地震后汶川县传染病应急预防控制措施和效果分析

[目的]总结特大地震灾害后传染病控制的有效方法。[方法]采取综合防控措施,及时恢复传染病网络直报,开展传染病监测,开展外环境重点部位消杀灭和病媒生物监测工作,成立应急检测实验室,开展食品、饮用水卫生监测,针对儿童和重点人群开展甲肝疫苗应急接种,做好防病知识宣传。[结果]与去年同期报告数比较,2008年甲乙丙类传染病病例报告数减少了68.8%。报告病例数减少较多的有:细菌性痢疾、乙肝和肺结核。汶川县震后传染病发病和症状监测相关病例以散发为主,无聚集性,发病水平总体平稳。无重大疫情和突发公共卫生事件发生。[结论]采取的防控措施能够有效预防灾后传染病暴发流行。     

国境口岸出入境人员传染病监测信息管理系统的建立与应用简

目的实现国境口岸传染病监测全过程的信息化,国境口岸传染病监测现场与卫生检疫实验室间的信息共享。方法集成采用条形码、证件识别和光纤技术建立信息系统并应用于口岸现场和实验室。结果本系统的应用实现了国境口岸传染病监测全过程的信息化和国境口岸传染病监测现场与卫生检疫实验室间的信息共享。结论本系统在深圳五个口岸应用以来,口岸传染病监测和实验室检测效率大大提高;系统的应用为国境口岸传染病症状监测的开展和输入性传染病早期预测预警水平的提高奠定了基础。     

国境口岸出入境人员传染病监测信息管理系统的建立与应用

目的实现国境口岸传染病监测全过程的信息化,国境口岸传染病监测现场与卫生检疫实验室间的信息共享。方法集成采用条形码、证件识别和光纤技术建立信息系统并应用于口岸现场和实验室。结果本系统的应用实现了国境口岸传染病监测全过程的信息化和国境口岸传染病监测现场与卫生检疫实验室间的信息共享。结论本系统在深圳五个口岸应用以来,口岸传染病监测和实验室检测效率大大提高;系统的应用为国境口岸传染病症状监测的开展和输入性传染病早期预测预警水平的提高奠定了基础。     

流感相关非处方药物销售与流感样病例监测的相关分析

目的　分析药店流行性感冒（简称流感）相关非处方（OTC）药物销售与医院流感样病例（ILI）就诊水平的相关性,探讨流感相关OTC药物销售监测应用流感监测的可行性。方法　收集2015年1月1日 - 2019年8月31日广州市内36家连锁药店流感相关OTC药物销售数据、国家级流感监测哨点医院ILI监测数据。应用移动流行区间法（MEM）判定流感是否进入流行高峰期。在流感流行高峰期内对OTC药物销售比例与ILI就诊比例（ILI%）进行互相关分析。结果　流感相关OTC药物销售比例为3.16%（1.69%～5.96%）,其中,中成药销售比例（2.68%,1.29%～5.20%）高于西药（0.48%,0.25%～1.08%）。OTC药物销售呈季节性波动,存在冬春季（12月 - 次年4月）与夏季高峰（7月）。观察期间,流感共出现6个流行高峰,与相应时期药物销售高峰期相近似。互相关分析结果表明,2015年至2018 - 2019年冬季,在流感流行高峰期内,OTC药物销售比例与ILI%存在强相关性（r:0.56～0.92,P＜0.05）;在流感冬季与冬春季流行高峰期内,药物销售比例与提前1周的ILI%相关系数最高（0.692,0.937,0.786,P＜0.05）,在春夏季流行高峰期内与同期或延后1周的ILI%相关系数最高（0.693,0.762,P＜0.05）;2019年春夏季高峰期时药物与ILI%呈负相关（ - 0.802,P＜0.05）。结论 药店流感相关OTC药物销售监测应用于流感监测与早期预警具有一定的可行性。     

广州白云国际机场传染病监测与控制技术报告

依据《国际卫生条例》、《中华人民共和国国境卫生检疫法》、《中华人民共和国传染病防治法》及其实施细则的规定，广州机场出入境检验检疫局对出入境的旅客实施传染病监测和控制，建立了1套完整的口岸传染病监测与控制的管理模式。广州白云国际机场（以下简称“白云机场”）开展传染病监测的对象还包括水源及口岸媒介生物，其中针对水源主要开展霍乱病原体监测，针对媒介生物则主要开展其携带病原体（如鼠疫、流行性出血热等）情况的监测。[第一段]     

常州市天宁区学校和托幼机构传染病监测与直报结果对比分析

目的了解辖区内各类教育机构传染病监测和医疗机构传染病监测运行状况。方法选取辖区学校与幼儿园开展传染病监测(学校疫情监测),通过学校卫生老师主动发现登记并报告传染病信息,并在"中国疾病预防控制信息系统"(大疫情系统)收集同期辖区个案信息,对比分析两种监测数据。结果学校疫情监测发现,幼儿园传染病发病以手足口病为主,中小学以流行性腮腺炎等呼吸道传染病为主,大学及职校法定传染病发病人数少且为呼吸道传染病。学校疫情监测系统法定传染病漏报率为24.85%,而医疗机构为52.43%。结论实施学校传染病监测能够较真实反映学校传染病的发生情况,弥补大疫情报告系统的不足。     

加强新发传染病哨点监测工作构筑重大疫情第一道防线

点监测是传染病早期发现的有效手段和技术,加强新发传染病哨点监测工作,构筑重大疫情第一道防线,对于及时发现病人、缩短传播窗口期和提高新发传染病防控效果至关重要。本文拟分析新发传染病哨点监测的作用和意义,总结新型冠状病毒疫情中哨点监测工作存在的不足,提出加强新发传染病哨点监测的具体措施与建议,以期为更强有力地开展疫情防控工作提供参考,也为建立新发传染病哨点监测长效机制提供依据。     

传染病流行病学特征分析常用方法介绍

传染病长期威胁人类健康,是当前全球疾病监测工作重点之一,开展传染病监测防控信息的联合通报,形成监测大数据平台,探索科学有效的本地与输入性病例信息共享途径,至关重要。传染病流行病学是以传染病的分布为起点,通过收集、整理并分析有关传染病在时间、空间和人群中的分布特征,以揭示其发生和发展的规律。该文用举例法和引证法描述传染病疫情资料流行病学分析方法及相关分析指标,探讨关于传染病疫情资料的流行病学分析方法,为进行传染病相关的流行病学分析研究与监测,提供理论参考依据。     

“4．20”芦山强烈地震灾后传染病应急监测体会

目的分析“4．20”芦山强烈地震灾后传染病应急监测工作,为今后应对类似重大突发公共卫生事件后传染病应急监测工作提供借鉴和参考。方法收集、整理、分析芦山强烈地震后雅安市疾控中心工作档案资料。结果芦山地震灾后,采取了快速恢复网络直报,建立震后传染病应急监测系统的措施,早期发现重点疾病和可能聚集性疫情,早期处置,震后一月无暴发疫情及突发公共卫生事件报告,传染病发病率与去年同期比呈下降。结论开展灾后传染病应急监测的关键是要迅速恢复网络直报系统。症状监测在地震灾后早期疾病应急监测中起着重要作用,但如何科学有效地开展灾后症状监测,是公共卫生部门今后需要思考和解决的问题。     

日本传染病监测制度对我国的启示

目的介绍日本开展传染病监测的基本情况及其特色,提出值得我国借鉴的建议。方法从传染病法律法规、传染病分类、报告要求等方面分析日本的传染病监测情况。结果日本的传染病监测已超百年历史,随时代变化和经济发展不断增加病种,重视流行病学信息的收集,利用互联网及时发布信息和开展宣传活动。结论我国应借鉴日本的做法,逐步增加法定报告传染病的数量,增加对传染病感染地域、途径等流行病学信息的收集,利用互联网加大信息公开的力度。     

基于医药电商平台的药品配送系统分析与设计

随着处方药网售政策的放开,未来医药电商平台作为药品销售的重要终端,将迎来长足的发展,但药品事关人民群众的生命健康安全,同时在流通过程中也要做到全程可追溯。基于此,本文梳理了目前我国医药电子商务物流的发展现状,并根据药品的特殊属性,系统分析了医药配送系统区别于常规物流配送的特殊需求。在充分借鉴美日等发达国家成熟的医药物流配送经验的基础上;提出了基于医药电商平台的药品配送系统框架,探索了在此框架上药品物流配送系统的作业流程。并充分利用信息技术,在系统中构建了药品配送信息平台,通过引入电子监管码,实现了药品编码的统一和数据在配送系统中的动态流动,从而建立起配送过程中的药品溯源系统,并通过协同配送,保证药品安全、高效、可监管的运送到患者手中。     

Syndromic surveillance of gastrointestinal illness using pharmacy over-the-counter sales. A retrospective study of waterborne outbreaks in Saskatchewan and Ontario

OBJECTIVE: To ascertain if monitoring over-the-counter (OTC) drug sales could provide a timely syndromic surveillance method of detecting outbreaks of gastrointestinal illness. METHOD: This study evaluated the potential of a syndromic surveillance system by comparing retrospective pharmacy OTC sales of anti-nauseants and anti-diarrheals to emergency room visits and case numbers from two Canadian outbreaks related to water contamination by Cryptosporidium, and E.coli O157:H7 and Campylobacter. RESULTS: Local sales trends of weekly aggregate OTC products were comparable to the outbreak epidemic curves. Statistical control tests on the sales data indicated the start of the outbreak periods. CONCLUSIONS: An automated monitoring tool based on spatial and temporal trend analyses of daily OTC sales would provide supplemental community health information for public health officials that is timelier than currently available laboratory-based surveillance systems.     

The pharmaceutical sales rep/physician relationship in Turkey: ethical issues in an international context

In many developed countries, the physician/pharmaceutical sales representative relationship has increasingly become the focus of ethical questions. Given this context, the purpose of the present study was to determine the ethical dilemmas faced by pharmaceutical sales representatives in Turkey in their relations with physicians, and to identify possible solutions. Through an investigator-designed questionnaire, the ethical problems perceived by 215 pharmaceutical sales representatives were quantitatively analyzed. Nearly all of the participants (96.7%) reported that they had faced ethical dilemmas in marketing drugs to physicians. The most commonly reported problems included paramedical requests (for free lab test kits, etc.) and the necessity of bargaining with physicians over the use of their firm's drugs by offering gifts and sponsorships. The participants in the study felt that physicians were the primary source of ethical problems in the marketing of drugs, and the participants' most highly ranked potential solution to these ethical problems was a better understanding, on the part of physicians, of the role of pharmaceutical sales representatives. At the end of this study, suggestions are given with a view to helping health policy makers understand and address the current controversies involving drug company representatives and physicians.     

Involvement of pharmacy faculty in the development of policies for pharmaceutical sales representatives.

BACKGROUND. Few studies evaluating the impact of the pharmaceutical industry on postgraduate medical education have been done. Recently, position statements and professional guidelines have emerged to ensure the integrity of physician-industry relationships in the areas of clinical judgement, research, and medical education. METHODS. The present study surveyed directors of family practice residency programs in the United States to define the level of pharmacotherapy curriculum development and the existence of policies for pharmaceutical sales representatives. RESULTS. Of the 383 directors, 325 (85%) responded to a mailed survey. Nearly one third (32%) of the responding programs had pharmacist faculty, the majority of whom held a doctor of pharmacy degree. Approximately 30% of programs reported that they had printed guidelines for pharmaceutical sales representatives. CONCLUSIONS. Programs with pharmacist faculty are more likely to have a well-developed pharmacotherapy curriculum and printed guidelines for pharmaceutical sales representatives.     

Attitudes and Beliefs Regarding Direct-to-Consumer Advertising of Pharmaceutical Drugs: An Exploratory Comparison of Physicians and Pharmaceutical Sales Representatives

Even with many changes in regulation in recent years, direct-to-consumer advertising (DTCA) of pharmaceutical drugs remains a complicated and contentious issue. Many in our society argue for increased legislation of DTCA while others believe that DTCA serves a useful purpose and should not be overregulated. This study was designed to compare attitudes and beliefs regarding DTCA held by two key stakeholder groups, physicians and pharmaceutical sales representatives. A questionnaire was created, pretested, and administered to 30 physicians and 30 pharmaceutical sales representatives to investigate these issues. Significant differences between these two groups were found and implications for DTCA are discussed.     

Use of pharmacy data to evaluate smoking regulations' impact on sales of nicotine replacement therapies in New York City

OBJECTIVES: Recently, New York City and New York State increased cigarette excise taxes and New York City implemented a smoke-free workplace law. To assess the impact of these policies on smoking cessation in New York City, we examined over-the-counter sales of nicotine replacement therapy (NRT) products. METHODS: Pharmacy sales data were collected in real time as part of nontraditional surveillance activities. We used Poisson generalized estimating equations to analyze the effect of smoking-related policies on pharmacy-specific weekly sales of nicotine patches and gum. We assessed effect modification by pharmacy location. RESULTS: We observed increases in NRT product sales during the weeks of the cigarette tax increases and the smoke-free workplace law. Pharmacies in low-income areas generally had larger and more persistent increases in response to tax increases than those in higher-income areas. CONCLUSIONS: Real-time monitoring of existing nontraditional surveillance data, such as pharmacy sales of NRT products, can help assess the effects of public policies on cessation attempts. Cigarette tax increases and smoke-free workplace regulations were associated with increased smoking cessation attempts in New York City, particularly in low-income areas.     

Effect of the economic recession on pharmaceutical policy and medicine sales in eight European countries

Objective

To identify pharmaceutical policy changes during the economic recession in eight European countries and to determine whether policy measures resulted in lower sales of, and less expenditure on, pharmaceuticals.

Methods

Information on pharmaceutical policy changes between 2008 and 2011 in eight European countries was obtained from publications and pharmaceutical policy databases. Data on the volume and value of the quarterly sales of products between 2006 and 2011 in the 10 highest-selling therapeutic classes in each country were obtained from a pharmaceutical market research database. We compared these indicators in economically stable countries; Austria, Estonia and Finland, to those in economically less stable countries, Greece, Ireland, Portugal, Slovakia and Spain.

Findings

Economically stable countries implemented two to seven policy changes each, whereas less stable countries implemented 10 to 22 each. Of the 88 policy changes identified, 33 occurred in 2010 and 40 in 2011. They involved changing out-of-pocket payments for patients in 16 cases, price mark-up schemes in 13 and price cuts in 11. Sales volumes increased moderately in all countries except Greece and Portugal, which experienced slight declines after 2009. Sales values decreased in both groups of countries, but fell more in less stable countries.

Conclusion

Less economically stable countries implemented more pharmaceutical policy changes during the recession than economically stable countries. Unexpectedly, pharmaceutical sales volumes increased in almost all countries, whereas sales values declined, especially in less stable countries.     

Medication sales and syndromic surveillance, France

Although syndromic surveillance systems using nonclinical data have been implemented in the United States, the approach has yet to be tested in France. We present the results of the first model based on drug sales that detects the onset of influenza season and forecasts its trend. Using weekly lagged sales of a selected set of medications, we forecast influenzalike illness (ILI) incidence at the national and regional level for 3 epidemic seasons (2000-01, 2001-02, and 2002-03) and validate the model with real-time updating on the fourth (2003-04). For national forecasts 1-3 weeks ahead, the correlation between observed ILI incidence and forecast was 0.85-0.96, an improvement over the current surveillance method in France. Our findings indicate that drug sales are a useful additional tool to syndromic surveillance, a complementary and independent source of information, and a potential improvement for early warning systems for both epidemic and pandemic planning.