Recent syphilis trends in Belgium and enhancement of STI surveillance systems

Over the past five years, a series of syphilis outbreaks mainly occurring among gay men have been observed in Europe. One of these outbreaks was reported in the city of Antwerp, Belgium, during the first quarter of 2001. This outbreak is still ongoing in 2004. Furthermore, active syphilis diagnoses reported by the Sentinel Laboratory Network rose by 89% in the country during the fourth quarter of 2003. An increase in Brussels was also observed during the same quarter (+300%; 24 cases reported). Overall, the sentinel network of clinicians reported that 93.4% of patients were male; among them, 79.9% were men having sex with men (MSM). The overall proportion of patients co-infected with HIV was 50.5% (MSM: 58.6%; male heterosexuals: 23.8%; females: 8.3%); 76.1% of co-infected patients were already aware of their HIV infection at the time they were diagnosed with syphilis.     

筛查和行为干预在梅毒控制中的作用

目的探讨性病哨点机构（包括哨点医院和专科哨点机构）开展梅毒筛查和行为干预,在梅毒控制中的作用。方法按照哨点医院和专科哨点机构分层抽样,选取广州市15个性病监测哨点,统计2005—2010年各机构梅毒快速血浆反应素试验（RPR）筛查量,分析两类哨点梅毒筛查的人次及阳性率变化趋势,以及同期因卖淫嫖娼被治安收容人群的梅毒感染率趋势。同时,统计同期哨点机构开展的行为干预的工作量。结果6年间,累计筛查39.8万人次,发现RPR阳性1.41万人次,阳性率3.54％;哨点机构初诊RPR筛查人次年均递增22.00％,RPR阳性率由4.06％下降至2.83％。按照不同哨点机构来源分析,性病专科哨点机构RPR阳性率分别从7.81％上升到12.19％,而哨点医院RPR阳性率则从3.79％下降到2.56％。卖淫嫖娼人群的RPR和梅毒螺旋体明胶凝集试验双阳性率,由2005年的5.85％下降到2011年的4.03％。结论广州市性病哨点医院普通人群梅毒筛查量逐年增加,结合性病哨点专科机构对高危人群的梅毒筛查及行为干预,在广州市梅毒控制中有重要作用。     

Role of a sentinel surveillance system in the context of global surveillance of infectious diseases

In some nation states, sustained integrated global epidemiological surveillance has been weakened as a result of political unrest, disinterest, and a poorly developed infrastructure due to rapidly increasing global inequality. The emergence of severe acute respiratory syndrome has shown vividly the importance of sensitive worldwide surveillance. The Agency for Cooperation in International Health, a Japanese non-governmental organisation, has developed on a voluntary basis a sentinel surveillance system for selected target infectious diseases, covering South America, Africa, and Asia. The system has uncovered unreported infectious diseases of international importance including cholera, plague, and influenza; current trends of acute flaccid paralysis surveillance in polio eradication; and prevalence of HIV, syphilis, hepatitis B, and hepatitis C in individual areas covered by the sentinels. Despite a limited geographical coverage, the system seems to supplement disease information being obtained by global surveillance. Further development of this sentinel surveillance system would be desirable to contribute to current global surveillance efforts, for which, needless to say, national surveillance and alert system takes principal responsibility.     

BED HIV-1发病捕获酶免疫测定法检测四川省2006年吸毒哨点HIV新发感染

目的 了解四川省2006年吸毒哨点艾滋病病毒(HIV)新发感染情况,探索BED HIV-1发病捕获酶免疫测定法(BED HIV-1 incidence capture enzyme immunoassay,BED-CEIA)的应用条件,以及引起偏移的因素和解决方法.方法 对2006年四川省吸毒哨点确认阳性的样本进行BED-CEIA方法检测,获得该人群2006年新发感染率.结果 2006年四川省吸毒哨点共计13个,监测吸毒人群3 708人,男女比例5.61∶1,年龄在9～65岁之间,平均年龄30.18岁.HIV-1确认阳性率为12.04%,新近感染率3.19%,其95%可信区间(CI)为(4.12%～2.26%).结论 将BED-CEIA方法应用于以吸毒为主要感染途径的地区,对其新近感染率的计算和估计具有实用性,并可较好地控制偏移,对艾滋病防治政策的制定和调整具有参考作用.     

Epidemiological evidence of multidrug-resistant Shigella sonnei colonization in India by sentinel surveillance in a Japanese quarantine station

We applied a previously reported method to clarify whether a multidrug-resistant Shigella colonizes in a south Asian country. At Kansai Airport Quarantine Station, stool samples were collected from overseas travelers who reported a history of diarrhea. Shigella strains were isolated, ranging from 53 to 106 (average, 82.4) isolates/year (2001-2005), and almost 80% of the isolates were Shigella sonnei. The most frequent country of origin was India. Strains from the country of the most frequent origin were studied by antimicrobial susceptibility testing. Resistance to tetracycline, sulfamethoxazole-trimethoprim and nalidixic acid was observed at the highest frequency: in 23 of the 25 strains isolated in 2001, 5 of the 13 strains isolated in 2002, and 16 of the 19 strains isolated in 2005. Strains showing the most prevalent multidrug-resistance pattern were analyzed by pulsed-field gel electrophoresis (PFGE). The PFGE profiles showed that 27 of the 44 strains isolated in 2001, 2002, and 2005 were identical in PFGE pattern, as determined using two restriction enzymes. We concluded that a multidrug-resistant Shigella sonnei colonizes in a south Asian country.     

2004年深圳市艾滋病哨点监测分析

目的 为了解深圳市高危人群中艾滋病流行趋势及危险因素,为决策部门评估深圳市艾滋病防治工作效果及制定防治策略措施提供科学依据.方法 2004年在深圳市分别对245名暗娼、1 100名性传播疾病（STD）门诊就诊者和852名吸毒哨点进行HIV哨点监测的对象,应用酶联免疫吸附试验（ELISA）对样本进行HIV筛查.结果2004年,STD门诊就诊者主要为男性和已婚的省外流动人员,其STD的病种构成以非淋、梅毒、尖锐湿疣等溃疡性性病为主,检出HIV抗体阳性者3例,检出率为0.27%（3/1100）;暗娼主要为未婚的省外流动人员,安全套使用率分别为73.9%,0.8%的暗娼为吸毒者,无静脉吸毒和共用注射器史,在两轮监测中,未检出HIV抗体阳性者,感染率为0;吸毒人群主要为未婚的省外流动人员,安全套使用率为27.7%,66.3%的吸毒者承认曾接受/提供有偿性服务,55.5%采用静脉吸毒和共用注射器,检出HIV抗体阳性者10例,感染率为1.2%.结论 监测结果表明,HIV在深圳市性病患者、吸毒者等高危人群中流行,存在HIV传播的多种危险性因素.     

A medical locum service as a site for sentinel influenza surveillance

Surveillance of influenza in the countries of the European Union includes a sentinel network of general practitioners reporting cases of influenza-like illness (ILI), the collection of specimens for virological testing, and laboratory reporting of influenza diagnoses. In Victoria, Australia we have a similar sentinel surveillance system, with ILI defined by fever, cough and fatigue, and influenza seasons described by thresholds. The coordination of sentinel general practices can, however, be time consuming and expensive. For the last two influenza seasons we have used a deputising medical locum service as a sentinel site for influenza surveillance. We are not aware of such a service being used as a sentinel site elsewhere in the world. In both retrospective and prospective comparisons, we have shown that ILI surveillance patterns from sentinel general practices are very similar to those from the locum service. Because of its timeliness, flexibility, patient mix and geographic spread, locum service surveillance is able to supplement sentinel ILI surveillance and may also have a role in the recognition of emerging disease patterns. This is likely to be true not only in Australia but also in countries of the European Union.     

南昌县血吸虫病易感地带水体感染性系统监测

目的测定鄱阳湖区南昌县水域水体日本血吸虫感染性。方法2011年6-7月在南昌县抚河入湖口附近、五星垦殖场外湖堤脚、赣江南支和赣江中支入湖口附近8个监测区域共59个监测点,采用哨鼠试验测定水体血吸虫感染性。结果59个监测点共投放600只健康小白鼠,回收哨鼠584只,解剖哨鼠577只,检获阳性哨鼠1只,哨鼠血吸虫总感染率为0.17%,检获血吸虫成虫4条。结论鄱阳湖区采用哨鼠法进行水体感染性监测时应以螺情为依据,水情、水位和流速等因素会影响哨鼠感染率。     

Colorectal cancer screening and surveillance practices by primary care physicians: results of a national survey

OBJECTIVE: Screening for colorectal cancer reduces its morbidity and mortality and is cost-effective. Screening is usually the responsibility of primary care physicians who may be unsure about its implementation. We aimed to assess primary care physicians' knowledge and practice regarding colorectal cancer screening, and to compare their responses with those of three national experts and with published guidelines. METHODS: We mailed a postal questionnaire to 2,310 primary care physicians regarding demographics, nature of practice, use of screening tests, and six hypothetical patients who may have been candidates for screening or surveillance. We used published national guidelines and the collective opinions of the three external experts as the so-called "gold standard." RESULTS: Of all respondents, 85.1% offered colorectal cancer screening. Most used suitable tests, starting at an appropriate age; 49.8% continued screening indefinitely irrespective of patients' age and 43.6% performed fecal occult blood testing without appropriate dietary advice to patients. Also, respondents frequently performed this test for inappropriate indications. Only 51.8% would follow a positive fecal occult blood test with colonoscopy. CONCLUSIONS: Colorectal cancer screening practices by primary care physicians vary considerably from those recommended. Many offer screening to individuals in whom it is not appropriate, and continue it into advanced age. Frequent, inappropriate use of fecal occult blood tests will produce many false positives. Primary care physicians often do not appropriately follow a positive test. Further educational efforts are needed in an attempt to improve practice and further reduce the morbidity and mortality from colorectal cancer.     

2005年中国高危人群艾滋病哨点监测报告

目的监测中国艾滋病病毒（HIV）感染流行趋势，为制定艾滋病防治规划和进行干预活动提供准确的信息。方法以重复横断面调查的方法对性病门诊就诊者、暗娼、吸毒者和男性同性恋等高危人群进行监测。结果（1）24．2％（29／120）的性病门诊就诊者哨点检出HIV抗体阳性者，阳性率均低于5％。（2）27．3％（18／66）的暗娼哨点检出阳性者，多数处于较低水平（〈5．0％），个别的暗娼哨点HIV抗体阳性率较高，如四川达州市大竹县和湖南省衡阳市分别为10．5％和5．2％。HIV阳性者中45．3％有注射毒品史，部分地区暗娼有注射吸毒史的比例高达50％；暗娼人群中报告每次性行为使用安全套比例的中位数为38．7％。（3）72．7％（56／77）的吸毒者哨点检出HIV抗体阳性者，各哨点阳性率差异较大，最高是四川达州市大竹县，为69．7％；其次为新疆伊宁市，为68．0％。阳性率高于20％的哨点集中于四川、新疆、广西和湖南等省份；吸毒者中注射吸毒比例的中位数为64．1％，注射吸毒者中共用注射器比例的中位数为46．8％。（4）3个男性同性恋哨点中，安徽合肥市的HIV抗体阳性率为3．3％，其余两个哨点均低于1％；男性同性恋肛交时使用安全套的比例仍很低。结论中国HIV感染疫情仍呈蔓延扩散之势。吸毒人群中高比例注射吸毒及高比例共用注射器行为，暗娼及男性同性恋中的低安全性行为，提示需要进一步加大有效干预措施的力度及覆盖面。     

北京性病门诊2008-2012年艾滋病哨点监测结果分析

目的利用北京佑安医院性病门诊艾滋病哨点监测资料,进一步掌握北京市性病人群及其他高危人群艾滋病流行现状,为艾滋病的预防控制策略和措施的制定,以及效果评价提供依据。方法按照全国哨点监测工作方案,对性病门诊就诊者进行监测,监测数据用统计软件进行统计分析。结果北京市性病门诊国家哨点监测2008-2012年共发现艾滋病病毒(Human immunodeficiency virus,HIV)抗体阳性者35例,HIV和梅毒阳性率逐年上升,HIV构成比分别为0.5%、0.8%、1.3%、1.8%和4.5%,梅毒阳性率构成比分别为10.8%、18.8%、15.3%、12.8%和18.8%。监测中其他性病构成比也略有增加。监测到的就诊人群大部分为青壮年,高危行为中商业性行为、临时性行为发生率较高,男性同性肛交性行为发生率逐年增加。结论近两年来北京市通过对性病高危人群实施健康教育和行为干预等活动,HIV感染经异性性传播流行情况有所改善,但经同性性传播流行情况不容乐观,建议疾病预防部门针对此情况加大对同性性行为人群的干预力度。     

2006-2010年岷县土源性线虫病监测点流行趋势分析

目的 通过对甘肃省岷县国家级土源性线虫病监测点人群土源性线虫感染率和土壤蛔虫卵检出率的连续监测,观察其流行趋势,为制定防治策略提供依据.方法 2006-2010年期间,每年在岷县监测点整户调查1000人,改良加藤厚涂片法检测蛔虫、鞭虫虫卵,分析感染率;饱和硝酸钠漂浮法检测土壤蛔虫卵;对调查的10户土壤样品蛔虫卵计数与家庭成员蛔虫卵感染度做相关性分析.结果5年期间人群土源性线虫感染率由20.31％下降到11.08％,下降44.26％;0 ～ 15岁组为高发病人群;土源性线虫感染率最高的分别是散居儿童,其次是幼托儿童和学生;证实调查户土壤蛔虫卵计数与蛔虫感染度呈正相关,单侧t检验有统计学意义(t =4.40,P＜0.10).结论 2006-2010年岷县监测点土源性线虫感染率有明显下降,但仍在当地人群保持低发病率的流行状态.     

Airport sentinel surveillance and entry quarantine for dengue infections following a fever screening program in Taiwan

ABSTRACT: BACKGROUND: Dengue has not reached an endemic status in Taiwan; therefore, we have implemented a fever screening program at airports for the early detection of febrile passengers with a dengue infection. This study is intended to assess the performance of the airport screening procedures for dengue infection. METHODS: We analyzed data from the national surveillance system of the Taiwan Centers for Disease Control. We included the imported dengue cases reported by sentinel airports and clinics as well as the domestic cases from 2007-2010. RESULTS: Approximately 44.9% (95%CI: 35.73-54.13%) of the confirmed imported dengue cases with an apparent symptom (febrile) in the viremic stage were detected via the airport fever screening program, with an estimated positive predictive value of 2.36% (95% CI: 0.96- 3.75%) and a negative predictive value > 99.99%. Fluctuations in the number of the symptomatic imported dengue cases identified in the airports (X) were associated with the total number of imported dengue cases (Y) based on a regression analysis of a biweekly surveillance (i.e., n = 104, R2X:Y = 0.61, P < 0.005). Additionally, the fluctuating patterns in the cumulative numbers of the imported dengue cases (X) with a 1-2 month lead time (t) was in parallel with that of the domestic dengue cases (Y) based on a consecutive 4-year surveillance (i.e., n = 48, R2 X(t-1):Y = 0.22, R2 X(t-2):Y = 0.31, P < 0.001) from 2007-2010. CONCLUSIONS: A moderate sensitivity of detecting dengue at the airports examined in this study indicated some limitations of the fever screening program for the prevention of importation. The screening program could assist in the rapid triage for self-quarantine of some symptomatic dengue cases that were in the viremic stage at the borders and contribute to active sentinel surveillance; however, the blocking of viral transmission to susceptible populations (neighbors or family) from all of the viremic travelers, including those with or without symptoms, is critical to prevent dengue epidemics. Therefore, the reinforcement of mosquito bite prevention and household vector control in dengue-endemic or dengue-competent hotspots during an epidemic season is essential and highly recommended.     

Epidemiology and burden of rotavirus diarrhea in Thailand: results of sentinel surveillance

Diarrhea remains an important cause of morbidity and mortality among children in Thailand, with >1 million cases reported in 2002. In anticipation of the development of vaccines against rotavirus, we evaluated the disease burden associated with rotavirus infection in Thai children and evaluated the rotavirus serotypes now circulating in Thailand. Diarrhea surveillance was conducted at 6 Thai hospitals in different geographic areas. Community-based surveillance was conducted in Huaykrajao District, Kanchanaburi Province. During the 24 months of surveillance, 4057 children were admitted to the 6 participating hospitals, and 1950 stool samples were collected. Of these stool samples, 43% (838) were positive for rotavirus. All rotavirus-positive stool samples were evaluated to identify their serotypes; 54.8% of samples were of serotype G9, which was predominant each year. Other identified rotavirus serotypes included G2, G4, G1, and G3 (17.2%, 5.3%, 0.8%, and 0.1% of isolates, respectively). Approximately one-half of the children hospitalized with rotavirus diarrhea were <1 year old. Community surveillance showed the proportion of cases of rotavirus diarrhea in the community to be much lower than that in the hospitalized population (12.2% vs. 43.0%).     

Genomic monitoring of SARS-CoV-2 variants using sentinel SARI hospital surveillance

Background

To support the COVID-19 pandemic response, many countries, including Belgium, implemented baseline genomic surveillance (BGS) programs aiming to early detect and characterize new SARS-CoV-2 variants. In parallel, Belgium maintained a sentinel network of six hospitals that samples patients with severe acute respiratory infections (SARI) and integrated SARS-CoV-2 detection within a broader range of respiratory pathogens. We evaluate the ability of the SARI surveillance to monitor general trends and early signals of viral genetic evolution of SARS-CoV-2 and compare it with the BGS as a reference model.

Methods

Nine-hundred twenty-five SARS-CoV-2 positive samples from patients fulfilling the Belgian SARI definition between January 2020 and December 2022 were sequenced using the ARTIC Network amplicon tiling approach on a MinION platform. Weekly variant of concern (VOC) proportions and types were compared to those that were circulating between 2021 and 2022, using 96,251 sequences of the BGS.

Results

SARI surveillance allowed timely detection of the Omicron (BA.1, BA.2, BA.4, and BA.5) and Delta (B.1.617.2) VOCs, with no to 2 weeks delay according to the start of their epidemic growth in the Belgian population. First detection of VOCs B.1.351 and P.1 took longer, but these remained minor in Belgium. Omicron BA.3 was never detected in SARI surveillance. Timeliness could not be evaluated for B.1.1.7, being already major at the start of the study period.

Conclusions

Genomic surveillance of SARS-CoV-2 using SARI sentinel surveillance has proven to accurately reflect VOCs detected in the population and provides a cost-effective solution for long-term genomic monitoring of circulating respiratory viruses.     

常德市武陵区2010年暗娼人群艾滋病哨点监测分析

目的了解武陵区暗娼人群艾滋病相关知识、行为现状及艾滋病、梅毒、丙型肝炎(丙肝)的感染状况,为干预工作提供依据。方法按照《全国艾滋病哨点监测实施方案(试行)》(2010年版)要求,抽查辖区内暗娼人群进行问卷调查和艾滋病病毒(Human immunodeficiency virus,HIV)、梅毒、丙肝病毒(Hepatitis C virus,HCV)抗体的检测。结果共调查400名暗娼,年龄中位数26岁,25～47岁占55.00%,本省户籍占90.00%,初中及以下文化占79.00%,有过婚史或有固定性伴者占58.00%。艾滋病知识知晓率为80.00%,最近1次与客人发生性行为时使用安全套的比例,最近1个月与客人发生性行为时坚持使用安全套的比例,分别为94.00%和77.50%。最近一年做过HIV检测并知晓检测结果的占34.50%,HIV、梅毒、HCV抗体阳性检出率分别为0.25%(1/400)、3.25%(13/400)、1.25%(5/400),HIV确认阳性率为0.25%。对HIV感染者追踪调查发现,第二代和第三代HIV感染者各1例。结论低档次的本土暗娼是该区性服务场所的"主力军",尽管目前HIV、梅毒、HCV的感染率较低,但传播风险不容忽视,控制传播是现阶段艾滋病性病防控工作的重点。