Epidemiological Week Research Articles

Impact of COVID-19 on the circulation of respiratory viruses in a children's hospital: an expected absence.

Respiratory viruses are the main cause of acute lower respiratory tract infection (ALRTI) in the pediatric population. In March 2020, the World Health Organization declared that the new coronavirus disease 2019 (COVID-19) had reached the pandemic status. Our objective was to describe the impact of COVID-19 pandemic on hospitalizations due to ALRTI at Hospital de Niños Ricardo Gutiérrez (HNRG) and virus circulation. Observational, retrospective, and descriptive study of patients hospitalized due to ALRTI comparing 2019 and 2020. In 2020, the rate of hospitalization due to ALRTI decreased by 73%. In 2019, 517 patients with ALRTI were hospitalized; the following viruses were identified in 174: respiratory syncytial virus (RSV) (71.2%), adenovirus (AV) (10.3%), parainfluenza virus (PIV) (9.7%), and influenza virus (FLU) (8.6%). In 2020, 94 patients with ALRTI were hospitalized. Until epidemiological week (EW) 13, cases of ALRTI due to PIV and AV were recorded; in EW 29, there was 1 case of bronchiolitis due to AV and rhinovirus (RV), followed by isolated cases of RV; no ALRTI due to RSV or FLU was recorded. In total, 9 cases of ALRTI due to COVID-19 were recorded: 2 moderate bronchiolitis and 7 focal pneumonia; 1 adolescent with comorbidities died due to COVID-19 pneumonia. In 2020, patients were older and had more comorbidities and prior hospitalizations compared to 2019. Focal pneumonia prevailed. In 2020, the rate of hospitalization due to ALRTI decreased significantly compared to 2019, with the absence of seasonal respiratory virus circulation in the pediatric population.

Characterization of Excess Death in the Mexican State of Guanajuato, During the COVID-19 Pandemic: An Ecological Study

Due to SARS-CoV-2 infection, which causes COVID-19, the total number of annual deaths increased in Mexico during 2020. To analyze the mortality in the Mexican state of Guanajuato from 2015 to 2020, we designed an ecological study. We used the registries of deaths in the vital statistics database of the Epidemiological and Statistical Subsystem of Deaths that includes age, sex, cause of death, epidemiological week of death as variables. Mortality Rates, Rates Ratios, Difference of Rates, Adjusted Mortality Rates, Adjusted Rates Ratios, and Difference of Rates were computed as part of the statistical analysis. To show the patterns regarding deaths in Guanajuato Sate from 2015 to 2020, we also calculated some dendrograms. The difference between the number of deaths in 2020 and 2019 is 13,286, while, in previous years, the differences were under 3000. The percentage of males that died (59.30%) shows an increment in 2020. Also, the mean age increased in 2020 (62.9 ± 22.56). The gender ratio of deaths (males/females) is greater than 1 in all the age groups except for those over 80. The age and geographic patterns of deaths changed in 2020. The 3rd cause of death among the top 10 leading causes is COVID-19. It has been detected an excess of mortality in 2020, although the integrity of the record is questionable since COVID-19 is an emergent disease. The highest effect is observed among males and older people. This situation has changed the age and geographic patterns of death in Guanajuato state. The long-term consequences on society remain to be observed.

Effectiveness of rAd26-rAd5, ChAdOx1 nCoV-19, and BBIBP-CorV vaccines for risk of infection with SARS-CoV-2 and death due to COVID-19 in people older than 60 years in Argentina: a test-negative, case-control, and retrospective longitudinal study

BackgroundIn January, 2021, a vaccination campaign against COVID-19 was initiated with the rAd26-rAd5, ChAdOx1 nCoV-19, and BBIBP-CorV vaccines in Argentina. The objective of this study was to estimate vaccine effectiveness at reducing risk of SARS-CoV-2 infection and COVID-19 deaths in people older than 60 years.MethodsIn this test-negative, case-control, and retrospective longitudinal study done in Argentina, we evaluated the effectiveness of three vaccines (rAd26-rAd5, ChAdOx1 nCoV-19, and BBIBP-CorV) on SARS-CoV-2 infection and risk of death in people with RT-PCR confirmed COVID-19, using data from the National Surveillance System (SNVS 2.0). All individuals aged 60 years or older reported to SNVS 2.0 as being suspected to have COVID-19 who had disease status confirmed with RT-PCR were included in the study. Unvaccinated individuals could participate in any of the analyses. People with suspected COVID-19 who developed symptoms before the start of the implementation of the vaccination programme for their age group or district were excluded from the study. The odds ratio of SARS-CoV-2 infection was evaluated by logistic regression and the risk of death in individuals with RT-PCR confirmed COVID-19 was evaluated by proportional hazard regression models, adjusted for possible confounders: age at the time of the symptom onset date, sex, district of residence, epidemiological week corresponding to the symptom onset date, and history of COVID-19. The estimation of vaccine effectiveness to prevent death due to COVID-19 was done indirectly by combining infection and death estimates. In addition, we evaluated the effect of the first dose of viral vector vaccines across time.FindingsFrom Jan 31, to Sept 14, 2021, 1 282 928 individuals were included, of whom 687 167 (53·6%) were in the rAd26-rAd5 analysis, 358 431 (27·6%) in the ChAdOx1 nCoV-19 analysis, and 237 330 (18·5%) in the BBIBP-CorV analysis. Vaccine effectiveness after two doses was high for all three vaccines, adjusted odds ratio 0·36 (95% CI 0·35–0·37) for rAd26-rAd5, 0·32 (0·31–0·33) for ChAdOx1 nCoV-19, and 0·56 (0·55–0·58) for BBIBP-CorV. After two doses, the effect on deaths was higher than that on risk of infection: adjusted hazard ratio 0·19 (95% CI 0·18–0·21) for rAd26-rAd5, 0·20 (0·18–0·22) for ChAdOx1 nCoV-19, and 0·27 (0·25–0·29) for BBIBP-CorV. The indirectly estimated effectiveness on deaths was 93·1% (95% CI 92·6–93·5) for rAd26-rAd5, 93·7% (93·2–94·3) for ChAdOx1 nCoV-19, and 85·0% (84·0–86·0) for BBIBP-CorV following two doses. First dose effect of viral vector vaccines remained stable over time.InterpretationThe vaccines used in Argentina showed effectiveness in reducing infection and death by SARS-CoV-2 and COVID-19.FundingNone.

Cardiovascular Mortality During the COVID-19 Pandemics in a Large Brazilian City: A Comprehensive Analysis.

Introduction:The impact of COVID-19 pandemics on cardiovascular diseases (CVD) may be caused by health system reorganization and/or collapse, or from changes in the behaviour of individuals. In Brazil, municipalities were empowered to define regulatory measures, potentially resulting in diverse effects on CVD morbimortality.Objective:To analyse the impact of COVID-19 pandemics on CVD outcomes in Belo Horizonte (BH), the sixth greater capital city in Brazil, including: mortality, mortality at home, hospitalizations, intensive care unit utilization, and in-hospital mortality; and the differential effect according to sex, age range, social vulnerability, and pandemic’s phase.Methods:Ecological study analysing data from the Mortality and Hospital Information System of BH residents aged ≥30 years. CVD was defined as in Chapter IX from ICD-10. Social vulnerability was classified by a composite socioeconomic index as high, medium and low. The observed age-standardized rates for epidemiological weeks 10–48, 2020, were compared to the expected rates (mean of 2015–2019). Risk ratios (RiR) were analysed and 95% confidence intervals were calculated for all estimates. Population projected to 2020 for BH and its census tracts were used to calculate rates.Results:We found no changes in CVD mortality rates (RiR 1.01, 95%CI 0.96–1.06). However, CVD deaths occurred more at homes (RiR 1.32, 95%CI 1.20–1.46) than in hospitals (RiR 0.89, 95%CI 0.79–0.99), as a result of a substantial decline in hospitalization rates, even though proportional in-hospital deaths increased. The rise in home deaths was greater in older adults and in had an increasing gradient in those more socially vulnerable (RiR 1.45); for high (RiR 1.45), medium (RiR 1.32) and low vulnerability (RiR 1.21).Conclusion:The greater occurrence of CVD deaths at home, in parallel with lower hospitalization rates, suggests that CVD care was disrupted during the COVID-19 pandemics, which more adversely affected older and more socially vulnerable individuals, exacerbating health inequities in BH.

Non-Pharmaceutical Interventions Implemented to Control the COVID-19 Were Associated With Reduction of Influenza Incidence.

BackgroundNon-pharmaceutical interventions were implemented in most countries to reduce the transmission of COVID-19. We aimed to describe the incidence of influenza in four countries in the 2019–2020 season and examined the effect of these non-pharmaceutical interventions on the incidence of influenza.MethodsWe used the network surveillance data from 2015 to 2020 to estimate the percentage increase in influenza cases to explore the effect of non-pharmaceutical interventions implemented to control the COVID-19 on the incidence of influenza in China, the United States, Japan, and Singapore.ResultsWe found that the incidence of influenza has been almost zero and reached a persistent near-zero level for a continuous period of six months since epidemiologic week 14 of 2020 in the four countries. Influenza incidence decreased by 77.71% and 60.50% in the early days of COVID-19 in the 2019–2020 season compared to the same period in preceding years in Japan and Singapore, respectively. Furthermore, influenza incidence decreased by 60.50–99.48% during the period of compulsory interventions in the 2019–2020 season compared to the same period in preceding years in the four countries.ConclusionThese findings suggest that the application of non-pharmaceutical interventions, even everyday preventive action, was associated with a reduction of influenza incidence, which highlights that more traditional public health interventions need to be reasserted and universalized to reduce influenza incidence.

An overview of Brazilian working age adults vulnerability to COVID-19

Brazil is a country of continental dimensions, where many smaller countries would fit. In addition to demographic, socioeconomic, and cultural differences, hospital infrastructure and healthcare varies across all 27 federative units. Therefore, the evolution of COVID-19 pandemic did not manifest itself in a homogeneous and predictable trend across the nation. In late 2020 and early 2021, new waves of the COVID-19 outbreak have caused an unprecedented sanitary collapse in Brazil. Unlike the first COVID-19 wave, in subsequent waves, preliminary evidence has pointed to an increase in the daily reported cases among younger people being hospitalized, overloading the healthcare system. In this comprehensive retrospective cohort study, confirmed cases of hospitalization, ICU admission, IMV requirement and in-hospital death from Brazilian COVID-19 patients throughout 2020 until the beginning of 2021 were analyzed through a spatio-temporal study for patients aged 20–59 years. All Brazilian federative units had their data disaggregated in six periods of ten epidemiological weeks each. We found that there is a wide variation in the waves dynamic due to SARS-CoV-2 infection, both in the first and in subsequent outbreaks in different federative units over the analyzed periods. As a result, atypical waves can be seen in the Brazil data as a whole. The analysis showed that Brazil is experiencing a numerical explosion of hospitalizations and deaths for patients aged 20–59 years, especially in the state of São Paulo, with a similar proportion of hospitalizations for this age group but higher proportion of deaths compared to the first wave.

First case of SARS-CoV-2 RNA detection in municipal solid waste leachate from Brazil

This work presents the first case of SARS-CoV-2 RNA detection in leachate collected from a transfer station in the city of São Paulo, Brazil. After calibration of the viral detection method already used for wastewater samples with a pilot leachate sample and virus fragments in laboratory, twelve polyethylene glycol concentrated leachates samples were tested by RT-qPCR. The results confirmed the presence of N1 gene in 9 of the 12 analyzed samples between epidemiological weeks 33 and 38 of the year 2021 (08/15/2021 to 09/19/2021). The occurrence of the N2 gene was only observed in 5 of the 12 samples. The concentration values for N1 and N2 genes varied between 3.1 and 4.6 log10.GC·L−1, which are values close to those measured in sanitary wastewater. This method showed to be a promising procedure to verify the presence of viral RNA in municipal solid waste leachate, being especially useful where there is no treatment system and sanitation infrastructure, which makes the conventional wastewater surveillance unfeasible.

Estimated number of deaths directly avoided because of COVID-19 vaccination among older adults in Colombia in 2021: an ecological, longitudinal observational study

Background: Colombia's national COVID-19 vaccination plan began in February of 2021. It gave priority to older adults, who constituted 77.7% of deaths from this illness in the year 2020. The main goal of the plan is to decrease specific mortality and the number of serious COVID-19 cases, however, the number of deaths avoided by this strategy is unknown. The objective of this study was to estimate the number of avoided deaths in Colombia by fully vaccinating older adults against COVID-19, during the first year of the implementation of the national vaccination plan. Methods: This study took on the design of an ecological, longitudinal study. Full vaccination coverage for older adults was calculated for each epidemiological week and age group from March to December 2021, based on which the number of avoided COVID-19 deaths was estimated. A sensitivity analysis was performed taking into account variations in the vaccines' effectiveness by age group. Results: In Colombia, over 5.3 million adults 60 years of age and older received full COVID-19 vaccinations between March and December 2021. During that same period, nearly 46,000 deaths of older adults from this cause were registered. We estimated that vaccination has avoided around 22,000 more older adults from dying from COVID-19 in Colombia, that is, 32.4% of expected deaths in 2021. According to the sensitivity analysis, the number of lives saved ranged from 19,597 to 36,507. Conclusions: Colombia's strategy to vaccinate older adults against COVID-19 has avoided mortality for this age group from being 48.0% higher than what was observed during the study period. Even more lives have been saved when taking into account the parameters that were defined and the omission of the contribution from partial vaccinations.

A temporal study of Brazilian pregnant and postpartum women vulnerability for COVID-19: Characteristics, risk factors and outcomes

BackgroundDuring the COVID-19 second wave in Brazil, there has been a significant increase in the number of daily cases and deaths, including pregnant and postpartum women. We assess risk factors and outcomes for this priority group compared to the COVID-19 non-pregnant cohort in two epidemic waves.MethodsIn this retrospective cohort study we evaluated data of hospitalized pregnant, postpartum, and nonpregnant women aged 15-44 years, between epidemiological weeks 2020–8 and 2021–15, who tested positive for SARS-CoV-2, retrieved from the Influenza Epidemiological Surveillance Information System maintained by Ministry of Health of Brazil. We analysed in-hospital case fatality rate, crude and adjusted risk ratios on different outcomes aiming to compare data in two waves.FindingsThe study included pregnant women (n = 7,132), postpartum women (n = 2,405) and nonpregnant women (n = 76,278) hospitalized with COVID-19. Case fatality rates of pregnant women were lower in both waves compared to nonpregnant women, but higher among postpartum women. The risk for admission to the intensive care unit and invasive mechanical ventilation requirement in both waves was significantly higher among postpartum women compared to nonpregnant women. Cardiac disease, diabetes, obesity, and asthma were the most frequent underlying medical conditions in all patient groups. These comorbidities were significantly less frequent among pregnant women.InterpretationPregnant women with COVID-19 are at lower risk of poor outcome compared to nonpregnant women. On the other hand, postpartum women are at higher risk of adverse outcomes compared to pregnant and nonpregnant women, especially during the second wave. There was a significant increase in the in-hospital case fatality rate for all patient groups during the second wave of COVID-19.FundingThis study was financed in part by CAPES, CNPq, FAPEMIG and UFSJ.

Epidemiological and clinical characteristics of children with COVID-19 cared for in a private health provider in Uruguay

After the detection of the first cases of SARS-CoV-2 and the declaration of a health emergency in the country, community transmission of the virus remained low to moderate until November 2020, later becoming medium and high. Children under 15 years of age constitute the least affected group. The diagnosis is confirmed by RT-qPCR. The usefulness of the CT (cycle threshold) is discussed. To describe the epidemiological and clinical characteristics of children infected with SARS-CoV-2 and the relationship between the CT value and clinical presentation. A descriptive, retrospective study was carried out in patients under 16 years of age with SARS-CoV-2 infection, assisted by a health provider in Montevideo between epidemiological week (EW) 3 of2020 and EW 9 of2021. Clinical variables, epidemiological notion, severity and evolution were described. The CT value at diagnosis was recorded and compared with the presence of symptoms. Patients under 16 years of age represented 16.6% of the total infected (794 in 4,792). 70% of the cases occurred between the months of January and February 2021. 67.6% presented intradomiciliary contact. The mean age was 7.5 ± 4.1 years, 51% were male. 55% presented symptoms and 45% were asymptomatic; no significant differences were observed in the mean, mode and age range of both groups. None presented comorbidities. In the group of 440 symptomatic patients, 55% presented fever: 32% associated with other symptoms, mainly upper respiratory symptoms, and 23% as the only symptom. The CT value was obtained in 536 of the 794 patients (67.5%). The mean CT was 29.7+5.8 in the symptomatic group vs. 31.5 ± 5.7 in asymptomatic patients (p > 0.05). Three patients were hospitalized, none required intensive care and none died. The prevalence and incidence of SARS-CoV-2 infection in children accompany that of adults and the majority had mild or asymptomatic forms, without complications. In this series, the CT value was not different in symptomatic and asymptomatic children. Close household contact was the main source of infection.

Adolescent behaviors during the preventive and mandatory social isolation in Argentina in 2020.

In March 2020, Argentina established a preventive and mandatory social isolation policy (ASPO, for its acronym in Spanish) due to the COVID-19 pandemic. To explore the behaviors and habits of the adolescent population during the ASPO and the extent of compliance. Qualitative and quantitative, cross sectional study in Argentine adolescents aged 12-20 years. An anonymous, semi-structured questionnaire was administered during epidemiological weeks 34 to 36. A total of 1535 questionnaires were analyzed. Participants' average age was 16 years; 72% were females. Non-compliance with the ASPO during the first 3 months was 27% versus 59% during the past month. A good to excellent family environment was described by 73%, and 87% performed educational activities. The average non-educational screen time was 6.8 hours per day. Results. A total of 1535 questionnaires were analyzed. Participants' average age was 16 years; 72% were females. Non-compliance with the ASPO during the first 3 months was 27% versus 59% during the past month. A good to excellent family environment was described by 73%, and 87% performed educational activities. The average non-educational screen time was 6.8 hours per day. Most adolescents maintained their educational activities, spent a lot of noneducational screen time, and referred a low drug use. Adherence to the ASPO decreased progressively over time. The main positive aspects were strengthening family bonds and discovering or returning to activities; whereas negative aspects were emotional distress and not being able to see family members or friends.

National FluWatch mid-season report, 2021-2022: Sporadic influenza activity returns.

Surveillance for Canada's 2021-2022 seasonal influenza epidemic began in epidemiological week 35 (the week starting August 29, 2021) during the ongoing coronavirus disease 2019 (COVID-19) global public health emergency. In the 2021-2022 surveillance season to date, there has been a return of persistent sporadic influenza activity, and the first influenza-associated hospitalizations since mid-2020 have been reported. However, as of week 52 (week ending 01/01/2022) activity has remained sporadic, and no influenza-confirmed outbreaks or epidemic activity have been detected. There has been a delay or absence in several traditional seasonal influenza milestones, including the declared start of the influenza season, marked by a threshold of 5% positivity, which historically has occurred on average in week 47. The 429 sporadic detections reported in Canada to date have occurred in 31 regions across seven provinces/territories. Nearly half (n=155/335, 46.3%) of reported cases have been in the paediatric (younger than 19 years) population. Three-quarters of the cases were influenza A detections (n=323/429, 75.3%). Of the subtyped influenza A detections, A(H3N2) predominated (n=83/86, 96.5%). Of the 12 viruses characterized by the National Microbiology Laboratory, 11 were seasonal strains. Among the seasonal strains characterized, only one was antigenically similar to the strains recommended for the 2021-2022 Northern Hemisphere vaccine, though all were sensitive to the antivirals, oseltamivir and zanamivir. Until very recently, seasonal influenza epidemics had not been reported since March 2020. Evidence on the re-emergence of seasonal influenza strains in Canada following the A(H1N1)pdm09 pandemic shows that influenza A(H3N2) and B epidemics ceased through the 2009-2010 season and second wave of A(H1N1)pdm09, but then re-emerged in subsequent seasons to predominate causing epidemics of higher intensity than in the pre-pandemic seasons. When and where seasonal influenza epidemic activity resumes cannot be predicted, but model-based estimates and historical post-pandemic patterns of intensified epidemics warrant continued vigilance through the usual season and for out-of-season re-emergence. In addition, ongoing population preparedness measures, such as annual influenza vaccination to mitigate the intensity and burden of future seasonal influenza epidemic waves, should continue.

Improving Dengue Forecasts by Using Geospatial Big Data Analysis in Google Earth Engine and the Historical Dengue Information-Aided Long Short Term Memory Modeling.

Simple SummaryForecasting dengue cases often face challenges from (1) time-effectiveness due to time-consuming satellite data downloading and processing, (2) weak spatial representation due to data dependence on administrative unit-based statistics or weather station-based observations, and (3) stagnant accuracy without historical dengue cases. With the advance of the geospatial big data cloud computing in Google Earth Engine and deep learning, this study proposed an efficient framework of dengue prediction at an epidemiological week basis using geospatial big data analysis in Google Earth Engine and Long Short Term Memory modeling. We focused on the dengue epidemics in the Federal District of Brazil during 2007–2019. Based on Google Earth Engine and epidemiological calendar, we computed the weekly composite for each dengue driving factor, and spatially aggregated the pixel values into dengue transmission areas to generate the time series of driving factors. A multi-step-ahead Long Short Term Memory modeling was used, and the time-differenced natural log-transformed dengue cases and the time series of driving factors were considered as outcomes and explantary factors, respectively, with two modeling scenarios (with and without historical cases). The performance is better when historical cases were used, and the 5-weeks-ahead forecast has the best performance.Timely and accurate forecasts of dengue cases are of great importance for guiding disease prevention strategies, but still face challenges from (1) time-effectiveness due to time-consuming satellite data downloading and processing, (2) weak spatial representation capability due to data dependence on administrative unit-based statistics or weather station-based observations, and (3) stagnant accuracy without the application of historical case information. Geospatial big data, cloud computing platforms (e.g., Google Earth Engine, GEE), and emerging deep learning algorithms (e.g., long short term memory, LSTM) provide new opportunities for advancing these efforts. Here, we focused on the dengue epidemics in the urban agglomeration of the Federal District of Brazil (FDB) during 2007–2019. A new framework was proposed using geospatial big data analysis in the Google Earth Engine (GEE) platform and long short term memory (LSTM) modeling for dengue case forecasts over an epidemiological week basis. We first defined a buffer zone around an impervious area as the main area of dengue transmission by considering the impervious area as a human-dominated area and used the maximum distance of the flight range of Aedes aegypti and Aedes albopictus as a buffer distance. Those zones were used as units for further attribution analyses of dengue epidemics by aggregating the pixel values into the zones. The near weekly composite of potential driving factors was generated in GEE using the epidemiological weeks during 2007–2019, from the relevant geospatial data with daily or sub-daily temporal resolution. A multi-step-ahead LSTM model was used, and the time-differenced natural log-transformed dengue cases were used as outcomes. Two modeling scenarios (with and without historical dengue cases) were set to examine the potential of historical information on dengue forecasts. The results indicate that the performance was better when historical dengue cases were used and the 5-weeks-ahead forecast had the best performance, and the peak of a large outbreak in 2019 was accurately forecasted. The proposed framework in this study suggests the potential of the GEE platform, the LSTM algorithm, as well as historical information for dengue risk forecasting, which can easily be extensively applied to other regions or globally for timely and practical dengue forecasts.

Assessment of Active Case Search of COVID-19 in Healthcare Facilities during the Third Wave of the Pandemic in Ekiti State, Nigeria

Early case detection and isolation of patients infected with highly infectious diseases through active case search (ACS) are important for early commencement of treatment and control of the disease within a population. This study aimed to assess the ACS of COVID-19 in healthcare facilities during the third wave of the pandemic in Ekiti State, Nigeria. This cross-sectional study was conducted in all healthcare facilities in Ekiti State. All cadres of local government primary healthcare workers were trained to carry out the ACS using semi-structured interviewer-administered questionnaire uploaded on android phone software open data kit (ODK). ACS was conducted between June and September (epidemiological week 23 to 36), 2021 and the collected data were analyzed using IBM SPSS version 23.0. P-value < 0.05 was taken as significant. The number of ACS visits for COVID-19 increases with epidemiological week progression, but the highest was in week 32 (9.9%). Cases of suspected COVID-19 in the healthcare facilities in the last one week were reported in more than half (58%) of the visits and 57.8% of those reported, documented between 1 - 4 cases. Also, out of those that were reported, 42% of them missed (not line listed) at least one suspected case of COVID-19. The private health facilities missed more cases of COVID-19 (54.3%) than other categories of health facilities (p < 0.001). The health educators and local government immunization officers (LIO) than other cadre of healthcare workers found most missed cases (57.1% and 51.4% respectively) in their visits (p < 0.001). The health educator as well as the LIO detected the highest proportion of missed suspected cases which shows that disease surveillance officers alone may not be adequate for ACS, there is a need to involve other local government team member.

Epidemiological and clinical characteristics of monkeypox cases in Brazil in 2022: a cross-sectional study.

to describe epidemiological and clinical characteristics of monkeypox (MPX) in Brazil, from the identification of the first case, on June 7, 2022, to Epidemiological Week (EW) 39, ending on October 1, 2022. this was a descriptive study of cases notified to the Ministry of Health; trends were analyzed based on the number of confirmed and probable cases per EW; the cases were also described according to demographic and clinical variables. out of 31,513 notifications, 23.8% were confirmed; 91.8% were male; 70.6% were cis men; and median age was 32 years. Fever (58.0%), adenomegaly (42.4%), headache (39.9%) and rash (37.0%) were the most frequent symptoms; 27.5% reported being immunosuppressed, 34.6% were living with HIV and 10.5% had a sexually transmitted infection; three deaths were recorded. the MPX case profile was similar to that of other countries; surveillance actions must be strengthened to control the outbreak.

Decrease in compulsory notifications registered by the Brazilian National Hospital Epidemiological Surveillance Network during the COVID-19 pandemic: a descriptive study, 2017-2020

To describe compulsorily notifiable diseases, health conditions and public health events (DAEs as per the Brazilian acronym) registered by the National Hospital Epidemiological Surveillance Network (RENAVEH as per the Brazilian acronym), before and during the COVID-19 pandemic. This was a descriptive ecological study using records held on the Notifiable Health Conditions Information System (SINAN as per the Brazilian acronym) between Epidemiological Week (EW) 1 of 2017 (January 1st, 2017) and 52 of 2020 (December 26, 2020). Between 2017 and 2020, RENAVEH notified 1,258,455 DAE form records, with only 225,081 (17.9%) notifications in 2020, representing a decrease of 146,340 records compared to 2019. The temporal analysis showed a decrease per EW of more than 1,000 notified records with effect from EW 12. There was a decrease in compulsorily notifiable DAEs registered by RENAVEH in Brazil taking the period analyzed as a whole, in particular in 2020.

How to overcome the stagnation of the first dose vaccine coverage curve against coronavirus disease 2019 in Brazil?

ABSTRACTBackground: A large percentage of the population has not yet started vaccination, for which the increase in coverage is almost null. Methods: We used segmented regression analysis to estimate trends in the first dose coverage curve. Results: There has been a slowdown in the application of the first doses in Brazil since epidemiological week 36 (average percent change [APC] 0.83%, 95% confidence interval [CI] 0.75-0.91%), with a trend close to stagnation. Conclusions: It is important to develop strategies to increase access to vaccination posts. Furthermore, it is recommended to expand vaccination to children, thereby increasing the eligible population.

Social vulnerability, survival, and hospital lethality by COVID-19 in patients aged 50 years and over: retrospective cohort of cases in Brazil in 2020 and 2021

The outcome of SARS-CoV-2 infection is not only associated with age and comorbidities but is also aggravated by social vulnerability. This study aims to analyze - according to social vulnerability - survival and hospital lethality by COVID-19 in the first 100 days from symptoms to death in individuals aged 50 years or older hospitalized in Brazil. This is a retrospective cohort from Epidemiological Week 11 of 2020 to week 33 of 2021. The Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) provided clinical and epidemiological data. The Geographic Index of the Socioeconomic Context for Health and Social Studies (GeoSES) measured social vulnerability. The Kaplan-Meier curve and the adjusted proportional risk model by Cox were used for survival, with hazard ratio (HR) and 95% confidence intervals (95%CI). Among the 410,504 cases, overall lethality was of 42.2% in general and 51.4% in the most vulnerable. We found a higher lethality according to worse socioeconomic status in all categories by age group; the double is registered for 50-59 years. The adjusted Cox model showed a 32% increase in risk of death (HR = 1.32; 95%CI: 1.24-1.42). Moreover, men, older adults, black or indigenous adults, with multiple comorbidities, and subjected to invasive ventilation, have a higher risk of death after hospitalization. Intersectoral policy measures need to be targeted to alleviate the effects of the COVID-19 pandemic aggravated by social vulnerability.

COVID-19 in a region of Cameroon hit by armed conflict.

Introductionthe emergence of more transmissible SARS-CoV-2 variants like Delta and Omicron have triggered the next wave of COVID-19 in many parts of the world. Here we report a surge in COVID-19 cases and deaths in the Northwest (NW) Region of Cameroon, which is plagued with low immunization coverage and armed conflict.Methodsa cross-sectional study was conducted in September 2021 and data on COVID-19 cases and vaccination were reviewed from the Ministry of Health database from January 1st, 2020 to September 4th, 2021. The security situation of the region was obtained from the districts and regional health managers. Data were analyzed with MS Excel and results presented as trends and proportions.Resultssince the onset of COVID-19 pandemic, there is an increasing prevalence in cases in the NW. Between epidemiological week 34-35 of 2021, there was a surge in COVID-19 cases in the NW. More than 70% of all COVID-19 related deaths reported in the country during epidemiological week-35 were recorded in this region. Despite this high mortality, COVID-19 vaccine uptake remains very low in the region. Indeed, just 0.6% of the 962,036-target population 18-years and above are fully immunized after 6-months of vaccination.Conclusionthough the country´s epi-curve does not suggest a third wave currently, the NW is experiencing a steady COVID-19 case surge amid insecurity and the circulation of the Delta variant. There is therefore a need to adopt innovative strategies to improve immunization and strengthen other SARS-CoV-2 preventive measures in this region.

Population-based virucidal phthalocyanine gargling/rinsing protocol to reduce the risk of coronavirus disease-2019: a community trial.

In this community trial, the objective was to evaluate the incidence of coronavirus disease-2019 (COVID-19) cases in two similar communities in three distinct phases: 1 (before the intervention), 2 (during the intervention), and 3 (after the intervention). The test community received the oral antiseptic intervention (experimental), while the control community did not. The official information agency ("Statewise System for Data Analysis") provided the number of confirmed COVID-19 cases. Data were analyzed according to the three phases per epidemiological week (epi) using the R Core Team (2021) program. The relative risk and 95% confidence intervals between the cumulative incidence values of the test and control communities were calculated for each period. In the test community, a total of 995 residents over 10 years of age received two bottles containing 600 ml of mouthwash containing antiviral phthalocyanine derivative (APD). The participants were asked to gargle/rinse with of 5 mL of the mouthwash containing ADP 3 to 5 times a day, for 1 min, until the bottles were empty. In phases 1 and 3, the disease risk between the two communities did not differ significantly (p>0.05), while in phase 2, the disease risk was 54% lower in the test community than in the control community. The use of the APD mouthwash protocol seems to reduce the COVID-19 incidence at the population level, and further studies are needed to confirm its protective effect under more precisely controlled conditions.