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Objectives: To explore the association between drug exposure and SARS-CoV-2 prognosis among elderly people living in long-term care facilities (LTC) Design: We carried out a cross-sectional study among old people living in LTC that had a proven SARS-CoV-2 infection, including socio-demographic data, comorbidities and drug intake at the moment of the diagnosis. The study was focused on ACE2 inhibitors, ARA-II blockers, inhaled bronchodilators, oral corti-coids, platelet antiaggregants, oral anti-coagulants, statins and Vitamin D. Results: 1 306 individuals were included, with a mean age of 86.7 years, and 72.3% were females. The case fatality rate was 24.4%. Among the studied exposures platelet antiaggregants were the most preva-lent (24.7%). After adjusting for propensity score, the intake of inhaled corticoids (OR 0.73; p = 0.03) and statins (OR 0.65; p = 0.03) were found to be protective factors of death, whereas ACE2 inhibitor showed an almost significant association (OR 0.73, p = 0.07). Conclusions: Considering the high prevalence of drug intake among elderly people, drug exposure may be an important Covid-19 disease modifier in LTC residents and should be considered when exploring prognostic risk factors associated to Covid-19. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )

Resumen Introduccion Existen escasos datos sobre el cribado serologico extenso, familiar, de Trypanosoma cruzi a partir de un infectado-indice. Por tratarse de una parasitosis con posibilidad de transmision materno-fetal, el estudio de la descendencia de mujeres cronicamente infectadas posee una especial relevancia. Metodos Estudio observacional por metodo de captura-recaptura que valora el estado serologico en la descendencia de las mujeres diagnosticadas de infeccion por T. cruzi en el area metropolitana norte de Barcelona durante el periodo 2005-2016. Resultados Se identificaron 238 mujeres son serologia positiva para T. cruzi. De ellas, se pudieron localizar 117 (49,2%) y sus 300 descendientes. Entre los descendientes, 192 (64%) tenian registro de serologia, con 23 positivas para T. cruzi (11,98%; IC 95%: 8,1-17,3). Hubo 53 ninos nacidos en el area de estudio, con 5 casos de transmision vertical (9,8%; IC 95%: 4,2-20,9). Todos los nacidos a partir de la implementacion del programa de cribado materno (en 2010) tenian registro serologico. Conclusiones La poblacion de descendientes de mujeres con serologia positiva para T. cruzi muestra una tasa elevada de seropositividad. La prevalencia de transmision vertical es notablemente alta, pero comparable a la obtenida en otros estudios europeos. La principal fuente de perdidas lo constituyen las mujeres ilocalizables. Es razonable incluir la determinacion serologica familiar extensa en los protocolos de cribado de enfermedad de Chagas. A fin de evitar perdidas, se deberia implementar un eventual cribado en el momento del diagnostico materno.

Introduction To date, very little data is available on the extensive, familiar, serological screening of Trypanosoma cruzi from infected-index cases. As it is a parasite with possibility of mother-to-child foetal transmission, the study of the offspring of chronically infected women has a special relevance. Methods An observational study using a capture-recapture method that evaluates the offspring serological status of women diagnosed with T. cruzi infection (positive serology) in the northern metropolitan area of Barcelona during 2005–2016. Results A total of 238 women with positive serology for T. cruzi were identified. Of these, 117 (49.2%) could be localised. Their offspring summarised 300 individuals, of which 192 (64%) had serology records, with 23 positive for T. cruzi (11.98%; CI95%: 8.1–17.3). Among the 53 children born within the study area, 5 (9.8%, CI95%: 4.2–20.9) cases of vertical transmission were recorded. All children born as of 2010 (the starting year of mother screening) had serological outputs. Conclusions Offspring of T. cruzi-seropositive women showed a high rate of seropositivity. The prevalence of vertical transmission is also remarkably high but comparable to that obtained in other European studies. The main source of loss was non-accessible women. It is reasonable to formally include extensive, familiar, serological assessment in Chagas screening guidelines. In order to avoid losses, any eventual screening should be implemented at the time of the maternal diagnosis.

Objectives The aim of this study was to determine the incidence of active tuberculosis (TB) among household contacts of TB-index cases diagnosed during a 7-year period in a public Primary Care Center located in a high-incidence area. Design and Sample A retrospective cohort study was performed. Data collection was based on the capture-recapture method; the two main sources crossed information from TB-index and contact cases from the El Fondo Primary Care Center (Santa Coloma de Gramenet, Spain) and their reports to the National Epidemiologic Surveillance Service. Measures Variables were divided into demographic and health data (result of the Mantoux test, chest X-ray, presence of risk factors, and indication for chemoprophylaxis). Results Community nurses identified 103 household contacts that underwent the conventional contact study. Overall, 60.19% were male; the mean age was 29.08 years. Only one case of secondary active TB was found, representing an incidence of 0.56% per TB-index case and year. Conclusion The incidence of new secondary TB among household contacts with TB-index cases was of a case. Nevertheless, a long-term follow-up of these householders beyond the conventional contacts study should be considered in areas with higher incidences of TB or among specific high-risk populations.

Introduction The economic world crisis has led to the migration of European workers to developing countries with a high incidence of infectious diseases. The objective of this study was to assess whether this context has produced an increase in the risks to international travelers for work reasons (TWR). Methods Observational, retrospective study. The study population included TWR who were attended before traveling at an International Health Unit in the year 2007 (the year before the initiation of the European crisis) and in the year 2012 (when the structural crisis was established). A comparative socioeconomic analysis was performed as well as an analysis of the risk factors present in both groups. Results In 2007 and 2012 a total of 9197 travelers were attended. Of these, there were 344 TWR (3.4%); 101 TWR (2.8%) in 2007 and 243 TWR (4.5%) in 2012 ( p p = .05), more comorbidity ( p = .018) and a greater proportion of stays in rural areas ( p = .0009) for longer time periods ( p = .001). Conclusions At 5 years from the start of the economic crisis, there was a change in the profile of TWR. Their number has increased significantly, as has the proportion who present risk factors for contracting imported diseases. The International Health Units should adapt to these new circumstances and adopt preventive measures for this population.

Resumen Introduccion La crisis economica mundial condiciona la migracion de trabajadores europeos hacia paises en vias de desarrollo con alta incidencia de enfermedades infecciosas. El objetivo de este estudio es valorar si este contexto produce un aumento de los riesgos de los viajeros internacionales que se desplazan por motivos laborales (VML). Metodos Estudio observacional retrospectivo. La poblacion de estudio fueron los VML atendidos antes de su viaje en una Unidad de Salud Internacional durante los anos 2007 (ano anterior al inicio de la crisis europea) y 2012 (con la crisis estructural establecida). Se realizo un analisis comparativo sociodemografico y de los factores de riesgo presentes entre ambos grupos. Resultados En 2007 y 2012 se atendieron un total de 9.197 viajeros. Los VML fueron 344 (3,4%); en 2007, 101 (2,8%) y en 2012, 243 (4,5%) (p Conclusiones A 5 anos del inicio de la crisis economica, existe una variacion en el perfil del VML. Su numero ha aumentado significativamente, asi como la proporcion de los que presentan factores de riesgo para contraer enfermedades importadas. Las Unidades de Salud Internacional deberian adaptarse a las nuevas circunstancias y adoptar medidas preventivas en dicho colectivo.

Summary Background The invasive mosquito Aedes albopictus, with proven vectorial ability to transmit European autochthonous cycles of dengue and chikungunya virus, has currently colonized every coastal department of Eastern Spain. The main objective of the study was to define the epidemiological and clinical characteristics as well as the trends of these two arboviral diseases in a European area heavily colonized by Ae. albopictus. Method A voluntarily-based, prospective and multicenter surveillance study was performed in all medical units of the North Metropolitan area of Barcelona (406,000 inhabitants, Catalonia; Spain) with diagnostic capability from 2009 to 2013. Since any possible increase in arboviral cases could be justified by changes in traveling behaviors along the study period (especially longer trips) the trend showed by these two arboviral diseases was compared with that displayed by malaria cases during the same period. Results 38 out of 52 (73.1%) suspected cases could be serologically confirmed (IgM+): dengue 34/38 (89.5%) and chikungunya 4/38 (11.5%). No autochthonous cases were identified. The overall incidence of both arboviruses was 0.19 cases/10,000 inhabitants-year (95% CI: 0.07–0.3); dengue = 0.17 cases/10,000 inhabitants-year (95% CI: 0.05–0.3), and chikungunya = 0.02 cases/10,000 inhabitants-year (95% CI: 0.001–0.03). The Incidence Relative Risk of arboviral disease between 2009 and 2013 shown a significant trend (IRR = 1.27. IC 95%: 1.01–1.59; p = 0.043) when compared with that displayed by malaria (IRR = 1.04. IC 95%: 0.924–1.192). If no unexpected circumstances concur, the arboviral disease incidence tax would equal that of malaria about 2021–2022. Conclusions The incidence of dengue and chikungunya is steadily increasing in the North Metropolitan area of Barcelona, a region densely colonized by Ae. albopictus, at the entire expense of imported cases (especially Visiting Friends and Relatives travelers). To date, no secondary autochthonous cases have been identified and, thus, they have not taken part in this rise.

After the first secondarily-transmitted ebola case in Spain, a wave of divergent opinions flooded mass and sanitary media. Very few of these opinions, however, came from experts on epidemiology or hemorrhagic fevers. This observational study aimed to assess the specific knowledge of Primary Care physicians and nurses about ebola and hemorrhagic fevers by means of analyzing the results obtained from a 5-item self-reported questionnaire dealing on hemorrhagic fevers basic knowledge. Validity and reliability of questionnaire were confirmed by a pilot study. The participants were 138 family doctors and nurses from the 64 public Primary Care centers sited in the North Metropolitan Area of Barcelona (1,400,000 inhab; Catalonia, Spain) taking part in training-the-trainers ebola workshops. Overall, there were 117 (84.8%) respondents out from 138 workshop participants; of them were physicians 61 (51.2%). The main age was 46.7 (8.8) years; stating previous specific knowledge on hemorrhagic fevers 39 (33.3%). On the whole, up to 92 (78.6%) of respondents shown a poor knowledge. Previous specific formation was significantly and independently associated with having proper knowledge (p < 0.001); OR = 8.6 (CI 95%: 3.199 - 23.623). In summary, confusion that accompanied the single secondary-transmitted ebola case in Spain could probably be explained by the existence of a serious gap on hemorrhagic fevers knowledge. More accurate, scientific and formally-presented information should be provided to Primary Care physicians and nurses.

Fundamento y objetivo Hay un acuerdo general en considerar que la poblacion de origen indostanico, sobre todo los inmigrantes de paises occidentales, tiene un riesgo especialmente elevado a desarrollar diabetes mellitus tipo 2 (DM2). Para explicarlo se han defendido argumentos basados en el impacto de los cambios debidos a la inmigracion, especialmente el atribuible a la adopcion de una dieta occidental (hipotesis ambiental) o debidos a la presencia de resistencia tisular a la insulina (hipotesis genetica). El objetivo principal del estudio es valorar la prevalencia de DM2 en tres poblaciones de inmigrantes: indostanicos, inmigrantes no indostanicos y autoctonos. Poblacion y metodo Estudio transversal y multicentrico realizado en 3 centros de atencion primaria de Santa Coloma de Gramenet (Barcelona, Espana). Se estudiaron tres poblaciones nacidas entre 1948 y 1973 segun su origen: indostanico, no indostanico y autoctono. Se analizo la prevalencia de DM2 y la relacion de variables sociodemograficas y de comorbilidad entre los pacientes diabeticos. Resultados Se estudio a 2.690 individuos de los que un 4,6% tenia DM2. La prevalencia de DM2 fue superior en el grupo de indostanicos (20,9%, intervalo de confianza [IC] del 95%, 12,1-29,1) en relacion con el grupo de autoctonos (3,6%, IC del 95%, 2,9-4,3; p Conclusiones Se observa una mayor prevalencia de DM2 en poblacion inmigrante joven en relacion con la poblacion autoctona. La prevalencia de DM2 en inmigrantes indostanicos es la mas alta de las registradas en la Union Europea y superior a la de los inmigrantes no indostanicos, despues son necesarios subsiguientes estudios que comparen ambas poblaciones.