Ethnicity,household composition and COVID-19 mortality: a national linked data study

ObjectiveTo estimate the proportion of ethnic inequalities explained by living in a multi-generational household.DesignCausal mediation analysis.SettingRetrospective data from the 2011 Census linked to Hospital Episode Statistics (2017-2019) and death registration data (up to 30 November 2020).ParticipantsAdults aged 65 years or over living in private households in England from 2 March 2020 until 30 November 2020 (n=10,078,568).Main outcome measuresHazard ratios were estimated for COVID-19 death for people living in a multi-generational household compared with people living with another older adult, adjusting for geographic factors, socioeconomic characteristics and pre-pandemic health.ResultsLiving in a multi-generational household was associated with an increased risk of COVID-19 death. After adjusting for confounding factors, the hazard ratios for living in a multi-generational household with dependent children were 1.17 (95% confidence interval [CI] 1.06–1.30) and 1.21 (95% CI 1.06–1.38) for elderly men and women. The hazard ratios for living in a multi-generational household without dependent children were 1.07 (95% CI 1.01–1.13) for elderly men and 1.17 (95% CI 1.07–1.25) for elderly women. Living in a multi-generational household explained about 11% of the elevated risk of COVID-19 death among elderly women from South Asian background, but very little for South Asian men or people in other ethnic minority groups.Conclusion Elderly adults living with younger people are at increased risk of COVID-19 mortality, and this is a contributing factor to the excess risk experienced by older South Asian women compared to White women. Relevant public health interventions should be directed at communities where such multi-generational households are highly prevalent.     

从发展的角度 深刻认识疾病对社会经济发展的影响

历史上大规模爆发的传染病对社会经济的发展有着非常深刻的影响，它直接打击了社会经济发展的核心与所有生产力要素中最根本的要素—人类本身。但是，在整个社会经济的发展过程中，公共卫生与医疗保健的作用一直未引起人们的关注，随着人类文明的不断进步，对疾病的控制已经成为世界各国的中心任务，卫生保健服务直接增进人类健康，促进社会经济健康、持续地发展。     

Seroprevalence of Strongyloides stercoralis in a South Australian Vietnam veteran cohort

Objectives: Strongyloides stercoralis is a parasitic roundworm causing chronic infection that is endemic in Southeast Asia. Vietnam veterans are considered to be at high risk of Strongyloides infection. The prevalence of persistent infection in this group is unknown. This study aimed to establish the seropositivity rate of Strongyloides antibodies in South Australian Vietnam veterans and to identify the most reported symptoms within the seropositive group. Method: This cross‐sectional study recruited 309 veterans who had served in Vietnamese territory between 1962 and 1975 and were currently resident in South Australia. Participants completed a self‐administered questionnaire examining demographics, deployment, somatic symptoms and depression. Venous blood was collected for Strongyloides serology and eosinophil count. Participants who demonstrated positive Strongyloides serology underwent faecal microscopy for parasites. Results: A total of 309 participants were recruited and 256 completed the questionnaire. Strongyloides seropositivity was demonstrated in 29 of 249 participants (11.6%). No participant had Strongyloides larvae detected by faecal microscopy. On multivariate analysis, only dermatological symptoms were associated with positive serology (OR 4.84, 95%CI 1.31–17.92, p‐value 0.01). Conclusions: This study found a high seroprevalence (11.6%) of Strongyloides antibodies within the Vietnam veteran community in South Australia. Seropositivity was associated with increased likelihood of dermatological symptoms. Implications: Post‐deployment screening and eradication therapy for Strongyloides should be offered to ADF staff after service in Strongyloides‐endemic areas. This should include those veterans who left the service many years ago.     

27起学校传染病突发公共卫生事件信息分析

目的了解济南市学校传染病突发公共卫生事件的流行病学规律,为预防控制学校突发公共卫生事件提供科学依据。方法应用描述流行病学方法,对济南市2006-2008年学校传染病突发公共卫生事件数据、资料进行统计分析。结果 2006-2008年济南市报告学校传染病突发公共卫生事件相关信息27起,以呼吸道传染病为主,发生起数较多的为水痘(9起)、流感样病例(6起)、流行性腮腺炎(6起);3～5月为报告发病高峰;乡中小学和县中小学是突发公共卫生事件好发场所;学校突发事件信息主要来源于属地医疗机构,占66.67%。结论应加强对各类学校、托幼机构人员培训和督查,提高突发公共卫生事件的报告、处理水平。     

Partially wrong? Partial equilibrium and the economic analysis of public health emergencies of international concern

We argue that traditional health economic analysis is ill-equipped to estimate the cost effectiveness and cost benefit of interventions that aim at controlling and/or preventing public health emergencies of international concern (such as pandemic influenza or severe acute respiratory syndrome). The implicit assumption of partial equilibrium within both the health sector itself and--if a wider perspective is adopted--the economy as a whole would be violated by such emergencies. We propose an alternative, with the specific aim of accounting for the behavioural changes and capacity problems that are expected to occur when such an outbreak strikes.     

新冠肺炎疫情下高校传染病防控工作的思考

在国内新冠疫情已进入科学精准的常态化防控阶段,高校传染病防控成为当前学校卫生工作的重点,系统性分析高校传染病 流行特点及传染病防控中存在的问题,并提出合理防控策略十分必要。探讨高校传染病防控的策略和方法,为高校传染病工作实践提供思考和帮助。     

Übertragbare Krankheiten: Herausforderung für die Öffentliche Gesundheit

Infectious diseases are increasingly in the focus of the population and of science. The number of infections with multi-drug resistant pathogens has increased through neglect of hygiene measures, as well as inadequate application of antibiotics. “Emerging and re-emerging infectious diseases” spread in part through vaccination gaps (e.g., measles) and vaccination scepsis. Indoor mold and ambient air anthropogenic bioaerosol emissions from plants of agriculture, waste management and legionella from cooling towers are sources of infections and outbreaks. The public health service tries to prevent the occurrence and reoccurence of infectious diseases and outbreaks through early identification and interdisciplinary standardised outbreak management.     

天津口岸国际邮轮疫情防控的探讨

目的探讨国际邮轮疫情防控对策,推动国际邮轮卫生检疫管理程序的建立,建立一套系统完善的邮轮疫情防控体系,促进邮轮经济发展。方法依据现有法律法规,分析邮轮传染性疾病的临床表现、流行病学特征与传染病种类的关系,结合天津局2009—2012年四年的邮轮卫生检疫工作实际,提出天津局国际邮轮疫情防控的具体对策。结果总结天津口岸国际邮轮疫情防控的对策,探讨建立完善国际邮轮疫情防控体系。结论国际邮轮疫情防控体系的完善,对于国际邮轮卫生检疫监管,保护出入境人员身体健康,保障国境口岸安全,促进邮轮经济发展,维护社会稳定具有重要意义。     

A survey of refugee health assessments in the United States

We conducted a survey among nine geographically dispersed, large metropolitan refugee health programs to estimate the number of U.S. refugee arrivals during 1997 and 1998, the number receiving health assessments, and the percentage of sites offering health services. The nine sites received an estimated 40% of all U.S. refugee arrivals during the study period. Of these refugees, 76% received a health assessment. The completeness of health assessments, including services offered, varied by site; some services were provided by the private sector. Most sites offered services for infectious diseases and vaccinations. While 78% of the sites offered mental health care, but only 33% actually performed mental status examinations. These statistics show that such health services need to be provided on a broader basis and possibly reflect a need to address cultural and language barriers that might be preventing their delivery to this diverse population.     

沈阳市皇姑区2006-2013年突发公共卫生事件分析

2006-2013年沈阳市皇姑区发生并报告的突发公共卫生事件均发生在学校,全部都是呼吸道传染病类疫情,包括风疹、水痘和流行性腮腺炎,发病主要集中在冬春季节.为了更好地预防和控制学校突发公共卫生事件的发生,减少因事件给学生造成的身心健康危害,应采取有效的控制措施.     

2003年洪涝灾害期间某乡镇受灾人员患病情况调查

目的　探索洪涝灾害期间乡镇受灾人员患病情况 ,为洪涝灾区防病治病工作提供依据。方法　采用现场调查的方法 ,了解受灾人员患病的基本特点和疾病的分布。结果　受灾地区 1 0 2 5名患者 ,多为蚊虫叮咬、中暑、腹泻、扁桃体炎、上呼吸道感染、皮肤感染。其中以感染性疾病为主。未出现肠道传染病、自然疫源性传染病和虫媒传染病的流行。结论　改善农民健康知识、行为水平 ,加强农村公共卫生体系建设 ,是保护受灾人员健康的重要策略     

2014-2018年重庆市九龙坡区传染病突发公共卫生事件时空特征分析

目的了解2014-2018年重庆市九龙坡区传染病突发公共卫生事件的流行病学特征,为九龙坡区传染病突发公共卫生事件的防控提供科学依据。方法采用描述性流行病学和时空自相关统计量对重庆市九龙坡区2014-2018年报告的传染病突发公共卫生事件进行分析,总结流行病学特征。结果2014-2018年九龙坡区累计报告传染病突发公共卫生事件71起,以未分级为主(73.24%);发生场所全部为中小学校和托幼机构;传播途径以呼吸道传播为主(54.93%);3-6月、10-12月季节性高发;事件的传染病病种主要为流行性感冒、流行性腮腺炎、其它感染性腹泻病(诺如病毒感染)、手足口病和水痘。九龙坡区传染病突发公共卫生事件数经时间序列arima模型拟合,ma1=-0.8627(95%CI:[-1.030,-0.695]),sar1=0.430(95%CI:[0.212,0.648]),有统计学意义。空间自相关分析显示,九龙坡区传染病突发公共卫生事件全局Moran’s I指数0.334(P<0.05),其中谢家湾街道(局部Moran’s I 1.598,P<0.01)、石坪桥街道(局部Moran’s I 1.238,P<0.01)和石桥铺街道(moran.plot影响显著性测量cov.r=1.382,影响显著)存在显著的高-高空间聚集模式。结论重庆市九龙坡区传染病突发公共卫生事件以中小学校和托幼机构为主要场所,发生水平呈现长期上升趋势、双峰形态的季节性高发以及显著的高发聚集特征。     

Low-Cost National Media-Based Surveillance System for Public Health Events,Bangladesh

We assessed a media-based public health surveillance system in Bangladesh during 2010–2011. The system is a highly effective, low-cost, locally appropriate, and sustainable outbreak detection tool that could be used in other low-income, resource-poor settings to meet the capacity for surveillance outlined in the International Health Regulations 2005.     

Health system preparedness for emerging infectious diseases: A synthesis of the literature

ABSTRACT

This review reflects on what the literature to date has taught us about how health systems of low- and middle-income countries (LMICs) respond to emerging infectious disease (EID) outbreaks. These findings are then applied to propose a conceptual framework characterising an EID prepared health system. A narrative synthesis approach was adopted to explore the key elements of LMIC health systems during an EID outbreak. Overarching themes (‘core health system constructs’) and sub-themes (‘elements’) relevant to EID preparedness were extracted from 49 peer-reviewed articles. The resulting conceptual framework recognised six core constructs: four focused on material resources and structures (i.e. system ‘hardware’), including (i) Surveillance, (ii) Infrastructure and medical supplies, (iii) Workforce, and (iv) Communication mechanisms; and two focused on human and institutional relationships, values and norms (i.e. system ‘software’), including (i) Governance, and (ii) Trust. The article reinforces the interconnectedness of the traditional health system building blocks to EID detection, prevention and response, and highlights the critical role of system ‘software’ (i.e. governance and trust) in enabling LMIC health systems to achieve and maintain EID preparedness. The review provides recommendations for refining a set of indicators for an ‘optimised’ health system EID preparedness tool to aid health system strengthening efforts.