Assessing healthcare workers’knowledge and confidence in the diagnosis,management and prevention of Monkeypox

BACKGROUND Monkeypox(Mpox),is a disease of global public health concern,as it does not affect only countries in western and central Africa.AIM To assess Burundi healthcare workers(HCWs)s’level of knowledge and confidence in the diagnosis and management of Mpox.METHODS We conducted a cross-sectional study via an online survey designed mainly from the World Health Organization course distributed among Burundi HCWs from June-July 2023.The questionnaire comprises 8 socioprofessional-related questions,22 questions about Mpox disease knowledge,and 3 questions to assess confidence in Mpox diagnosis and management.The data were analyzed via SPSS software version 25.0.A P value<0.05 was considered to indicate statistical significance.RESULTS The study sample comprised 471 HCWs who were mainly medical doctors(63.9%)and nurses(30.1%).None of the 22 questions concerning Mpox knowledge had at least 50%correct responses.A very low number of HCWs(17.4%)knew that Mpox has a vaccine.The confidence level to diagnose(21.20%),treat(18.00%)or prevent(23.30%)Mpox was low among HCWs.The confidence level in the diagnosis of Mpox was associated with the HCWs’age(P value=0.009),sex(P value<0.001),work experience(P value=0.002),and residence(P value<0.001).The confidence level to treat Mpox was significantly associated with the HCWs’age(P value=0.050),sex(P value<0.001),education(P value=0.033)and occupation(P value=0.005).The confidence level to prevent Mpox was associated with the HCWs’education(P value<0.001),work experience(P value=0.002),residence(P value<0.001)and type of work institution(P value=0.003).CONCLUSION This study revealed that HCWs have the lowest level of knowledge regarding Mpox and a lack of confidence in the ability to diagnose,treat or prevent it.There is an urgent need to organize continuing medical education programs on Mpox epidemiology and preparedness for Burundi HCWs.We encourage future researchers to assess potential hesitancy toward Mpox vaccination and its associated factors.

Sustainable Community Epidemic Prevention Countermeasures against Public Health Emergencies

How to deal with public health emergencies is an important issue related to the normal life of community residents. However, after the corresponding understanding, it is found that a series of unsustainable epidemic prevention factors have been exposed in the community in the COVID-19, such as blocked access to basic materials, unsafe living environment, and lack of social platforms. In view of these problems, based on Maslow’s hierarchy of needs, the changes in the hierarchy of needs of residents during the epidemic were analyzed, and sustainable community epidemic prevention strategies were proposed from five aspects of material storage, safe environment, social platform, respect opportunity and self-worth realization, so as to provide effective reference for future response to public health emergencies.

REDISSE in Benin and Lessons Learned for the Management of Public Health Emergencies after Five Years of Implementation

Introduction: Benin was embarked on phase 3 of the REDISSE Benin project (Regional Disease Surveillance Systems Enhancement) which began in 2018. The objectives were in five key components namely, Surveillance and health information;Laboratory capacity building;Emergency preparedness and response;Human resources management for effective disease surveillance and epidemic preparedness;and Institutional Capacity Building, Project Management, Coordination and Advocacy. After five years of implementation, this study aimed at the documentation of lessons learned and best practices. Methods: A descriptive cross-sectional study. Apart from individual semi-structured interviews, a thematic workshops bringing together the project’s main stakeholders recruited on an exhaustive way by component to identify and validate lessons learned, good practices and propose improvement mechanisms to be taken into account by the sector. Criteria were set up and used to validate best practices and lessons learned. Results: A total 54 (Surveillance workshop), 47 (Preparedness & response workshop), 53 (Human Resources workshop), 26 (Laboratories workshop) participated to the thematic workshops, and five interviews. The good practices (33: 9 for animal health, 7 for human health and 17 crosscutting) and lessons learned (10: 3 for animal health and 7 for human health) have been identified and have been the subject, depending on the case, of proposals for improvement or conditions necessary for their maintenance. Discussion: The richness of a project lies not only in the immediate achievement of its results, but also and above all, in its usefulness for similar interventions, whether in the local, regional, national or international context. It is in this context that the REDISSE project has set out to make public the various lessons learned and best practices from the implementation of its activities over a period of some five consecutive years.

China's model to combat the COVID-19 epidemic:a public health emergency governance approach

The outbreak of Coronavirus Disease 2019(COVID-19)is of global health concern.It is a serious public health emergency for the entire world,threatening human life and public health security.To address the epidemic,it is necessary not only to take good prevention and treatment measures,but also to have effective and targeted public health emergency governance.That said,reports focusing on governance are scant.In this commentary,we summarize China’s model to combat the COVID-19 epidemic from a public health emergency governance approach.Stemmed from goals and values,a number of mechanisms are put forward,which include:a whole-ofgovernment response and accountability,setting up a multi-sectoral cooperation platform,swiftly scaling up epidemic emergency capacity,whole-of-society actions with engagement of social organizations,and engaging citizens in the epidemic prevention and control.As the epidemic continues to evolve,other countries might learn from China to build their own,context-specific models for better outcomes.

Analysis of CDC’s Role in Public Health Emergencies

Objective:To explore the role of the Centers for Disease Control and Prevention(CDC)in public health emergencies.Methods:The details of 12 public health events that occurred between January 2021 to December 2022 were analyzed to explore the roles of the CDC.Results:There were 160 patients involved in 10 public health events in 2021 and 48 patients involved in 2 public health events in 2022.Besides,the proportion of school public health events in 2022 was 0%,which was lower than in 2021,which was 80%(P<0.05).99.38%of patients during public health events were sent to the hospital promptly in 2022,which was higher than that in 2021,which was 81.25%(P<0.05).Furthermore,the average time taken for the CDC to control public health events in 2022 was 20.11±1.62 hours,and the average time taken to send inspection reports was shorter than that in 2021.The public satisfaction score was also higher in 2022 compared to 2021(P<0.05).Conclusion:The role of the CDC is to control infectious diseases.Therefore,it is important to pinpoint the existing problems in the strategies implemented by the CDC so that more improvements can be made to better prevent infectious diseases.

Development Path and Urgency of Further Strengthening Construction of Public Hospitals Based on Novel Coronavirus Pneumonia Treatment

During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented challenges and tests.Based on the treatment of severe patients in Wuhan,combined with the treatment practice in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,this paper puts forward the urgency of further strengthening the construction of public hospitals,discusses the feasible path for promoting the development of public hospitals,so as to meet the growing medical needs of the people,improve the ability to respond to major public health emergencies,and effectively guarantee the safety of people's lives and the promotion of a healthy China construction.

2005-2022年重庆市永川区突发公共卫生事件流行特征及发展趋势分析

目的分析2005—2022年重庆市永川区突发公共卫生事件的流行特征和发展趋势,为科学应对和有效防控突发公共卫生事件提供依据。方法通过突发公共卫生事件管理信息系统和现场流行病学调查报告收集2005年1月—2022年12月永川区突发公共卫生事件的相关信息,并对其流行特征进行分析。采用WPS Office和EPi info 7.0软件进行数据整理、统计分析等。结果2005—2022年永川区共报告突发公共卫生事件121起,报告病例数为4864例,死亡3例。较大事件2起(1.65%),一般事件45起(37.19%),未分级事件74起(61.16%)。不同时间段达到分级标准的事件比例比较,差异有统计学意义(χ^(2)=24.142,P<0.001),其中2005—2009年达到分级标准的事件比例为62.96%,较2010—2019年达到分级标准的事件比例(48.33%)和2020—2022年达到分级标准的事件比例(2.94%)更高。以传染病事件最多(119起,98.35%);传染病事件以其他类传染病(水痘)为主(61起,50.41%);中毒事件1起,其他公共卫生事件1起,且在2010年后二者未有报告,占比较低。报告事件数在4—6月和9—11月出现2个高峰。以城区报告事件为主(66起,54.55%)。主要发生场所为学校(106起,87.60%),发病4320例,占比88.82%;学校里主要发生场所为小学(75起,70.75%)。以呼吸道传染病为主(107起,88.43%)。事件发病规模为24(17,40)例,持续时间为20.29(6.92,43.75)d,处置时间为11.13(2.31,27.93)d。结论永川区突发公共卫生事件时有发生,未分级事件呈逐年增加趋势,以传染病类事件为主,学校是突发公共卫生事件防控的重点。

突发重大公共卫生事件中信息疫情防治策略研究

突发重大公共卫生事件涉及范围广泛、影响区域庞大,对社会发展以及人民生命健康构成重大威胁。信息疫情防治策略的研究在突发重大公共卫生事件中起着举足轻重的作用。本文从背景、挑战、策略以及未来展望4个方面,探讨了突发重大公共卫生事件背景下的信息疫情防治策略。通过运用信息化技术构建突发重大公共卫生事件防控体系,普及健康教育和卫生知识,建立突发重大公共卫生事件知识库,将能够更为有效地预防和控制突发重大公共卫生事件的扩散,保障社会稳定以及人民身心健康。

时空大数据在突发公共卫生事件应急指挥中的应用与挑战

时空是人类生存和发展一切活动的基础,时空大数据是同时具有时间和空间维度的、与地理位置有关的大数据,是突发公共卫生事件应急指挥与控制的重要支撑。针对我国在新冠肺炎疫情应急响应中出现的各种问题,总结时空大数据在新冠肺炎疫情应急响应中的应用。在此基础上分析我国突发公共卫生事件应急指挥系统存在的问题、时空大数据在突发公共卫生事件应急指挥中面临的挑战。提出面向突发公共卫生事件的时空大数据应急指挥技术框架,以期深化时空大数据在突发公共卫生事件领域的应用。

医联体内护士传染病相关应急能力现状及影响因素调查

目的探讨医联体内护士传染病突发公共卫生事件应急能力的现状及影响因素。方法采用便利抽样的方法,选取2022年1月—2023年1月404名医联体内护士进行问卷调查分析。统计404名不同特征护士应急能力得分、应急能力得分较低和较高的条目、应急能力得分情况,采用logistic多元分层回归分析医联体内护士传染病突发公共卫生事件应急能力得分的影响因素。结果一级指标准备得分最高的项目为“救援能力”(126.67±10.89)分,得分最低的项目为“风险沟通能力”(3.02±0.77)分;二级指标得分最高项目为“预防能力评分”(13.67±1.07)分,得分最低的项目是“应急演练评分”(3.43±0.78)分。三级医院、男性、年龄>39岁、临床经验>14年、硕士、有救援工作经验、有突发事件应急救援经验、过去5年参加过新发传染病事件应急演练、过去5年参加过常见传染病或新发传染病培训的护士应急能力得分高于一二级医院、女性、年龄<31岁和31~39岁、临床经验<6年和6~14年、本科和专科、无救援工作经验、无突发事件应急救援经验、过去5年未参加过新发传染病事件应急演练、过去5年未参加过常见传染病或新发传染病培训的护士,差异有统计学意义(P<0.05)。性别、年龄、学历、医院级别、临床经验、突发事件应急救援经验、过去5年参加新发传染病事件应急演练、过去5年参加常见传染病或新发传染病培训均为应急能力的主要影响因素(P<0.05)。结论医联体内护士应急能力评分处于中等水平。护理管理人员应选择适当的方法对医联体内护士进行传染病突发事件应急能力的演练和培训,以提高其应急能力。

面向信息公开的突发公共卫生事件知识表示模型构建

近年来,突发公共卫生事件频发给政府应急管理带来了极大挑战。政府及时公开事件信息有助于消除公众恐慌,对于疫情防控和社会经济发展至关重要。然而,当前突发公共卫生事件信息以碎片化、不连续、不完整方式散落在不同位置,未能较好地集成融合。如何对海量、多样、变化的信息进行描述与组织是政府应急管理的关键。因此,本文面向信息公开,融合知识图谱和事理图谱,构建突发公共卫生事件知识表示模型,并对其中的核心概念及关系进行表示,提出了一种既能刻画疫情时空演化状态,又能展示疫情信息的突发公共卫生事件信息组织方法。研究结果显示,本文构建的知识表示模型具有较好的垂直性质,能够展示较为丰富的概念关系和属性特征,大部分类能够得到实例填充。本文提出的知识表示模型为突发事件知识库构建提供新思路,扩充了突发事件信息组织的方法体系,有助于存量信息公开与价值释放,进一步满足公众的信息需求,提升应急管理效果。

后疫情时代我国基层医疗卫生服务发展现状、挑战及建议

基层医疗机构是我国医疗卫生服务体系的主力军,是国家卫生保健系统的基石。在COVID-19疫情期间,我国基层医疗机构发挥了巨大作用,但同时也凸显出许多短板。本文通过系统文献检索与分析,发现我国基层医疗机构存在患者就医需求不高、卫生系统整合性不强、服务基础薄弱、突发公共卫生事件应急能力不足等问题,据此提出基于“三力理论”的基层医疗机构建设策略,以期为完善基层医疗卫生服务体系、提升基层医疗卫生服务能力、更好地完成“健康中国2030”战略目标提供参考。

突发公共卫生事件下大学生焦虑现状调查——以广西壮族自治区在校大学生为例

目的了解突发公共卫生事件下大学生焦虑情绪现状及其影响因素,为突发公共卫生事件背景下大学生心理健康教育提供依据。方法采用便利抽样法,对272名广西壮族自治区在读本科大学生使用焦虑自评量表(SAS)进行调查。结果大学生焦虑发生率22.79%(62/272),其中轻度焦虑和中重度焦虑发生率分别为18.38%(50/272)和4.41%(12/272);不同性别、专业、生源地的在校大学生焦虑得分差异无统计学意义(P>0.05),但不同年级的在校大学生焦虑得分差异有统计学意义(P<0.05),大四、大五学生的SAS得分显著高于大一、大二、大三学生。结论突发公共卫生事件背景下,学校有关部门对于突发公共卫生事件防控最新政策的宣教需要与时俱进,增强在校大学生对突发公共卫生事件防控政策的信心和耐心;同时,扩大与学生交流的媒介,扩宽学生密切关注突发公共卫生事件防控新举措和新政策的途径,拓展第二课堂形式,帮助学生进行积极心理建设,积极进行自我调适,及时化解焦虑等负性情绪。

后疫情时期韧性卫生系统的挑战及建设策略

目的 了解国内外后疫情时期韧性卫生系统面临的现状,为建设我国高韧性卫生系统提出策略。方法 通过回顾国内外文献,总结国内外卫生系统韧性建设中所遭遇的瓶颈及挑战,对卫生系统的弱点与结构性缺陷进行深入分析,提出建议。结果 我国疫情时期韧性卫生系统面临卫生人力资源短缺、应急物资储备体系不完善、卫生筹资结构不合理、卫生信息系统资源冗杂、管理与合作能力不足、医疗卫生服务中断等问题,从卫生人力资源、医疗产品与技术、卫生筹资、卫生信息系统、领导与治理、医疗卫生服务为核心的卫生系统发展等方面对我国韧性卫生系统建设与管理提出建议。结论 在总结国内外后疫情时期卫生系统韧性的基础上,完善我国关于高韧性卫生系统的研究,对建立更加全面而有韧性的卫生服务模式具有重要意义。

安徽省医疗机构突发公共卫生事件应急药品供应保障现状分析

目的 通过深入探析安徽省医疗机构突发公共卫生事件应急药品供应保障现状,分析应急药品在不同医疗机构的可获得性及短缺障碍因素,为完善我国应急药品供应保障体系建设提供思路。方法 2022年9―11月运用文献研究法、问卷法等,向安徽省171家医疗机构进行调查,实际回收150份问卷,除无效问卷及废卷,共139家医疗机构纳入研究。参考安徽省药学会药物经济学专委会委员所在医疗机构的级别比例,其中三级医疗机构73家,二级医疗机构53家,一级医疗机构13家。比较该省不同等级的医疗机构应急药品准备能力的差异,从解决实际问题的角度完善应急药品供应保障体系的建设。结果 调研显示,在应急药品准备能力的三个方面,该省各级医疗机构总体上差异有统计学意义(P<0.05),医疗机构等级越高,应急药品准备能力越强,二级与一级医疗机构之间差距很小。该省应急药品短缺障碍因素总体上差异无统计学意义,但对各级医疗机构来说,其中有7个应急药品短缺障碍因素差异有统计学意义,它们分别是药品价格偏低、原材料短缺、药品市场需求量小、企业不愿意生产、药品生产质量管理规范认证改造或未通过认证、药品生产企业数量少、存在可替代的高价新药、利润过低导致经营企业不愿意经营药品。结论 突发公共卫生事件下,该省医疗机构应急药品供应保障形势仍很严峻,各等级医疗机构之间有差距,三级医疗机构应急药品准备能力最强。努力提升基层医疗机构的应急药品准备能力,克服应急药品短缺的障碍因素,能辅助健全该省医疗机构突发公共卫生事件应急药品供应保障体系。

优化新冠疫情防控措施对120救护服务影响及应对策略分析

目的 通过对新冠防控“新十条”实施后通州急救中心站执行院前急救任务进行回顾性分析,探讨突发疫情对院前急救产生的影响及应对策略,为院前急救系统应对突发公共卫生事件提供参考。方法 收集通州急救中心站2022年12月7日—2023年1月7日(2022年组)与2021年12月7日—2022年1月7日(2021年组)的两个时间段急救任务运行指标及疾病类别数据,对两组数据进行统计学分析。结果 2022年组出车总次数及救护车组数均较2021年组明显增长,90分钟内完成的救治任务占比明显下降(均p<0.05)。救援疾病分类中,2022年组患者的呼吸系统疾病、循环系统疾病数量较2021年组明显增长,而外伤任务占比较2021年组明显下降,且差异均有统计学意义(p<0.05)。结论 突发疫情对急救工作影响较大,通过优化急救流程、增加急救资源、加强医疗保障等措施,可以提高120救护服务的效率和质量,更好地满足人民群众的需求。

儿科公共卫生事件应急响应护理队伍培训课程的实施与评价研究

目的针对儿童突发公共卫生事件,设置和实施应急响应救护培训课程,并探索其应用效果。方法基于WHO灾害救护与应急响应理论模型、国际护士协会灾害护理胜任力标准科学建立儿科应急响应课程,通过专家咨询法对课程设置和内容进行论证。并于2021年11—12月选取93名护理人员参与课程培训,应用理论和技能考核、护士在线学习态度量表和课程满意度问卷进行教学评价。结果93名护理队员全程参加并完成课程考核。经过系统教学培训,护理人员应急响应救护理论考核成绩显著提升,合格率从56.3%提升至89.2%(P<0.05),技能考核合格率100%。调查结果中,护理队员对在线学习接受度高,但认为对促进临床实践作用有限。同时对整体课程感到满意,认为教师授课质量较高,但建议增加线下讨论课频次,提升学习效果。结论建立系统的儿童公共卫生事件应急响应培训课程能够有效帮助护理人员提升综合救护能力,且混合式教学有助于最大化保障教学效率和质量。

护理人员传染病突发事件防控能力的研究进展

介绍护理人员传染病突发事件防控能力的内涵及现状,其主要能力有临床实践能力、学习与教育能力、心理抗压能力;总结影响护理人员传染病突发事件防控能力的主要因素,包括个人因素(如性别、年龄、学历、参与培训的个人意愿等)、工作因素(如工作满意度、工作年限、职业角色、是否参加培训演练、是否具备相关救援经历等)及组织因素(如医院级别和组织支持等);采用的评估工具有葛森医院安全氛围量表、护士重大传染病疫情应急能力调查问卷等。提出提升护理人员传染病突发事件防控能力的相关策略,以期为提升护理人员传染病突发事件防控能力提供参考。

基于UIE的深圳市公共卫生事件应急管理知识图谱构建与应用

目的:构建深圳市公共卫生事件应急管理体系知识图谱,促进公共卫生事件应急管理向依赖大量知识和数据的智能模式发展。方法:从多个信息源收集相关内容,利用经过少量标注数据微调后的ERNIE-UIE模型,实现实体关系联合抽取,并将结果存储于Neo4j图数据库,进行应用与分析。结果:利用微调后的模型抽取得到6787个实体和6052个实体关系三元组。结论:ERNIE-UIE为垂直领域的低资源大规模知识图谱构建提供了一种可行手段,研究得到的深圳市公共卫生事件应急管理知识图谱能够满足较多情况下的应用场景,为提高公共卫生事件应急管理能力提供了模板。

基于事理图谱的公共卫生事件次生衍生事件预警模型构建研究

为了预判公共卫生事件演化态势,提出基于事理图谱的公共卫生事件次生衍生事件预警模型。利用2层本体实现结构化情景表示,综合利用预训练模型与深度神经网络实现事件抽取,运用模式匹配的方法抽取事件逻辑关系,融合词嵌入模型与聚类算法进行事件泛化,进而实现事理图谱构建,运用相似度计算与逻辑预测实现次生衍生事件预警,并以“甲型流感”和“肺炎支原体肺炎”事件为例进行实证研究。研究结果表明:“甲型流感”事理图谱能够清晰展示该事件与相关事件的逻辑关联,基于该事理图谱能够实现“肺炎支原体肺炎”事件的次生衍生事件预警。研究结果可为公共卫生事件次生衍生事件预防工作提供参考。