Epidemiological Methods Research Articles

Too few epidemiologists in humanitarian crises: a critical gap that needs addressing. A new course organised by the Italian Association of Epidemiology

The current humanitarian crises in Ukraine and Gaza, along with the chronic crises, and the climate-related disasters, have exposed the limitations of the humanitarian system. Within these contexts, humanitarian organisations frequently struggle with collecting, analysing, interpreting, and utilising health data, due to the challenging environments in which they operate and funding constraints. It is precisely in these contexts that field epidemiology plays a crucial, but often overlooked role.Field epidemiologists face unique challenges, including rapidly changing conditions, poor-quality data, and biases. Despite these difficulties, accurate epidemiological data are essential for needs assessment, guidance on interventions, and advocacy. Conventional methods often need adaptation for crisis settings, and there are still gaps in measurement.This article discusses the role of epidemiology in such contexts, noting a shortage of trained 'humanitarian epidemiologists' and specialised training as major issues.To address these needs, the Italian Association of Epidemiology organised a course in early 2024 to enhance the epidemiological skills of staff working in humanitarian crises and introduce traditional epidemiologists to crisis-specific challenges. The course covered key concepts and methods of field epidemiology, emphasising the use of secondary health data. Its positive reception underscored the demand for such specialised training.Improving public health information collection and use in humanitarian crises is an ethical and practical necessity. Indeed, investing in field epidemiology and recognising its importance can enhance humanitarian interventions and better serve vulnerable populations.

Risk Ratio of Noise-Induced Hearing Loss in Mineral Ore Processing Industry Workers

The mining industry employs machines and equipment that generate noise. Noise is an unwanted sound that can cause discomfort to listeners, leading to health issues. One of the health problems caused by noise is Noise-Induced Hearing Loss (NIHL), a hearing impairment resulting from continuous exposure to hazardous noise levels. The Permissible Noise Exposure (PNE) value in the mining industry is set at 85 dB(A). This study aims to assess the risk of noise exposure in relation to the occurrence of NIHL among mineral ore processing workers in the mining industry in Indonesia. The study employs the epidemiological frequency measurement method Relative Risk Ratio (RR). The study categorizes workers into two groups: native mining industry workers and contractor workers in the mining industry. The RR results for each group are 2.68 and 2.76 (RR>1), respectively. These results indicate that the noise-exposed group is at a 2.68-2.76 times higher risk of experiencing NIHL compared to the non-exposed group. Noise exposure in the mining industry poses a high risk of NIHL to workers, necessitating control measures. Control measures involve reducing noise exposure using Personal Protective Equipment (PPE) such as earplugs for workers in noisy areas. The use of earplugs can reduce noise by around 24-32 dB(A). Additionally, some industrial companies conduct awareness programs to encourage workers to use earplugs or other PPE, known as the hearing conservation program.

Epidemiological statistical methods: A comparative review of their implementation in public health studies in the USA and Africa

This scholarly exploration delves into the realm of epidemiological statistical methods, juxtaposing their application within the distinct public health landscapes of the United States and Africa. The study's core objective was to dissect and compare the evolution, effectiveness, and adaptability of these methods across these diverse regions, thereby enriching the understanding of global health dynamics. Embracing a qualitative methodology, the study employed advanced analytical tools and AI technologies, ensuring a thorough examination of data, and facilitating a nuanced comparative analysis. The findings reveal a marked evolution in the United States, characterized by a shift from traditional epidemiological approaches to more sophisticated, data-driven techniques. In contrast, African epidemiological practices emphasized community engagement and education in disease prevention, gradually pivoting towards non-communicable diseases and mental health. The study also illuminated the critical role of technology in modern epidemiological research, enhancing efficiency and broadening the scope of investigations. Furthermore, it highlighted the significant impact of international policies on epidemiological methods and underscored the dynamic interplay between technology and policy in shaping public health strategies. Conclusively, this study not only achieved its objectives but also offered a comprehensive view of the current state and potential future directions of epidemiological research. Recommendations emphasize the need for continued innovation in methodologies, adoption of inclusive approaches considering socioeconomic contexts, and alignment of technological advancements with policy decisions. As epidemiology continues to evolve, this study serves as a guiding light, steering future research and interventions towards more effective and equitable public health outcomes.

ECCO Grant Risk of cardiovascular disease in patients with inflammatory bowel disease (IBD)

Abstract Background and Aims Although evidence has suggested an increased risk of venous thromboembolism and arteriosclerotic events in patients with inflammatory bowel disease (IBD), there are still substantial knowledge gaps about the long-term risk of cardiovascular disease (CVD) in patients with IBD and how CVD risks vary by disease histological and clinical activity. The aims of this project are: 1) to investigate the long-term risk (both absolute and relative) of CVD in patients with IBD, and 2) to assess CVD risks for patients in different phases of histological and clinical periods of IBD. Methods We will apply epidemiological and statistical methods to tackle the proposed research questions through using data from a comprehensive linkage of a nationwide histopathology cohort, one quality register for IBD, and several nationwide registers in Sweden. Individual informed consent will be waived as the study is register-based. Anticipated Impact The project will address several important knowledge gaps and benefit the IBD community in multifaceted ways. Findings from Aim 1 will help us identify patients with IBD at a high risk of developing CVD and enhance the awareness of screening, management, and treatment of cardiovascular risk factors in patients with IBD among healthcare professionals as well as patients and their families. Findings from Aim 2 will contribute towards an improved comprehension of CVD risk in different periods of histological and clinical activity, which can offer novel insights into guiding current therapeutic strategies aiming to mitigate the risk of adverse cardiovascular events in IBD patients. Overall, knowledge from our project can provide valuable evidence for the development of clinical guidelines for CVD management in patients with IBD. Currently, such guidelines remain underdeveloped.

Epidemiological changes and molecular characteristics of Brucella strains in Ningxia, China.

Human brucellosis causes serious public health concerns in Ningxia, China. This study employed epidemiological, bacteriological, and multiple-locus variable-number tandem repeat analysis (MLVA) methods to conduct an epidemiological investigation, which is necessary for devising tailored control strategies. Between 1958 and 2022, 29,892 cases were reported, with an average annual number of cases and incidence of 467 and 7.1/100,000, respectively. The epidemic situation gradually worsened, with cases escalating from 26 cases in 2005 to 6,292 in 2022, with the incidence rate rising from 0.441 in 2005 to 86.83 in 2022. Geographically, the disease spread from a single affected county in 2004 to encompass all 22 counties in 2022. Yanchi County had the highest incidence, followed by the Hongsibao and Tongxin counties. These data suggest that Brucella infection has become a rampant regional concern in human brucellosis. Between 1958 and 2019, a total of 230 Brucella strains were identified across four studied hosts. These strains comprised four species with 12 biovars, including B. melitensis bv. 1, bv. 2, bv. 3, B. abortus bv. 1, bv. 3, bv. 4, bv. 5, bv. 6, bv. 7, B. suis bv. 1 and bv. 3, and B. canis. These data highlight the high species/biovars and host diversity of the Brucella population, posing a substantial challenge to brucellosis surveillance. There was an apparent transition from multiple species/biovars historically to the current dominance of a single species, B. melitensis, emphasizing the requirement for strengthening surveillance of B. melitensis. Genotypes 42 and 116, constituting 96.2% of the total number of genotypes, predominated in panel 1 and MLVA-11, indicating that all strains belong to the East Mediterranean lineage. MLVA cluster analysis revealed persistent transmission of dominant circulating genotypes, presenting an epidemic pattern characterized primarily by epidemiologically related cases with a few sporadic cases. Strains in this study exhibited high genetic homogeneity with strains from the Northwest, and those from Kazakhstan and Mongolia. The epidemic situation of human brucellosis has gradually worsened; the rampant epidemic of the disease has become a regional concern. The present study highlights that implementing the of targeted surveillance and intervention strategies is urge.

The Spatial Epidemiology models on Covid-19 cases in India Mathematical models and data used in Spatial Epidemiology

Geographical epidemiology has been description of geographical patterns of mortality rates as part of descriptive epidemiological investigations, with the goal of developing theories regarding disease causation. Disease mapping, disease clustering, and ecological analysis are the predominant methods of geographical epidemiology, having close relationships between them. For describing the transmission of an illness within a geographically dispersed population, many models incorporating frameworks based on individuals, networks, stochastic processes, as well as partial derivative equations have been made. However, these models need a large amount of information and even a large amount of computational performance. Keeping this in mind, we have tried to create deterministic models formulated as partial differential equations to model spatial epidemics in spatial domains. This has been by assuming two types of population, the susceptible population, and the infective population, considering the functions of space and time. COVID-19 is a global tragedy, with India likely to be among the most hit. The fluctuation in the dispersion of COVID-19-related well-being results is most likely connected with numerous basic factors, like segment, financial, or natural poisons related factors.

Epidemiological characteristics and prediction model construction of hemorrhagic fever with renal syndrome in Quzhou City, China, 2005-2022.

Hemorrhagic fever with renal syndrome (HFRS) is one of the 10 major infectious diseases that jeopardize human health and is distributed in more than 30 countries around the world. China is the country with the highest number of reported HFRS cases worldwide, accounting for 90% of global cases. The incidence level of HFRS in Quzhou is at the forefront of Zhejiang Province, and there is no specific treatment for it yet. Therefore, it is crucial to grasp the epidemiological characteristics of HFRS in Quzhou and establish a prediction model for HFRS to lay the foundation for early warning of HFRS. Descriptive epidemiological methods were used to analyze the epidemic characteristics of HFRS, the incidence map was drawn by ArcGIS software, the Seasonal AutoRegressive Integrated Moving Average (SARIMA) and Prophet model were established by R software. Then, root mean square error (RMSE) and mean absolute error (MAE) were used to evaluate the fitting and prediction performances of the model. A total of 843 HFRS cases were reported in Quzhou City from 2005 to 2022, with the highest annual incidence rate in 2007 (3.93/100,000) and the lowest in 2022 (1.05/100,000) (P trend<0.001). The incidence is distributed in a seasonal double-peak distribution, with the first peak from October to January and the second peak from May to July. The incidence rate in males (2.87/100,000) was significantly higher than in females (1.32/100,000). Farmers had the highest number of cases, accounting for 79.95% of the total number of cases. The incidence is high in the northwest of Quzhou City, with cases concentrated on cultivated land and artificial land. The RMSE and MAE values of the Prophet model are smaller than those of the SARIMA (1,0,1) (2,1,0)12 model. From 2005 to 2022, the incidence of HFRS in Quzhou City showed an overall downward trend, but the epidemic in high-incidence areas was still serious. In the future, the dynamics of HFRS outbreaks and host animal surveillance should be continuously strengthened in combination with the Prophet model. During the peak season, HFRS vaccination and health education are promoted with farmers as the key groups.

Analysis on the characteristics of natural foci of hemorrhagic fever with renal syndrome in Gansu Province, 2012-2022

Objective: To explore the characteristics of natural foci of hemorrhagic fever with renal syndrome (HFRS) in Gansu Province. Methods: The information of HFRS case data and rodent density monitoring data from 2012 to 2022 in Gansu Province were collected and epidemiological methods were used to analyze and investigate the characteristics of the epidemic focus. Results: A total of 869 cases of HFRS were reported, and four patients died from 2012 to 2022. The annual incidence rate is between 0.05 per 100 000 and 1.21 per 100 000. The cases were mainly distributed in the eastern, southeast, southern, and south of the central region of Gansu Province. Most cases were distributed between age 20-60, and the sex ratio was 1.85∶1 (564∶305). Most cases were farmers (61.80%, 537/869), herdsmen (19.79%,172/869) and students (6.33%, 55/869). In a wild rat-type epidemic focus,the incidence peak was from November to January of the following year. The natural rodent hosts of HFRS were Rattus norvegicus, Apodemus agrarius, and Mus musculus. The hantaan virus carriage rates were 2.79% (21/754), 0.42% (5/1 179) and 0.31% (2/643),respectively. Three epidemic foci were defined: two derived from the Pingliang and Gannan prefecture new outbreaks epidemic foci, respectively, while the other was the residue of the Dingxi epidemic focus. Conclusions: The southern, south of the central region and eastern part of Gansu Province are current key HFRS epidemic foci dominated by Rattus norvegicus, Apodemus agrarius, and Mus musculus, respectively. The virus genotype is hantaan virus. Case reporting areas should strengthen epidemic monitoring; the key epidemic areas should strengthen and implement various prevention and control measures to reduce the harm caused by HFRS.

Campylobacter Species: New Insight, Clinical Diagnosis and Laboratory Approach

Campylobacter, a prevalent cause of global gastroenteritis, has exhibited an escalating impact worldwide, affecting both industrialized and developing nations. Even though Campylobacter jejuni and C. coli are the main causes of infection, new pathogens make it imperative to comprehend the disease mechanisms, dynamics of transmission, and evolution of less-studied species. Accessible whole-genome sequences obtained through high-throughput sequencing have made it easier to conduct in-depth pathogenomic studies, particularly on species such as C. fetus and C. concisus. These studies have shown novel applications in clinical microbiology by revealing genomic traits associated with pathogenicity and offering insights into the evolutionary mechanisms shaping their genomes. Effective pathogen management urgently requires deeper understanding of the evolution of pathogenicity in emerging Campylobacter species are urgently required for effective pathogen management. This comprehensive review synthesizes existing knowledge and outlines future research directions in this crucial field. The Gram-negative, non-spore-forming, curved or spiral rods known as campylobacters include a "thermophilic group" that is important to the water industry and includes C. jejuni, C. coli, and C. upsaliensis. Acute diarrhea is the usual symptom of a human Campylobacter infection, and key virulence factors have been identified as antibiotic resistance genes and flagellar DNA. Many campylobacters are frequently found in sewage and treated sewage effluents, whereas surface waters are less contaminated. Testing for Campylobacter prevalence through epidemiological methods requires a careful balance between phenotypic and genotypic data. Campylobacters are sensitive to oxygen, but they have strong survival strategies that may involve the formation of biofilms. Methods of inactivation that work well for coliforms are thought to be appropriate for Campylobacter. In addition to providing a synthesis of current knowledge and identifying future research directions to advance strategies for the effective management and mitigation of Campylobacter-related infections, this thorough review highlights the urgent need for additional research to deepen our understanding of these pathogens. The investigation of genetic features linked to pathogenicity, dynamics of transmission, and survival strategies highlights the complex character of Campylobacter infections. The dynamic nature of Campylobacter as a primary cause of gastroenteritis necessitates continued research endeavors to guide focused interventions and lessen the worldwide impact of this grave public health issue.

Reflections on the design and application of ‘Surveypura’: a simulation-based pedagogical tool for quantitative research methods in public health and social sciences

It has been reported from various contexts that learning quantitative methods for public health and social research is challenging for students. Based on our observations of these challenges, we designed a simulation-based pedagogical tool called Surveypura to support classroom-based learning of quantitative research methods. The tool includes a large illustration of a fictional village with 155 houses, alongside data for each of the households. The features of the houses, household characteristics, and the village have been carefully designed to give the visual feel of an actual village and better assist the pedagogical process. The tool was used by five facilitators with their masters’ students at our university in courses on social research and epidemiology. Our observations of the sessions and interactions with facilitators and students suggested that the tool supported more engaged learning of quantitative research methods in a non-intimidating manner. We believe that Surveypura can be a useful simulation-based pedagogical tool to teach quantitative research methods in epidemiology and social sciences even in other contexts.

Epidemiological characteristics of a local cluster epidemic caused by the BA.2 evolutionary branch of Omicron variant

Descriptive epidemiological methods were used to analyze the epidemiological characteristics of the local cluster of COVID-19 in the logistic park of Yuhang District in Hangzhou in March 2022. The cluster epidemic was detected by a case who actively visited the fever clinic. The epidemic lasted for 8 days, and a total of 58 cases (53 workers, 2 students, 1 farmer, 1 teacher and 1 unemployed) were found, including 40 males and 18 females. The age was (33.29±12.22) years. There cases were mainly in Yuhang District (48 cases, 82.77%) and Shangcheng District (7 cases, 12.07%) of Hangzhou. The real-time regeneration number peaked at 2.31 on March 10th and decreased to 0.37 on March 15th. The sequencing result of the indicated case was 100% homologous with the sequence uploaded from South Korea on March 4th, 2022.

The role of medical and organizational measures in improving the quality of early detection and clinical examination of autoimmune thyroiditis among the population of the Republic of Belarus

Objective. To evaluate the role of medical and organizational measures in improving the quality of early detection and medical examination of autoimmune thyroiditis in the population of the Republic of Belarus.Materials and methods. The data of population statistics and the State register of persons affected by the Chernobyl catastrophe and other accidents on cases of thyroid pathology, as well as outpatient records of patients were analyzed. Epidemiological, statistical and sociological methods were used.Results. It was noted that different clinical and laboratory variants of autoimmune thyroiditis (AIT) are encountered in clinical practice. Subclinical AIT with sonographic signs of the disease but without diagnostic concentrations of antibodies to thyroid peroxidase (AB/TPO) and disturbances of its function is registered in 14.1 (6.0-24.4) %. AIT with diagnostic concentrations of autoantibodies to AB/TPO, with preserved thyroid function or hypothyroidism occurs in 22.5 (13.534.0) % of the cohort subjects. The frequency of combining AIT with nodular neoplasms of the thyroid increased by the 4th stage of screening and reached 20.7 (11.2-33.4) %.The reasons for different approaches to diagnosis were analyzed and measures to improve organizational and medical measures for early detection and dispensary treatment of patients with AIT were proposed: groups of persons at high risk of AIT and primary hypothyroidism (PHT) were identified, an algorithm for early detection and dispensary treatment was developed, etc.Conclusion. When making a decision to improve the quality of medical care to the population of the Republic of Belarus on early detection and medical examination of patients with AIT, it is necessary to take into account the timeliness of thyroid status studies in the population, compliance with the terms of dynamic observation for persons at high risk of AIT and PHT development, peculiarities of clinical and laboratory variants of AIT course.

Spatio-temporal modeling of co-dynamics of smallpox, measles, and pertussis in pre-healthcare Finland.

Infections are known to interact as previous infections may have an effect on risk of succumbing to a new infection. The co-dynamics can be mediated by immunosuppression or modulation, shared environmental or climatic drivers, or competition for susceptible hosts. Research and statistical methods in epidemiology often concentrate on large pooled datasets, or high quality data from cities, leaving rural areas underrepresented in literature. Data considering rural populations are typically sparse and scarce, especially in the case of historical data sources, which may introduce considerable methodological challenges. In order to overcome many obstacles due to such data, we present a general Bayesian spatio-temporal model for disease co-dynamics. Applying the proposed model on historical (1820-1850) Finnish parish register data, we study the spread of infectious diseases in pre-healthcare Finland. We observe that measles, pertussis, and smallpox exhibit positively correlated dynamics, which could be attributed to immunosuppressive effects or, for example, the general weakening of the population due to recurring infections or poor nutritional conditions.

ЭПИДЕМИОЛОГИЧЕСКИЕ АСПЕКТЫ НАРУШЕНИЙ МЕНТАЛЬНОГО ЗДОРОВЬЯ – ОТ ПРЕДИКТОРОВ К СЛЕДСТВИЮ

Introduction. Due to the high social significance of mental health disorders, the study of the spread and degree of influence of modifiable predictors of depressive psychoemotional status can contribute to the development of new approaches to active prevention. The purpose of the study. To study the epidemiological characteristics of mental health disorders and identify key predictors among students. Methods. To conduct the study, epidemiological diagnostic methods were used, such as: retrospective epidemiological analysis, descriptive and evaluative methods, as well as statistical methods, methods of epidemiological diagnostics using methods of clinical epidemiology and statistical analysis were used. Results. There was a moderate long-term epidemic trend towards an increase in the incidence of mental disorders (an increase rate of 3.68%) and a high long-term average (164.44+1.72о/оооо). The risk area is determined on the basis of the characteristic pronounced tendency to growth and an increased level of relative epidemiological risk: Minsk region, Minsk, Vitebsk and Mogilev regions (Tpr = 6.56%, 9.99%, 15.21%, and 15.57%, respectively. Consequently, the risks were: in Minsk – 0.77, in Vitebsk and Mogilev regions – 0.78 and 0.86, respectively). The result of our own original research was the identification of a depressive state in 59.25% of cases and generalized anxiety disorder – in 64.1% of cases. An aggravating circumstance is the fact of comorbidity in more than 80% of cases. When studying the epidemiological characteristics of these disorders, significant predictors were identified that increased the chance of developing a state by 2.5-11.5 times. Conclusion. The high levels of prevalence and comorbidity of depressive psychoemotional status and anxiety disorder characterize the general epidemiological situation within the mental health of students as unfavorable and require the development of preventive measures.

Influence of respiratory infections pandemics on the mortality of the population of Ukraine.

Aim: To analyze the dynamics and structure of the excess mortality of the population of Ukraine for 76 years (1945-2021). Materials and Methods: An observational population study was conducted. Epidemiological methods were used, in particular, the method of graphical construction of time series, intensive, extensive indicators and indicators of excess mortality were calculated. Conclusions: The coronavirus disease pandemic in Ukraine became the largest documented respiratory infection pandemic after 76 years, but did not outweigh the dramatic increase in mortality in the 1990s-2000s, in including death in 1995.

An outbreak of septic conditions following surgery in the operating theatres of a primary hospital.

A systematic investigation of an outbreak of postoperative sepsis in nine patients following surgery in the operating rooms of a primary-type hospital between November 26 and 28, 2018 was conducted to determine the extent of the outbreak, the vehicle, and the route of transmission. The comprehensive investigation included epidemiological, microbiological, molecular biological, and environmental methods. A retrospective cohort study was used to find associations between individual exposure factors and outcomes, the respective septic conditions. Nine of 24 surgery patients were infected (AR 37.5 %). An identical strain of Acinetobacter calcoaceticus was found in biological specimens of two infected patients. The combined investigation did not reveal the vector or route of transmission. Immediate infection prevention and control measures avoided new cases of postoperative sepsis.

Diagnosis of neuroinfections in children

Presents an overview of domestic and foreign sources on the diagnosis of neuroinfections in children of different etiologies based on epidemiological, physical, cerebrospinal fluid, etiological, radiation and other methods. Their combination makes it possible to establish the syndrome of neuroinfection (meningitis, encephalitis, myelitis, polyradioloneuritis, etc.), the severity, the presence of complications, the nature of the course, etiology. Cytological and biochemical examination of CSF is still of great importance in diagnosis. To establish the etiology, both well-known methods (microbiological, serological, immunocytochemical) and molecular genetic methods, including PCR and next-generation sequencing, are used. Radiation methods, especially MRI with the use of modern programs, are also important in the diagnosis of neuroinfections. Using the example of diagnosing viral encephalitis in children, the need for an integrated approach to establish a probable, possible and reliable diagnosis is demonstrated, which ensures the earliest possible prescription of not only etiotropic, but also pathogenetic therapy using drugs with a multimodal mechanism of action, for example Cytoflavin, which helps improve the outcomes of neuroinfections.

Epidemiology, Clinical Presentation, and Treatment of Thrombotic Thrombocytopenic Purpura

Thrombotic Thrombocytopenic Purpura (TTP) is a critical medical condition characterized by thrombocytopenia, hemolytic anemia, and organ damage due to microvascular clotting. This review delves into TTP's epidemiology, clinical presentation, and treatment methods. Advances in understanding the disease's pathophysiology have allowed significant improvements in management strategies. The shift from traditional therapies like therapeutic plasma exchange and corticosteroids to innovative, targeted treatments such as rituximab and caplacizumab marks a significant positive effect. These novel therapies offer less invasive, patient-centric approaches, heralding a new era in TTP treatment. The review also highlights the future directions of TTP research and therapy, emphasizing the need for continued innovation and tailored care strategies. This evolution in TTP management underscores a move towards personalized medicine, focusing on improving outcomes and the quality of life for patients. The dynamic nature of TTP treatment is shifting towards more effective, patient-focused therapeutic options, reflecting the ongoing advancements in the field.

Comparative study of the resistance level of the organism in schoolchildren with socio-psychological disadaptation among Uzbek population studying in different conditions

Socio-psychological disadaptation in children and adolescents at the present time should be considered not only from the perspective of existing disorders of the emotional state and limitations of sociability but also from the standpoint of the deterioration of their somatic health and quality of life. The purpose of the research is to carry out comparative study of the level of body resistance in schoolchildren of the Uzbek population with socio-psychological maladjustment studying in different academic conditions. To achieve the set goal, clinical, clinical-psychological, and epidemiological research methods were chosen. In addition, psychopathological and paraclinical analyses were conducted, and long-term results were monitored. Disruption of adaptation mechanisms and unsatisfactory adaptation are more common in adolescent boys, regardless of the type of education (30.1% and 24.1% in boys with traditional education, 26.2% and 19.7% in boarding lyceums, P &gt;0.05- &gt; 0.01). Among all surveyed girls with maladjustment, adolescent girls with traditional education were more likely to have a breakdown in adaptation mechanisms (20.7% versus 16.9%, P &gt; 0.05). Tense adaptation mechanisms were also predominantly recorded in adolescent boys in both study groups (64.3% and 67.6%, respectively), which has to be well considered when organizing preventive measures. The developed method for assessing the development of disadaptation, based on a systematic analysis of risk factors, considering the clinical and psychological characteristics of the child’s development, personality, family structure and teaching methods, the state of the central nervous system, and hormonal changes, facilitates the diagnostic procedure before the onset of clinical signs of maladjustment.

Epidemiological intelligence, investment in information technologies and new perspectives for the use of data in health surveillance

In the municipality of Rio de Janeiro, Brazil, the incorporation of the concept of epidemic intelligence and technological resources has supported new perspectives for the use of data by health surveillance, since the COVID-19 pandemic. This article presents the Epidemiological Intelligence Center (CIE) and the tools and products developed in its coordination. The CIE was inaugurated in March 2022, with a multiprofessional team, supported by the premises of transparency and integration of various data sources for early detection of changes in the trends of events of importance in Public Health. The initial acquisition of a data lake favored changes in the consumption, management and security processes for the data processed. This data lake currently stores the Carioca Base - a retrospective cohort of individuals with a history of COVID-19 vaccination and/or events related to the disease. Descriptive and analytical dashboards have been developed and made available, respectively for public use and for health surveillance administrators. An alert panel, aimed at monitoring trends in care in the urgency and emergency network, was implemented and subsidizes rapid response actions in the city's territories. The CIE developed the concept of epidemiological intelligence in the Brazilian Unified National Health System and this paradigm shift was made possible by investments in physical/human resources, the integration of epidemiological, statistical and data science methods, as well as the incorporation of different data sources in data analysis.