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Diez M.,Institute Salud Carlos III | Oliva J.,Institute Salud Carlos III | Sanchez F.,Institute Salud Carlos III | Vives N.,Institute Catala dOncologia ICO | And 3 more authors.
Gaceta Sanitaria | Year: 2012

Objective: To describe the incidence of new HIV diagnoses and its trend in Spain. Methods: All new HIV diagnoses notified to the case-registries of 15 autonomous regions (64% of the total Spanish population) in 2009 were analyzed. To evaluate trends from 2004 to 2009, data from only nine regions were available. Clinical-epidemiological data were obtained from the notification forms. Distributions of new HIV diagnoses and late diagnoses according to several variables were performed. The Poisson distribution was used to evaluate trends. Results: In 2009, 2264 new HIV diagnoses were notified, mostly in men (80%). The median age at diagnosis was 36 years (interquartile range 29-43) and 37.6% of affected individuals were immigrants, mostly from Latin-America and sub-Saharan Africa. The most common transmission category (42.5%) was men who have sex with men (MSM) followed by the heterosexual and parenteral modes of transmission (34.5% and 8.1%, respectively). The median CD4 count at diagnosis was 347 (interquartile range: 152-555), and CD4 count was <350 in 50.2% of patients. From 2004 to 2009, the mean incidence rate of new HIV diagnoses was 91.14 per million inhabitants; an increasing trend for rates in MSM, as well as a decreasing trend for the parenteral mode of transmission, were observed. Conclusions: In Spain, the epidemiology of HIV infection has changed since the mid-1990s. Currently, the most frequent transmission category is sexual transmission, particularly among MSM, and immigrants are an important part of the epidemic. Heterogeneous trends for the three main transmission categories were observed from 2004 to 2009. © 2011 SESPAS. Source


Gomez-Barroso D.,CIBER ISCIII | Gomez-Barroso D.,Carlos III Institute of Health | Martinez-Beneito M.A.,Centro Superior Of Investigacion En Salud Publica Csisp Fisabio | Flores V.,Carlos III Institute of Health | And 27 more authors.
Epidemiology and Infection | Year: 2014

The aim of this study was to monitor the spatio-temporal spread of influenza incidence in Spain during the 2009 pandemic and the following two influenza seasons 2010-2011 and 2011-2012 using a Bayesian Poisson mixed regression model; and implement this model of geographical analysis in the Spanish Influenza Surveillance System to obtain maps of influenza incidence for every week. In the pandemic wave the maps showed influenza activity spreading from west to east. The 2010-2011 influenza epidemic wave plotted a north-west/south-east pattern of spread. During the 2011-2012 season the spread of influenza was geographically heterogeneous. The most important source of variability in the model is the temporal term. The model of spatio-temporal spread of influenza incidence is a supplementary tool of influenza surveillance in Spain. Copyright © 2014 Cambridge University Press. Source


Oliva J.,Institute Salud Carlos III | Oliva J.,CIBER ISCIII | Malo C.,Direccion General de Salud Publica | Fernandez A.,Servicio de Vigilancia y Alertas Epidemiologicas | And 8 more authors.
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2014

Objetive To describe linkage to care among new HIV diagnoses in Spain; and to estimate factors associated to linkage to care within three months after diagnosis. Methods The distribution of the time elapsing between the date of HIV diagnosis and the date of first determination of CD4 (considered to be the date of linkage to care) was calculated among new HIV diagnoses in 2010 in the seven Autonomous Regions participating, where data on date of CD4 count was available. Linkage to care was considered «correct» if done within three months after diagnosis. Factors associated to correct linkage to care were estimated using logistic regression. Results A total of 1769 new HIV diagnoses were included. Of them, 83.1% had evidence of linkage to care within a year, and 75.7% were linked within three months after diagnosis. Being an injectable drug user (IDU) was the only factor inversely associated with linkage to care within 3 months (OR = 0.3; 95% CI: 0.2-0.6). Conclusion In Spain linkage to care after HIV diagnosis is good, but there is still room for improvement, especially among IDUs. © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Source


Mari-Dell'Olmo M.,CIBER ISCIII | Mari-Dell'Olmo M.,Biomedical Research Institute Sant Pau | Gotsens M.,CIBER ISCIII | Gotsens M.,Biomedical Research Institute Sant Pau | And 22 more authors.
Journal of Urban Health | Year: 2014

The aim of this study was to analyze the evolution of socioeconomic inequalities in mortality due to ischemic heart diseases (IHD) in the census tracts of nine Spanish cities between the periods 1996-2001 and 2002-2007. Among women, there are socioeconomic inequalities in IHD mortality in the first period which tended to remain stable or even increase in the second period in most of the cities. Among men, in general, no socioeconomic inequalities have been detected for this cause in either of the periods. These results highlight the importance of intra-urban inequalities in mortality due to IHD and their evolution over time. © 2013 The New York Academy of Medicine. Source


Oliva J.,Institute Salud Carlos III | Oliva J.,CIBER ISCIII | Diez M.,Institute Salud Carlos III | Diez M.,CIBER ISCIII | And 14 more authors.
Gaceta Sanitaria | Year: 2014

Objective: To present surveillance data on advanced disease (AD) and late presentation (LP) of HIV in Spain and their determinants. Methods: We included all new HIV diagnoses notified by the autonomous regions that consistently reported such cases throughout the period 2007-2011. Coverage was 54% of the total Spanish population. Data sources consisted of clinicians, laboratories and medical records. AD was defined as the presence of a CD4 cell count <200. cells/μL in the first test after HIV diagnosis, while LP was defined as the presence of a CD4 cell count <350. cells/μL after HIV diagnosis. Odds ratios and their 95% confidence intervals (OR, 95% CI) were used as the measure of association. Logistic regressions were fit to identify predictors of AD and LP. Results: A total of 13,021 new HIV diagnoses were included. Among these, data on the outcome variable were available in 87.7%. The median CD4 count at presentation was 363 (interquartile range, 161-565). Overall, 3356 (29.4%) patients met the definition of AD and 5494 (48.1%) were classified as LP. Both AD and LP increased with age and were associated with male sex and infection through drug use or heterosexual contact. All immigrants except western Europeans were more prone to AD and LP. Multivariate models disaggregated by sex showed that the effect of age and region of origin was weaker in women than in men. Conclusions: Despite universal health care coverage in Spain, men, immigrants and people infected through drug use or heterosexual contact seem to be experiencing difficulties in gaining timely access to HIV care. © 2013 SESPAS. Source

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