Highlights • We report on both a retrospective cohort study and data from mandatory notification. • The reported rate of mumps was 31.5/100,000 for Flanders for 2012/2013. • Students working in bars ...had a significantly higher risk of reporting parotitis. • An estimate of vaccine effectiveness for two doses compared to one was 68% (95%CI 24–92%) in students. • Orchitis was the most frequently reported complication (11% of male cases).
To assess the cost-effectiveness of the tuberculosis screening activities currently funded by the Flemish government in Flanders, Belgium.
After estimating the expenses for 2013-2014 of each of nine ...screening components - which include high-risk groups, contacts and people who are seeking tuberculosis consultation at a centre for respiratory health care - and the associated costs per active case of tuberculosis identified between 2007 and 2014, we compared the cost-effectiveness of each component. The applied perspective was that of the Flemish government.
The three most cost-effective activities appeared to be the follow-up of asylum seekers who were found to have abnormal X-rays in initial screening at the Immigration Office, systematic screening in prisons and contact investigation. The mean costs of these activities were 5564 (95% uncertainty interval, UI: 3791-8160), 11 603 (95% UI: 9010-14 909) and 13 941 (95% UI: 10 723-18 201) euros (€) per detected active case, respectively. The periodic or supplementary initial screening of asylum seekers and the screening of new immigrants from high-incidence countries - which had corresponding costs of €51 813 (95% UI: 34 855-76 847), €126 236 (95% UI: 41 984-347 822) and €418 359 (95% UI: 74 975-1 686 588) - appeared much less cost-effective. Between 2007 and 2014, no active tuberculosis cases were detected during screening in the juvenile detention centres.
In Flanders, tuberculosis screening in juvenile detention centres and among new immigrants and the periodic or supplementary initial screening of asylum seekers appear to be relatively expensive ways of detecting people with active tuberculosis.
Le cout moyen de ces activites etait respectivement de 5564 (intervalle d'incertitude de 95%, II: 3791-8160), 11 603 (Il 95%: 9010-14 909) et 13 941 (Il 95%: 10 723-18 201) euros (euro) par cas actif ...detecte. Le depistage initial periodique ou complementaire des demandeurs d'asile et le depistage des nouveaux immigrants originaires de pays a forte incidence--dont le cout etait respectivement de 51 813 euro (Il 95%: 34 855-76 847), 126 236 euro (Il 95%: 41 984-347 822) et 418 359 euro (Il 95%: 74 975-1 686 588)--se sont reveles beaucoup moins rentables. Entre 2007 et 2014, aucun cas de tuberculose active n'a ete detecte lors du depistage dans les centres de detention pour mineurs. Metodos Tras calcular los gastos de 2013-2014 de cada uno de los nueve componentes de los examenes de deteccion (que incluyen grupos de alto riesgo, contactos y personas que buscan consulta para la tuberculosis en un centra de atencion respiratoria) y los costes asociados por caso activo de tuberculosis identificados entre 2007 y 2014, se comparo la rentabilidad de cada componente. Se aplico la perspectiva del gobierno flamenco.
Microbiology reference laboratories are critical in the development of high-quality clinical and public health services. In Belgium, the reference laboratories performed their activities on a ...voluntary basis and lacked a legal status.
Pathogens or groups of pathogens necessitating a national reference center (NRC) were prioritized based on diagnostic and epidemiologic relevance. Terms of reference for each of these pathogens were developed.
Recently, 40 NRCs for different pathogens or groups of pathogens have been installed in Belgium to fulfill the following core functions: offering reference diagnostics, collecting reference materials, sharing information and scientific advice, participating in national and international networks, collaborating with research workgroups, and contributing to surveillance activities.
These NRCs are important focal points of the national and international network in public health microbiology.
Initial findings are presented of a 1994 cross-national European study of the social service issues in AIDS (acquired immune deficiency syndrome) prevention programs targeted at prostitutes. Based on ...data for 11 European countries, reforms of current laws & guidelines that block the prostitute's or sex worker's accsss to haelth care & social services & that curtail the prostitute's occupational control are called for. Specifically, it is suggested that stable funding is crucial for provision of integrated health services. Considering the challenges to interventions with such a group (eg, high mobility), the key to effective AIDS prevention programs built on experiences of successful risk reduction & safer sex initiatives is the personal involvement of prostitutes themselves. Adapted from the source document.
Endocuff Vision (Olympus Europe, Hamburg, Germany) has been designed to enhance mucosal visualization, thereby improving detection of (pre-)malignant colorectal lesions. This multicenter, ...international, back-to-back, randomized colonoscopy trial compared the adenoma detection rate (ADR) and adenoma miss rate (AMR) between Endocuff Vision–assisted colonoscopy (EVC) and conventional colonoscopy (CC).
Patients aged 40 to 75 years referred for non–immunochemical fecal occult blood test–based screening, surveillance, or diagnostic colonoscopy were included at 10 hospitals and randomized into 4 groups: group 1, 2 × CC; group 2, CC followed by EVC; group 3, EVC followed by CC; and group 4, 2 × EVC. Primary outcomes included ADR and AMR.
A total of 717 patients were randomized, of whom 661 patients (92.2%) had 1 and 646 (90.1%) patients had 2 completed back-to-back colonoscopies. EVC did not significantly improve ADR compared to CC (41.1%; 95% confidence interval (CI), 36.1-46.3 vs 35.5% 95% CI, 30.7-40.6, respectively; P = .125), but EVC did reduce AMR by 11.7% (29.6% 95% CI, 23.6-36.5 vs 17.9% 95% CI, 12.5-23.5, respectively; P = .049). AMR of 2 × CC compared to 2 × EVC was also not significantly different (25.9% 95% CI, 19.3-33.9 vs 18.8% 95% CI, 13.9-24.8, respectively; P = .172). Only 3.7% of the polyps missed during the first procedures had advanced pathologic features. Factors affecting risk of missing adenomas were age (P = .002), Boston Bowel Preparation Scale (P = .008), and region where colonoscopy was performed (P < .001).
Our trial shows that EVC reduces the risk of missing adenomas but does not lead to a significantly improved ADR. Remarkably, 25% of adenomas are still missed during conventional colonoscopies, which is not different from miss rates reported 25 years ago; reassuringly, advanced features were only found in 3.7% of these missed lesions. (Clinical trial registration number: NCT03418948.)
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Hybrid integrated semiconductor laser sources offering extremely narrow spectral linewidth, as well as compatibility for embedding into integrated photonic circuits, are of high importance for a wide ...range of applications. We present an overview on our recently developed hybrid-integrated diode lasers with feedback from low-loss silicon nitride (Si 3 N 4 in SiO 2 ) circuits, to provide sub-100-Hz-level intrinsic linewidths, up to 120 nm spectral coverage around a 1.55 μ m wavelength, and an output power above 100 mW. We show dual-wavelength operation, dual-gain operation, laser frequency comb generation, and present work towards realizing a visible-light hybrid integrated diode laser.
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