BACKGROUND // Knowledge of social and gender determinants, which influence the places where people are exposed to COVID-19,
may be relevant in the development of preventive and control strategies. ...The aim of this paper was to determine the context in which
COVID-19 cases were infected (household, work/labor, health, social-health, and social-leisure settings) according to country of origin,
occupational social class and gender, which is essential in order to designing public health strategies.
METHODS // A cross-sectional study of an epidemiological registry of 56,628 COVID-19 incident cases was made, whose exposure/
contagion setting was studied according to the previous variables from June 15 to December 23, 2020, in the Region of Murcia (Spain). An
exact Fisher test was used to study the distribution of COVID-19 cases based on the above variables.
RESULTS // The cumulative incidence was higher in people from Africa (5,133.5 cases/100,000 inhabitants) and Latin America (11,351.1)
than in non-immigrants (3,145.7). It was also higher in women (3,885.6) than in men (3,572.6). It is noteworthy, that 53.3% of the cases
with employment were workers in industry or construction, artisans, agricultural workers, or elementary occupations. In contrast,
during the second semester of 2020, 41.3% of the employed population in the Region of Murcia performed such jobs. The household
was the main exposure setting (56.5% of cases with a known setting), followed by social-leisure (20.7%) and work/labor (18.2%). The
labor settings were more important in immigrants from Africa (28.4%) and Latin America (35.7%) than in non-immigrants (12%),
inversely to social-leisure settings. Labor context was more important in women (19.6%) than in men (16.5%) and in manual workers
(44.1%) than in non-manual workers (26.6%).
CONCLUSIONS // The context in which COVID-19 cases were infected is different according to social inequalities related to country
of origin, gender and occupational social class.
FUNDAMENTOS // El conocimiento de los determinantes sociales y de género que influyen en el ámbito de exposición al SARS-CoV-2
puede ser relevante en el planteamiento de estrategias preventivas y de control de la transmisión. No se han encontrado estudios previos
que evalúen cómo influyen la clase social ocupacional y el país de origen en el ámbito de exposición del SARS-CoV-2. El objetivo de este
trabajo fue conocer el contexto en que se contagiaron los casos de COVID-19 (ámbito: hogar, trabajo, sanitario, sociosanitario y social-ocio)
según país de origen, clase social ocupacional y género, lo cual es esencial para orientar estrategias de Salud Pública.
MÉTODOS // Se realizó un estudio descriptivo de un registro epidemiológico de 56.628 casos incidentes de COVID-19 en los que se
estudió el ámbito de exposición/contagio en función de las variables anteriormente indicadas entre el 15 de junio y el 23 de diciembre
de 2020 en la Región de Murcia. Se utilizó una prueba exacta de Fisher para el estudio de la distribución de los casos de COVID-19 en
función de las variables anteriores.
RESULTADOS // La incidencia acumulada fue mayor en personas procedentes de África (5.133,5 casos por cada 100.000 habitantes)
y Latinoamérica (11.351,1) que en no inmigrantes (3.145,7) y superior en mujeres (3.885,6) que en hombres (3.572,6). Es destacable que
el 53,3% de los casos COVID-19 con empleo registrado eran operarios en industria o construcción, artesanos, trabajadores agrarios o
con ocupaciones elementales (15 de junio y el 23 de diciembre de 2020). En contraste, el 41,3% de la población ocupada en la Región
de Murcia realizaba dichos empleos (promedio 3º y 4º trimestre de 2020). El hogar fue el principal ámbito de contagio (56,5% de los
casos con ámbito conocido), seguido del social-ocio (20,7%) y el laboral (18,2%). Este último tuvo mayor peso en personas procedentes
de África (28,4%) y Latinoamérica (35,7%) que en no inmigrantes (12%), a la inversa que el social-ocio. Fue más importante en
mujeres (19,6%) que en hombres (16,5%) y en trabajadores manuales (44,1%) que en no manuales (26,6%).
CONCLUSIONES // El contexto en el que los casos de COVID-19 se contagiaron es diferente en función de las desigualdades sociales
relativas a país de origen, género y clase social ocupacional.
Hepatitis C and hepatitis B-related mortality in Spain García-Fulgueiras, Ana; García-Pina, Rocío; Morant, Consuelo ...
European journal of gastroenterology & hepatology,
2009-August, Letnik:
21, Številka:
8
Journal Article
Recenzirano
BACKGROUNDAlthough hepatitis C and hepatitis B virus (HCV/HBV) infections are an important health problem worldwide, their burden of disease (BoD) taking into account their chronic consequences, ...cirrhosis, and hepatocellular carcinoma (HCC), is still unknown. Our aim was to assess the total number of deaths attributable to these viruses in Spain and the years of life lost, first component of the disability adjusted life years, a comparative index of BoD.
METHODSWe selected the International Classification of Diseases-Tenth Revision specific codes related to HCV/HBV. For unspecified cirrhosis and HCC, the attributable fraction of mortality was assessed in two stepsliterature review and expert panel. Deaths in Spain in 2000 were obtained from the National Statistics Institute. Years of life lost were calculated using the estimated mortality and life expectancies (Princeton Model Life Table).
RESULTSHCV could have caused around 70% of HCC deaths and 50% of cirrhosis mortality in Spain in 2000 (60% HCC, 40% cirrhosis with HCV lower estimate). For HBV these proportions are 10 and 13%, respectively. We estimated 4342 HCV-related deaths and 877 HBV-related deaths in Spain in 2000, globally 1.5% of total deaths in Spain that year. Mortality by cirrhosis and HCC represented most of these viral-related deaths. Attributable mortality in AIDS patients was also estimated.
CONCLUSIONHCV leads the list of infectious disease-related mortality in Spain in 2000, doubling the AIDS mortality even if lower HCV attributable fractions are considered. Exclusion of cirrhosis and HCC-related mortality severely underestimates the BoD attributable to HCV/HBV. Improving early diagnosis and access to treatment could have an important impact on mortality because of hepatitis virus in the next decades.
Purpose
To describe the prevalence of and the risk factors for poor mental health in female and male Ecuadorian migrants in Spain compared to Spaniards.
Method
Population-based survey. Probabilistic ...sample was obtained from the council registries. Subjects were interviewed through home visits from September 2006 to January 2007. Possible psychiatric case (PPC) was measured as score of ≥5 on the General Health Questionnaire-28 and analyzed with logistic regression.
Results
Of 1,122 subjects (50% Ecuadorians, and 50% women), PPC prevalence was higher in Ecuadorian (34%, 95% CI 29–40%) and Spanish women (24%, 95% CI 19–29%) compared to Ecuadorian (14%, 95% CI 10–18%) and Spanish men (12%, 95% CI 8–16%). Shared risk factors for PPC between Spanish and Ecuadorian women were: having children (OR 3.1, 95% CI 1.4–6.9), work dissatisfaction (OR 4.1, 95% CI 1.6–10.5), low salaries (OR 2.5, 95% CI 1.1–5.9), no economic support (OR 1.8, 95% CI 0.9–3.4), and no friends (OR 2.2, 95% CI 1.1–4.2). There was an effect modification between the nationality and educational level, having a confidant, and atmosphere at work. Higher education was inversely associated with PPC in Spanish women, but having university studies doubled the odds of being a PPC in Ecuadorians. Shared risk factors for PPC in Ecuadorian and Spanish men were: bad atmosphere at work (OR 2.4, 95% CI 1.3–4.4), no economic support (OR 3.5, 95% CI 1.3–9.5), no friends (OR 2.5, 95% CI 0.9–6.6), and low social support (OR 1.6, 95% CI 0.9–2.9), with effect modification between nationality and partner’s emotional support.
Conclusions
Mental health in Spanish and Ecuadorian women living in Spain is poorer than men. Ecuadorian women are the most disadvantaged group in terms of prevalence of and risk factors for PPC.
•Evaluation of a new analytical method for Phenylacetylglutamine in urine.•Biomarker of monitoring and adherence to the treatment in urea cycle disorders.•Clinical data are correlated to ...Phenylacetylglutamine for the first time in Europe.•The use of spot urines is easier to send for analysis due to its stability.
Salts of phenylacetic acid (PAA) and phenylbutyric acid (PBA) have been used for nitrogen elimination as a treatment for hyperammonaemia caused by urea cycle disorders (UCD). A new analytical method for PBA measurement in urine which helps to evaluate the drug adherence has been implemented.
Urine specimens from UCD patients receiving PBA were analysed by tandem mass spectrometry to measure urine phenylacetylglutamine (PAGln). Some clinical and biochemical data for each patient were collected.
Our study included 87 samples from 40 UCD patients. The PAGln levels did not correlate with height, weight or age. However, the PAGln values showed correlation with PBA dose (r = 0.383, P = 0.015). Plasma glutamine and ammonia levels presented a positive correlation (r = 0.537, P < 0.001). The stability for PAGln in urine was determined at different storage temperatures.
We have developed a simple method for the determination of PAGln in urine, which acts as useful biomarker of effective drug delivery. PAGln in urine is stable at room temperature at least for 15 days, and for several months when frozen at -20 °C. This procedure is useful for the optimization and monitorization of the drug dose allowing the use of spot urine samples.
Purpose
We aimed to study the association between the Ecuadorians’ ethnic density (EED) of the areas of residence (AR) with the mental health of Ecuadorians in Spain.
Methods
Multilevel study of 568 ...Ecuadorian adults in 33 AR randomly selected from civil registries and interviewed at home. Possible psychiatric case (PPC) was measured by scoring ≥5 in General Health Questionnaire-28. Ecuadorians’ ethnic density was dichotomized in high and low EED (<6 %). Multilevel logistic regression was used to estimate odds ratios (OR) and 95 % confidence intervals (CI).
Results
Prevalence of PPC, 24 % (95 %CI 20–28 %), varied by area of residence. Ecuadorians’ ethnic density varied by area of residence ranging from 0.9 to 19.5 %. PPC prevalence in High Ecuadorians’ ethnic density AR was 29.5 and 20.4 % in low EED AR (
p
0.013). Ecuadorians from High EED AR had higher odds of PPC than those from Low EED AR (OR 1.65 95 %CI 1.01–2.72). Adjusting for individual confounders (largely self-perceived discrimination), OR decreased to 1.48 (95 %CI 0.87–2.55). The final model, adjusted by area of residence and educational level, yielded an OR 1.37 (95 %CI 0.78–2.40).
Conclusions
No protective association between the Ecuadorians’ ethnic density of the Area of residence and Ecuadorian migrants’ mental health was found. Mechanisms underlying beneficial ethnic density effects may be absent in recent migration settings.
Fundamento: el efecto de las temperaturas sobre la mortalidad ha sido estudiado más en profundidad que el efecto sobre la morbilidad. En Murcia se monitorizan el número de urgencias diarias y los ...casos de golpes de calor atendidos en los hospitales de la Región.
Objetivo: valorar el efecto de la temperatura sobre el número de urgencias hospitalarias y la utilidad de estos indicadores para vigilar la morbilidad por calor.
Métodos: se ha estudiado el efecto de la temperatura sobre el número de urgencias en verano (periodo 2000-2005), estimando el incremento porcentual de urgencias cuando se superan los umbrales establecidos por el Ministerio de Sanidad y Consumo (Tª máxima 38ºC y Tª mínima 22,4ºC) y por cada grado de aumento de temperatura, expresado en Riesgo Relativo (RR) con un IC95%. Se han cotejado los golpes de calor comunicados con los ingresos registrados en el Conjunto Mínimo Básico de Datos al Alta Hospitalaria (CMBD).
Resultados: En 2000-2005 las urgencias se incrementaron un 1,6% en los días con más de 22,4ºC de mínima (RR 1,016; IC95% 1,0076-1,0244), y un 0,21% por cada grado de aumento de la mínima (RR 1,0021; IC95% 1,0000-1,0044). El 38% de los golpes de calor ingresados no se notificaron, y el 40% de los notificados tenían exposición laboral.
Conclusiones: La temperatura mínima podría tener un mayor efecto en Murcia que la máxima. Con los actuales umbrales, el número de urgencias diarias no parece un indicador adecuado para monitorizar el efecto de la temperatura, necesitándose información sobre el diagnóstico y la edad. Los golpes de calor aportan información parcial del impacto, pero resaltan grupos de población en riesgo menos considerados.
Se realizó una investigación multinivel sobre el impacto de las características ambientales de la zona de residencia en la salud mental de población autóctona e inmigrante. El objetivo de este ...artículo es describir el planteamiento metodológico de la investigación, el trabajo de campo, las tasas de respuesta correspondientes y discutir el diseño metodológico y las dificultades derivadas de su puesta en práctica.
Los datos individuales se obtuvieron aplicando un cuestionario estructurado de aproximadamente 40 minutos, mediante entrevista domiciliaria a personas españolas y ecuatorianas de 18 a 55 años. El trabajo se realizó de septiembre de 2006 a enero de 2007 en una muestra
estimada de 1.186 personas equiparada por sexo y nacionalidad, obtenida aleatoriamente de los Padrones Municipales de 33 áreas (municipios o barrios) de Madrid, Alicante, Almería y Murcia, seleccionadas
según criterios de densidad étnica y socioeconómicos. Previamente
se realizó un estudio piloto (n=113)Los indicadores sociodemográficos
de las áreas se obtuvieron a partir de fuentes secundarias. Se entrevistó a 1.144 personas (96%). La tasa de respuesta global fue del 61%, superior entre ecuatorianos (69%), colectivo que presentó más problemas de localización (34%). Las negativas a colaborar fueron más altas entre españoles (21%).
Se concluye que en este tipo de estudios sería conveniente revisar las estrategias de muestreo para combinar criterios de eficiencia con la necesidad de obtener una muestra representativa de la población diana. Se constata la dificultad de obtener datos inframunicipales de integración
social.
The omicron (B.1.1.529) variant of SARS-CoV-2 has increased capacity to elude immunity and cause breakthrough infections. The aim of this study was to estimate the effectiveness of mRNA-based vaccine ...boosters (third dose) against infection with the omicron variant by age, sex, time since complete vaccination, type of primary vaccine, and type of booster.
In this nationwide cohort study, we linked data from three nationwide population registries in Spain (Vaccination Registry, Laboratory Results Registry, and National Health System registry) to select community-dwelling individuals aged 40 years or older, who completed their primary vaccine schedule at least 3 months before the start of follow-up, and had not tested positive for SARS-CoV-2 since the start of the pandemic. On each day between Jan 3, and Feb 6, 2022, we matched individuals who received a booster mRNA vaccine and controls of the same sex, age group, postal code, type of vaccine, time since primary vaccination, and number of previous tests. We estimated risk of laboratory-confirmed SARS-CoV-2 infection using the Kaplan-Meier method and compared groups using risk ratios (RR) and risk differences. Vaccine effectiveness was calculated as one minus RR.
Between Jan 3, and Feb 6, 2022, 3 111 159 matched pairs were included in our study. Overall, the estimated effectiveness from day 7 to 34 after a booster was 51·3% (95% CI 50·2–52·4). Estimated effectiveness was 52·5% (51·3–53·7) for an mRNA-1273 booster and 46·2% (43·5–48·7) for a BNT162b2 booster. Effectiveness was 58·6% (55·5–61·6) if primary vaccination had been with ChAdOx1 nCoV-19 (Oxford–AstraZeneca), 55·3% (52·3–58·2) with mRNA-1273 (Moderna), 49·7% (48·3–51·1) with BNT162b2 (Pfizer–BioNTech), and 48·0% (42·5–53·7) with Ad26.COV2.S (Janssen). Estimated effectiveness was 43·6% (40·0–47·1) when the booster was administered between 151 days and 180 days after complete vaccination and 52·2% (51·0–53·3) if administered more than 180 days after primary scheduled completion.
Booster mRNA vaccine-doses were moderately effective in preventing infection with the omicron variant of SARS-CoV-2 for over a month after administration, which indicates their suitability as a strategy to limit the health effects of COVID-19 in periods of omicron variant domination. Estimated effectiveness was higher for mRNA-1273 compared with BNT162b2 and increased with time between completed primary vaccination and booster.
None.
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