Mapas de riesgo de Arbovirosis en España

MARVEE. Mapas de riesgo de vectores y enfermedades emergentes y reemergentes en España. Objetivo Principal: Mapas de riesgo de distribución de Aedes albopictus, y aedes aegypti, culex spp. y Anopheles Mapas de riesgo de enfermedades: dengue,Chikungunya, Zika, Fiebre amarilla y de Fiebre del Nilo Occidental.N

Climatic Factors and Influenza Transmission, Spain, 2010-2015

The spatio-temporal distribution of influenza is linked to variations in meteorological factors, like temperature, absolute humidity, or the amount of rainfall. The aim of this study was to analyse the association between influenza activity, and meteorological variables in Spain, across five influenza seasons: 2010-2011 through to 2014-2015 using generalized linear negative binomial mixed models that we calculated the weekly influenza proxies, defined as the weekly influenza-like illness rates, multiplied by the weekly proportion of respiratory specimens that tested positive for influenza. The results showed an association between influenza transmission and dew point and cumulative precipitation. In increase in the dew point temperature of 5 degrees produces a 7% decrease in the Weekly Influenza Proxy (RR 0.928, IC: 0.891-0.966), and while an increase of 10 mm in weekly rainfall equates to a 17% increase in the Weekly Influenza Proxy (RR 1.172, IC: 1.097-1.251). Influenza transmission in Spain is influenced by variations in meteorological variables as temperature, absolute humidity, or the amount of rainfall.This study has been funded by Instituto de Salud Carlos III through the project “PI15/01398” (Co-funded by European Regional Development Fund/European Social Fund “Investing in your future”).S

Association between meteorological factors and hepatitis A in Spain 2010-2014

BACKGROUND: There is growing concern of how climate change could affect public health, due to the increase number of extreme climate events. Hence, the study of the role that climate events play on the distribution of waterborne diseases, like Hepatitis A, could be key for developing new prevention approaches. OBJECTIVE: To investigate the association between climate factors and Hepatitis A in Spain between 2010 and 2014. METHODS: Weekly Hepatitis A cases between 2010 and 2014 were obtained from the Spanish Epidemiology Surveillance Network. Climate variables (weekly cumulative rainfall, rainy days, storm days and snow days) were obtained from National Climatic Data Center (NOAA satellite and information Service of USA). Each municipality was assigned to the nearest weather station (N=73). A Mixed-Effects Poisson regression was performed to estimate Incidence Rate Ratios (IRR), including a time lag of 2, 3 and 4weeks (most probable incubation period for Hepatitis A). RESULTS: Rainfall higher than 90th percentile (extreme precipitation) was associated with increased number of Hepatitis A cases 2weeks (IRR=1.24 CI 95%=1.09-1.40) and 4weeks after the event (IRR=1.15 CI 95%=1.01-1.30). An extra rainy day increased the risk of Hepatitis A two weeks after (IRR=1.03 CI 95%=1.01-1.05). We found higher risk of Hepatitis A two weeks after each extra storm day (IRR=1.06 CI 95%=1.00-1.12), and lower risk with 3 and 4weeks' lag (IRR=0.93 CI 95%=0.88-0.99 for lag3; IRR=0.94 CI 95%=0.88-0.99 for lag 4). CONCLUSIONS: There is an increased risk of Hepatitis A 2weeks after water-related climate events. Including meteorological information in surveillance systems might improve to develop early prevention strategies for waterborne diseases.This study has been funded by Instituto de Salud Carlos III through the project “PI15/01398” (Co-funded by European Regional Development Fund/European Social Fund “Investing in your future”). Pedro Gullón was supported by the Medical Residents program of Spanish Ministry of Health and by the Enrique Nájera grant for Young Epidemiologists (12th edition) awarded by the Sociedad Española de Epidemiología.S

La leishmaniasis en España: evolución de los casos notificados a la Red Nacional de Vigilancia Epidemiológica desde 2005 a 2017 y resultados de la vigilancia de 2014 a 2017

[ES] La leishmaniasis es una enfermedad endémica en España. Es de declaración obligatoria en todo el territorio desde 2015 a través de la Red Nacional de Vigilancia Epidemiológica (RENAVE). Los objetivos son conocer su distribución temporal y espacial, describir la epidemiología de los casos autóctonos y conocer la calidad de las notificaciones. Se realizó un estudio descriptivo en el que se analizó la distribución temporal de casos y las tasas de las comunidades autónomas (CCAA) con notificación estable (2005 a 2017). Además, a partir de los casos autóctonos notificados entre 2014 y 2017 se realizó un estudio descriptivo que incluyó la distribución temporal y espacial (casos y tasas). La calidad se midió según la exhaustividad en la cumplimentación de las variables. Entre 2005 y 2017 hubo 8 CCAA con notificación estable (media 141 casos/año, tasa de período 0,62 casos/100.000 hab.). Hubo picos en 2011 y 2012 debidos principalmente a la Comunidad de Madrid. Excluyendo los casos de la C. de Madrid (TI Otras) la evolución observada fue más estable, con tendencia ascendente desde 2012. Entre 2014 y 2017 hubo 1359 casos autóctonos (media 340 casos/año; tasa 0,76) de 15 CCAA, con una tendencia ascendente. El mayor número correspondió a enero y junio. 5 CCAA acumularon el 89,9% de los casos del período: Comunidad Valenciana, Comunidad de Madrid, Cataluña, Baleares y Andalucía. Presentaron tasas superiores a la del período Baleares, Comunidad Valenciana, Comunidad de Madrid y Castilla La-Mancha. El 61,1% de los casos eran hombres y la edad mediana 48 años. Las tasas más elevadas se observan en los niños y niñas <1 año y de 1 a 4. El 51,6% fueron formas viscerales. La cumplimentación de las variables de riesgo fue muy escasa o nula. Del resto, las variables con mayor frecuencia de datos desconocidos fueron: municipio del caso (63,2%), defunción (57,9%), fecha de diagnóstico (52%), hospitalización (49,4%) y país de nacimiento (37,7%). La tendencia ascendente de notificación de leishmaniasis observada en los últimos años es probablemente multifactorial. La enfermedad se distribuye por todo el país durante todo el año, con regiones y épocas de mayor riesgo. El grupo de mayor riesgo son niños menores de 5 años. Existe amplio margen de mejora en la calidad de la información.[EN] Leishmaniasis is a disease endemic in Spain. Reporting is compulsory for every Autonomous Region (CCAA) through the National Surveillance Network since 2015. The objectives are to know its temporal and spatial distribution, to describe the epidemiology of autochthonous cases and to find out the quality of case reporting. A descriptive analysis was carried out. Temporal distribution of the cases and rates by CCAA were conducted considering regions with stable notification (2005 to 2017). Using autochthonous cases from 2014 to 2017, a descriptive analysis including temporal and spatial distribution (cases and rates) was also performed. Quality was measured according to the completeness in the completion of variables. From 2005 to 2017 there were 8 CCAA with stable reporting (mean 141 cases/year, period rate 0.62 cases/100.000 inhabitants). Peaks in 2011 and 2012 were mainly due to the Community of Madrid. Excluding these cases (TIOtras), a more stable trend was observed with an increase since 2012. Between 2014 and 2017 there were 1359 autochthonous cases (mean 340 cases/year; rate 0.76) from 15 CCAA, with an upward trend. The largest number corresponded to January and June. 89.9% of cases corresponded to 5 CCAA: Valencian Community, Madrid, Catalonia, Balearic Islands and Andalusia. Rates higher than the period one were observed in Balearics, Valencian Community, Madrid and Castilla La-Mancha. Men represented 61.1% of the cases. The median age was 48 years. The highest rates corresponded to children <1 year and from 1 to 4. 51.6% of cases were visceral diseases. The completion of risk variables was almost null. Among the other variables, those with highest missing values proportion were: municipality of the case (63.2%), death (57.9%), date of diagnosis (52%), hospitalization (49.4%) and country of birth (37.7%). The recent upward trend of leishmaniasis notification is probably multifactorial. The disease is distributed throughout the country along the year, with variable risk by regions and periods. The highest risk group are children under 5 years-old. There is a large scope for improvement in the quality of data.N

Big Mosquito Bytes. Ciencia ciudadana y Salud Pública

Comunicación presentada en las II Jornada del Centro Nacional de Epidemiología - 2021.Se expone la aplicación "Mosquito Alert" como proyecto de ciencia ciudadana. La ciencia ciudadana hace referencia a involucrar al público general en actividades de investigación científica. Está herramienta pretende tener una predicción en tiempo real de la interacción mosquito-humano

Human Q fever in Spain (2016-2020)

Artículo BES V.31N.1Introducción: La fiebre Q es una antropozoonosis causada por Coxiella burnetii. una bacteria extremadamente resistente a condiciones medioambientales adversas. Se transmite por vía aérea de animales a personas y, en España, país que más casos anuales notifica a Europa, los reservorios principales son los rumiantes domésticos. Método: Análisis epidemiológico descriptivo de los casos de fiebre Q notificados a la Red Nacional de Vigilancia Epidemiológica (RENAVE) entre 2016 y 2020 en 45 provincias. Se analizaron variables temporales y espaciales. Análisis espacial en las zonas de mayor incidencia y cálculo del riesgo relativo suavizado (RRs) por municipio. Resultados: 1749 casos totales, de los cuales1249 son hombres (71,2%). La mayoría se producen entre los 35 y los 55 años. La incidencia aumenta de marzo a junio. La distribución espacial es heterogénea y se concentra en las Islas Canarias, el País Vasco, La Rioja, Navarra y Andalucía Occidental. Las zonas más afectadas tienen patrones espaciales con distintos niveles de RRs. En Canarias el RRs parece superior en las islas orientales. En las provincias del norte peninsular es superior las provincias occidentales. En Andalucía y Badajoz es mayor en el sureste de Badajoz y norte de Sevilla. Conclusiones: La situación epidemiológica de la fiebre Q parece mantenerse estable. La infección es más frecuente en varones en edades medias. El aumento de casos en primavera puede relacionarse con el ciclo reproductivo del ganado. Factores ambientales pueden condicionar la distribución espacial. Dado el carácter zoonótico y geográfico-estacional, serán necesarios futuros estudios orientados desde una perspectiva Una Salud.N

Using hospital discharge database to characterize Chagas disease evolution in Spain: there is a need for a systematic approach towards disease detection and control

After the United States, Spain comes second in the list of countries receiving migrants from Latin America, and, therefore, it is the European country with the highest expected number of infected patients of Chagas disease. We have studied the National Health System's Hospital Discharge Records Database (CMBD) in order to describe the disease evolution from 1997 to 2011 in Spain. We performed a retrospective descriptive study using CMBD information on hospitalizations including Chagas disease. Data was divided in two periods with similar length in time: 1997-2004 and 2005-2011. Hospitalization rates were calculated and clinical characteristics were described. We used multivariable logistic regression to calculate adjusted odds-ratio (aOR) for the association between various conditions and being hospitalized with organ affectation. A total of 1729 hospitalization records were identified. Hospitalization rates for the two periods were 18 and 242.8/100000 population, respectively. The median age was 35 years (range 0-87), 74% were female and the 16-45 age-group was mostly represented (69.8%). Overall, 23.4% hospitalizations included the diagnosis of Chagas disease with organ complications. Being male [aOR: 1.3 (1.00-1.77)], aged 45 and 64 years [aOR: 2.59 (1.42-4.71)], and a median hospitalization cost above 3,065 euro [aOR: 2.03 (3.73-7.86)] were associated with hospitalizations with organ affectation. Since 2005, the number of detected infections increased in Spain. The predominant patients' profile (asymptomatic women at fertile age) and the conditions associated with organ affectation underlines the need for increased efforts towards the early detection of T cruzi.We would like to thank the General Sub-direction of the Institute for Health Information, Spanish Ministry of Health, Social Services and Equality, for providing the information on which this study is based. Corresponding author's affiliation center belongs to the Network Biomedical Research on Tropical Diseases (RICET in Spanish): RD12/0018/0001.S

Spatial clustering of onchocerciasis in Bioko Island, Equatorial Guinea

INTRODUCTION: Onchocerciasis is a chronic neglected tropical disease caused by the filarial nematode Onchocerca volvulus, which is endemic in Equatorial Guinea. The aim was to estimate the current spatial distribution of onchocerciasis, and its related factors, in Bioko Island after several years of mass drug administration and vector control activities, by using GIS technics. METHODOLOGY: The survey was carried out within the framework of a wider research project entitled "Strengthening the National Programme for Control of Onchocerciasis and other Filariasis in Equatorial Guinea". A structured questionnaire was designed to cover basic socio-demographic information and risk factors for onchocerciasis and the coordinates of household. the hydrographic network data to calculate the positive onchocerciasis rate was used. Poisson generalized linear model was used to explore the association between onchocerciasis and the following covariates: distance to the river, preventive practices, water source and household´s main source of income. Two different cluster analysis methods were used: Getis-Ord Gi statistic and SaTScan™ purely spatial statistic estimator. RESULTS: The risk of onchocerciasis was higher for those who drank water from external sources (RR 25.3) than for those who drank home tap water (RR 8.0). The clusters with z-score higher were located at the east of the island. For 5 km and 1 km distances, one significant cluster in the east was detected (RR 5.91 and RR 7.15). CONCLUSION: No environmental factors related with onchocerciasis were found, including proximity to rivers. This could be partially explained by the fact that the vector was eliminated in 2005.S

The impact of climate change on mosquito-borne diseases in Africa.

Despite being one of the continents with the least greenhouse gas emissions, no continent is being struck as severely by climate change (CC) as Africa. Mosquito-borne diseases (MBD) cause major human diseases in this continent. Current knowledge suggests that MBD range could expand dramatically in response to CC. This study aimed at assessing the relationship between CC and MBD in Africa. Methods For this purpose, a systematic peer review was carried out, considering all articles indexed in PubMed, Scopus, Embase and CENTRAL. Search terms referring to MBD, CC and environmental factors were screened in title, abstract and keywords.Results A total of twenty-nine studies were included, most of them on malaria (61%), being Anopheles spp. (61%) the most commonly analyzed vector, mainly in Eastern Africa (48%). Seventy-nine percent of these studies were based on predictive models. Seventy-two percent of the reviewed studies considered that CC impacts on MBD epidemiology. MBD prevalence will increase according to 69% of the studies while 17% predicted a decrease. MBD expansion throughout the continent was also predicted. Most studies showed a positive relationship between observed or predicted results and CC. However, there was a great heterogeneity in methodologies and a tendency to reductionism, not integrating other variables that interact with both the environment and MBD. In addition, most results have not yet been tested. A global health approach is desirable in this kind of research. Nevertheless, we cannot wait for science to approve something that needs to be addressed now to avoid greater effects in the future.S

El papel de la movilidad geográfica en la expansión de Aedes albopictus y en la transmisión de enfermedades infecciosas

Ponencia sobre el papel de la movilidad geográfica en la expansión de Aedes albopictus y en la transmisión de enfermedades infecciosas. Se estudia la dispersión de Aedes albopictus basados en el análisis de datos de la invasión en la provincia de Girona durante 2009-2011; y la dispersión epidémica en redes desarrollando un marco teórico para la modelización de la propagación de enfermedades infecciosas.N