新型冠状病毒肺炎疫情后公共卫生展望

新型冠状病毒肺炎疫情（新冠疫情）使全社会认识到公共卫生的重要性。公共卫生关系到公众健康和社会行为规范、公共安全和社会稳定、社会经济发展、国际政治格局和国际关系以及社会治理和精细化管理等。新冠疫情使人们对公共卫生有了新启示和新定位,要改革与完善公共卫生体系,强化病原的变异监测及预警,加强传染源的早期识别与发现,关注传播途...     

The recommended lifetime immunization schedule from the board of vaccination calendar for life in Italy: A continuing example of impact on public health policies

The Vaccination Calendar for Life is an alliance of scientific and professional societies of public health physicians, paediatricians and general practitioners in Italy which provides a periodical update on the ideal, scientifically driven vaccination calendar throughout lifetime. Since 2012, the Lifetime Immunization Schedule has represented a benchmark for Regional and National Authorities to set up the updated list of vaccines provided actively and free of charge to infants, children, adolescents, adults and the elderly by inclusion in the Triennial National Vaccination Plan (TNVP), and in the Essential Levels of Care (LEA). The impact of the different editions of the Lifetime Immunization Schedule on the TNVP was deep, representing the inspiring source for the present vaccination policy. The 2019 edition called for more attention to pregnant women immunization; risk groups vaccination; uniform high coverage with the MMRV vaccine; extension of Meningococcal B vaccination also at adolescent age; use of quadrivalent conjugate meningococcal vaccine also at 1 year of life; progressive decrease of the age of free-of-charge offer of influenza to ≥ 60 and then to ≥ 50 year-old population; implementation of flu immunization ages 6 months-6 years; HPV vaccination also offered to 25-year old women at the time of the first screening (gender neutral immunization already offered); sequential PCV13-PPV23 pneumococcal vaccination in 65 year-old subjects; increased coverage with rotavirus vaccine in infants and zoster vaccine in the elderly.     

广州市白云区新型冠状病毒肺炎国内本地疫情阶段流行病学特征分析

目的 掌握新型冠状病毒(新冠)肺炎国内本地疫情阶段广州市白云区疫情流行病学特征.方法 从中国疾控中心传染病信息系统及病例流行病学调查资料获取白云区截至2020年2月29日的新冠病例疾病报告和流行病学信息进行分析.结果 国内本地疫情阶段白云区累计报告新冠病例74例.首例报告于1月21日,报告数高峰在1月29日,末例报告于...     

L’impact de l’épidémie de COVID-19 sur les soins de premier recours en région Provence-Alpes-Côte d’Azur : retour d’expérience sur la mise en place d’un dispositif de surveillance en temps réel à partir des données régionales de l’Assurance maladie

BackgroundStarting in spring 2020, the COVID-19 pandemic markedly impacted the French healthcare system. Lockdown and risks of exposure to the coronavirus induced patients to modify their ways of use. The objective of this article was to share feedback on the implementation of a real-time monitoring system concerning (a) the activity of private practitioners in southeastern France, and (b) the evolution of reimbursements for drugs prescribed to persons with diabetes, for treatment of mental health disorders, and for performance of some vaccines.MethodsData regarding 2019 and 2020 were extracted from regional health insurance databases. They were used to elaborate several indicators relative to the general health insurance scheme, which were calculated and updated each week, starting with week 2.ResultsWe observed a drop in private physician activity during the lockdown (?23% for general practitioners; ?46% for specialist doctors), followed by a return to a semblance of normalcy. Concomitantly, a boom in teleconsultations occurred: at the height of the crisis they represented 30% of medical acts. The initial stage of the lockdown was characterized by peak provisioning for drugs, whereas vaccination strongly declined (?39% regarding measles, mumps and rubella vaccine among children aged less than 5 years; ?54% regarding human papillomavirus vaccine among girls aged 10 to 14 years).ConclusionThe COVID-19 pandemic could lead to health effects other than those directly attributable to the coronavirus itself. Renouncing care may result in healthcare delays highly deleterious for people and society. Public authorities are preoccupied with these questions; they have set up action plans aimed at encouraging patients to seek treatment without delay. That said, the COVID-19 pandemic crisis has also created opportunities, such as the expansion of telemedicine. Although partial, these indicators can provide useful information enabling public decision makers to be reactive and to implement specific actions to meet the health needs of the population.     

甘肃省新型冠状病毒肺炎流行病学特征分析

目的 对甘肃省确诊的新型冠状病毒肺炎（COVID-19）病例进行流行病学特征分析,探索疫情流行的阶段性特征。方法 通过流行病学调查收集甘肃省COVID-19病例资料,包括基本资料、流行病学史、发病、就诊和确诊时间、临床表现等信息。结果 截至2020年2月25日,甘肃省共报告91例确诊病例,COVID-19流行分为输入病例期、输入病例与本地病例并存期、本地病例为主期3个阶段。聚集性疫情病例共63例（69.23%）。医务人员有3例,均为非职业暴露感染。首发症状为发热、咳嗽和乏力的比例分别为54.95%（50/91）、52.75%（48/91）和28.57%（26/91）,且在3个阶段中的比例呈下降趋势,但只有发热与乏力症状的差异有统计学意义（趋势χ²值分别为2.20和3.18,P<0.05）;3个阶段的重型/危重型病例比例分别为42.86%（6/14）、23.73%（14/59）和16.67%（3/18）,呈下降趋势（H=6.40,P<0.05）;潜伏期随着疫情的3个阶段有延长的趋势（F=51.65,P<0.01）;发病到就诊、发病到确诊的时间间隔随着疫情进展有缩短的趋势（F值分别为5.32和5.25,P<0.01）;基本再生数（R₀）从输入病例期的2.61降至本地病例为主期的0.66。结论 甘肃省COVID-19流行早期均为湖北省输入,聚集性疫情占三分之二,未发现医务人员职业性暴露感染。总体流行呈阶段性变化特征,随着疫情进展有首发症状不明显和潜伏期延长的特点,并提示体温监测不能作为单一的早期筛查手段。     

不同免疫策略下流行性腮腺炎发病特症的初步比较分析

目的分析采取不同免疫策略的地区流行性腮腺炎（流腮）疫情趋势,探讨不同免疫策略下流腮的流行病学特征。方法利用描述流行病学分析方法,对常规免疫实施两剂含流腮成分疫苗（Mumps-containing Vaccine,Mu CV）免疫策略的北京、天津、上海三个市和全国其他地区流腮疫情资料以及突发公共卫生事件信息进行分析。结果2004-2011年,全国流腮报告发病率呈逐年上升趋势。2008年以来,三个市流腮报告发病率呈下降趋势。全国流腮疫情呈规律的季节分布,每年存在冬季和夏季两个发病高峰,北京和上海市仅夏季高发。流腮报告发病率最高为5-9岁儿童,2008-2011年三个市5-9岁儿童流腮发病率较2004-2007年平均水平大幅下降,全国5-9岁儿童流腮发病率呈逐年上升趋势。2009年以来,三个市报告流腮突发公共卫生事件起数大幅下降并维持在低水平。结论实行两剂Mu CV常规免疫,有助于降低流腮高发人群发病率,有效地控制爆发疫情的发生。     

Hesitation of the Tunisian population to COVID-19 vaccination,and its associated factors

Background: Many people are reluctant to be vaccinated against COVID-19. Aim: To determine the intention to accept COVID19 vaccine and its associated factors among Tunisians. Methods: We conducted a cross-sectional study among Tunisians from December 2020 to January 2021 using an online questionnaire. Factors associated with intention to accept coronavirus vaccine were analysed using multinomial logistic regression. Results: In total, 169 Tunisians participated in our study. The majority were female (85.2%). The mean age was 48.3 ± 11.8 years. Only 33.1% intended to accept to be vaccinated when COVID-19 vaccine will be available in Tunisia and 22.5% were still hesitant. In multinomial logistic regression, participants having high or very high perceived personal risk of COVID-19 infection (aOR:3.257, 95% CI :1.204 – 8.815) were more prone to hesitate to accept COVID-19 vaccine rather than those being willing to accept it. Respondents undergoing seasonal influenza vaccination (aOR: 0.091, 95% CI : 0.019 – 0.433)were less prone to refuse COVID-19 vaccine rather than those being willing to accept it. Young ones aged less than 40 years (aOR: 4.324, 95% CI: 1.180 – 15.843) were more prone to refuse COVID-19 vaccine rather than those being willing to accept it. Conclusion: The acceptance rate of coronavirus vaccination was moderate. Therefore, a good communication and health education at a community level are needed.     

高校教职工突发公共卫生事件相关知识知晓率的调查*——以高校新冠肺炎疫情防控为例

目的:了解高校教职工新冠肺炎疫情防控相关知识知晓情况,为加强高校教职工突发公共卫生事件应急处理综合能力培养提供依据。方法:于2020年5月13日—6月13日,采用问卷星制作电子问卷并通过微信推送,随机抽取全国165所高校的438名高校教职工突发公共卫生事件相关知识知晓情况。结果:研究发现,新冠肺炎疫情发生前有49.54%的高校教职工从没学习过《突发公共卫生事件应急条例》《传染病防治法》等相关法律法规;对新冠肺炎防控相关知识总体知晓率为79.59%;高校突发公共卫生事件健康教育开展情况不容乐观;有医学专业的高校或有医学专业背景的教职工相关调查项目反应结果较好。结论:高校教职工传染病及突发公共卫生事件相关知识水平不高,应加强学习,并做到学以致用,培养人才,服务社会。