Leishmaniasis worldwide and global estimates of its incidence.

As part of a World Health Organization-led effort to update the empirical evidence base for the leishmaniases, national experts provided leishmaniasis case data for the last 5 years and information regarding treatment and control in their respective countries and a comprehensive literature review was conducted covering publications on leishmaniasis in 98 countries and three territories (see 'Leishmaniasis Country Profiles Text S1, S2, S3, S4, S5, S6, S7, S8, S9, S10, S11, S12, S13, S14, S15, S16, S17, S18, S19, S20, S21, S22, S23, S24, S25, S26, S27, S28, S29, S30, S31, S32, S33, S34, S35, S36, S37, S38, S39, S40, S41, S42, S43, S44, S45, S46, S47, S48, S49, S50, S51, S52, S53, S54, S55, S56, S57, S58, S59, S60, S61, S62, S63, S64, S65, S66, S67, S68, S69, S70, S71, S72, S73, S74, S75, S76, S77, S78, S79, S80, S81, S82, S83, S84, S85, S86, S87, S88, S89, S90, S91, S92, S93, S94, S95, S96, S97, S98, S99, S100, S101'). Additional information was collated during meetings conducted at WHO regional level between 2007 and 2011. Two questionnaires regarding epidemiology and drug access were completed by experts and national program managers. Visceral and cutaneous leishmaniasis incidence ranges were estimated by country and epidemiological region based on reported incidence, underreporting rates if available, and the judgment of national and international experts. Based on these estimates, approximately 0.2 to 0.4 cases and 0.7 to 1.2 million VL and CL cases, respectively, occur each year. More than 90% of global VL cases occur in six countries: India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil. Cutaneous leishmaniasis is more widely distributed, with about one-third of cases occurring in each of three epidemiological regions, the Americas, the Mediterranean basin, and western Asia from the Middle East to Central Asia. The ten countries with the highest estimated case counts, Afghanistan, Algeria, Colombia, Brazil, Iran, Syria, Ethiopia, North Sudan, Costa Rica and Peru, together account for 70 to 75% of global estimated CL incidence. Mortality data were extremely sparse and generally represent hospital-based deaths only. Using an overall case-fatality rate of 10%, we reach a tentative estimate of 20,000 to 40,000 leishmaniasis deaths per year. Although the information is very poor in a number of countries, this is the first in-depth exercise to better estimate the real impact of leishmaniasis. These data should help to define control strategies and reinforce leishmaniasis advocacy

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Cuantificación del absentismo laboral en la empresa

Cuando hablamos de los fenómenos de salud en la empresa, uno de los aspectos más relevantes es el análisis del absentismo laboral observado en la población trabajadora, que se verifica a través de los correspondientes indicadores de los niveles de morbilidad y siniestralidad laboral. Con independencia de la necesidad de incorporar en dicho análisis la repercusión de los aspectos psicosociales que influyen sobre estos niveles, uno de los aspectos que más debe de cuidar la epidemiología y el Servicio de Prevención de la empresa en el repetido análisis, es la detección y corrección de todos aquellos factores de confusión y de error que, deliberada o artificiosamente, pueden introducirse en la computación, determinación y comparación de los repetidos indicadores. El objetivo, pues, de este artículo, es la revisión de los procedimientos actuales para el cálculo y cómputo de los principales indicadores de siniestralidad y morbilidad utilizados en la empresa. Para el desarrollo de este objetivo general, nos planteamos como objetivos específicos la revisión de los parámetros básicos que suelen utilizarse en el análisis del absentismo, la de los principales indicadores del absentismo médico, así como la de aquellos errores de sesgo que suelen incorporarse en el análisis final de este fenómeno

Bordón : revista de pedagogía

Resumen tomado de la publicaciónLa globalización económica actual fomenta la entrada de un mercado altamente competitivo. Las organizaciones deberían fomentar la formación continua, principal estrategia para obtener todo el potencial de los propios recursos humanos. La detección de necesidades de formación es el primer paso de todo proceso formativo. Para localizar dichas necesidades de formación, se plantea un enfoque innovador, en línea con las exigencias actuales de desarrollo e implicación de los recursos humanos. El estudio se acompaña, entre otras, de tablas relativas a los distintos enfoques de detección y análisis de necesidades formativas, y de las fases del proyecto desarrollado en la organización. También incorpora dos anexos. El primero con una ficha para cumplimentar las necesidades formativas individuales. El segundo es un ejemplo para trabajar en grupo.MadridMadrid (Comunidad Autónoma). Servicio de Formación del Profesorado. CRIF Las Acacias; Calle General Ricardos, 179; 28025 Madrid; Tel. +34915250893; Fax +34914660991; [email protected]

Reported and estimated incidence of visceral leishmaniasis in the Mediterranean region.

1<p>Underreporting considered mild (1.2–1.8-fold).</p>2<p>Underreporting considered moderate (2–4-fold).</p

Reported and estimated incidence of visceral leishmaniasis in the East African region.

1<p>Underreporting considered moderate (2–4-fold).</p>2<p>Underreporting considered severe (4.2–8.1-fold).</p>3<p>Underreporting considered mild (1.2–1.8).</p

Reported and estimated incidence of visceral leishmaniasis in the American region.

1<p>Underreporting considered moderate (2–4-fold) based on recent introduction of VL into the country.</p>2<p>Underreporting considered mild (1.2–1.8-fold) based on data from Brazil <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0035671#pone.0035671-MaiaElkhoury1" target="_blank">[25]</a>.</p

Reported and estimated incidence of cutaneous leishmaniasis in the sub-Saharan African region.

1<p>Underreporting considered moderate (5–10-fold).</p