Health Vigilance and Risk Factors for Cervical Cancer: A Study in the State of Maranhão, Brazil

The purpose of this cross-sectional study was to investigate the importance of health vigilance in the prevention of cervical cancer. The sample consisted of 536 women. To identify which risk factors were associated with cervical cancer or with an increase in the mortality rate of this kind of cancer, a logistic regression model was used. The Odds Ratios (OR) and their respective 95% confidence intervals were also calculated. Most of them were at the age of highest incidence of cervical cancer (21 - 59 years old), had an unstable conjugal situation, minimal educational level (78.7%), low income (58.3%), consumed alcoholic beverages (56.4%), had a history of smoking (57.0%) and possessed limited knowledge about the prevention. These results are discussed in terms of a predictive model for cervical cancer that considers the importance of public health vigilance in the screening and precocious diagnosis.

Modelling the utility of group testing for public health surveillance

In epidemic or pandemic situations,resources for testing the infection status of individuals may be scarce.Although group testing can help to significantly increase testing capabilities,the(repeated)testing of entire populations can exceed the resources of any country.We thus propose an extension of the theory of group testing that takes into account the fact that definitely specifying the infection status of each individual is impossible.Our theory builds on assigning to each individual an infection status(healthy/infected),as well as an associated cost function for erroneous assignments.This cost function is versatile,e.g.,it could take into account that false negative assignments are worse than false positive assignments and that false assignments in critical areas,such as health care workers,are more severe than in the general population.Based on this model,we study the optimal use of a limited number of tests to minimize the expected cost.More specifically,we utilize information-theoretic methods to give a lower bound on the expected cost and describe simple strategies that can significantly reduce the expected cost over currently known strategies.A detailed example is provided to illustrate our theory.

Analysis of temporal trends of human brucellosis between 2013 and 2018 in Yazd Province, Iran to predict future trends in incidence: A time-series study using ARIMA model

Objective:To determine the temporal patterns of cumulative incidence of brucellosis using autoregressive integrated moving average models.Methods:This cross-sectional study employed yearly and monthly data of 1117 laboratory-confirmed human brucellosis cases from January 2013 to December 2018 using the Yazd brucellosis national surveillance system.The monthly incidences constructed a timeseries model.The trend of cumulative incidence was perceived by tracing a line plot,which displayed a seasonal trend with periodicity.Thus,the ARIMA models were selected.Thereafter,Akaike information criteria(AIC)and Bayesian information criterion(BIC)values among different models indicated a preferable model from models which were expanded by diverse lags[(3,0,3),(2,0,3),(3,0,2),(4,0,3)and(3,0,4)].Then,the achieved ARIMA model was applied to the forecasting cumulative incidence of monthly brucellosis incidences.All analyses were performed using Stata,version 11.2.Results:For the ARIMA(3,0,4)model,MAPE value was 56.20%with standard error 0.009–0.016,and white noise diagnostic check(Q=19.79,P=0.975)for the residuals of the selected model showed that the data were completely modelled.The monthly incidences that were fitted by the ARIMA(3,0,4)model,with AIC(25.7)and BIC(43.35)with a similar pattern of actual cases from 2013 to 2018 and forecasting incidences from January 2019 to December 2019 were,respectively,0.50,0.44,0.45,0.49,0.55,0.58,0.56,0.51,0.46,0.44,0.45 and 0.49 per 100000 people.Conclusions:In summary,the study showed that the ARIMA(3,0,4)model can be applied to forecast human brucellosis patterns in Yazd province,supplementing present surveillance systems,and may be better for health policy-makers and planners.

Natural Course of Silicosis in Dust-exposed Workers

To provide a scientific basis for determining the health surveillance period of dust-exposed workers, data of a retrospective cohort study was re-analyzed with emphasis on natural course of silicosis. 33640 workers exposed to silica dust who were employed for at least 1 year from 1972 to 1974 in twenty Chinese mines or pottery factories were included as subjects, and were followed up till December 31, 1994. The cohort included subjects from 8 tungsten mines, 4 tin mines and 8 pottery factories. Our results showed that the mean latency of silicosis, for all the cases of the cohorts, was 22.9±9.8 y. 52.2 % of silicosis was diagnosed approximately 9.1±5.7 y after the dust exposure had ceased. The progression rates of silicosis from stage Ⅰ to Ⅱ and from stage Ⅱ to Ⅲ were 48.2 % and 18.5 %, and the duration was 4.1±0. 2 and 6.8±0.2 y, respectively. The survival times of silicosis stage Ⅰ , Ⅱ and Ⅲ, from the year of diagnosis to death, were 21.5, 15.8 and 6.8 years, respectively. There was 25 % of the silicosis patients whose survival time was beyond 33 y. The mean death age of all silicosis cases was 56.0 y. The death age inereased to 65.6 y in the middle of 1990s. Among dust-exposed workers, subjects who became suspected case （0^＋ ） accounted for 15.0 %. 48.7 % of the suspected silicosis cases developed to silicosis, and the average year from the time of being suspected of the disease to the first stage of silicosis was 5.1y. The natural characteristics, as mentioned above, varied with different mines and factories. We are led to conclude that silicosis is chronic in nature, but progress quickly. As a serious occupational disease it significantly reduces the life span of exposed workers. The study of its natural history is of importance for the development of health surveillance criteria for dust-exposed workers.

The Reference Value for Biomonitoring in Chemicals Risk Area in Thailand

The workers’biological standard value(WBSV)is generally used to assess chemicals health risks in community.It may cause the deviate biomonitoring.Therefore,this study was aimed to set the pilot reference value for exposed people to chemicals.The study was divided into three phases:the two phases for field-study method and one phase for stakeholder’s adoption.Phase I was proceeded in one industrial zone in Thailand during the years 2012-2014 to collect blood and urine samples of 402 working-age people in community accompanied with in-depth interview.The 4 heavy metals(arsenic,cadmium,lead,mercury)in blood and urine were analyzed by atomic absorption spectroscopy(AAS)analysis and inductively coupled plasma mass spectrometry(ICP-MS).The metabolites of 4 volatile organic compounds(VOCs,benzene,toluene,styrene,xylenes)in urine were analyzed by high performance liquid chromatography(HPLC)analysis.The 8 chemicals concentrations of the volunteers’average chemicals concentration(VACC)were calculated.Phase II was proceeded during the years 2015-2016 to compare risk group identification between usage of VACC and usage of WBSV.The results were presented in mean value,standard deviation,percentage,and significant.The results showed approximately 90 percent of VACCs were lower than WBSV.The exceptional result was volunteers’average urinary arsenic concentration.It was clearly higher than WBSV.The comparative results showed the adjusted amount of risk people by VACC was higher than the adjusted amount risk people by WBSV.Phase III was proceeded in the year 2017 for stakeholder’s adoption.This study indicated that general people’s average chemicals concentration should be used as the reference value for biomonitoring and active health surveillance.

A Community Health Service Architecture Based on the Internet of Things on Health-Care

In order to assure a real-time medical care for the elders who live alone or have a chronic disease and also to improve the responsiveness and quality of the community hospital, a community health service architecture was designed according to the Internet of Things on Health-Care. The users' body physiological and sports information can be collected intelligently by the health sensors at home and then the health information can be transmitted to the community health-care center through networks after information processing. The community doctors can provide a medical service on kinds of video, voice or email according to the users' process notes, test data and symptoms. Of course, doctors also can communicate and share their opinions with other specialist who is online. The key technology of this system is Internet of Things on Health-Care, which system can get users' health information actively and then make out intelligent decisions promptly and finally provide a more personal health service.

Injury surveillance information system: A review of the system requirements

Purpose: An injury surveillance information system (ISIS) collects, analyzes, and distributes data on injuries to promote health care delivery. The present study aimed to review the data elements and functional requirements of this system.Method: This study was conducted in 2019. Studies related to injury surveillance system were searched from January 2000 to September 2019 via the databases of PubMed, Web of Knowledge, ScienceDirect, and Scopus. Articles related to the epidemiology of injury, population survey, and letters to the editor were excluded, while the review and research articles related to ISISs were included in the study. Initially 324 articles were identified, and finally 22 studies were selected for review. Having reviewed the articles, the data needed were extracted and the results were synthesized narratively.Results: The results showed that most of the systems reviewed in this study used the minimum data set suggested by the World Health Organization injury surveillance guidelines along with supplementary data. The main functions considered for the system were injury track, data analysis, report, data linkage, electronic monitoring and data dissemination.Conclusion: ISISs can help to improve healthcare planning and injury prevention. Since different countries have various technical and organizational infrastructures, it is essential to identify system requirements in different settings.

A community-based prospective cohort study of dengue viral infection in Malaysia: the study protocol

Background:Globally,dengue infections constitute a significant public health burden.In recent decades,Malaysia has become a dengue hyper-endemic country with the co-circulation of the four dengue virus serotypes.The cyclical dominance of sub-types contributes to a pattern of major outbreaks.The consequences can be observed in the rising incidence of reported dengue cases and dengue related deaths.Understanding the complex interaction of the dengue virus,its human hosts and the mosquito vectors at the community level may help develop strategies for addressing the problem.Methods:A prospective cohort study will be conducted in Segamat district of Johor State in Peninsular Malaysia.Researchers received approval from the Malaysian Medical Research Ethics Committee and Monash University Human Research Ethics Committee.The study will be conducted at a Malaysian based health and demographic surveillance site over a 1 year period in three different settings(urban,semi-urban and rural).The study will recruit healthy adults(male and female)aged 18 years and over,from three ethnic groups(Malay,Chinese and Indian).The sample size calculated using the Fleiss method with continuity correction is 333.Sero-surveillance of participants will be undertaken to identify asymptomatic,otherwise healthy cases;cases with dengue fever who are managed as out-patients;and cases with dengue fever admitted to a hospital.A genetic analysis of the participants will be undertaken to determine whether there is a relationship between genetic predisposition and disease severity.A detailed medical history,past history of dengue infection,vaccination history against other flaviviruses such as Japanese encephalitis and Yellow fever,and the family history of dengue infection will also be collected.In addition,a mosquito surveillance will be carried out simultaneously in recruitment areas to determine the molecular taxonomy of circulating vectors.Discussion:The research findings will estimate the burden of asymptomatic and symptomatic dengue at the community level.It will also examine the relationship between virus serotypes and host genotypes,and the association of the clinical manifestation of the early phase with the entire course of illness.