scholarly journals Characteristics of child daycare centres associated with clustering of major enteropathogens

2016 ◽  
Vol 144 (12) ◽  
pp. 2527-2539 ◽  
Author(s):  
R. PIJNACKER ◽  
L. MUGHINI-GRAS ◽  
H. VENNEMA ◽  
R. ENSERINK ◽  
C. C. VAN DEN WIJNGAARD ◽  
...  

SUMMARYInsights into transmission dynamics of enteropathogens in children attending daycare are limited. Here we aimed at identifying daycare centre (DCC) characteristics associated with time-clustered occurrence of enteropathogens in DCC-attending children. For this purpose, we used the KIzSS network, which comprises 43 DCCs that participated in infectious disease surveillance in The Netherlands during February 2010–February 2013. Space–time scan statistics were used to identify clusters of rotavirus, norovirus, astrovirus,Giardia lambliaandCryptosporidiumspp. in a two-dimensional DCC characteristic space constructed using canonical correlation analysis. Logistic regression models were then used to further identify DCC characteristics associated with increased or decreased odds for clustering of enteropathogens. Factors associated with increased odds for enteropathogen clustering in DCCs were having indoor/outdoor paddling pools or sandpits, owning animals, high numbers of attending children, and reporting outbreaks to local health authorities. Factors associated with decreased odds for enteropathogen clustering in DCCs were cleaning child potties in designated waste disposal stations, cleaning vomit with chlorine-based products, daily cleaning of toys, extra cleaning of toys during a suspected outbreak, and excluding children with gastroenteritis. These factors provide targets for reducing the burden of gastrointestinal morbidity associated with time-clustered occurrence of major enteropathogens in DCC attendees.

BMJ ◽  
1924 ◽  
Vol 2 (3329) ◽  
pp. 741-742
Author(s):  
J. G. Bennett

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Xiao Fan Liu ◽  
Xiao-Ke Xu ◽  
Ye Wu

AbstractThe 2019 coronavirus disease (COVID-19) is pseudonymously linked to more than 100 million cases in the world as of January 2021. High-quality data are needed but lacking in the understanding of and fighting against COVID-19. We provide a complete and updating hand-coded line-list dataset containing detailed information of the cases in China and outside the epicenter in Hubei province. The data are extracted from public disclosures by local health authorities, starting from January 19. This dataset contains a very rich set of features for the characterization of COVID-19’s epidemiological properties, including individual cases’ demographic information, travel history, potential virus exposure scenario, contacts with known infections, and timelines of symptom onset, quarantine, infection confirmation, and hospitalization. These cases can be considered the baseline COVID-19 transmissibility under extreme mitigation measures, and therefore, a reference for comparative scientific investigation and public policymaking.


Vaccines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 120
Author(s):  
Michela Sabbatucci ◽  
Anna Odone ◽  
Carlo Signorelli ◽  
Andrea Siddu ◽  
Andrea Silenzi ◽  
...  

The COVID-19 pandemic has affected national healthcare systems worldwide, with around 282 million cumulative confirmed cases reported in over 220 countries and territories as of the end of 2021. The Italian National Health System was heavily affected, with detrimental impacts on preventive service delivery. Routine vaccination services were disrupted across the country during the first months of the pandemic, and both access to and demand for vaccines have decreased during the pandemic. In many cases, parents preferred to postpone scheduled appointments for routine paediatric vaccinations because of stay-at-home orders or fear of COVID-19 infection when accessing care. The objective of the current study was to assess the routine childhood vaccine coverage (VC) rates during the COVID-19 epidemic in Italy. We compared 2020 and 2019 VC by age group and vaccine type. The Italian Ministry of Health collected anonymised and aggregated immunisation national data through the local health authorities (LHAs). Results were considered statistically significant at a two-tailed p-value ≤ 0.05. VC rates for mandatory vaccinations decreased in 2020 compared to 2019 (range of VC rate decrease: −1% to −2.7%), while chicken pox increased (+2.2%) in 7-year-old children. Recommended vaccinations were moderately affected (range of VC rate decrease in 2020 vs. 2019: −1.4% to −8.5%), with the exception of anti-HPV in males, Men ACWY, and anti-rotavirus vaccination (VC increase 2020 vs. 2019: +1.8%, +4.7% and +9.4%, respectively). In the COVID-19 era, the implementation of coherent, transparent, and effective communication campaigns and educational programs on safe childhood vaccinations, together with the increase in the number of healthcare staff employed, is essential to support strategies to reinforce vaccination confidence and behaviour, thus avoiding health threats due to VPD during and beyond COVID-19 times.


Author(s):  
Trevor Hoppe

As the HIV epidemic wore on in the 2000s, public health authorities became enamored with the idea of “ending AIDS.” That is, if they could just get HIV-positive people to take their pills and stop infecting other people. Health departments began to track HIV-positive clients more closely, aiming to control their behavior and ensure their adherence to treatment regimens. This chapter explores how local health authorities ensure that HIV-positive clients behave in a manner officials deem responsible—and how they catch and punish those who do not. While the state maintains that the work of local health officials is done solely in the interests of promoting public health, their efforts to control HIV-positive clients reveal that they are also engaged in policing and law enforcement.


2019 ◽  
Vol 147 ◽  
Author(s):  
R. A. Dias ◽  
F. Rocha ◽  
F. M. Ulloa-Stanojlovic ◽  
A. Nitsche ◽  
C. Castagna ◽  
...  

AbstractIn Brazil, rabies surveillance is based on monitoring domestic and wild animals, although the most prevalent lineage of the rabies virus (RABV) currently diagnosed in Brazil is associated with bats, particularly non-haematophagous bats. Disease control is based on the mass vaccination of dogs and cats. We used data collected by the passive surveillance system of the city of Campinas from 2011 to 2015, to describe the temporal and geographic distributions of the bat specimens and RABV and discuss the current rabies surveillance with the advent of the declaration of canine and feline rabies-free areas in Brazil. We described the species, locations and health statuses of the collected bat specimens. Moreover, all samples were submitted for RABV diagnosis. Then, we performed a time series decomposition for each bat family. Additionally, we determined the spatiotemporal relative risk for RABV infection using the ratio of the kernel-smoothed estimates of spatiotemporal densities of RABV-positive and RABV-negative bats. From the 2537 bat specimens, the most numerous family was Molossidae (72%), followed by Vespertilionidae (14%) and Phyllostomidae (13%). The bat families behaved differently in terms of seasonal and spatial patterns. The distribution of bats varied geographically in the urban environment, with Molossidae and Phyllostomidae being observed downtown and Vespertilionidae being observed in peripheral zones. Concurrently, a significant relative risk of RABV infection was observed downtown for Vespertilionidae and in peripheral zones for Molossidae. No RABV-positive sample clusters were observed. As a result of the official declaration of RABV-free areas in southern Brazil, mass dog and cat vaccinations are expected to halt in the near future. This stoppage would make most dog and cat populations susceptible to other RABV lineages, such as those maintained by non-haematophagous bats. In this scenario, all information available on bats and RABV distribution in urban areas is essential. Currently, few studies have been conducted. Some local health authorities, such as that in Campinas, are spontaneously basing their surveillance efforts on bat rabies, which is the alternative in reality scenario of increased susceptibility to bat-associated RABV that is developing in Brazil.


1963 ◽  
Vol 109 (458) ◽  
pp. 29-36 ◽  
Author(s):  
Brice Pitt ◽  
Morris Markowe

Slowly but surely the emphasis of the mental health service is moving from the mental hospital into the community which it serves. The trend of these community developments can be seen as far back as the establishment of psychiatric out-patient clinics at general hospitals under the Mental Treatment Act, 1930, together with arrangements for after care, and continued by mental hospitals and regional hospital boards since the advent of the National Health Service. While the new era in British psychiatry awaits the implementation by local health authorities of their mandatory functions under the Mental Health Act, 1959, much can still be done within the hospital services proper to shift the emphasis into the community. One such method is described in this study of a Day Hospital developed within a large general hospital.


2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Vishal Dogra ◽  
Shailendra Hegde ◽  
Nitin Rathnam ◽  
Sridhar Emmadi ◽  
Vishal Phanse

ObjectiveWe report the findings of Andhra Pradesh state’s mobile medical service programme and how It is currently used to strengthen the disease surveillance mechanisms at the village level.IntroductionIndia has an Integrated Disease Surveillance project that reports key communicable and infectious diseases at the district and sub-district level. However, recent reviews suggest structural and functional deficiencies resulting in poor data quality (1). Hence evidence-based actions are often delayed. Piramal Swasthya in collaboration with Government of Andhra Pradesh launched a mobile medical unit (MMU) programme in 2016. This Mobile medical service delivers primary care services to rural population besides reporting and alerting unusual health events to district and state health authorities for timely and appropriate action.The MMU service in the Indian state of Andhra Pradesh is one of the oldest and largest public-private initiatives in India. Two hundred and ninety-two MMUs provide fixed-day services to nearly 20,000 patients a day across 14,000 villages in rural Andhra Pradesh. Every day an MMU equipped with medical ( a doctor) and non-medical (1 nurse, 1 registration officer, 1 driver, 1 pharmacist, 1 lab technician, 1 driver) staff visit 2 service points (villages) as per prefixed route map. Each MMU also has its own mobile tablet operated by registration officer for capturing patient details. The core services delivered through MMUs are the diagnosis, treatment, counseling, and free drug distribution to the beneficiaries suffering from common ailments ranging from seasonal diseases to acute communicable and common chronic non-communicable diseases. The routinely collected patient data is daily synchronized on a centrally managed data servers.MethodsFor this analysis, we used aggregated and pooled data that were routinely collected from August 2016-March 2018. Patient details such as socio-demographic variables (age, sex etc.) medical history and key vitals (random blood sugar, blood pressure, pulse rate etc.) and disease diagnosis variables were analyzed. Besides, communication and action taken reports shared with Government of Andhra Pradesh were also analyzed. We report the findings of the programme with reference to strengthing the village level communicable disease surveillance. Unusual health events were defined as more than 3 patients reporting the epidemiologically linked and similar conditions clustered in the same village.ResultsWe observed 4,352,859 unique beneficiaries registrations and 9,122,349 patient visits. Of all unique beneficiaries, 79.3% had complete diagnosis details (53% non-communicable disease, 39% communicable and 8% others conditions). A total of 7 unusual health events related to specific and suspected conditions (3 vector-borne diseases related, 4 diarrhea-related) were reported to district health authorities, of which 3 were confirmed outbreaks (1 dengue, 1 malaria, and 1 typhoid) as investigated by local health authorities.ConclusionsMobile medical services are useful to detect unusual health events in areas with limited resources. It increases accountability and response from the Government authorities if the timely information is shared with competent health authorities. Careful evaluation of the mobile health interventions is needed before scaling-up such services in other remote rural areas.References1. Kumar A, Goel MK, Jain RB, Khanna P. Tracking the Implementation to identify gaps in Integrated Disease Surveillance Program in a Block of District Jhajjar (Haryana). Journal of Family Medicine and Primary Care. 2014;3(3):213-215.2. Raut D, Bhola A. Integrated disease surveillance in India: Way forward. Global Journal of Medicine and Public Health.2014;3(4):1-10


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