Seasonal syndromic surveillance by sentinel system of ILI, ARI, SARI and pneumonia in Romania – season 2023/2024

Syndromic surveillance was initially developed for early detection compared to traditional methods of an epidemiological event with an impact on public health, but as it was applied by more countries it was observed that it can provide information on the size, dynamics of the spread with an emphasis on the potential for national, regional and global evolution, the severity and the most affected population groups, but also to the development of a quick, specific response. Globalization, which involves the intensification of the movement of people (including sick or incubating infectious diseases), live animals, or products of animal origin in and from any part of the planet, but also climate change and pollution, amplifies the danger of the spread of communicable infectious diseases from areas so-called “specific” diseases in new areas, unknown to populations and healthcare systems. In this context, the One Health initiative needs efficient surveillance methods to help promote the health of people, animals, the environment, and ultimately the planet Earth. Recently, there have been substantial changes in the surveillance and control of infectious diseases with an impact on public health aimed at assessing the risks of the emergence of infectious agents with epidemic and pandemic potential by identifying and analyzing favorable factors related to the infectious agent (virulence, variability, transmissibility, etc.), the host organism (immunity, physiological factors, vaccination status, associated chronic diseases, nutritional status, living conditions, etc.), demographic factors (birth rate, mortality, population agglomerations), climatic factors and insect populations vectors, rodents and wild animals (including birds) and last but not least domestic animal populations (including birds). Among these methods, syndromic surveillance stands out, which in addition has the quality of using automatic data acquisition and generating statistical alerts, monitors disease indicators in real-time or near real-time to detect disease outbreaks earlier than would be possible with conventional methods traditional public health. In this context, we will present the Romanian experience regarding the syndromic surveillance of ILI, ARI and SARI in Romania through the national sentinel system season 2023/2024

La Imagen y la Narrativa como Herramientas para el Abordaje Psicosocial en Escenarios de Violencia. Santa Marta, Departamento del Magdalena

Colombia ha sido escenario, por más de cincuenta años, de múltiple Violencia por el conflicto armado, que ha generado situaciones de crisis e intimidación y afectaciones psicosociales en los territorios, en lo físico, lo psicológico, la identidad de las personas, en cuanto a la Subjetividad, y lo social, dejando profundas huellas en la memoria de muchas poblaciones con consecuencias psicosociales, reflejadas en el aumento de las tasas de suicidio y enfermedades mentales por estrés post traumático. En este documento se desarrolla un ejercicio de reflexión y aprendizaje basado en el uso de la imagen y la narrativa, como herramientas para el abordaje psicosocial en escenarios de violencia. Se abordan los siguientes temas para el desarrollo: primer paso se hará el análisis del relato: Camilo Victima, del conflicto tomado de la UNAD relatos de vida: historias de violencia y esperanza en Colombia., (2007), complementando con la formulación de preguntas estratégicas, circulares y reflexivas y su respectiva sustentación teórica El segundo Punto, corresponde al análisis y presentación de estrategias de abordaje psicosocial, para el caso de las comunidades de Cacarica, respondiendo a las preguntas: ¿Qué Emergentes Psicosociales, considera están latentes después de la incursión y el hostigamiento militar? ¿Qué impactos genera para la población ser estigmatizada como cómplice de un actor armado?; además de la respuesta a las anteriores preguntas, se presentan las acciones de apoyo en la situación de crisis generada por la tortura y el asesinato de miembros y líderes de la comunidad; las estrategias psicosociales con los pobladores de Cacarica, que facilitan la potenciación de recursos de Afrontamiento, a la situación expresada. Por último se desarrolla un informe analítico y reflexivo de la experiencia de Foto Voz, se maneja la imagen como una estrategias de intervención, con la intención de recuperar la Memoria, y no dejar en el olvido estos hechos, los cuales son importantes para las víctimas, teniendo en cuenta la subjetividad y los recursos de afrontamiento; seguidamente las conclusiones sobre la experiencia, aplicación de la herramienta foto voz; y finalmente el link del blog construidoColombia has been the scene, for more than fifty years, of multiple Violence, by the armed conflict, which has generated situations of crisis and intimidation and psychosocial affectations in the territories, in the physically, psychologically, the identity of people, in terms of Subjectivity, and the social, leaving deep traces in the memory of many populations with psychosocial consequences, reflected in the increase in suicide rates and mental illness due to post traumatic stress. This document develops a reflection and learning exercise based on the use of image and narrative, as tools for the psychosocial approach in settings of violence. The following topics for development are addressed: the first step will be the analysis of the story: Camilo Victim, the conflict, taken from UNAD life stories: stories of violence and hope in Colombia. (2007), complementing with the formulation of questions strategic, circular and reflective and their respective theoretical support The second Point corresponds to the analysis and presentation of psychosocial approach strategies, in the case of the communities of Cacarica, answering the questions: What Psychosocial Emergent, do you consider to be latent after the incursion and military harassment? What impacts does it generate for the population to be stigmatized as an accomplice of an armed actor?; In addition to the answer to the previous questions, the support actions in the crisis situation generated by the torture and murder of community members and leaders are presented; psychosocial strategies with the residents of Cacarica, which facilitate the empowerment of Coping Resources, to the expressed situation. Finally, an analytical and reflective report Photo Voice, experience is developed, the image is managed as an intervention strategies, with the intention of recovering the Memory, and not forgetting these events, which are important for the victims, taking into account subjectivity and coping resources; then the conclusions about the experience, application voice photo tool; and finally the link of the blog buil

Are There Regional Variations in the Diagnosis, Surveillance, and Control of Methicillin-Resistant Staphylococcus aureus?

Abstract Objective: To assess the way healthcare facilities (HCFs) diagnose, survey, and control methicillin-resistant Staphylococcus aureus (MRSA). Design: Questionnaire. Setting: Ninety HCFs in 30 countries. Results: Evaluation of susceptibility testing methods showed that 8 laboratories (9%) used oxacillin disks with antimicrobial content different from the one recommended, 12 (13%) did not determine MRSA susceptibility to vancomycin, and 4 (4.5%) reported instances of isolation of vancomycin-resistant S. aureus but neither confirmed this resistance nor alerted public health authorities. A MRSA control program was reported by 55 (61.1%) of the HCFs. The following isolation precautions were routinely used: hospitalization in a private room (34.4%), wearing of gloves (62.2%), wearing of gowns (44.4%), hand washing by healthcare workers (53.3%), use of an isolation sign on the patient's door (43%), or all four. When the characteristics of HCFs with low incidence rates (< 0.4 per 1,000 patient-days) were compared with those of HCFs with high incidence rates (P = 0.4 per 1,000 patient-days), having a higher mean number of beds per infection control nurse was the only factor significantly associated with HCFs with high incidence rates (834 vs 318 beds; P = .02). Conclusion: Our results emphasize the urgent need to strengthen the microbiologic and epidemiologic capacities of HCFs worldwide to prevent MRSA transmission and to prepare them to address the possible emergence of vancomycin-resistant S. aureu

Prevention and control of meningococcal disease: Updates from the Global Meningococcal Initiative in Eastern Europe

Authors would like to thank Dr Olivier Ronveaux (Infectious Hazard Management, World Health Organization, Geneva, Switzerland) for his contributions during this GMI Roundtable Meeting and for providing permission to use his presentation content in this manuscript. The authors were assisted in the preparation of the manuscript by Hannah Birchby, a professional medical writer at CircleScience, an Ashfield Company, part of UDG Healthcare plc. Medical writing support was funded by Sanofi Pasteur.The Global Meningococcal Initiative (GMI) aims to prevent invasive meningococcal disease (IMD) worldwide through education, research and cooperation. In March 2019, a GMI meeting was held with a multidisciplinary group of experts and representatives from countries within Eastern Europe. Across the countries represented, IMD surveillance is largely in place, with incidence declining in recent decades and now generally at <1 case per 100,000 persons per year. Predominating serogroups are B and C, followed by A, and cases attributable to serogroups W, X and Y are emerging. Available vaccines differ between countries, are generally not included in immunization programs and provided to high-risk groups only. Available vaccines include both conjugate and polysaccharide vaccines; however, current data and GMI recommendations advocate the use of conjugate vaccines, where possible, due to the ability to interrupt the acquisition of carriage. Ongoing carriage studies are expected to inform vaccine effectiveness and immunization schedules. Additionally, IMD prevention and control should be guided by monitoring outbreak progression and the emergence and international spread of strains and antibiotic resistance through use of genomic analyses and implementation of World Health Organization initiatives. Protection of high-risk groups (such as those with complement deficiencies, laboratory workers, migrants and refugees) is recommended.S

Prevention and control of meningococcal disease: Updates from the Global Meningococcal Initiative in Eastern Europe

Authors would like to thank Dr Olivier Ronveaux (Infectious Hazard Management, World Health Organization, Geneva, Switzerland) for his contributions during this GMI Roundtable Meeting and for providing permission to use his presentation content in this manuscript. The authors were assisted in the preparation of the manuscript by Hannah Birchby, a professional medical writer at CircleScience, an Ashfield Company, part of UDG Healthcare plc. Medical writing support was funded by Sanofi Pasteur.The Global Meningococcal Initiative (GMI) aims to prevent invasive meningococcal disease (IMD) worldwide through education, research and cooperation. In March 2019, a GMI meeting was held with a multidisciplinary group of experts and representatives from countries within Eastern Europe. Across the countries represented, IMD surveillance is largely in place, with incidence declining in recent decades and now generally at <1 case per 100,000 persons per year. Predominating serogroups are B and C, followed by A, and cases attributable to serogroups W, X and Y are emerging. Available vaccines differ between countries, are generally not included in immunization programs and provided to high-risk groups only. Available vaccines include both conjugate and polysaccharide vaccines; however, current data and GMI recommendations advocate the use of conjugate vaccines, where possible, due to the ability to interrupt the acquisition of carriage. Ongoing carriage studies are expected to inform vaccine effectiveness and immunization schedules. Additionally, IMD prevention and control should be guided by monitoring outbreak progression and the emergence and international spread of strains and antibiotic resistance through use of genomic analyses and implementation of World Health Organization initiatives. Protection of high-risk groups (such as those with complement deficiencies, laboratory workers, migrants and refugees) is recommended.S

Risk factors for death from invasive pneumococcal disease, europe, 2010

We studied the possible association between patient age and sex, clinical presentation, Streptococcus pneumoniae serotype, antimicrobial resistance, and death in invasive pneumococcal disease cases reported by 17 European countries during 2010. The study sample comprised 2,921 patients, of whom 56.8% were men and 38.2% were >65 years of age. Meningitis occurred in 18.5% of cases. Death was reported in 264 (9.0%) cases. Older age, meningitis, and nonsusceptibility to penicillin were signifcantly asso ciated with death. Non-pneumococcal conjugate vaccine (PCV) serotypes among children 65 years of age, risk did not differ by serotype. These fndings highlight differences in case-fatality rates between sero types and age; thus, continued epidemiologic surveillance across all ages is crucial to monitor the long-term effects of PCVs

Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

Background Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings Globally in 2019, 1.14 billion (95% uncertainty interval 1.13-1.16) individuals were current smokers, who consumed 7.41 trillion (7.11-7.74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27.5% [26. 5-28.5] reduction) and females (37.7% [35.4-39.9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0.99 billion (0.98-1.00) in 1990. Globally in 2019, smoking tobacco use accounted for 7.69 million (7.16-8.20) deaths and 200 million (185-214) disability-adjusted life-years, and was the leading risk factor for death among males (20.2% [19.3-21.1] of male deaths). 6.68 million [86.9%] of 7.69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation In the absence of intervention, the annual toll of 7.69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a dear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe