Dominguez A.,University of Barcelona |
Dominguez A.,CIBER ISCIII |
Salleras L.,University of Barcelona |
Salleras L.,CIBER ISCIII |
And 7 more authors.
European Respiratory Journal | Year: 2010
The objective of our study was to evaluate the effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPV) in preventing hospital admission for community-acquired pneumonia (CAP) in people ≥65 yrs of age. We conducted a matched case-control study in patients with CAP admitted to five Spanish hospitals. Cases were persons aged ≥65 yrs admitted to hospital through the emergency department, who presented a clinical and radiological pattern compatible with pneumonia, assessed using established criteria. We matched each case with three control subjects by sex, age (±5 yrs), date of hospitalisation (±30 days) and underlying disease. The study period was May 1, 2005 to January 31, 2007. The PPV immunisation status of cases and controls was investigated. Adjusted ORs for vaccination were calculated using logistic regression analysis. A total of 489 cases and 1,467 controls were included in the final analysis. The overall adjusted vaccination effectiveness for all patients was 23.6% (95% CI 0.9-41.0). The adjusted vaccination effectiveness for immunosuppressed patients was 21.0% (95% CI -18.7-47.5). Our results suggest that the PPV may potentially reduce hospitalisations for pneumonia in the elderly and supports vaccination programmes in this age group. Copyright©ERS 2010.
Garcia-Subirats I.,CIBER ISCIII |
Garcia-Subirats I.,Public Health Agency of Barcelona |
Perez G.,CIBER ISCIII |
Perez G.,Public Health Agency of Barcelona |
And 3 more authors.
Maternal and Child Health Journal | Year: 2011
To describe social and economic inequalities in non-fatal pregnancy outcomes (low birth weight, preterm birth and small for gestational age births) in the neighbourhoods of the city of Barcelona (Spain), according to maternal age and maternal country of origin, between 1991 and 2005. A cross-sectional ecological study was carried out using the 38 neighbourhoods of Barcelona as the unit of analysis. The study population comprises the 192,921 live births to resident women aged 12-49 residing from 1991 to 2005. Information was gathered from births registry. Prevalence of low birth-weight, preterm birth and small for gestational age, was calculated for each of the 38 neighbourhoods of mothers' residence, stratifying results by maternal age and country of origin. The indicator of neighbourhood socioeconomic level was the unemployment rate. Quartile maps along with Spearman correlation coefficients and linear regression were performed between indicators. The present study reports socio-economic inequalities in pregancy outcomes among neighbourhoods in Barcelona (Spain): the more disadvantaged neighbourhoods have worse pregnancy outcomes (low birth weight, preterm birth and small for gestational age births) in all women age groups. These inequalities do not exist among immigrant women, and some groups of foreign mothers even have lower rates of low birth weight, pretem birth, and small for gestational age births than autochthonous women. The existing inequalities suggest that policy efforts to reduce these inequalities are not entirely successful and should focus on improving pregnancy and delivery care in less privileged women in a country with universal access to health care. © Springer Science+Business Media, LLC 2011.
Dominguez A.,University of Barcelona |
Dominguez A.,CIBER ISCIII |
Nebot M.,CIBER ISCIII |
Nebot M.,Public Health Agency of Barcelona |
And 3 more authors.
Clinical Microbiology and Infection | Year: 2013
The number of elderly patients in the community with immunosuppressive conditions has increased progressively over recent decades. We sought to determine the incidence, causative organisms and outcome of community-acquired pneumonia (CAP) occurring in immunocompromised older patients. We prospectively compared cases of CAP in immunocompromised and non-immunocompromised patients admitted to five public hospitals in three Spanish regions. Of 320 cases studied, 115 (36%) occurred in immunocompromised patients, including: solid or hematological malignancy (97), corticosteroids or other immunosuppressive drugs (44), solid organ or stem cell transplant (five), and other conditions (eight). The etiology was established in 44% of immunocompromised patients vs. 32% of non-immunocompromised patients (p0.03). Streptococcus pneumoniae was the most common causative organism in both groups (29% vs. 21%; p0.08), followed by Legionella pneumophila (3% vs. 6%; p0.01). Gram-negative bacilli were more frequent among immunocompromised patients (5% vs. 0.5%; p<0.01), particularly Pseudomonas aeruginosa (3% vs. 0%; p0.04). Nocardiosis was only observed in immunocompromised patients (two cases). Bacteremia occurred similarly in the two groups. No significant differences were found with respect to ICU admission (8%, in both groups) or the length of stay (12.5 vs. 10.4days). The early (<48h) (3.5 vs. 0.5%; p0.04) and overall case-fatality rates (12% vs. 3%; p<0.01) were higher in immunocompromised patients. In conclusion, a substantial number of older patients hospitalized for CAP are immunocompromised. Although relatively uncommon, CAP due to gram-negative bacilli, including P. aeruginosa, is more frequent among these patients. CAP occurring in immunocompromised patients causes significant morbidity and mortality. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.
Lopez M.J.,Public Health Agency of Barcelona |
Lopez M.J.,CIBER ISCIII |
Burhoo P.,Mauritius Institute of Education |
Moussa L.,Mauritius Institute of Education |
And 2 more authors.
Environmental Research | Year: 2011
A new smoking regulation came into force in Mauritius in March 2009. Environmental nicotine and particles less than 2.5μm in diameter (PM2.5) were measured in 60 hospitality venues and shopping malls on December 2009. There was presence of secondhand smoke in 69% of the samples. The overall median [IQR] nicotine and PM2.5 concentrations were 0.05 [
PubMed | Public Health Agency of Catalonia, Public Health Agency of Barcelona and CIBER ISCIII
Type: Journal Article | Journal: PloS one | Year: 2016
The epidemiology of cases of acute gastroenteritis (AGE) of viral etiology is a relevant public health issue. Due to underreporting, the study of outbreaks is an accepted approach to investigate their epidemiology. The objective of this study was to investigate the epidemiological characteristics of AGE outbreaks due to norovirus (NoV) and sapovirus (SV) in Catalonia.Prospective study of AGE outbreaks of possible viral etiology notified during two years in Catalonia. NoV and SV were detected by real time reverse transcription polymerase (RT-PCR).A total of 101 outbreaks were registered affecting a total of 2756 persons and 12 hospitalizations (hospitalization rate: 0.8x1,000,000 persons-year); 49.5% of outbreaks were foodborne, 45.5% person to person and 5% waterborne. The distribution of outbreaks according to the setting showed a predominance of catering services (39.6%), nursing homes and long term care facilities (26.8%) and schools (11.9%). The median number of cases per outbreak was 17 (range 2-191). The total Incidence rate (IR) was 18.3 per 100,000 persons-years (95%CI: 17.6-19.0). The highest IR was in persons aged 65 years (43.6x100,000 (95% CI: 41.0-46.2)) (p<0.001). A total of 1065 samples were analyzed with a positivity rate of 60.8%. 98% of positive samples were NoV (GII 56.3%; GI 4.2%; GII+GI 4.2%; non- typable 33.0%). SV was identified in two person-to-person transmission outbreaks in children.These results confirm the relevance of viral AGE outbreaks, both foodborne and person-to-person, especially in institutionalized persons. SV should be taken into account when investigating viral AGE outbreaks.
PubMed | Public Health Agency of Catalonia, University of Barcelona, Public Health Agency of Barcelona and CIBER ISCIII
Type: Journal Article | Journal: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology | Year: 2016
Pertussis vaccination with 4-5 doses of acellular vaccines is recommended in Spain to all children at 2months to 6years of age. The effectiveness of the acellular pertussis vaccination was assessed in this study by comparing the incidence of secondary pertussis in vaccinated (4-5 doses) and unvaccinated or partially vaccinated (0-3 doses) household contacts 1-9years old of confirmed cases of pertussis in Spain in 2012-13. Eighty-five percent of contacts had been vaccinated with 4-5 doses of acellular pertussis vaccines. During the 2-year study period, 64 cases of secondary pertussis were detected among 405 household contacts 1-9 years old: 47 among vaccinated and 17 among unvaccinated or partially vaccinated contacts. The effectiveness for preventing secondary pertussis, calculated as 1 minus the relative risk (RR) of secondary pertussis in vaccinated vs. unvaccinated/partially vaccinated contacts, was 50% [95% confidence interval (CI): 19-69%, p<0.01] when household contacts were vaccinated using DTaP, Tdap, hexavalent or heptavalent vaccines, and it was 51.3% (95% CI: 21-70%, p<0.01) when they were vaccinated using DTaP or TdaP vaccines. The effectiveness adjusted for age, sex, pertussis chemotherapy and type of household contact was 58.6% (95% CI: 17-79%, p<0.05) when contacts were vaccinated using available acellular vaccines, and it was 59.6% (95% CI: 18-80%, p<0.01) when they were vaccinated using DTaP vaccines. Acellular pertussis vaccination during childhood was effective for preventing secondary pertussis in household contacts 1-9years old of pertussis cases in Catalonia and Navarra, Spain.
PubMed | Public Health Agency of Barcelona and Barcelona Health Consortium
Type: Journal Article | Journal: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease | Year: 2016
The Barcelona Tuberculosis Programme was established in 1987, and in 2007 five tuberculosis (TB) clinical units were created to improve the follow-up of cases and contacts. This included the designation of a nurse for case management.To assess the impact of the TB clinical units on the screening programme for TB contacts.Before-after population-based study before (2003-2007) and after (2008-2013) the creation of the clinical units. To determine which factors were related to contact tracing, we fitted a multivariate logistic regression model to estimate odds ratios (OR) with their 95% confidence intervals (CIs).Following the creation of the clinical units, the proportion of prescriptions for latent tuberculous infection among contacts in the clinical units increased from 40.7% to 57.4% (P < 0.001), and treatment adherence from 75.9% to 80.3% (P = 0.035). One factor associated with contact tracing was receiving care after the creation of the clinical units (2008-2013) (OR 1.2, 95%CI 1.0-1.3). During the second period, receiving care outside the clinical units reduced the probability of contact tracing (OR 0.7, 95%CI 0.5-0.9).The creation of the TB clinical units represents an organisational improvement for the study and management of contacts of patients with TB.
Perez-Sautu U.,University of Barcelona |
Costafreda M.I.,University of Barcelona |
Cayla J.,Public Health Agency of Barcelona |
Tortajada C.,Public Health Agency of Barcelona |
And 3 more authors.
Emerging Infectious Diseases | Year: 2011
Six hepatitis A virus antigenic variants that likely escaped the protective effect of available vaccines were isolated, mostly from men who have sex with men. The need to complete the proper vaccination schedules is critical, particularly in the immunocompromised population, to prevent the emergence of vaccine-escaping variants.
Ospina J.E.,Public Health Agency of Barcelona
BMC public health | Year: 2012
The important increase in immigration during recent years has changed the epidemiology and control strategies for tuberculosis (TB) in many places. This study evaluates the effectiveness of intervention with community health workers (CHW) to improve contact tracing among immigrants. The study included all TB cases detected by the Barcelona TB Program from 2000 to 2005 and compared a period without CHW intervention (2000-2002) to a period with CHW intervention (2003-2005). The influence on contact tracing of sex, age, hospital of diagnosis, district of residence, birthplace, HIV, homeless and CHW intervention was analysed by logistic regression. Odds ratio (OR) and 95% confidence intervals (CI) were calculated. 960 foreign born TB cases were detected, 388 in the intervention period. Contact tracing was performed on 65,7% of 201 smear-positive cases during the pre-intervention period compared to 81.6% of 152 smear-positive TB cases during the intervention period (p < 0.001). Risk factors associated with incomplete contact tracing of smear-positive index cases included being diagnosed in two hospitals without contact tracing TB unit (OR = 3.5; CI:1.4-8.9) and (OR = 4.6; CI:1.6-13.5) respectively, birth place in India-Pakistan (OR = 4.4; CI:1.9-10.3) or North Africa (OR = 4.3; CI:1.8-10.5), having an unknown residence (OR = 5.4; CI:1.6-18.0), being HIV-infected (OR = 6.1; CI:2.5-14.8) or homeless (OR = 3.3; CI:1.3-8.2), and the absence of CHW intervention (OR = 2.4; CI:1.3-4.3). The effectiveness of contact tracing for TB control in areas with high immigration can be improved by incorporating CHWs who act as translators, cultural mediators and facilitators who accompany cases and contacts through treatment and follow-up.
News Article | February 26, 2017
Exposure to secondhand smoke has long been associated with negative health effects. A study of secondhand smoke exposure after two smoking bans in Spain, publishing today in Nicotine & Tobacco Research, suggests that overall exposure can be decreased across all settings by comprehensive legislative efforts. The authors reviewed approximately 2,500 adult non-smokers' self-reported rates of tobacco smoke exposure in several public and private settings following smoking bans in 2006 and 2011. The survey results showed significantly lower exposure following the second legislation, with participants reporting their overall exposure falling from 72% in 2006 to 45% in 2011. Exposure decreased across all locations surveyed, beyond the workplaces and hospitality settings covered by the 2011 legislation. For example, exposure also decreased in residences from 29% to 13% and in transportation spaces from 41% to 13%. "The study findings highlight the impact of smoke-free policies, which contradict the hypothesis driven by the tobacco industry that smoke-free legislation merely displace smoking from public to private places," said lead author Esteve Fernández of the Catalan Institute of Oncology. Senior author Maria J. López of the Public Health Agency of Barcelona said that "exposure to secondhand smoke in selected outdoor settings may be further reduced by extending smoke-free legislation." The paper "Changes in secondhand smoke exposure after smoke-free legislation (Spain, 2006-2011)" is available at: https:/