Public Health Agency of Catalonia

Barcelona, Spain

Public Health Agency of Catalonia

Barcelona, Spain
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Plans-Rubio P.,Public Health Agency of Catalonia
Open Pharmacoeconomics and Health Economics Journal | Year: 2012

Two priority-setting frameworks to decide how to allocate limited resources among available treatments were developed, the first one based on cost-effectiveness and the second one based on cost-effectiveness and a social welfare function (SWF). The framework based on cost effectiveness gives a higher priority to therapies with lower average or incremental cost-effectiveness ratios. The framework based on cost effectiveness and a SWF takes into account social aversion to inequality in the distribution of health-related gains, and gives a higher priority to independent therapies associated with values of ε consistent with the social welfare function. The framework to set priorities based on cost effectiveness maximizes effectiveness from available resources, but in non-utilitarian societies, it could not maximize health-related social welfare. The framework based on cost-effectiveness and a SWF maximizes health-related social welfare in non-utilitarian societies when several independent and mutually exclusive therapies are available. This framework can reduce health inequalities among different groups of patients, since it reduces the cost of treating all groups of patients with at least one therapy. In conclusion, the framework based on cost effectiveness could be used to decide priorities in utilitarian societies, and the framework based on cost effectiveness and a SWF could be used in non-utilitarian societies. © Pedro Plans-Rubió Licensee Bentham Open.

Plans-Rubio P.,Public Health Agency of Catalonia | Plans-Rubio P.,CIBER ISCIII
Expert Review of Anti-Infective Therapy | Year: 2014

Elimination of measles and rubella in Europe is a feasible objective, but it requires achieving a maintaining a high prevalence of protected individuals in order to prevent cases and outbreaks from imported cases. The epidemiology of measles and rubella in Europe in the period 2003-2013 suggests that we are far away from the elimination target for measles, while the situation is better for rubella. In this situation, a new preventive strategy based on serological surveillance systems should be developed in Europe in order to identify and immunise individuals in population groups without sufficient herd immunity against measles and rubella. © 2014 Informa UK, Ltd..

Hurtado J.C.,University of Barcelona | Mosquera M.M.,University of Barcelona | de Lazzari E.,University of Barcelona | Martinez E.,University of Barcelona | And 7 more authors.
BMC Infectious Diseases | Year: 2015

Background: Influenza virus infections are responsible for significant morbidity and mortality in both pediatric and adult populations worldwide. Rapid and accurate diagnosis of influenza is necessary for appropriate patient management during the influenza season and for optimal utilization of anti-influenza therapy. We prospectively tested the accuracy of a simple and rapid diagnostic method. Methods: Ninety-eight samples (nasal and pharyngeal swabs) from patients with upper respiratory tract infection symptoms who presented to primary healthcare centres in Barcelona (Spain) were prospectively analyzed. The samples were collected as part of influenza surveillance program. Samples that had enough volume to make the new test after aliquoting the amount needed to perform routine tests were included. None of the samples were pre-selected as a result of their status in relation to influenza virus. Samples were analyzed by in-house real-time PCR and Alere™ i Influenza A & B (Alere™ i), which uses isothermal amplification of nucleic acids for the qualitative detection of influenza A and B in nasal swabs transported in viral transport media. The two techniques were compared by positive percent agreement (PPA) and negative percent agreement (NPA). Statistical analysis was performed with Stata. Results: Of the 98 samples analysed 90 were concordant; 46 (46.9%) were positive and 44 (44.9%) were negative. Five samples showed invalid results with the Alere™ i test and could be not re-tested due to insufficient sample volume and were not included in the final statistical analysis. In the 93 remaining samples, the Alere™ i test showed 97% of accuracy having correctly classified 90 samples. We obtained discordant results in 3 samples (3%). The PPA was 93.8% for influenza A and 94.1% for influenza B, and NPA was 100% for influenza A and influenza B virus. In addition, the Alere™ i was very rapid (15 minutes or less) and extremely easy to use. Conclusions: The Alere™ i test provided a good correlation compared to the real-time PCR test for the diagnosis of influenza. Since this method can be performed in minutes, it allows immediate, accurate clinical decisions to prescribe appropriate antiviral treatment or isolation of patients. © Hurtado et al.

Plans P.,Public Health Agency of Catalonia | Plans P.,CIBER ISCIII | Torner N.,Public Health Agency of Catalonia | Torner N.,CIBER ISCIII | And 3 more authors.
International Journal of Infectious Diseases | Year: 2014

Objectives: The objective of this study was to assess the association between lack of herd immunity in some population groups and the re-emergence of measles in Catalonia in 2006. Methods: Herd immunity was considered established in the different population groups when the prevalence of positive serological results to measles was higher than the herd immunity threshold of 90%. The Chi-square test and the odds ratio were used to assess the association between lack of herd immunity and measles cases in the outbreak of 2006-2007. Results: Herd immunity was not established against measles in individuals aged 0-14 years and 25-34 years, as the prevalence of positive serological results was <90% in these groups. In the measles outbreak of 2006-2007, 91% of cases occurred in age groups without herd immunity, and only 9% of cases occurred in age groups with herd immunity (p<. 0.001). The odds ratio for the association between lack of herd immunity and measles cases in the outbreak of 2006-2007 was 104 (p<. 0.001). Conclusion: Lack of herd immunity in individuals aged. <. 35 years could be one of the factors underlying the re-emergence of measles in Catalonia. © 2013 The Authors.

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.

Plans P.,Public Health Agency of Catalonia | Plans P.,CIBER ISCIII
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2013

Herd immunity blocks the transmission of measles, mumps and rubella in a population group when the prevalence of positive serologic results (p) is higher than a critical value (p c), known as the herd immunity threshold. A new preventive strategy should be developed in order to achieve the elimination of measles, rubella and mumps in Europe based on the serological assessment of herd immunity levels in different population groups. This strategy could detect population groups without herd immunity (p < p c) and indicate the additional vaccination coverage required in these groups in order to establish herd immunity and prevent outbreaks. The serological assessment of herd immunity levels in Catalonia, Spain, showed that herd immunity had not been established for measles and mumps in schoolchildren (5-9 years of age) and youths/younger adults (15-29 years of age), and that the additional vaccination coverage required to establish herd immunity in these groups was 1-7 %. The new preventive strategy should be used to detect priority population groups for preventive and surveillance activities in European countries. © 2013 Springer-Verlag Berlin Heidelberg.

Colom J.,Public Health Agency of Catalonia | Scafato E.,Instituto Superiore Of Sanita | Segura L.,Public Health Agency of Catalonia | Gandin C.,Instituto Superiore Of Sanita | And 2 more authors.
Frontiers in Psychiatry | Year: 2014

Alcohol related health problems are important public health issues and alcohol remains one ofthe leading risk factors of chronic health conditions. In addition, only a small proportion ofthose who need treatment access it, with figures ranging from 1 in 25 to 1 in 7. In thiscontext, Screening and Brief Interventions (SBI) have proven to be effective in reducingalcohol consumption and alcohol related problems in primary health care (PHC) and are verycost effective, or even cost-saving, in PHC. Even if the widespread implementation of SBIhas been prioritized and encouraged by the WHO, in the global alcohol strategy, the evidenceon long term and population level effects is still weak. This review study will summarize the SBI programs implemented by six European countrieswith different socio-economic contexts. Similar components at health professional level butdifferences at organizational level, especially on the measures to support clinical practice, incentives and monitoring systems developed were adopted. In Italy cost-effectivenessanalyses and Internet trials shed new light on limits and facilitators of renewed, evidencebasedapproaches to better deal with brief intervention in PHC. The majority of the effortswere aimed at overcoming individual barriers and promoting health professionals'involvement. The population screened have been in general too low to be able to detect anypopulation level effect, with a negative impact on the acceptability of the program to allstakeholders. This paper will present a different point of view based on a strategic broadening of theimplemented actions to real inter-sectoriality and a wider holistic approach. Effective alcoholpolicies should strive for quality provision of Health Services (HS) and the empowerment ofthe individuals in a Health System (HSys) approach. © 2014 Colom, Scafato, Segura, Gandin and Struzzo.

Fuentes C.,University of Barcelona | Guix S.,University of Barcelona | Perez-Rodriguez F.J.,University of Barcelona | Fuster N.,University of Barcelona | And 3 more authors.
Food Microbiology | Year: 2014

A quadruplex Real-Time RT-PCR assay for the simultaneous quantitative detection of hepatitis A virus (HAV), norovirus (NoV) GI and GII, and mengovirus (used as process control for determination of the virus/nucleic acid extraction efficiency) has been developed. This multiplex assay has been comparatively evaluated with the individual monoplex assays and showed to be slightly less sensitive, with average δCq values of 0.90, 0.28 and 0.44 for HAV, NoV GI and NoV GII, respectively, in standard curves of viral RNA, or 0.32, 0.37 and 0.51 for the same viruses respectively, in naturally-contaminated samples. These δCq values were mostly negligible since it represented, in the worst case scenario, a loss of 0.43 log in genome copy numbers.The quadruplex assay shows similar theoretical detection limits than the monoplex assay for NoV GII, and 10 times higher for HAV and NoV GI. However, when naturally-contaminated food and water samples were tested, these theoretical detection thresholds were often exceeded and very low genome copy numbers (below the limit of detection) could be quantified.The quadruplex assay fulfills the requirements of the method developed by the European Committee on Standardization (CEN) for virus detection in selected foodstuffs with significant advantages in labor and reagent costs. © 2013.

Vila M.,CSIC - Institute of Marine Sciences | Abos-Herrandiz R.,Catalan Health Institute | Isern-Fontanet J.,CSIC - Institute of Marine Sciences | Alvarez J.,Public Health Agency of Catalonia | Berdalet E.,CSIC - Institute of Marine Sciences
Scientia Marina | Year: 2016

Blooms of the benthic dinoflagellate Ostreopsis have been related to sporadic acute respiratory symptoms and general malaise in people exposed to marine aerosols on some Mediterranean beaches. However, the direct link between recurrent Ostreopsis blooms and health problems has not been clearly established. In order to establish and elucidate the connection, we conducted a joint ecology and epidemiology study in an Ostreopsis hot spot. Throughout the bloom, which extended from the end of June until the end of October 2013, 81% of the human cohort that we studied experienced at least one Ostreopsis-related symptom. Paradoxically, the time when the effects were greatest was during a short time window in early August. This corresponded to the transition from the exponential growth to the stationary phase of the bloom. Negligible symptoms were reported from August to mid-October, during the stationary period of the proliferation, when O. cf. ovata maintained high concentrations of epiphytic cells. No clear patterns in the landward wind component were noted during the time when health effects were greatest. Our main hypothesis is that the irritants present in the aerosol are produced during a particular physiological phase of the Ostreopsis cells during the bloom. © 2016 CSIC.

Colom Farran J.,Public Health Agency of Catalonia
European Addiction Research | Year: 2012

The aim of this study was to evaluate the feasibility of conducting double-blind controlled randomized clinical trials using twice-a-day immediate-release oral diacetylmorphine (DAM) in heroin-dependent patients, by means of measuring the capacity of oral DAM to block opiate withdrawal and clinicians' ability to distinguish it from morphine and methadone. This was a randomized, phase II, double-blind, multicenter pilot study comparing immediate-release oral DAM, slow-release oral morphine and oral methadone administered twice a day during 10 days. Forty-five heroin-dependent patients were randomly assigned to these three treatment groups in an inpatient regime. Patients were stabilized with a mean of 350 mg (SD = 193) of immediate-release oral DAM, 108 mg (SD = 46.2) of slow-release oral morphine and 40 mg (SD = 17.9) of methadone. No statistically significant differences were found between any studied medication in clinical outcome. Neither patients nor clinicians were able to identify the administered medication. This study shows the feasibility of double-blind clinical trials using b.i.d. immediate-release oral DAM allowing further phase III clinical trials in the process of introducing oral DAM as a medication for heroin-dependent patients not responding to standard maintenance treatments. Copyright © 2012 S. Karger AG, Basel.

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