Notifiable Diseases Research Articles

Integrative strategies for zoonotic disease surveillance: A review of one health implementation in the United States

Zoonotic diseases pose significant public health threats worldwide, highlighting the need for effective surveillance strategies. The One Health approach, which recognizes the interconnection between human, animal, and environmental health, has gained traction as a comprehensive framework for addressing zoonotic disease surveillance. This review explores integrative strategies for zoonotic disease surveillance in the United States, focusing on the implementation of One Health principles. The review examines the collaborative efforts between human and animal health sectors, environmental agencies, and other relevant stakeholders in implementing One Health surveillance strategies. It highlights the importance of data sharing, communication, and coordination among these sectors to enhance early detection, rapid response, and effective control of zoonotic diseases. Key findings include the establishment of cross-sectoral surveillance systems, such as the National Notifiable Diseases Surveillance System (NNDSS) and the National Animal Health Monitoring System (NAHMS), which facilitate the collection and analysis of zoonotic disease data. These systems enable the identification of emerging zoonotic threats and the implementation of targeted interventions to mitigate risks. The review also discusses the role of technology, such as geographic information systems (GIS) and molecular epidemiology, in enhancing zoonotic disease surveillance. These tools enable the visualization of disease patterns and the tracking of disease transmission pathways, aiding in the development of effective control strategies. Challenges in implementing One Health surveillance strategies include limited resources, fragmented data systems, and regulatory barriers. Addressing these challenges requires increased investment in infrastructure, capacity building, and policy development to support integrated surveillance approaches. Overall, this review highlights the importance of One Health implementation in zoonotic disease surveillance and underscores the need for continued collaboration and innovation to enhance the effectiveness of surveillance efforts in the United States.

Ceftriaxone-Resistant Gonorrhea - China, 2022.

Gonorrhea is a widespread sexually transmitted infection; in 2022, China reported 96,313 cases of gonorrhea, making it the fourth most common notifiable infectious disease in the country after viral hepatitis, pulmonary tuberculosis, and syphilis. The rise in prevalence in antimicrobial-resistant strains, particularly the international spread of ceftriaxone-resistant clones, poses a formidable challenge to gonorrhea control. The China Gonococcal Resistance Surveillance Program (China-GRSP), established in 1987 and covering 19 of 34 provincial-level administrative units, continuously monitors gonococcal antimicrobial resistance. In 2022, 13 China-GRSP sentinel sites collected 2,804 gonococcal isolates, representing 2.9% of all cases reported in China, and 4.1% of cases reported in the 13 participating provinces. The prevalence of Neisseria gonorrhoeae resistance to ceftriaxone was 8.1%, approximately three times the 2017 rate of 2.9%; five provinces reported >10% ceftriaxone resistance. Resistance prevalences to cefixime, azithromycin, tetracycline, penicillin, and ciprofloxacin were 16.0%, 16.9%, 77.1%, 77.8%, and 97.6%, respectively. Only one case of spectinomycin resistance was reported. These data highlight a substantial increase in ceftriaxone resistance from 2017 to 2022. Effective diagnosis and treatment and appropriate management of sex partners are essential to protect the health of infected persons and prevent ongoing transmission of gonorrhea, including transmission of resistant strains. Identifying reasons for the spread of ceftriaxone-resistant N. gonorrhoeae in China could guide strategies, such as antibiotic stewardship, to mitigate the rising resistance rate and curb the spread of resistant strains.

Spatio-temporal patterns of tick-borne disease diagnoses in Indiana, USA (2009-2018).

Although tick-borne disease (TBD) incidence has increased in the United States (U.S.) in the past decade, new evidence suggests that notifiable diseases surveillance records may not accurately reflect the true magnitude of TBD diagnoses. Furthermore, while regional electronic health records (EHR) are readily accessible their potential use as a more stable and consistent source of TBD diagnoses data has remained largely unexplored. In this study, we used EHR from a database of more than 100 hospitals, healthcare networks, and insurance providers in Indiana, U.S., to better understand incidence, spatio-temporal and demographic distribution of TBD Diagnoses from 2009-2018. Our results revealed that in Indiana, from 2009 to 2018, there were 5173 unique TBD Diagnoses across three diagnoses categories: Lyme disease (72.5%, n = 3751), Rickettsioses (12.0%, n = 623) and Other TBD Diagnoses (15.4%, n = 799). Using EHR, the average yearly Lyme disease diagnoses was more than double the cases obtained using notifiable disease surveillance data for the same period. Patients with a TBD Diagnoses were generally older (ages 45-59) and less racially diverse (96.3% white). Rickettsiosis diagnoses were reported more among male patients (55.2%), while Lyme disease diagnoses were higher among female patients (57.1%). Temporal data illustrated higher frequencies of diagnoses from May to July. Hot spot analysis identified a Lyme disease hot spot in northwest Indiana, while hotspots of Rickettsiosis and Other TBD Diagnoses category were identified in southwest Indiana. Extrapolated to the Indiana population, chi-squared (χ2) tests of independence revealed that the observed distribution of TBD diagnoses in our data was significantly different from the expected distribution in the Indiana population-based race, gender and age groups. Our study findings demonstrate that in Indiana, EHR provide a stable data source for elucidating TBD disease burden and for monitoring spatio-temporal trends in TBD diagnoses.

PCR-based study on viral pathogens circulation among cervids in the Moscow region

A molecular survey of selected viruses in free-ranging cervids was conducted in 15 different districts of Moscow region. Samples were collected from 178 game animals including 144 moose (Alces alces), 19 roe deer (Capreolus capreolus) and 15 deer without species information. Nasal swabs and tissue samples including parts of the nasal septum, upper tracheal rings, lung, heart, liver, kidneys and pooled organ samples were tested using polymerase chain reaction (PCR). Samples were studied for pestiviruses, herpesviruses, coronaviruses, group A rotaviruses, adenoviruses, hepatitis e and parainfluenza type 3 virus. None of the samples were positive for Bovine Coronavirus and SARS-COV-2, hepatitis E virus and parainfluenza type 3 virus. PCR results were positive for bovine herpesviruses (5.05%), pestiviruses (0.56%), rotaviruses (1.68%). DNA of a new adenovirus, presumably causing a mild course of animal respiratory disease, was detected in samples of 6 animals (3.37%). In conclusion, the conducted studies have shown that game animals of the Moscow region can be a natural reservoir of cattle viruses, and this must be taken into account when planning and organizing measures for the control and eradication of such notifiable diseases as bovine viral diarrhoea and infectious bovine rhinotracheitis. Monitoring studies and general disease surveillance of wild animal populations provide additional information on the epidemiology of infectious diseases in the region and allow timely measures to be taken to protect wild animals, domestic animals and the public.

Efficacy of prenatal care in preventing congenital syphilis: a retrospective longitudinal analysis in Araçatuba, São Paulo

Introduction: Congenital syphilis stands as one of the primary causes of abortion worldwide, presenting a public health challenge in Brazil, where its incidence has been on the rise for the past 10 years, despite its preventable nature. Aim: To assess the effectiveness of prenatal care in averting congenital syphilis and mitigating adverse complications for newborns. Design: An observational, longitudinal, retrospective study was conducted, involving 65 newborns with congenital syphilis and their respective mothers. Data were gathered from the Notifiable Diseases Information System of Araçatuba-SP, spanning from 2018 to 2021. Results: A significant correlation was observed between attendance of prenatal care and neonatal outcomes. It was discovered that delayed diagnosis of infection in pregnant women was linked to more severe clinical manifestations in newborns. While only 13.7% of infants born to mothers diagnosed during prenatal care exhibited early symptoms, this figure rose to 57.1% in cases where diagnosis occurred during delivery. Implications: Despite endeavors to eradicate congenital syphilis, the persistent uptick in its incidence indicates deficiencies in prenatal care, underscoring the urgent necessity for interventions in primary healthcare.

Quantifying gaps in the tuberculosis care cascade in Brazil: A mathematical model study using national program data.

In Brazil, many individuals with tuberculosis (TB) do not receive appropriate care due to delayed or missed diagnosis, ineffective treatment regimens, or loss-to-follow-up. This study aimed to estimate the health losses and TB program costs attributable to each gap in the care cascade for TB disease in Brazil. We constructed a Markov model simulating the TB care cascade and lifetime health outcomes (e.g., death, cure, postinfectious sequelae) for individuals developing TB disease in Brazil. We stratified the model by age, human immunodeficiency virus (HIV) status, drug resistance, state of residence, and disease severity, and developed a parallel model for individuals without TB that receive a false-positive TB diagnosis. Models were fit to data (adult and pediatric) from Brazil's Notifiable Diseases Information System (SINAN) and Mortality Information System (SIM) for 2018. Using these models, we assessed current program performance and simulated hypothetical scenarios that eliminated specific gaps in the care cascade, in order to quantify incremental health losses and TB diagnosis and treatment costs along the care cascade. TB-attributable disability-adjusted life years (DALYs) were calculated by comparing changes in survival and nonfatal disability to a no-TB counterfactual scenario. We estimated that 90.0% (95% uncertainty interval [UI]: 85.2 to 93.4) of individuals with TB disease initiated treatment and 10.0% (95% UI: 7.6 to 12.5) died with TB. The average number of TB-attributable DALYs per incident TB case varied across Brazil, ranging from 2.9 (95% UI: 2.3 to 3.6) DALYs in Acre to 4.0 (95% UI: 3.3 to 4.7) DALYs in Rio Grande do Sul (national average 3.5 [95% UI: 2.8 to 4.1]). Delayed diagnosis contributed the largest health losses along the care cascade, followed by post-TB sequelae and loss to follow up from TB treatment, with TB DALYs reduced by 71% (95% UI: 65 to 76), 41% (95% UI: 36 to 49), and 10% (95% UI: 7 to 16), respectively, when these factors were eliminated. Total health system costs were largely unaffected by improvements in the care cascade, with elimination of treatment failure reducing attributable costs by 3.1% (95% UI: 1.5 to 5.4). TB diagnosis and treatment of false-positive individuals accounted for 10.2% (95% UI: 3.9 to 21.7) of total programmatic costs but contributed minimally to health losses. Several assumptions were required to interpret programmatic data for the analysis, and we were unable to estimate the contribution of social factors to care cascade outcomes. In this study, we observed that delays to diagnosis, post-disease sequelae and treatment loss to follow-up were primary contributors to the TB burden of disease in Brazil. Reducing delays to diagnosis, improving healthcare after TB cure, and reducing treatment loss to follow-up should be prioritized to improve the burden of TB disease in Brazil.

Representation of marginalised populations in digital surveillance for notifiable conditions in Australia: a systematic review.

This study aims to establish whether digital surveillance methods for notifiable diseases in Australia collect and report data in relation to marginalised populations. The literature was systematically reviewed to identify primary research studies published between January 2005 and July 2023. Studies were included if they described an Australian digital surveillance system for notifiable conditions. The results were synthesised with a focus on evaluating the collection and reporting of data in relation to marginalised populations. A total of 13 articles reporting on seven surveillance systems were identified. Influenza and adverse events following immunisation were the two most common notifiable conditions monitored. A total of six surveillance systems encompassing 16 articles reported information on sub-populations. Of these, three surveillance systems (nine articles) included data on marginalised populations. The data collected or reported in relation to sub-groups that characterise diversity in terms of health care needs, access, and marginalised populations are minimal. It is recommended that a set of equity and reporting principles is established for the future creation and use of any digital surveillance system.

Knowledge, awareness and perception about equine glanders among veterinarians and medical professionals in India.

Glanders is a highly infectious and notifiable disease of equines that occurs due to Burkholderia mallei. In India, glanders re-emerged in 2006 and thereafter regular outbreaks have been reported in various states (n = 14). Frequent and prolonged contact with equids with glanders may transmit B. mallei infection to humans. This study was designed to learn more about the Knowledge, Awareness and Perception (KAP) of veterinarians, para veterinarians, and physicians about equine glanders, which will help in enhancing the nation-wide glanders eradication programme. A total of 165 respondent's from 11 Indian states and one union territory were surveyed. Most of the respondents (n = 160) were from equine glanders affected or endemic states. Knowledge gap analysis revealed that 40.3 and 22% of the participants were not aware of government regulations and the transmission of glanders, respectively. These are major concerns given the wide spread occurrence of disease in the country. Awareness test on glanders revealed that 65(39.4%) participants would collect biological samples for laboratory confirmation, 67(40.6%) would inform the concerned authorities and 106 (64.2%) replied that they would eliminate the glanders infected equines. Analysis of perception towards equine glanders showed that majority of the participants (n = 113, 68.4%) observed that equine keepers were reluctant to disclose the clinical symptoms of B. mallei infection. Furthermore, non-co-operation and unwillingness by superiors (33.9%), financial (31%), administrative (28.4%), and technical limitations (27.8%) were major constraints under the perception analysis. This study reveals that veterinarians need to be educated on governmental policies and guidelines on equine glanders with regular training and awareness programs. Intersectoral co-ordination to investigate human glanders is also needed.

Web search volume as a near-real-time complementary surveillance tool of tick-borne encephalitis (TBE) in Italy

The Internet is an important gateway for accessing health-related information, and data generated through web queries have been increasingly used as a complementary source for monitoring and forecasting of infectious diseases and they may partially address the issue of underreporting. In this study, we assessed whether tick-borne encephalitis (TBE)-related Internet search volume may be useful as a complementary tool for TBE surveillance in Italy. Monthly Google Trends (GT) data for TBE-related information were extracted for the period between January 2017 and September 2022, corresponding to the available time series of TBE notifications in Italy. Time series modeling was performed by applying seasonal autoregressive integrated moving average (SARIMA) models with or without GT data. The search terms relative to tick bites reflected best the observed temporal distribution of TBE cases, showing a correlation coefficient of 0.81 (95 % CI: 0.71–0.88). Particularly, both the reported number of TBE cases and GT searches occurred mainly during the summer. The peak of disease notifications coincided with that of Google searches in 4 of 6 years. Once calibrated, SARIMA models with or without GT data were applied to a validation set. Retrospective forecast made by the model with GT data was associated with a lower prediction error and accurately predicted the peak timing. By contrast, the traditional SARIMA model underestimated the actual number of TBE notifications by 65 %. Timeliness, easy availability, low cost and transparency make monitoring of the TBE-related Internet search queries a promising addition to the traditional methods of TBE surveillance in Italy.

Impact of the coronavirus disease 2019 pandemic on the diversity of notifiable infectious diseases: a case study in Shanghai, China.

The outbreak of coronavirus disease 2019 (COVID-19) has not only posed significant challenges to public health but has also impacted every aspect of society and the environment. In this study, we propose an index of notifiable disease outbreaks (NDOI) to assess the impact of COVID-19 on other notifiable diseases in Shanghai, China. Additionally, we identify the critical factors influencing these diseases using multivariate statistical analysis. We collected monthly data on 34 notifiable infectious diseases (NIDs) and corresponding environmental and socioeconomic factors (17 indicators) from January 2017 to December 2020. The results revealed that the total number of cases and NDOI of all notifiable diseases decreased by 47.1% and 52.6%, respectively, compared to the period before the COVID-19 pandemic. Moreover, the COVID-19 pandemic has led to improved air quality as well as impacted the social economy and human life. Redundancy analysis (RDA) showed that population mobility, particulate matter (PM2.5), atmospheric pressure, and temperature were the primary factors influencing the spread of notifiable diseases. The NDOI is beneficial in establishing an early warning system for infectious disease epidemics at different scales. Furthermore, our findings also provide insight into the response mechanisms of notifiable diseases influenced by social and environmental factors.

Contribution of the veterinary profession to the Australian animal health surveillance system and opportunities for future contributions

Animal health surveillance is crucial for early detection of emergency animal diseases and effective responses. However, surveillance systems are complex and rely on the contributions of many animal health stakeholders. Veterinarians are key stakeholders in this system, given their role and skills in investigating, diagnosing, and reporting notifiable diseases. This study investigated the contribution of the veterinary workforce to the Australian animal health surveillance system and opportunities for future involvement. To achieve the aims of the study, an online cross-sectional survey among the veterinary profession was conducted. Descriptive statistics and regression analyses were used to provide an overview and investigate drivers of attitudes and practices of veterinarians in relation to animal health surveillance. A total of 311 usable responses were obtained, with 191 being from veterinarians who worked in private practice in the previous 12 months. Among private practitioners, 58.6% worked with companion animals, 34.0% were mixed practice veterinarians and 7.3% were equine veterinarians. Over half (56.6%) of all participants considered themselves active participants in the local animal disease management system. The level of confidence in understanding the reporting system and knowing and identifying signs of endemic and exotic diseases was moderate among those working in private practice, with companion animal veterinarians reporting the lowest levels of confidence (p < 0.05). Approximately 40% of veterinarians had taken samples for diagnosis for notifiable diseases in the last year, with just over 20% reporting a notifiable disease. Awareness of and participation in training and surveillance programs for animal diseases by veterinarians was low, with those working in private practice having lower levels of both awareness and participation for most programs. In relation to potential future contribution to the surveillance system, over half of participants reported being interested and available to undertake surveillance work on behalf of the government, with those in mixed practice reporting higher levels of interest (69.6%) compared to those in companion (49.5%) and equine practice (30.8%). However, key challenges identified were related to perceived conflict of interest, and tensions between client needs and government agenda, followed by profitability and suitability of the business. This study provides evidence of a significant existing contribution by the veterinary profession to the surveillance system, and the capacity and willingness to increase this contribution. However, there are gaps in awareness, confidence and participation, as well as financial and veterinary-client relationship challenges that should be considered in any future planning to strengthen the Australian surveillance system.

The trend of AIDS in China: A prediction and comparative analysis with G20 countries based on the Global Burden of Disease Study 2019.

In China, AIDS has become the most severe notifiable infectious disease. The study aimed to analyse and predict the trend of AIDS in China and compared with Group of Twenty (G20) countries. We utilised incidence, mortality or disability-adjusted life years (DALY), age-standardised rates (ASR), average annual percentage changes (AAPC) to estimate the trend via GBD 2019. The Joinpoint regression analysis was applied to identify the most significant years of change. We explored the relationship between AAPC and social development index (SDI) or health care access and quality (HAQ), and predicted trends for the next 20 years. The DALY in G20 increase of 340.42%, and 794.50% in China. The age-standardised DALY rate (ASDR) in G20 was 309.49 (95% uncertainty interval (UI) = 284.69, 350.58) in 2019, with an AAPC of 4.30. Among G20, the United States had the highest DALY in 1990, but it experienced a significant decline. In China, the ASDR was 98.15 (95% UI = 78.78, 119.58) with the 5th AAPC ranking. In term of gender, the incidence, mortality, DALY, and ASR of them in China and G20 were all higher in males. Furthermore, the gender gap in China had been widening. The most significant periods of ASDR increase in China were 1990-1995 and 2013-2016, and 1990-1994 in G20. The prediction for DALY indicated that high SDI countries were expected to exhibit a stable or declining trend, while low SDI countries showed an upward trend. China demonstrated a 57.66% increase in 2040 compared to 2019. AIDS continues to be a significant burden. In China, the ASIR exhibited a decline trend in certain age groups, while the ASMR and ASDR continued to increase, with a widening gender disparity. In addition, according to our predict results, some countries could not achieve the 2030 Agenda for Sustainable Development set by the UNAIDS. Therefore, it is necessary to establish more effective and targeted measures, as well as actively explore new treatment approaches.

Incomplete recording of race/colour in health information systems in Brazil: time trend, 2009-2018.

This ecological study of time trends and multiple groups evaluated incompleteness in the race/colour field of Brazilian health information system records and the related time trend, 2009-2018, for the diseases and disorders most prevalent in the black population. The Romero and Cunha (2006) classification was applied in order to examine incompleteness using secondary data from Brazil's National Notifiable Diseases System, Hospital Information System and Mortality Information System, by administrative regions of Brazil, while percentage underreporting and time trend were calculated using simple linear regression models with Prais-Winsten correction (p-value<0.05). All records scored poorly except those for mortality from external causes (excellent), tuberculosis (good) and infant mortality (fair). An overall downward trend was observed in percentage incompleteness. Analysis by region found highest mean incompleteness in the North (30.5%), Northeast (33.3%) and Midwest (33.0%) regions. The Southeast and Northeast regions showed the strongest downward trends. The findings intended to increase visibility on the implications of the race/color field for health equity.

Working with small‐scale pig keepers. Part 1: encouraging legislative adherence

Background: Threats such as African swine fever (ASF) are in close proximity to the UK; therefore, it is a crucial time to protect the British pig herd from exotic notifiable disease, which can be best achieved through legislative adherence. This is especially the case for laws around the feeding of pigs, which remains the likely route for ASF to enter the UK. Keepers of pigs on a small scale, including keepers of pet pigs, may show variable adherence to the relevant legislation. Furthermore, general farm practitioners, often responsible for supervising small‐scale pig holdings, may be less familiar with legislative requirements than those vets who deal solely with pigs. Despite this, legal requirements must be met on all holdings and overseeing vets are key to encouraging legislative compliance among keepers.Aim of the article: This article, the first in a two‐part series on working with small‐scale pig keepers, serves as a reference for vets so that they can provide their clients with up‐to‐date advice on how to keep pigs within the legal framework for the UK. It also offers advice on how this information could be shared among pig keepers. Part two, which will be published in a subsequent issue of In Practice, will focus on how we, as vets, can encourage antibiotic stewardship on smallholdings.

Challenges of rabies surveillance in Madagascar based on a mixed method survey amongst veterinary health officers.

IntroductionIn Madagascar, rabies is endemic and a notifiable disease. The objective of this mixed study was to understand the challenges faced by the Veterinary Health Officers (VHOs) in the current rabies surveillance system in Madagascar.MethodsA survey was conducted from mid-April to the end of July 2021 during which all officially-listed VHOs (N = 150) were contacted by phone at least twice. Participants, representative of the 22 regions of Madagascar, were interviewed by phone based on a semi-structured questionnaire on (1) their knowledge of rabies epidemiology in their area of activities, (2) the occurrence of human and animal rabies and the species affected in the region where they work, (3) the factors that might influence rabies surveillance depending on (a) their activities and area of operation, (b) the socio-cultural aspects of local communities, and (c) the general organization of animal rabies surveillance.ResultsThe majority (80/90) of VHOs declared having been informed of at least one suspected or confirmed case of human and/or animal rabies in their area of activity during their work as VHOs: at least once a month for 11 of them, at least once a year for 40 and with undetermined frequency for 29. Several obstacles hinder the surveillance of rabies resulting in under-reporting. The lack of funds to access suspect animals, collect, pack and ship samples in compliance with biosecurity measures and the cold chain, was mentioned as a major obstacle to surveillance. The second barrier is socio-cultural: in many large coastal regions, dogs are taboo and VHOs fear rejection by the community if they treat dogs.Discussion and conclusionWhile the general population requires information on the rabies situation in Madagascar and on how to proceed in the event of a bite, veterinarians and decision-makers need to be fully aware of an evidence-based approach to rabies surveillance, prevention and control. Communication between the human and animal health sectors should be improved. Politicians need to be persuaded of the importance of funding to eliminate rabies in Madagascar. The adoption, in early 2023, of a national strategic plan for rabies control is a first step in this direction.

Investigation of in Vitro Immunostimulating Effects of FreezeThaw Antigens against Visceral Leishmaniasis Caused by L. Infantum

Background: Visceral leishmaniasis, also known as Kala-Azar among the public, is among the notifiable infectious diseases. The fact that an effective and safe drug or vaccine formulation suitable for use on humans has not been developed causes the disease threat to continue. The aim of this study is to determine the immune system stimulating properties and cytotoxicity of the formulations obtained by combining the antigen obtained from Leishmania infantum parasites with different adjuvants. Methods: L. infantum (EP 126) antigens were obtained by the freeze-thaw method. Freund's adjuvant (Complete and Incomplete), a classical adjuvant, was used in the studies. Mouse macrophage (J774) and mouse fibroblast (L929) cell lines were used for cytotoxicity studies. Additionally, the responses at both 10ug/ml and 40ug/ml were investigated to ensure that the developed formulations were easily adaptable to in vivo. While the cytotoxicity of the formulations was determined by the MTT cell viability analysis method, the antileishmanial property was determined by the Nitric Oxide (NO) determination method. Results: It was determined that all the developed formulations did not have a toxic effect on the host cell, the immunostimulating activity increased with increasing concentration, and the highest value was obtained at a concentration of 200 µg/ml. Cell viability at the maximum concentration was found to be between 78% and 89% for both J774 and L929 cells. The highest cell viability values and NO production abilities (37% increase compared to the control group) were obtained with Incomplete Freund's adjuvant (40 ug/ml formulation). Conclusion: It has been understood that the combination of antigens obtained by the freeze-thaw method with Freunds adjuvant (incomplete) supports NO production, thus having an immunostimulating effect.

Enhancing the notification system for surveillance of infectious diseases in Qatar during the FIFA World Cup 2022: project overview

BackgroundIn 2022, the Surveillance Department of the Ministry of Public Health in Qatar adopted an integrated project called the Notification Enhancement Project (NEP) to enhance the infectious disease notification system. Efficient surveillance and notification promote early alerts and allow immediate interference in reducing morbidity and mortality from outbreaks. The project was designed to improve the knowledge, attitudes, practices, and notification processes of healthcare workers in Qatar by increasing their reporting rates.MethodsThe strategy for comprehensively enhancing notifications was based on the observation and evaluation of the current notification system, the implementation of interventions, and post-evaluation follow-up. To implement the project, we relied on three aspects: effective methods used in previous relevant studies through a literature review, feedback received from healthcare workers, and suggestions from public health surveillance experts from the Ministry of Public Health, Qatar. A preassessment was conducted through an online survey by the Ministry of Public Health. The effectiveness of the different interventions was assessed by analyzing the data of notified patients reported through the Disease Surveillance and Reporting Electronic System. Pre- and postintervention assessments were performed by comparing the percentage of patients notified by healthcare providers with that of patients confirmed by healthcare providers in the laboratory to compare the notification rates over three time periods between January and December 2022.ResultsThere was significant improvement in the infectious disease notification process. A comparison before and after the implementation of the interventions revealed an increase in the communicable disease notification rate among healthcare workers. Pre- and postintervention data were compared. Infectious disease notification activities by healthcare workers increased from 2.5% between January and May 2022 to 41.4% between November and December 2022.ConclusionThis study highlights the efficiency of different interventions in correcting the underreporting of infectious diseases. Our findings suggest that implementing the Notification Enhancement Project significantly improves notification rates. We recommend continuing interventions through constant education and training, maintaining solid communication with HCWs through regular reminder emails and feedback, periodic assessment of the electronic notification system, and engagement of healthcare workers and other stakeholders to sustain and expand progress achieved through continuous evaluation.

Clinical and epidemiological aspects of patients injured by stingrays in the state of Pará, Brazil

The objective of this study was to outline the clinical-epidemiological profile of patients injured by stingrays from 2007 to 2021. A descriptive study was carried out through an epidemiological retrospective of ichthyism in 20 municipalities in Pará belonging to the Amazon Basin. Notified cases were obtained from the Notifiable Diseases Information System, where the following variables were investigated: socioeconomic profile, affected anatomical region, local and systemic clinical symptomatology. Treatment evolution regarding death and cure was also evaluated. Data were statistically evaluated using the chi-square test, at 5% significance level. A total of 737 cases of accidents caused by stingrays were reported during the period. Of these, 438 forms were not completed with the education data of the patients treated, followed by 158 forms not completed for the race item. Accidents caused by stingrays tend to happen to brown men, aged over 20 years, with incomplete secondary education, living in urban areas, with accidents occurring mainly on the region's beaches. The foot and leg were the most affected regions (p&lt;0.05). Patients sought care in the first hours after the accident or only 24 hours (p&lt;0.05) later. They presented local symptoms, such as pain and swelling. Some cases had systemic complications, mainly myolytic and neurological. This study reinforces the need to adopt strategies related to health and environmental education for people who visit risky areas to mitigate the occurrence of accidents caused by stingrays.

Mandatory childhood vaccination coverage and notifications of vaccine-preventable diseases in a municipality in the Eastern Amazon

The mandatory vaccination coverage rate for children has been declining over time in Brazil, leading to the reappearance of diseases considered eradicated or under control. This study aims to analyze the trend of the historical series (2016 to 2022) of vaccination coverage (VC) in children under nine years of age and the records of vaccine-preventable diseases in this age group in the municipality of Belém, Pará. This is a cross-sectional, descriptive, quantitative study based on collecting secondary data from the National Immunization Program Information System. Descriptive statistics were used to calculate the arithmetic mean, median, standard deviation, and simple linear regression. The data obtained on VC for seven vaccines contained in the Brazilian calendar, associated with cases of reported diseases, were placed in combinatorial graphs to better interpret and demonstrate the data. Analysis of this data indicated a downward trend in VC, with only the BCG vaccine reaching its targets in the period analyzed in two alternate years: 2016 and 2018. The targets (95%) for coverage recommended by the National Immunization Program were not reached for the other six. As for records of illnesses, the occurrences of meningitis (29.14 ± 12.37) and measles (27.85 ± 55.05) were the highest among cases of reported diseases. Tuberculosis was also high in the municipality of Belém between 2016 (1,315) and 2017 (1,435), in other words, an increase of 120 cases. However, the number of cases notified to the Ministry of Health in this period was 7 (5.8%). Therefore, it should be noted that more attention should be paid to the cases notified and those occurring and registered in the municipality to better plan and achieve the vaccination targets and, in this way, diminish or keep these diseases under control.

LEISHMANIOSE TEGUMENTAR AMERICANA EM UMA MICRORREGIÃO DA AMAZÔNIA BRASILEIRA ENTRE 2010-2019

Objective: The study sought to analyze the epidemiological profile of people with American Tegumentary Leishmaniasis (ATL) in the Lake Tucuruí Integration Region, between 2010 and 2019. Methods: Descriptive study, with data obtained from the Health System Notifiable Disease Information System. Results: There were 3,305 patients with ATL distributed in seven cities. Males, aged 15-39 and 40-59 years were the most affected. New cases are the main route of transmission and the most prevalent clinical form is cutaneous leishmaniasis. The cure was shown in four of the seven cities studied. The cities of Itupiranga and Novo Repartimento showed that the rural area is the main area of ​​infection. The urban area was the area of ​​greatest contagion for the cities of Jacundá and Tucuruí. Conclusion: The study for ATL showed that this zoonosis is endemic in this Amazon microregion and it mainly affects male individuals, with low education and aged between 15-39 and 40-59 years.