Epidemiological Surveillance System Research Articles

Genomic surveillance strategy. Problems and perspectives

The topic of epidemiologic surveillance is one of the basic concepts in the theory and practice of epidemiologic science. In Russia, generalization of the accumulated factual material and theoretical developments have allowed us to formulate a number of provisions on the nature of the epidemic process. The pandemic of a new coronavirus infection has forced adjustments in all spheres of society, including the activities of the infectious disease epidemiological surveillance system, requiring the development and implementation of innovative solutions. Based on the experience of prompt response to the tasks set by the COVID-19 pandemic, the authors raised the problem of development and implementation of a system of molecular genetic monitoring for pathogens of emerging and re-emerging infections as a priority vector of epidemiological surveillance development. The introduction of modern molecular biological technologies for the identification of pathogens with epidemic potential, taking into account their genetic diversity, into the system of epidemiologic surveillance has been substantiated based on the experience of using platform solutions created by the Central Research Institute of Epidemiology of Rospotrebnadzor. The strategy of genomic epidemiologic surveillance as a powerful tool to ensure readiness for response measures and management of the epidemic process by implementing and adjusting preventive and anti-epidemic measures was developed. The Russian platform for aggregation of information on virus genomes (VGARus) developed at the Central Research Institute of Epidemiology of Rospotrebnadzor as a technological, scientific, organizational and infrastructural base of genomic epidemiological surveillance, acting as an interdepartmental consortium, has been introduced into practice. The efficiency of VGARus was shown to assess the mutational variability of SARS-CoV-2, the influence of evolutionary development of circulating pathogens on the characteristics of the epidemic process, the implementation of operational and retrospective analysis of morbidity and prediction of the spread of genetic variants of pathogens.

Emerging challenges in antimicrobial resistance: implications for pathogenic microorganisms, novel antibiotics, and their impact on sustainability.

Overuse of antibiotics is accelerating the antimicrobial resistance among pathogenic microbes which is a growing public health challenge at the global level. Higher resistance causes severe infections, high complications, longer stays at hospitals and even increased mortality rates. Antimicrobial resistance (AMR) has a significant impact on national economies and their health systems, as it affects the productivity of patients or caregivers due to prolonged hospital stays with high economic costs. The main factor of AMR includes improper and excessive use of antimicrobials; lack of access to clean water, sanitation, and hygiene for humans and animals; poor infection prevention and control measures in hospitals; poor access to medicines and vaccines; lack of awareness and knowledge; and irregularities with legislation. AMR represents a global public health problem, for which epidemiological surveillance systems have been established, aiming to promote collaborations directed at the well-being of human and animal health and the balance of the ecosystem. MDR bacteria such as E. coli, Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus spp., Acinetobacter spp., and Klebsiella pneumonia can even cause death. These microorganisms use a variety of antibiotic resistance mechanisms, such as the development of drug-deactivating targets, alterations in antibiotic targets, or a decrease in intracellular antibiotic concentration, to render themselves resistant to numerous antibiotics. In context, the United Nations issued the Sustainable Development Goals (SDGs) in 2015 to serve as a worldwide blueprint for a better, more equal, and more sustainable existence on our planet. The SDGs place antimicrobial resistance (AMR) in the context of global public health and socioeconomic issues; also, the continued growth of AMR may hinder the achievement of numerous SDGs. In this review, we discuss the role of environmental pollution in the rise of AMR, different mechanisms underlying the antibiotic resistance, the threats posed by pathogenic microbes, novel antibiotics, strategies such as One Health to combat AMR, and the impact of resistance on sustainability and sustainable development goals.

Prevalence of Drug-Resistant Tuberculosis in HIV-Positive and Diabetic Patients in Sinaloa, Mexico: A Retrospective Cross-Sectional Study.

Tuberculosis (TB) is a disease caused by the bacillus Mycobacterium tuberculosis (MTB). Human immunodeficiency virus (HIV) infection and type 2 diabetes mellitus (T2DM) are among the main risk factors for the development of TB and increase the risk of drug-resistant TB developing (DR-TB). The aim of this study was to estimate the prevalence of DR-TB in patients with HIV or T2DM in Sinaloa, Mexico. This was an observational and cross-sectional study. The analysis was conducted using the clinical data of patients registered on the National Epidemiological Surveillance System for TB (SINAVE/PUI-TB) platform with a presumed diagnosis of TB during 2019 to 2021 in Sinaloa, Mexico. The prevalence of DR-TB was estimated in HIV and T2DM patients, as well as the odds ratios for their sociodemographic variables, using the Chi-square test. There were 2, 4, and 4 TB-HIV cases and 2, 6, and 9 TB-T2DM cases during 2019, 2020, and 2021, respectively, whereas there were 2 and 1 DRTB-HIV and DRTB-T2DM cases, respectively. The results indicated that the WHO guidelines for DR-TB were not properly applied to this high-risk population. Hence, the appropriate application of guidelines for TB and DR-TB detection in these patients needs to be immediately implemented by the State health system.

GPs’ practices when prescribing buprenorphine in primary care: A survey among the Sentinelles network

France is a leading country for opioid agonist treatment providing, with a predominance of buprenorphine. General practitioners (GPs) are the main prescribers of buprenorphine, but they seem to be less involved over the last 10 years. This work is the second part of a larger study analysing buprenorphine prescribing among French GPs working in primary care, and aims to describe GPs' practices when prescribing buprenorphine. This is a cross-sectional study conducted in France from March to July 2021 among a sample of GPs in the Sentinelles network, a national epidemiologic surveillance system. Data about the last situations of initiation and renewal of buprenorphine were collected. Among the 237 participants (34.3% response rate), 156 responded to the questionnaire about the last situation of renewal and 41 about the last situation of initiation. The last initiation occurred more than 12 months earlier for 46.3% of respondents, whereas the last renewal occurred less than 1 month ago for 68.6%. There was an over-representation of the male gender among the patients who were consulting (initiation 70.7%, renewal 68.6%). A majority of patients had an illicit opioid use disorder (initiation 78.0%, renewal 82.7%). Overall, GPs were involved in the general care of patients with opioids use disorder and in opioids harm reduction (initiation 87.8% and 82.9%, renewal 88.5% and 51.9%). Among buprenorphine prescribers, initiations were infrequent unlike renewals and involved mainly illicit opioid users.

Individualized Prediction of SARS-CoV-2 Infection in Mexico City Municipality during the First Six Waves of the Pandemic.

After COVID-19 emerged, alternative methods to laboratory tests for the individualized prediction of SARS-CoV-2 were developed in several world regions. The objective of this investigation was to develop models for the individualized prediction of SARS-CoV-2 infection in a large municipality of Mexico. The study included data from 36,949 patients with suspected SARS-CoV-2 infection who received a diagnostic tested at health centers of the Alvaro Obregon Jurisdiction in Mexico City registered in the Epidemiological Surveillance System for Viral Respiratory Diseases (SISVER-SINAVE). The variables that were different between a positive test and a negative test were used to generate multivariate binary logistic regression models. There was a large variation in the prediction variables for the models of different pandemic waves. The models obtained an overall accuracy of 73% (63-82%), sensitivity of 52% (18-71%), and specificity of 84% (71-92%). In conclusion, the individualized prediction models of a positive COVID-19 test based on SISVER-SINAVE data had good performance. The large variation in the prediction variables for the models of different pandemic waves highlights the continuous change in the factors that influence the spread of COVID-19. These prediction models could be applied in early case identification strategies, especially in vulnerable populations.

Evaluasi Sistem Surveilans Epidemilogi Penyakit Covid-19 Pasca Pandemi Di Puskesmas Nambo Kota Kendari

COVID-19 has spread rapidly throughout the world that affecting the community life. The government has strictly taken health and social measures that have been imposed by all countries to decrease of COVID-19 spreading. Health care units are the forefront of dealing with health problems in the community due to COVID-19. Therefore, the role of Puskesmas in the detection, prevention and response very crucial as the health care unit in the first level. In supporting that matter, the implementation of epidemiological surveillance system can be used to monitor the trend of COVID-19 transmission from local, national and global levels in conducting early detection in the areas without virus transmission, monitoring cases in the areas with virus transmission, including vulnerable populations identification, providing epidemiological information to carry out risk assessments and to evaluate the impact of pandemic on health and social service. This study aimed to provide an overview the implementation of COVID-19 epidemiological surveillance system at the puskesmas level in Kendari City, 2021 to improve the epidemiological surveillance system quality. A descriptive qualitative with phenomenological design was carried out. The informants consisted of 2 key informants (surveillance programmer and head of puskesmas) and 1 ordinary informant, KTU of Nambo Health Center. The results showed that the implementation of COVID-19 epidemiological surveillance system at the Nambo Health Center in the aspects of data collection and dissemination have been carried out optimally, but the data analysis has not been carried out properly. The data processing and data interpretation aspects are not implemented.

Agreement Between the Rapid Antigen Test for SARS-CoV-2 and the RT-qPCR Diagnostic Test

Objective: to assess the agreement between the rapid antigen testing (RATs) for SARS-CoV-2 and quantitative reverse transcription polymerase chain reaction (RT-qPCR). Methods: analytical CROSS-sectional study, conducted in three medical units from January 1, 2021, to June 30, 2022, in Mexico City, Mexico. Non-probabilistic sampling was performed using data from the Online Notification System for Epidemiological Surveillance. Data analysis was performed using frequency measures, Cohen’s kappa index, and maximum likelihood estimation. Results: Of 2173 participants with both diagnostic tests: 565 respiratory samples were concordant with a positive result (26.09% CI95% 24.25 - 27.99%), and 1229 with a negative result (56.55% CI95% 54.44 - 58.65%). The sensitivity of RAT VERSUS RT-qPCR was estimated to be 65.17% (95%CI 61.99 - 68.33%), while the specificity was 94.10% (95%CI 92.82 - 95.38%); a positive predictive value of 88.01% (95%CI 85.23 - 90.41%), and a negative predictive value of 80.27% (95%CI 78.19 - 82.24%). The Cohen’s kappa index was 0.62 (substantial agreement), and a calculated likelihood ratio of 40% at pre-test prevalence, a post-test probability of 88.3% was observed for a positive result with RAT in case of having COVID-19. Conclusion: The present study demonstrated substantial concordance between RAT and RT-qPCR, supporting the feasibility of using both tests. This provides clinicians with a valuable tool for informed decision making in the diagnostic context of COVID-19. 

Characterization of suicidal behavior in Coquimbo, Chile, between 2018 and 2020.

Suicidal behavior is a public health problem worldwide. The World Health Organization estimated 700 000 deaths for the year 2021. This study aimed to estimate the prevalence of suicidal behavior and describe its related factors in the Coquimbo Region, Chile, between 2018 and 2020. 2190 suicide attempt notifications from the regional epidemiological surveillance system were analyzed, corresponding to 1781 people, along with 217 reports from the Forensic Medical Service of people who died by suicide. The overall suicide rate for the region during that period was 9.79 deaths per 100 000 inhabitants. The 2018 rates were standardized according to available information, with direct methods for the regional rate (9.55 per 100 000 inhabitants) and indirect methods for the communes. Rural communes presented higher rates than urban ones. Women showed a higher risk of attempts (OR 1.28; 95% CI 1.23 to 1.33) and a lower risk of suicide compared to men (0.086; 0.06 to 0.13). Young people had a higher risk of suicide attempts and a lower risk of suicide compared to older people. The increased suicide rates in older people (70 to 79 years) during 2020 are noteworthy. Basic education level is a risk variable for suicide (2.21; from 1.15 to 4.23), compared to having higher education. Previous suicide attempts and psychiatric pathology are risk factors. Suicide prevalence and related factors are similar to those reported in other studies and national reports, highlighting rurality and higher risk in older male adults. In contrast to suicides, attempts are more frequent in women and young people. A history of mental health problems, previous attempts, and family violence are risk factors for both outcomes. Knowing the patterns of suicidal behavior in the population is fundamental for its prevention.

Benford’s law analysis to evaluate the quality data of COVID-19 epidemiological surveillance in Indonesia

Countries worldwide, including Indonesia, grappled with the unprecedented challenges brought about by the coronavirus disease (COVID-19) pandemic. Surveillance data vividly illustrates the profound effect of the COVID-19 pandemic in Indonesia. Both daily cases and deaths were raised, revealing the rapid transmission of the virus within communities. A quantitative study using a statistical approach was accomplished with secondary data to evaluate the quality of COVID-19 epidemiological surveillance data in Indonesia during the period between March 2020 to January 2021. The data was sourced from the World Health Organization (WHO) website using data reports on COVID-19 confirmed cases and deaths. A rapid tool called the first digit law or the fulfillment of Benford’s law was used to suggest good data quality for epidemiological surveillance. Data analysis used the Chi-squared test and the log-likelihood ratio test. Also, it displayed the difference in mean absolute deviation (MAD) to identify the proximity of the data and Benford’s law distribution. The results showed that both confirmed, and death case distributions were statistically non-conformity with Benford’s law distribution. In terms of quality data regarding the COVID-19 pandemic, the epidemiological surveillance system falls short of Benford’s law assumption. Benford's law has been acknowledged as an initial analysis that can expeditiously assess the performance of a surveillance system. The next phase of this study would be to conduct a complete evaluation suitably, especially in post-pandemic COVID-19.

Operational effectiveness of tafenoquine and primaquine for the prevention of Plasmodium vivax recurrence in Brazil: a retrospective observational study.

Prevention of Plasmodium vivax malaria recurrence is essential for malaria elimination in Brazil. We evaluated the real-world effectiveness of an updated treatment algorithm for P vivax radical cure in the Brazilian Amazon. In this non-interventional observational study, we used retrospective data from the implementation of a P vivax treatment algorithm at 43 health facilities in Manaus and Porto Velho, Brazil. The treatment algorithm consisted of chloroquine (25 mg/kg over 3 days) and point-of-care quantitative glucose-6-phosphate dehydrogenase (G6PD) testing followed by single-dose tafenoquine 300 mg (G6PD normal, aged ≥16 years, not pregnant and not breastfeeding), 7-day primaquine 0·5 mg/kg per day (G6PD intermediate or normal, aged ≥6 months, not pregnant, and not breastfeeding or breastfeeding for >1 month), or primaquine 0·75 mg/kg per week for 8 weeks (G6PD deficient, aged ≥6 months, not pregnant, and not breastfeeding or breastfeeding for >1 month). P vivax recurrences were identified from probabilistic linkage of routine patient records from the Brazilian malaria epidemiological surveillance system. Recurrence-free effectiveness at day 90 and day 180 was estimated using Kaplan-Meier analysis and hazard ratios (HRs) by multivariate analysis. This clinical trial is registered with ClinicalTrials.gov, NCT05096702, and is completed. Records from Sept 9, 2021, to Aug 31, 2022, included 5554 patients with P vivax malaria. In all treated patients of any age and any G6PD status, recurrence-free effectiveness at day 180 was 75·8% (95% CI 74·0-77·6) with tafenoquine, 73·4% (71·9-75·0) with 7-day primaquine, and 82·1% (77·7-86·8) with weekly primaquine. In patients aged at least 16 years who were G6PD normal, recurrence-free effectiveness until day 90 was 88·6% (95% CI 87·2-89·9) in those who were treated with tafenoquine (n=2134) and 83·5% (79·8-87·4) in those treated with 7-day primaquine (n=370); after adjustment for confounding factors, the HR for recurrence following tafenoquine versus 7-day primaquine was 0·65 (95% CI 0·49-0·86; p=0·0031), with similar outcomes between the two treatments at day 180 (log-rank p=0·82). Over 180 days, median time to recurrence in patients aged at least 16 years who were G6PD normal was 92 days (IQR 76-120) in those treated with tafenoquine and 68 days (52-94) in those treated with 7-day primaquine. In this real-world setting, single-dose tafenoquine was more effective at preventing P vivax recurrence in patients aged at least 16 years who were G6PD normal compared with 7-day primaquine at day 90, while overall efficacy at 180 days was similar. The public health benefits of the P vivax radical cure treatment algorithm incorporating G6PD quantitative testing and tafenoquine support its implementation in Brazil and potentially across South America. Brazilian Ministry of Health, Municipal and State Health Secretariats; Fiocruz; Medicines for Malaria Venture; Bill & Melinda Gates Foundation; Newcrest Mining; and the UK Government. For the Portuguese translation of the abstract see Supplementary Materials section.

Malaria in the Legal Amazon: a retrospective study of reported cases

Malaria is an endemic disease in the tropical region of the Americas, with increasing trends in cases in the second decade of the 21st-century. This study analyzed cases reported by the Malaria Epidemiological Surveillance System (SIVEP-Malaria) from 2003 to 2018 in the Brazilian legal Amazon. A total of 6,017,752 cases were reported (annual average 376 thousand), and the following states stand out: Amazonas (2,081,231), Pará (1,460,252), Rondônia (964,526), and Acre (678,692), which correspond to 86.2% of reported cases. Three peaks of cases were observed: 2005 (757,514), 2010 (415,264), and 2018 (243,180). A growing trend in the number of cases between 2003 and 2005 (average of 597 thousand cases). Decrease from 2006 to 2016 (average reduction of 12%) with a new upward trend until 2018. The spatial distribution shows that 67% of cases is located in the Western Amazon and 33% in the Eastern Amazon. Brazil presented good results in combating malaria during the study period. Fluctuations in the number of cases are an expression of the complex system that involves the transmission of the disease, which makes monitoring and follow-up by health services necessary

COVID-19 reinfections in Mexico City: implications for public health.

Since its appearance, COVID-19 has immensely impacted our society. Public health measures, from the initial lockdowns to vaccination campaigns, have mitigated the crisis. However, SARS-CoV-2's persistence and evolving variants continue to pose global threats, increasing the risk of reinfections. Despite vaccination progress, understanding reinfections remains crucial for informed public health responses. We collected available data on clinical and genomic information for SARS-CoV-2 samples from patients treated in Mexico City from 2020 epidemiological week 10 to 2023 epidemiological week 06 encompassing the whole public health emergency's period. To identify clinical data we utilized the SISVER (Respiratory Disease Epidemiological Surveillance System) database for SARS-CoV-2 patients who received medical attention in Mexico City. For genomic surveillance we analyzed genomic data previously uploaded to GISAID generated by Mexican institutions. We used these data sources to generate descriptors of case number, hospitalization, death and reinfection rates, and viral variant prevalence throughout the pandemic period. The fraction of reinfected individuals in the COVID-19 infected population steadily increased as the pandemic progressed in Mexico City. Most reinfections occurred during the fifth wave (40%). This wave was characterized by the coexistence of multiple variants exceeding 80% prevalence; whereas all other waves showed a unique characteristic dominant variant (prevalence >95%). Shifts in symptom patient care type and severity were observed, 2.53% transitioned from hospitalized to ambulatory care type during reinfection and 0.597% showed the opposite behavior; also 7.23% showed a reduction in severity of symptoms and 6.05% displayed an increase in severity. Unvaccinated individuals accounted for the highest percentage of reinfections (41.6%), followed by vaccinated individuals (31.9%). Most reinfections occurred after the fourth wave, dominated by the Omicron variant; and after the vaccination campaign was already underway. Our analysis suggests reduced infection severity in reinfections, evident through shifts in symptom severity and care patterns. Unvaccinated individuals accounted for most reinfections. While our study centers on Mexico City, its findings may hold implications for broader regions, contributing insights into reinfection dynamics.

[Is the epidemiological surveillance of malignant mesothelioma implemented in Italy still valid and necessary?]

The register of malignant mesotheliomas can still play an informative role in the context of both remediation activities and the health surveillance of former asbestos-exposed persons, and become an epidemiological surveillance system on the harmful effects of exposure to asbestos. It must, however, maintain and improve the level of quality achieved, resolve the problems that have emerged in the interaction between the local level (where cases and their exposure histories are identified, registered, assessed, and medical insurance procedures activated) and the central insurance body that also manages the national register, and become an active participant in research, including clinical research. All this is important to meet the social and welfare justice needs of individual cases.

Sociodemographic factors associated with the success or failure of anti-tuberculosis treatment in the Chiapas Highlands, Mexico, 2019-2022.

To estimate the incidence rate of tuberculosis (TB) in the Highlands (Tsotsil-Tseltal) region of Chiapas and to analyze sociodemographic factors that might influence the success of anti-TB treatment from the period of January 2019 to June 2022. Retrospective study in which the TB databases of the National Epidemiological Surveillance System (SINAVE) were analyzed. TB incidence rates were calculated based on the number of registered TB cases and estimated annual populations. The success-failure of anti-TB treatment was analyzed according to sociodemographic indicators, degree of concentration of indigenous population of the municipality of residence and admission to SINAVE. Two hundred thirty-three cases were analyzed. The variables associated to a lower success rate of treatment against TB were: living in a municipality with high-very high concentration of indigenous population, being indigenous, having a primary school education or lower, and agricultural occupation. The number of TB diagnosed from 2020-2022 and the incidence rates from 2020-2021 decreased significantly compared to 2019. It is necessary to strengthen the follow-up of TB cases in the region, mainly in areas with high-very high indigenous concentration, in people with low levels of education and engaged in agricultural work.

Features of the epidemiological surveillance system of rabies and monkeypox in the Republic of Cameroon

The prevention and control of zoonotic infections remain a problem in most countries. However, this problem has become particularly relevant in recent decades, when the occurrence and pandemic spread of zoonotic diseases have become more frequent. All spheres of the national economy that ensure the fight against infections of this group (healthcare systems, veterinary medicine, and ecology) are trying to jointly find appropriate solutions to ensure antiepidemic protection of the population by taking adequate measures to prevent and combat infectious zoonoses. According to the World Health Organization, the spread of zoonotic infections is observed on all continents, particularly in Asia and Africa. The epidemiological significance of zoonoses depends on their effects on the population (morbidity and mortality), their ability to overcome interspecific barriers, and the individual characteristics of pathogens. It is also influenced by factors such as geographical location, climate, population density, economic growth rates, and development level of private and industrial livestock and poultry farming. The epidemiological surveillance systems in Cameroon are compared with the surveillance system in Russia and with the standards set by international organizations such as the World Health Organization and the Food and Agriculture Organization of the United Nations. The emergence and spread of current zoonotic infections in the Republic of Cameroon are presented. The study showed the geographical, social, administrative, economic, and health characteristics of Cameroon, which may influence the emergence and spread of infectious zoonosis in the country. Zoonotic diseases have only begun to receive special attention in Cameroon’s health system in 2014–2016, following an outbreak of monkeypox (mpox) in Cameroon. Moreover, the study described the epidemiological surveillance system and a classification of epidemic events monitored by the Cameroon Disease, Epidemic and Pandemic Control Authority. In general, the surveillance system for human and animal zoonoses in Cameroon was designed to ensure a rapid response during an epidemic. However, some shortcomings exist, such as low data for some zoonotic diseases and insufficient or virtually nonexistent surveillance in some regions of the country. To intensify the fight against the epidemic spread of these zoonotic infections, the capacity of health workers and technical means for detection and monitoring must be improved. The update of the national vaccination schedule should consider diseases such as rabies, given its endemic nature in the country; this may be possible through the establishment of a service or office responsible for surveillance, detection, and response to infectious zoonotic diseases.

ВІД ЕПІДЕМІЙ МИНУЛОГО ДО СЬОГОДЕННЯ І ХВОРОБИ Х, ДОСВІД БОРОТЬБИ ТА ПЕРСПЕКТИВИ

People have faced epidemics and pandemics since ancient times, without yet understanding either their nature, their consequences, or how to protect themselves and prevent their spread. Each infectious disease has its own history, features related to the virulence of the pathogen, the mechanism of its transmission, contagiousness, which depend on the epidemic potential of the pathogen, the intensity of the epidemic process of infection, and the consequences for eachindividual and society in general. Every year, new human microorganisms appear, among which viruses play a leading role,new parasitic systems are formed or already existing parasitic systems change, in which a person becomes the biological host of one or another pathogen. It is shown that zoonotic microorganisms prevail among human pathogens, in particular among emergent ones. Viruses predominate among pathogens with epidemic and pandemic potential. The article examines the chronology of major epidemics and pandemics, starting with an unknown disease in China 5,000 years ago and ending with monkeypox, the spread of which began in May 2022. Considerable attention is paid to current infectious diseases with pandemic potential, namely zoonotic influenza, emerging coronavirus infections (SARS, MERS, COVID-19), Ebola and Zika diseases, re-emerging monkeypox. A list of 10 potentially pandemic infectious diseases, which WHO has identified as priority, is provided, which also includes disease X. Taking into account the lessons of the COVID-19 pandemic, all countries, including Ukraine, need to make a lot more efforts to achieve a truly adequate level of preparedness for preventing biological threats and responding to future challenges. It is noted that preparations are currently underway for the adoption of the WHO Convention, an agreement or another international document on pandemic prevention, preparedness and response, the draft of which is currently undergoing the coordination stage. The implementation of its provisions at the international and national levels will contribute to increasing the effectiveness of international and national biosecurity systems and strengthening the potential for combating biological threats. It is emphasized that the national biosafety system in Ukraine needs significant improvement in the direction of strengthening the system of epidemiological surveillance of infectious diseases. Key words: epidemic, pandemic, emergent infection, pathogen, MERS, COVID-19, monkeypox, disease X.

Detection and risk assessment of COVID-19 through machine learning

COVID-19, also known as coronavirus disease, is caused by the SARS-CoV-2 virus. People infected with COVID-19 may show a range of symptoms from mild to severe, including fever, cough, difficulty breathing, tiredness, and nasal congestion, among others. The goal of this study is to use machine learning to identify if a person has COVID-19 based on their symptoms and to predict how severe their illness might become. This could lead to outcomes like needing a ventilator or being admitted to an Intensive Care Unit. The methods used in this research include Artificial Neural Networks (specifically, Multi-Layer Perceptrons), Classification and Regression Trees, and Random Forests. Data from the National Epidemiological Surveillance System of Mexico City was analyzed. The findings indicate that the Multi-Layer Perceptron model was the most accurate, with an 87.68% success rate. It was best at correctly identifying COVID-19 cases. Random Forests were more effective at predicting severe cases and those requiring Intensive Care Unit admission, while Classification and Regression Trees were more accurate in identifying patients who needed to be put on a ventilator.

Prediction models of COVID-19 fatality in nine Peruvian provinces: A secondary analysis of the national epidemiological surveillance system.

There are initiatives to promote the creation of predictive COVID-19 fatality models to assist decision-makers. The study aimed to develop prediction models for COVID-19 fatality using population data recorded in the national epidemiological surveillance system of Peru. A retrospective cohort study was conducted (March to September of 2020). The study population consisted of confirmed COVID-19 cases reported in the surveillance system of nine provinces of Lima, Peru. A random sample of 80% of the study population was selected, and four prediction models were constructed using four different strategies to select variables: 1) previously analyzed variables in machine learning models; 2) based on the LASSO method; 3) based on significance; and 4) based on a post-hoc approach with variables consistently included in the three previous strategies. The internal validation was performed with the remaining 20% of the population. Four prediction models were successfully created and validate using data from 22,098 cases. All models performed adequately and similarly; however, we selected models derived from strategy 1 (AUC 0.89, CI95% 0.87-0.91) and strategy 4 (AUC 0.88, CI95% 0.86-0.90). The performance of both models was robust in validation and sensitivity analyses. This study offers insights into estimating COVID-19 fatality within the Peruvian population. Our findings contribute to the advancement of prediction models for COVID-19 fatality and may aid in identifying individuals at increased risk, enabling targeted interventions to mitigate the disease. Future studies should confirm the performance and validate the usefulness of the models described here under real-world conditions and settings.

Notification of Self-inflicted Injuries in the Caparaó Capixaba Region: Suicide Prevention Interfaces

Abstract Background: Complex by nature and with a wide social impact, the suicide spectrum includes fatal and non-fatal behaviors and a series of terminologies related to them. In Brazil, the epidemiological surveillance system adopts the term self-inflicted injury for cases of self-inflicted violence, registering them in the National Disease Notification System (NDNS). Information systems must be continuously evaluated in order to verify the quality of their operability. Objective: to evaluate the quality, according to the attributes of completeness and duplicity of self-harm records on NDNS from 2011 to 2019, in the region of Caparaó Capixaba-ES-Brazil. Method: A descriptive cross-sectional study was conducted using secondary data on self-harm obtained from NDNS, covering the municipalities of the Caparaó Capixaba region from 2011 to 2019. The data were exported from the NDNS municipal databases and analyzed in the Statistical Package for Social Sciences version 25 for Windows. The results were presented in the form of percentage averages and classified according to the parameters adopted. Results: No duplicates were identified in the analyzed records. Regarding completeness, an average of 18.34% of variables remained incomplete during the period from 2011 to 2014. There was an improvement in the subsequent period from 2015 to 2019, with a reduction to 12.35% of incomplete entries. Conclusions: Over the period from 2011 to 2019, there was a proportional percentage variation of 4500% in the number of cases registered for self-inflicted injuries in the region. Duplicity indicated adequate performance; however, despite the increase in the completeness rate, the averages remained classified as regular. Keywords: Suicide Attempt, Suicide, Health Information Systems, Epidemiological Monitoring

A brief history of rabies in Haiti until the adoption of the One Health approach for its epidemiological surveillance and control

Rabies was first identified in dogs and humans by a French veterinarian, Jean Lompagieu Lapole, in 1788 in the colony of Saint-Domingue, which later became Haiti. Rabies has continued to persist in the country despite some intermittent successes in combating this disease over the past 20 years. We are trying to understand why rabies, which has officially existed in the country for around 250 years, is still classified as a neglected disease and continues to result in cases of human mortality. For a significant period, until the implementation of the Haiti Animal Rabies Surveillance Program (HARSP) in 2011, there was no robust initiative to fight against rabies based on regular vaccination campaigns and an effective epidemiological surveillance system despite certain efforts made by the Ministry of Agriculture and Pan American Health Organization Project of Strengthening Public Agricultural Services (RESEPAG): Projet de Renforcement des Services publics Agricoles (PAHO) to increase dog vaccinations. The HARSP program was established with technical assistance from the Center for Disease Prevention and Control of Infectious Diseases (CDC) to control and eliminate rabies in the short term, according to the One Health approach. It was a passive surveillance system based on strengthening the rabies diagnostic capacity of the Veterinary Laboratory, training veterinary and public health technicians, and supporting rabies vaccination campaigns. This approach has resulted in effective cooperation between the Ministry of Agriculture and the Ministry of Public Health based on the “One Health” enabling the Ministry of Public Health to report daily on bite to the Ministry of Agriculture for further investigations. HARSP marked a pivotal moment in the Rabies Control and Elimination Program. Between January 2013 and December 2017, there were 9,342 reported human exposures to animals suspected of carrying rabies in Haiti. The number of Human exposures to rabies suspected animals in Haiti from January 2013 to December 2017 was 9,342 heads. Among these cases, 2.4% were confirmed, 4.9% probable, 17.8% suspected, and 74.6% discarded. The One Health rabies program has demonstrated the potential for achieving control of both animal and human rabies in Haiti if the ministries of Agriculture and Health commit unequivocally to continue their collaborative development efforts and adhere to HARSP methodology, including vaccinating over 70% of the dog population.