Academic literature on the topic 'National Centre for Disease Control and Public Health after L'

ObjectivesTo explore the association between non-high-density lipoprotein (non-HDL) and mortality risk, both short-term and long-term, in Chinese people.DesignA prospective cohort study.SettingThe National Basic Public Health Service (BPHS) in China.ParticipantsIncluding 621 164 elderly individuals around Hunan Province who underwent healthcare management receiving check-ups in China BPHS from 2010 to 2020. Exclusion criteria: (1) missing information on gender; (2) missing records of lipid screening; (3) missing information on key covariates; and (4) missing records of comorbidities (cardiovascular disease, hypertension, diabetes, cancer.)Primary and secondary outcome measuresThe study’s primary endpoint was all-cause and cause-specific mortality, sourced from Hunan’s CDC(Center for Disease Control and Prevention)-operated National Mortality Surveillance System, tracking participants until 24 February 2021.Results26 758 (4.3%) deaths were recorded, with a median follow-up of 0.83 years. Association between non-HDL and mortality was non-linear after multivariable adjustment, with the optimum concentration (OC) being 3.29 and 4.85 mmol/L. Compared with OC, the risk increased by 1.12-fold for non-HDL <3.29 mmol/L (HR: 1.12 (1.09 to 1.15)) and 1.08-fold for non-HDL ≥4.85 mmol/L (HR: 1.08 (1.02 to 1.13)) for all-cause mortality. Furthermore, there is also an increased risk of cardiovascular mortality (HRfor non-HDL <3.29: 1.10 (1.06 to 1.32) and HRfor non-HDL ≥4.85: 1.07 (1.01 to 1.14)). However, cancer mortality risk was significantly increased only for non-HDL <3.29 mmol/L (HR: 1.11 (1.04 to 1.18)). Non-optimum concentration of non-HDL had significant effects on both the long-term and the short-term risk of mortality, especially for risks of mortality for all-cause (log HR:0 .086 (0.038 to 0.134)), cardiovascular (log HR:0 .082 (0.021 to 0.144)), and cancer (log HR:0 .187 (0.058 to 0.315)) within 3 months. A two-sided value of p <0.05 was considered to be statistically significant.ConclusionsNon-HDL was non-linearly associated with the risk of mortality, and non-optimal concentrations of non-HDL significantly increased short-term mortality in elderly Chinese, which needs more attention for cardiovascular disease prevention.

Health surveillance is the ongoing, systematic use of routinely collected health data to guide public health action in a timely fashion. This paper describes the creation and growth of national surveillance systems in Canada and their impact on chronic disease and injury prevention. In 2008, the authors started a review process to retrace the history of the early development of national chronic disease surveillance in Canada from 1960 to 2000. A 1967 publication describes the history of the development of the Laboratory of Hygiene from 1921 to 1967. This review is a sequel to that paper and describes the history of the development of national chronic disease surveillance in Canada before and after the formation of the Laboratory Centre for Disease Control (LCDC).

Abstract Olanzapine is a thienobenzodiazepine class antipsychotic that strongly antagonises the 5-HT2A serotonin receptor, but acute poisonings are reported rarely. Symptoms of an overdose include disorder of consciousness, hypersalivation, myosis, and coma. Serum concentration higher than 0.1 mg/L is toxic, while concentration above 1 mg/L can be fatal. Here we report key data about 61 patients admitted to the National Poison Control Centre in Belgrade, Serbia over olanzapine poisoning in 2017 and 2018. The ingested doses ranged from 35 to 1680 mg, and time from ingestion to determination from two to 24 hours. In 34 patients olanzapine serum concentrations were in the therapeutic range and in 27 in the toxic range. In five patients they were higher than fatal, but only one patient died. The most common symptoms of poisoning were depressed consciousness (fluctuating from somnolence to coma), tachycardia, hypersalivation, hypotension, myosis, and high creatine kinase. All patients but one recovered fully after nonspecific detoxification and symptomatic and supportive therapy.

ObjectivesThis mixed-method study aimed to understand the effectiveness of linkage to biopsy and treatment in women with a high-risk mammography result (Breast Imaging Reporting and Data System, BI-RADS 4 and 5) in the national telemammography programme and to explore women’s experiences during this process.SettingQuantitative component: we collected and linked health data from the telemammography reading centre, the national public health insurance, the national centre for disease control and the national referral cancer centre. Qualitative component: we interviewed participants from different regions of the country representing diverse social and geographical backgrounds.ParticipantsQuantitative: women who underwent telemammography between July 2017 and September 2018 and had high-risk results (BI-RADS 4–5) were collected. Qualitative: women with a high-risk telemammography result, healthcare providers and administrators.Outcomes measuresQuantitative: we determined biopsy and treatment linkage rates and delays. Qualitative: we explored barriers and facilitators for obtaining a biopsy and initiating treatment.ResultsOf 126 women with high-risk results, 48.4% had documentation of biopsy and 37.5% experienced a delay of >45 days to biopsy. Of 51 women diagnosed with breast cancer, 86.4% had evidence of treatment initiation, but 69.2% initiated treatment >45 days after biopsy. Travelling to major cities for care, administrative factors and breast cancer misconceptions, among other factors, impeded timely, continuous care for breast cancer. A multidisciplinary and culturally tailored patient education facilitated understanding of the disease and prompt decision making about subsequent medical care.ConclusionsStrengthened breast cancer care capacity outside the capital city, standardised referral pathways, ensured financial support for travel expenses, and enhanced patient education are required to secure linkage to the breast cancer care continuum. Robust information systems are needed to track patients and to evaluate the programme’s performance.

Background: Rabies has been the subject of fear ever since the disease was recognized. Worldwide the number of deaths annually, due to rabies, is estimated to be between 35,000 to 50,000 approximately Rabies continues to be a major public health problem in Bangladesh killing an estimated 2000 people annually and 100,000 people receive post-exposure treatment in the country. In this regard the post-exposure treatment of animal bite cases is of prime importance. Materials and Methods: Communicable disease control(CDC) of, Directorate General of Health Services (DGHS) took the noble initiative to establish the national rabies elimination programme 2010 with an comprehensive approach of care for human and control of rabid animal. An expert group meeting for strategic plan and finalizing the guidelines for prevention and control of rabies cases was held in 2010, under CDC of DGHS to bring out uniformity in post-exposure treatment practices. . The participants in the meeting included practitioners managing anti-rabies clinics, laboratory medicine practitioners, policy makers, public health experts from both public and private sector. The guideline, which emerged out of consensus of expert groups, is summarized in this paper. Results: Until recently the Nervous Tissue Vaccine (NTV) was the mainstay for post-exposure prophylaxis in Bangladesh. As per WHO recommendations, the production and use of this reactogenic vaccine should be gradually phased out from our country. Modern, safe and effective anti-rabies Cell Culture Vaccines (CCVs) will be used for post-exposure prophylaxis in public sectors. The limitation is the high cost of this vaccine and also the cost and unavailability of Anti Rabies Immunoglobulin. WHO recommended the use of intra-dermal (ID) route of application of CCVs. Considering the recommendations of experts, results of clinical trials and international experience, experts of Bangladesh recommends ID regimen phase wise. In first phase, only Dhaka Infectious Disease Hospital will serve as Anti-rabies centre for ID regimen. After its successful implementation, ID regimen will spread out to Division and then to District level hospitals. National experts suggested and recommended the use of cost-effective vaccination schedules such as abbreviated multisite IM Zagreb protocol (4 dose, 3 visits) and updated Thai Red Cross (TRC) intradermal regimen(2-2-2-0-2) to phase out NTV and to make available modern rabies vaccine in public sector. Conclusion: This guideline will be extremely useful for the country to make rational use of modern rabies vaccine and phase out NTV by 2011. The guideline will be of immense use for better management of animal bite cases and availability and affordability of modern rabies vaccine will be of great help for physician to manage appropriately for preventing the deadly disease rabies. DOI: http://dx.doi.org/10.3329/jom.v12i2.7691 JOM 2011; 12(2): 153-159

BackgroundLong Covid (LC) refers to prolonged symptoms after Sars-CoV2 infection not explained by alternative diagnosis lasting 4-12 weeks as defined by the National Institute for Health and Care Excellence.Few studies explored LC in rheumatic diseases patients (RD) concluding that they present persistent symptoms after infection, although lacking a healthy control (HC) group.ObjectivesTo evaluate incidence and clinical features of LC on patients affected by Rheumatoid (RA) or Psoriatic arthritis (PsA) as well as infection’s influence on disease activity.MethodsA monocentric retrospective case-control study was conducted on consecutive outpatients affected by RA or PsA in Low Disease Activity or remission, referring to the Rheumatology Unit of University of Tor Vergata (Rome, Italy) between Sep ’21 - Sep ’22.Inclusion criteria: age ≥ 18 years, proven Sars-CoV2 infection between Jun ’21 – Jun ’22, 3 doses anti Sars-CoV2 vaccination, recovered for at least 12 weeks, diagnosis of PsA/RA before Feb ‘20.Exclusion criteria: symptoms explained by other diagnosis (as fibromyalgia, COPD ecc), hospitalization for Sars-CoV2.Patient were evaluated at 12 weeks after infection: demographic data, baseline comorbidities, ongoing therapy at infection and symptoms during and after infection were recorded; disease related data were recorded referred to the last clinical assessment too. Clinical features were compared among RA and PsA and with HC than among females and males patients.Results120 (60 PsA/60 RA) patients and 60 HC were enrolled (Table 1).Patients compared to HC reported higher incidence of dyspnoea during infection while at resolution: lower VAS general health (GH), higher asthenia, joint pain and higher incidence of dyspnoea, chest pain, sleep disturbances and depression. All patients continued their therapy during infection and no differences were found about baseline comorbidities and ongoing therapy.No statistical differences emerged between PsA and RA patients among them but when compared with HC both presented higher VAS fatigue, joint pain, lower GH and a longer duration of anosmia and anageusia after infection. Moreover, PsA presented higher incidence of chest pain after infection and headache during and after infection; RA reported higher incidence of chest pain and headache after infection and dyspnoea during and after. Regarding gender: females reported higher VAS disease activity, asthenia and higher incidence of joint pain, dyspnoea, depression and sleep disturbances at infection resolution. Lastly, female PsA patients presented higher DAPSA score after infection than man. Disease related items were compared before and after infection (Figure 1): statistical significant differences emerged regarding VAS disease activity, asthenia, joint pain and GH in RA and PsA patients.ConclusionHere, we documented that RD patients – particularly females - suffer from a higher burden after Sars-Cov2 infection showing statistical significant higher incidence of symptoms than HC and a worsening of disease activity although no disease flare were registered. Thus, LC carrying a significant burden is becoming an urgent health issue that needs immediate prioritization to prevent anothernational health disasterthat could be a further blow to health systems.References[1]National Institute for Health and Care Excellence, 2022[2]Leon L et al. Rheumatol Adv Pract. 2022[3]Di Iorio et al. Sem in arth and rheum, 55Table 1.*: p <0,05; **: p<0,01Total RDHCpPsaRAp PsA vs HCp RA vs HCMalesFemalesPPatients1206060604872Disponea during26,60%11,60%*20%33,30%-.22,90%35%- after25%8,30%**18,30%31,60%--14,50%38,3*Chest pain during24,10%16,60%-20%28,30%--20,80%31,60%- after12,50%0-10%15%***10,40%16,60%-Sleep disturbance43,30%16,60%**41,60%45%****27%65%** during after38,30%26,60%-35%41,60%--18,70%61,60%**Headache during42,50%28,30%-46,60%38,30%***39,50%53,30%- after21,60%11,60%-35%38,30%***14,50%31,60%-Depression after35,80%15%*35%36,60%--20,80%53,30%**Acknowledgements:NIL.Disclosure of InterestsNone Declared.

The pandemic of COVID-19 has afflicted every individual and has initiated a cascade of directly or indirectly involved events in precipitating mental health issues. The human species is a wanderer and hunter-gatherer by nature, and physical social distancing and nationwide lockdown have confined an individual to physical isolation. The present review article was conceived to address psychosocial and other issues and their aetiology related to the current pandemic of COVID-19. The elderly age group has most suffered the wrath of SARS-CoV-2, and social isolation as a preventive measure may further induce mental health issues. Animal model studies have demonstrated an inappropriate interacting endogenous neurotransmitter milieu of dopamine, serotonin, glutamate, and opioids, induced by social isolation that could probably lead to observable phenomena of deviant psychosocial behavior. Conflicting and manipulated information related to COVID-19 on social media has also been recognized as a global threat. Psychological stress during the current pandemic in frontline health care workers, migrant workers, children, and adolescents is also a serious concern. Mental health issues in the current situation could also be induced by being quarantined, uncertainty in business, jobs, economy, hampered academic activities, increased screen time on social media, and domestic violence incidences. The gravity of mental health issues associated with the pandemic of COVID-19 should be identified at the earliest. Mental health organization dedicated to current and future pandemics should be established along with Government policies addressing psychological issues to prevent and treat mental health issues need to be developed. References World Health Organization (WHO) Coronavirus Disease (COVID-19) Dashboard. 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Abstract This study aimed to describe the impact of the COVID-19 pandemic and related public health decisions on dental services. A retrospective study was conducted using secondary data on dental services (2019–2021). Data were obtained from the Latvian National Health Service and the Centre for Disease Prevention and Control and analysed using descriptive statistics and data visualisation methods. In the first wave of COVID-19, the frequency of routine dental services decreased by 81.6% at the patient level, which coincided with the restrictions imposed as public health measures. The amount of regular dental manipulations returned to its previous level immediately after lifting restrictions. Still, they decreased to a more moderate extent (not exceeding 25% decline) with the beginning of the second wave. We observed a decrease in all manipulations, regardless of their aerosol-generating risk, and no increase in preventive manipulations that could be performed without any physical contact. We conclude that the most significant decrease in the availability of services was directly linked to existing public health measures. It seems that these measures allowed time to adapt the clinics to the new sanitary requirements, further ensuring continuity of service provision.

Uganda has had repeated outbreaks of Rift Valley fever (RVF) since March 2016 when human and livestock cases were reported in Kabale after a long interval. The disease has a complex and poorly described transmission patterns which involves several mosquito vectors and mammalian hosts (including humans). We conducted a national serosurvey in livestock to determine RVF virus (RVFV) seroprevalence, risk factors, and to develop a risk map that could be used to guide risk-based surveillance and control measures. A total of 3,253 animals from 175 herds were sampled. Serum samples collected were screened at the National Animal Disease Diagnostics and Epidemiology Centre (NADDEC) using a competition multispecies anti-RVF IgG ELISA kit. Data obtained were analyzed using a Bayesian model that utilizes integrated nested Laplace approximation (INLA) and stochastic partial differential equation (SPDE) approaches to estimate posterior distributions of model parameters, and account for spatial autocorrelation. Variables considered included animal level factors (age, sex, species) and multiple environmental data including meteorological factors, soil types, and altitude. A risk map was produced by projecting fitted (mean) values, from a final model that had environmental factors onto a spatial grid that covered the entire domain. The overall RVFV seroprevalence was 11.39% (95% confidence interval: 10.35–12.51%). Higher RVFV seroprevalences were observed in older animals compared to the young, and cattle compared to sheep and goats. RVFV seroprevalence was also higher in areas that had (i) lower precipitation seasonality, (ii) haplic planosols, and (iii) lower cattle density. The risk map generated demonstrated that RVF virus was endemic in several regions including those that have not reported clinical outbreaks in the northeastern part of the country. This work has improved our understanding on spatial distribution of RVFV risk in the country as well as RVF burden in livestock.

Background: As malaria is among the leading public health problems globally as well as in India, early diagnosis and treatment of cases is one of the key interventions for its control and elimination. Present study was done to assess treatment-seeking behaviour and associated factors among malaria suspected patients.Methods: Present study was carried out at urban health and training center, Sagar, Madhya Pradesh. The hospital based prospective study by facility based identification of patients. Study was under taken from 1st Oct 2018 to 31st march 2019. All malaria suspected cases of fever cases who got tested for malaria. Purposive sampling technique. After a pilot study final questionnaire regarding treatment seeking behavior were used to collect information from 285 patients of fever data was analyzed in word excel 2007 using percentage and proportion.Results: In present study we found that out of 285 patients only 54 (18.94%) patient approached health facility within 24 hours. Majority of patient 93(32.63%) adopted self medication practice, 20.00% patient, who did nothing and waited for self resolution of fever. Majority of 39.82% answered mildness of disease as a reason for delay in getting treatment.Conclusions: A low proportion of malaria-suspected patients sought treatment within 24 h of fever onset compared to the national target. Awareness about the advantage early treatment-seeking need to be increased through health education and behavioural change communication.

Introduction During the Covid-19 pandemic, non-pharmacological interventions (NPIs) aimed to minimise the spread of the virus as much as possible to avoid the most severe cases and the collapse of health systems. These measures included mobility restrictions in several countries, including Spain. Objective To assess the impact of mobility constraints on incidence, transmission, severe cases and mortality in the evolution of the Covid-19 pandemic. These constraints include: • Mandatory home confinement. • - Recommendation to stay at home. • - Perimeter closures for entry and/or exit from established areas. • - Restriction of night-time mobility (curfew). Methodology Systematic literature review, including documents from official bodies, systematic reviews and meta-analyses. The following reference databases were consulted until October 2021 (free and controlled language): Medline, EMBASE, Cochrane Library, TripDB, Epistemonikos, Royal college of London, COVID-end, COVID-19 Evidence Reviews, WHO, ECDC and CDC. Study selection and quality analysis were performed by two independent researchers. References were filtered firstly by title and abstract and secondly by full text in the Covidence tool using a priori inclusion and exclusion criteria. Synthesis of the results was done qualitatively. The quality of the included studies was assessed using the AMSTAR-II tool. Results The literature search identified 642 studies, of which 38 were excluded as duplicates. Of the 604 potentially relevant studies, 12 studies (10 systematic reviews and 2 official agency papers) were included in the analysis after filtering. One of the official agency papers was from the European Centre for Disease Prevention and Control (ECDC) and the other paper was from the Ontario Agency for Health Promotion and Protection (OHP). The result of the quality assessment with the AMSTAR-II tool of the included systematic reviews was: 3 reviews of moderate quality, 6 reviews of low quality and 1 review of critically low quality. The interventions analysed in the included studies were divided into 2 categories: the first category comprised mandatory home confinement, recommendation to stay at home and curfew, and the second category comprised perimeter blocking of entry and/or exit (local, cross-community, national or international). This division is because the included reviews analysed the measures of mandatory home confinement, advice to stay at home and curfew together without being able to carry out a disaggregated analysis. The included systematic reviews for the evaluation of home confinement, stay-at-home advice and curfew express a decrease in incidence levels, transmission and severe cases following the implementation of mobility limitation interventions compared to the no measure comparator. These conclusions are supported by the quantitative or qualitative results of the studies they include. All reviews also emphasise that to increase the effectiveness of these restrictions it is necessary to combine them with other public health measures. In the systematic reviews included for the assessment of entry and/or exit perimeter closure, most of the studies included in the reviews were found to be modelling studies based on mathematical models. All systematic reviews report a decrease in incidence, transmission and severe case levels following the implementation of travel restriction interventions. The great heterogeneity of travel restrictions applied, such as travel bans, border closures, passenger testing or screening, mandatory quarantine of travellers or optional recommendations for travellers to stay at home, makes data analysis and evaluation of interventions difficult. Conclusions Mobility restrictions in the development of the Covid-19 pandemic were one of the main NPI measures implemented. It can be concluded from the review that there is evidence for a positive impact of NPIs on the development of the COVID-19 pandemic. The heterogeneity of the data from the included studies and their low quality make it difficult to assess the effectiveness of mobility limitations in a disaggregated manner. Despite this, all the included reviews show a decrease in incidence, transmission, hospitalisations and deaths following the application of the measures under study. These measures are more effective when the restrictions were implemented earlier in the pandemic, were applied for a longer period and were more rigorous in their application.