged 15-19 (OR=2.86; 95% CI: 2.09-3.91) and 20-39 years old (OR=2.30; 95% CI: 1.81-2.92) were more likely to default on TB treatment than those aged 0-14 years old. In contrast, patients aged ≥60 years were more likely to die from TB (OR=2.22; 95% CI: 1.43-3.44) or other causes (OR=2.86; 95% CI: 2.14-3.83). Black patients were more likely to default on TB treatment (OR=1.33; 95% CI: 1.22-1.44) and die from TB (OR=1.50; 95% CI: 1.29-1.74). Finally, alcoholism was associated with all unfavorable outcomes: default (OR=1.94; 95% CI: 1.73-2.17), death due to TB (OR=1.46; 95% CI: 1.25-1.71), death due to other causes (OR=1.38; 95% CI: 1.21-1.57) and MDR-TB (OR=2.29; 95% CI: 1.46-3.58).ConclusionsSocio-economic vulnerability has a significant effect on treatment outcomes among TB-HIV co-infected patients in Brazil. Enhancing social support, incorporation of alcohol abuse screening and counseling into current TB surveillance programs and targeting interventions to specific age groups are interventions that could improve treatment outcomes.

Resumen: Introducción: La giardiosis es una parasitosis gastrointestinal de impacto en salud pública. Pacientes y métodos: Estudio observacional de los casos, en menores de 15 años, atendidos durante el periodo 2012-2019 en el Departamento 3 de Salud de la Provincia de Castellón (España). Resultados: Se registraron 190 casos en menores de 15 años. El número de casos varió significativamente según grupo etario (55% en el grupo de 0-4 años) y momento del año (mayoría en agosto-noviembre). El índice de masculinidad resultó de 115. Los síntomas más frecuentes fueron diarrea y dolor abdominal. El tratamiento más empleado fue metronidazol en pauta estándar (80% de los pacientes). El 13% de los casos presentaron coinfección y el 36% comorbilidades, principalmente dermatitis atópica e intolerancia a la lactosa/fructosa. Se registró un 8% de recidivas/reinfecciones. Todos los casos se diagnosticaron por tests coproparasitológicos convencionales y algunos, además, con inmunocromatografía (63 casos). Treinta y cinco muestras fueron confirmadas para Giardia duodenalis por qPCR, descartándose sesgo diagnóstico. Se detectó un sesgo de notificación a escala nacional para el periodo 2012-2016. El coste sanitario directo por paciente resultó de 117€. Conclusiones: La giardiosis es una enfermedad vigente en nuestra región que debe ser considerada (en el diagnóstico diferencial) como diagnóstico probable de patología gastrointestinal ante un niño menor de cuatro años con diarrea y dolor abdominal. Su correcto manejo clínico disminuiría la posibilidad de empeoramiento del paciente y evitaría la hospitalización, reduciendo el impacto económico de la patología en términos de costes directos sanitarios. Abstract: Introduction: Giardiasis is a gastrointestinal parasitosis that has a great public health impact. Patients and methods: Observational case study - in children under 15 years old in the Health Department 3 of the Province of Castellon (Spain), during the period 2012-2019. Results: A total of 190 cases of giardiasis were recorded in children under 15 years old. The number of cases varied significantly according to age group and month of the year. There were 115 males. The most frequent symptoms were diarrhea and abdominal pain. The most commonly used treatment was standard metronidazole (80% of patients). Co-infection occurred in 13% of cases, and comorbidities in 36%, especially atopic dermatitis and lactose/fructose intolerance. Relapses and/or re-infections were recorded in 8%. All cases were diagnosed by conventional parasitological stool tests and complementary immunochromatography (63 cases). Thirty-five samples were positive for Giardia duodenalis by qPCR. The direct health cost per patient was 117€. A disease notification bias was detected between 2012-2016 at a national scale. Conclusions: Giardiasis is a current disease in Castellon, and should be considered as a probable diagnosis of gastrointestinal disease in a child under 4 years-old with diarrhea and abdominal pain. Its correct clinical and therapeutic management could reduce the possibility of worsening of the patient's condition and, additionally, would reduce the economic impact of the disease in terms of direct health costs.

Background: Diagnosis, notification and timely initiation of treatment is an important cornerstone for the elimination of tuberculosis (TB). The referral and feedback mechanism under National Tuberculosis Programme of India has been changed from paper-based to web-based electronic system (Nikshay) since 2018. The current study was carried out to assess the effect of Nikshay in referral and receipt of feedback on treatment initiation and to understand the early implementation challenges. Methods: A mixed-methods study was conducted in a medical college referral unit (MCRU) of Delhi, India. The electronic TB notification data for July 2018–March 2019 were abstracted from Nikshay portal and analysed. Unadjusted and adjusted relative risk (aRR) was calculated to assess the factors associated with the receipt of feedback. Themes and subthemes were generated from qualitative data obtained through key-informant interviews of healthcare providers. Results: Of the total 4395 patients handled by MCRU during the study period, 3315 (75.4%) were referred out within and outside Delhi for treatment. Feedback was received among 797 (24.0%) of the patients who were referred out. Patients with extrapulmonary TB (aRR: 1.3, confidence interval (CI): 1.1–1.8), previously treated (aRR: 1.2, CI: 1.2–1.3) and registered for drug-resistant TB care (aRR: 1.4, CI: 1.1–1.8), had high chance of receiving feedback. Four broad themes emerged, namely, (a) awareness of programme and Nikshay; (b) tracking of patients; (c) user-friendly portal and (d) workload. Conclusion: The low feedback on treatment initiation of patients with TB needs further research after health system-level quality improvement interventions. Real-time tracking of patients is the need of the hour towards the path for TB elimination.

Hepatitis E virus (HEV) is an important cause of acute hepatitis, however, is highly neglected and largely underreported. This study aimed to describe the detailed epidemiology of hepatitis E (HE) through a 10-year surveillance. A community-based active hepatitis surveillance was conducted between November 2007 and October 2017 in 11 townships of Dongtai City in China, involving 355,673 residents. Serum samples were obtained from patients presenting with hepatitis symptoms for more than 3 days. Serum alanine aminotransferase (ALT) levels greater than 2.5 times the upper limit of normal (ULN) were considered acute hepatitis. Samples were subsequently tested for IgG and IgM anti-HEV antibodies, HEV RNA, and hepatitis B surface antigen (HBsAg). The data indicated the incidence of HE fluctuated downward from 2007 to 2017, with an average annual age-standardized incidence of 17.50 per 100,000, exceeding the 10.26 per 100,000 in the National Notifiable Disease Report System (NNDRS). The incidence was notably higher among males (20.95 per 100,000) and individuals aged 50-69 years (37.47 per 100,000). Genotype 4 (HEV-4) was the predominantly circulating genotype during the study period. Furthermore, the study revealed the incidence of hepatitis with HEV and hepatitis B virus (HBV) co-infection was 4.99 per 100,000. The active surveillance system identified a higher incidence of HE compared to NNDRS, with a decreased prevalence over a 10-year period. While efforts are still needed to prevent HE in high-risk populations, including individuals with hepatitis B and the elderly.

Objective: to identify the sociodemographic profile of interpersonal violence associated with alcohol consumption in São Paulo-SP, Brazil. Method: a cross-sectional study carried out through notifications of suspected or confirmed cases of interpersonal violence from the Notifiable Diseases Information System submitted between 2016 and 2019. Collection took place between March and June 2020. Chi-square or Fisher's exact tests were performed in the statistical analysis. Results: 27,775 notifications were obtained, whose prevalent profile was female victims (60.6%), aged between 20 and 34 years old (41.4%), brown- or black-skinned (51%), and with complete high school (18.8%). Physical violence was more frequent (81.9%), perpetrated by an intimate partner (20.3%), motivated by sexism (9.9%) and generational conflict (11.2%). In sexual violence, rape prevailed with 69.4% and there was a low supply of emergency contraception methods (14.7%). Conclusion: the study contributes to reflections and subsidies in the planning of public policies to control the problem. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira em Promoção da Saúde is the property of Revista Brasileira em Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A robust epidemic-prone disease surveillance system is a critical component of public health infrastructure and supports compliance with the International Health Regulations (IHR). One digital health platform that has been implemented in numerous low- and middle-income countries is the District Health Information System Version 2 (DHIS2). In 2015, in the wake of the Ebola epidemic, the Ministry of Health in Guinea established a strategic plan to strengthen its surveillance system, including adoption of DHIS2 as a health information system that could also capture surveillance data. In 2017, the DHIS2 platform for disease surveillance was piloted in two regions, with the aim of ensuring the timely availability of quality surveillance data for better prevention, detection, and response to epidemic-prone diseases. The success of the pilot prompted the national roll-out of DHIS2 for weekly aggregate disease surveillance starting in January 2018. In 2019, the country started to also use the DHIS2 Tracker to capture individual cases of epidemic-prone diseases. As of February 2020, for aggregate data, the national average timeliness of reporting was 72.2%, and average completeness 98.5%; however, the proportion of individual case reports filed was overall low and varied widely between diseases. While substantial progress has been made in implementation of DHIS2 in Guinea for use in surveillance of epidemic-prone diseases, much remains to be done to ensure long-term sustainability of the system. This paper describes the implementation and outcomes of DHIS2 as a digital health platform for disease surveillance in Guinea between 2015 and early 2020, highlighting lessons learned and recommendations related to the processes of planning and adoption, pilot testing in two regions, and scale up to national level.

INTRODUCTION: This cross-sectional descriptive study aimed to evaluate the distribution of the diseases which were reported to the mandatory disease system and the characteristics of the patients in 2018. METHODS: Between January 2018 – December 2018, all patients who were notified according to the 'Ministry of Health, Standard Diagnosis, Surveillance and Laboratory Guidelines of the Communicating Diseases and Notification System' in Dr. Behçet Uz Children's Hospital except rabies risk-contact cases were included in the current study. Data of the patients was collected from medical records. RESULTS: During the study period 392 communicable diseases were notified. Of these, 41 cases were excluded due to recurrence of notified diseases. As a result a total of 351 patients included in the final evaluation. The most frequently reported diseases were varicella diseases (176 cases, 50%), pertussis (35 cases, 10%), and influenza (25 cases, 7.1%). The most frequent notification was made by the emergency department (129 cases, 36.8%). DISCUSSION AND CONCLUSION: There are very few studies on the notification of the communicable disease reports in Turkey, especially in childhood. Evaluation of the notifications of communicable diseases is accurate for the proper epidemiological surveillance,

Background: Legionella pneumophila can cause severe respiratory disease and is notifiable in NSW. An analysis of notifications linked to hospitalisation and death data over the period 2010-2022 was conducted to determine the burden of disease and any association with the introduction of NSW regulatory changes in 2018., Methods: Cases were retrospectively identified from the Notifiable Conditions Records for Epidemiology and Surveillance (NCRES). Data on related morbidity and mortality were obtained from linked data within the NSW Communicable Disease Register (CDR). The impact of the regulatory change was evaluated by analysing monthly count data using an interrupted time series analysis., Results: A total of 928 cases were notified with 84% admitted to hospital. Annual adjusted notification and admission rates increased over the period from 4.40 to 7.92 cases and 3.72 to 7.20 admissions, per 1,000,000 population, respectively. The mean length of hospital stay (LOS) was 14 days with a median of 8 days (range 1-262 days). Time series analysis identified an underlying increasing time trend in cases notified per month with an IRR of 1.069 (95% ci 0.751-1.523) post 2018 regulatory implementation., Conclusion: L. pneumophila is posing an increasing burden of disease with an underlying upward trend in notification incidence despite the introduction of regulatory changes in 2018., Implication for Public Health Practice: This study demonstrates how linking notification, hospitalisation and death data can measure the health burden of a notifiable condition. Furthermore, time-series analysis using these data is able to identify underlying temporal trends and evaluate policy changes., (Copyright © 2024 Australasian College for Infection Prevention and Control. Published by Elsevier B.V. All rights reserved.)