Servicio de Vigilancia de Andalucia

La Roda de Andalucía, Spain

Servicio de Vigilancia de Andalucia

La Roda de Andalucía, Spain

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PubMed | Servicio de Vigilancia de Andalucia, University of León and CIBER ISCIII
Type: | Journal: BMC public health | Year: 2016

Obesity is a world-wide epidemic whose prevalence is underestimated by BMI measurements, but CUN-BAE (Clnica Universidad de Navarra - Body Adiposity Estimator) estimates the percentage of body fat (BF) while incorporating information on sex and age, thus giving a better match. Our aim is to compare the BMI and CUN-BAE in determining the population attributable fraction (AFp) for obesity as a cause of chronic diseases.We calculated the Pearson correlation coefficient between BMI and CUN-BAE, the Kappa index and the internal validity of the BMI. The risks of arterial hypertension (AHT) and diabetes mellitus (DM) and the AFp for obesity were assessed using both the BMI and CUN-BAE.3888 white subjects were investigated. The overall correlation between BMI and CUN-BAE was R(2) = 0.48, which improved when sex and age were taken into account (R(2) > 0.90). The Kappa coefficient for diagnosis of obesity was low (28.7 %). The AFp was 50 % higher for DM and double for AHT when CUN-BAE was used.The overall correlation between BMI and CUN-BAE was not good. The AFp of obesity for AHT and DM may be underestimated if assessed using the BMI, as may the prevalence of obesity when estimated from the percentage of BF.


Baricot M.,Research Center Biomedica En Red Of Epidemiologia lud Publica | Toledo D.,Research Center Biomedica En Red Of Epidemiologia lud Publica | Castilla J.,Research Center Biomedica En Red Of Epidemiologia lud Publica | Castilla J.,Institute Salud Publica Of Navarra | And 14 more authors.
Vacunas | Year: 2013

Influenza is a highly contagious disease that has a significant effect on the community. During the season 2010-2011, the overall rate of hospitalization for severe confirmed influenza in Spain was estimated at 5.76 cases per 100,000 inhabitants, although this number is probably underestimating the problem. Health workers can act as vectors for nosocomial transmission of influenza virus to patients, thus their immunization is an essential aspect in programs for prevention and control of infections associated with health care. In order to investigate the influenza vaccination coverage in season 2011-2012 and in the 3 previous seasons, and also to determine the knowledge and attitudes of medical and primary care professionals in Spain as regards the seasonal and pandemic influenza vaccine, a multicentre study was conducted in 7 regions (Andalusia, Castile and Leon, Catalonia, Valencia, Madrid, Navarra and Basque Country) using an anonymous online questionnaire. The objectives and methodology of the study are presented, as well as the main lessons to be learned from the use of new information technologies and communication, together with the information available for research in Public Health are discussed. © 2013 Elsevier España, S.L. Todos los derechos reservados.


Castilla J.,Institute Salud Publica Of Navarra | Castilla J.,CIBER ISCIII | Godoy P.,CIBER ISCIII | Dominguez A.,CIBER ISCIII | And 24 more authors.
Clinical Infectious Diseases | Year: 2013

Background. In most seasons, the influenza vaccine is effective in preventing influenza, but it is not clear whether it is equally effective in preventing mild and severe cases. We designed a case-control study to compare the effectiveness of the influenza vaccine in preventing outpatient, inpatient, and severe or fatal cases of laboratory-confirmed influenza.Methods. Hospitalized patients (n = 691) with laboratory-confirmed influenza in the 2010-2011 season recruited in 29 Spanish hospitals were individually matched by age, admission/visit date, and province with an outpatient with laboratory-confirmed influenza and an outpatient control. Severe cases were considered those patients admitted to intensive care units or who died in the hospital (n = 177). We compared the influenza vaccine status of controls and outpatient cases, inpatient cases, and severe cases using conditional logistic regression adjusted for potential confounding factors. Severe and nonsevere inpatient influenza cases were compared using unconditional logistic regression. Vaccine effectiveness was (1-odds ratio) × 100.Results. Vaccine effectiveness was 75% (adjusted odds ratio [AOR], 0.25; 95% confidence interval [CI],. 16-.39) in preventing influenza outpatient cases, 60% (AOR, 0.40; 95% CI,. 25-.63) in preventing influenza-associated hospitalizations, and 89% (AOR, 0.11; 95% CI,. 04-.37) in preventing severe cases. In inpatients, influenza vaccination was associated with a lower risk of severe influenza (AOR, 0.42; 95% CI,. 22-.80).Conclusions. Influenza vaccination prevented influenza cases and hospitalizations and was associated with a better prognosis in inpatients with influenza. The combined effect of these 2 mechanisms would explain the high effectiveness of the vaccine in preventing severe cases due to influenza. © 2013 The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.


Dominguez A.,University of Barcelona | Dominguez A.,CIBER ISCIII | Castilla J.,CIBER ISCIII | Castilla J.,Institute Salud Publica Of Navarra | And 22 more authors.
Vaccine | Year: 2012

Vaccines are leading pharmacological measures for limiting the impact of pandemic influenza in the community. The objective of this study was to investigate the effectiveness of influenza (pandemic and seasonal) vaccines in preventing pandemic influenza-associated hospitalization. We conducted a multicenter matched case-control study in 36 Spanish hospitals. Patients hospitalized with confirmed pandemic influenza between November 2009 and February 2010 and two hospitalized controls per case, matched according to age, date of hospitalization and province of residence, were selected. Multivariate analysis was performed using conditional logistic regression. Subjects were considered vaccinated if they had received the vaccine >14 days (seasonal influenza vaccine) or >7 days (pandemic influenza vaccine) before the onset of symptoms (cases) or the onset of symptoms of the matched case (controls). For the pandemic influenza vaccine, vaccination effectiveness (VE) was estimated taking into account only patients recruited from November 23, 2009, seven days after the beginning of the pandemic influenza vaccination campaign.638 cases and 1250 controls were included. The adjusted VE of the pandemic vaccine in the ≥18 years age group was 74.2% (95% CI, 29-90) and that of the influenza seasonal vaccine 15.0% (-34 to 43).The recommendation of influenza vaccination should be reinforced as a regular measure to reduce influenza-associated hospitalization during pandemics and seasonal epidemics. © 2012 Elsevier Ltd.


Dominguez A.,University of Barcelona | Dominguez A.,CIBER ISCIII | Soldevila N.,CIBER ISCIII | Toledo D.,University of Barcelona | And 12 more authors.
PLoS ONE | Year: 2016

Vaccination of the elderly is an important factor in limiting the impact of influenza in the community. The aim of this study was to investigate the factors associated with influenza vaccination coverage in hospitalized patients aged ≥65 years hospitalized due to causes unrelated to influenza in Spain.We carried out a cross-sectional study. Bivariate analysis was performed comparing vaccinated and unvaccinated patients, taking in to account sociodemographic variables and medical risk conditions. Multivariate analysis was performed using multilevel regression models.We included 1038 patients: 602 (58%) had received the influenza vaccine in the 2013-14 season. Three or more general practitioner visits (OR = 1.61; 95% CI 1.19-2.18); influenza vaccination in any of the 3 previous seasons (OR = 13.57; 95% CI 9.45-19.48); and 23-valent pneumococcal polysaccharide vaccination (OR = 1.97; 95% CI 1.38-2.80) were associated with receiving the influenza vaccine. Vaccination coverage of hospitalized elderly people is low in Spain and some predisposing characteristics influence vaccination coverage. Healthcare workers should take these characteristics into account and be encouraged to proactively propose influenza vaccination to all patients aged ≥65 years. © 2016 Domínguez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Castilla J.,Institute Salud Publica Of Navarra | Castilla J.,CIBER ISCIII | Martinez-Baz I.,Institute Salud Publica Of Navarra | Martinez-Baz I.,CIBER ISCIII | And 18 more authors.
Preventive Medicine | Year: 2013

Objective: To evaluate trends in seasonal influenza vaccination coverage in primary healthcare workers (PHCWs) in Spain between 2008 and 2011. Methods: We made an anonymous web survey of PHCWs in 2012. Information on attitudes towards and knowledge of influenza vaccine, and immunization in previous seasons was collected. Self-reported vaccination coverage and factors related to vaccination continuity were analysed. Results: Of 5433 workers contacted, 2625 (48.3%) responded to the survey: 47.0% were general practitioners, 10.3% paediatricians and 42.7% nurses. Their reported vaccination rates from seasons 2008-2009 to 2011-2012 decreased over time: 58.4%, 57.4%, 53.2% and 49.3% (linear trend, p. <. 0.001). Among workers vaccinated in any previous season, 70.2% were vaccinated again in 2011-2012, compared with 5.2% among those not previously vaccinated (p. <. 0.001). Continuity of vaccination increased with age and with the worker or cohabitant having a major chronic condition. Vaccination was higher in workers who recognized vaccination as effective and those worried about being infected or infecting patients. Conclusion: Influenza vaccination coverage in PHCWs has declined, especially after the pandemic. Intensive interventions are needed to change this trend. Knowledge of vaccination should be reinforced by stressing the effectiveness of the vaccine and the risks of influenza for workers and patients. © 2013 Elsevier Inc.


Dominguez A.,University of Barcelona | Dominguez A.,CIBER ISCIII | Castilla J.,CIBER ISCIII | Castilla J.,Institute Salud Publica Of Navarra | And 22 more authors.
Human Vaccines and Immunotherapeutics | Year: 2013

Background: Since influenza predisposes to bacterial pneumonia caused by Streptococcus pneumoniae, studies have suggested that pneumococcal vaccination might reduce its occurrence during pandemics. We assessed the effectiveness of pneumococcal polysaccharide vaccination alone and in combination with influenza vaccination in preventing influenza hospitalization during the 2009.2010 pandemic wave and 2010.2011 influenza epidemic. Results: 1187 cases and 2328 controls were included. The adjusted estimate of effectiveness of pneumococcal vaccination in preventing influenza hospitalization was 41% (95% CI 8.62) in all patients and 43% (95% CI 2.78) in patients aged ≥ 65 y. The adjusted effectiveness of dual PP V23 and influenza vaccination was 81% (95% CI 65.90) in all patients and 76% (95% CI 46.90) in patients aged ≥ 65 y. The adjusted effectiveness of influenza vaccination alone was 58% (95% CI 38.72). Methods: We conducted a multicenter case-control study in 36 Spanish hospitals. We selected patients aged . 18 y hospitalized with confirmed influenza and two hospitalized controls per case, matched according to age, date of hospitalization and province of residence. Multivariate analysis was performed using conditional logistic regression. Subjects were considered vaccinated if they had received the pneumococcal or seasonal influenza vaccine >= 14 d (or >= 7 d for pandemic influenza vaccine) before the onset of symptoms (cases) or the onset of symptoms in matched cases (controls). Conclusions: In elderly people and adults with chronic illness, pneumococcal vaccination may reduce hospitalizations during the influenza season. In people vaccinated with both the influenza and pneumococcal vaccines, the benefit in hospitalizations avoided was greater than in those vaccinated only against influenza. © 2013 Landes Bioscience.


PubMed | University of Barcelona, Subdireccion de Vigilancia, CIBER ISCIII, University of Jaén and 4 more.
Type: Journal Article | Journal: Archivos de bronconeumologia | Year: 2016

Obesity has emerged as a significant independent predictor of severity in pandemic influenzaA (H1N1)pdm09. The aim of this study was to investigate the association between body mass index (BMI) and the risk of hospitalization due to influenza.Hospitalized patients (n=755) with laboratory-confirmed influenza were individually matched by age, admission/visit date, and province with an outpatient (n=783) with laboratory-confirmed influenza and an outpatient control (n=950). We compared the BMI using conditional logistic regression adjusted for potential confounding factors (aOR). The population attributable fraction (PAF) was calculated.A higher BMI was associated with an increased risk of hospitalization compared to both outpatient cases (aOR=1.11; 95%CI: 1.07-1.16) and outpatient controls (aOR=1.04; 95%CI: 1.01-1.07). Compared with normal weight, obesity type I, obesity type II and obesity type III was associated with a greater likelihood of hospitalization compared with outpatient cases (aOR=1.85, 95%CI: 1.05-3.26; aOR=5.24, 95%CI: 1.94-14.15 and aOR=44.38, 95%CI: 4.47-440.5). Compared with normal weight, obesity type II and obesity type III was associated with a greater likelihood of hospitalization compared with outpatient controls (aOR=4.37, 95%CI: 1.79-10.69 and aOR=4.95, 95%CI: 1.45-16.87). In persons without influenza vaccination, all categories of BMI30kg/m(2) were associated with a greater likelihood of hospitalization compared with normal weight in both outpatient cases and outpatient controls. The PAF of hospitalization by influenza due to BMI ranged from 21.9% to 8.5%; in the case of unvaccinated against influenza between 20.5% to 16.9%.A high BMI is associated with an increased risk of hospitalization due to influenza. High percentage of hospital admissions are attributable to their BMI, especially in non vaccinated.


PubMed | University of Barcelona, Hospital Of Mataro, CIBER ISCIII, Consejeria de Sanidad and 4 more.
Type: Journal Article | Journal: PloS one | Year: 2016

Vaccination of the elderly is an important factor in limiting the impact of influenza in the community. The aim of this study was to investigate the factors associated with influenza vaccination coverage in hospitalized patients aged 65 years hospitalized due to causes unrelated to influenza in Spain. We carried out a cross-sectional study. Bivariate analysis was performed comparing vaccinated and unvaccinated patients, taking in to account sociodemographic variables and medical risk conditions. Multivariate analysis was performed using multilevel regression models. We included 1038 patients: 602 (58%) had received the influenza vaccine in the 2013-14 season. Three or more general practitioner visits (OR = 1.61; 95% CI 1.19-2.18); influenza vaccination in any of the 3 previous seasons (OR = 13.57; 95% CI 9.45-19.48); and 23-valent pneumococcal polysaccharide vaccination (OR = 1.97; 95% CI 1.38-2.80) were associated with receiving the influenza vaccine. Vaccination coverage of hospitalized elderly people is low in Spain and some predisposing characteristics influence vaccination coverage. Healthcare workers should take these characteristics into account and be encouraged to proactively propose influenza vaccination to all patients aged 65 years.


PubMed | Servicio Andaluz de Salud, CIBER ISCIII, Servicio de Vigilancia de Andalucia, Agencia de Salud Publica de Catalonia and 3 more.
Type: | Journal: BMC family practice | Year: 2015

To assess the contribution of physician-related factors, especially their influenza vaccine status, in the vaccination coverage of their patients.A study of vaccination coverage was carried out in Spain in 2011-12. The dependent variable (vaccination coverage in patients aged 65 years) was obtained from regional records. Information was gathered on the vaccination of physicians through an anonymous web survey. We compared the vaccination coverage of patients with the vaccination of their physicians using the Student t test. Associations were determined using a multilevel regression model.The coverage in patients aged 65 years was 56.3% and was higher (57.3%) in patients whose physician had been vaccinated than in those whose physician had not (55.2%) (p = 0.008). In the multilevel regression model, vaccination of the physician was associated (p = 0.049) with vaccination of their patients after controlling for the effects of age (p = 0.046), region (p = 0.089), and opinions on the effectiveness of the vaccine (p = 0.013).Vaccination of physicians together with their opinions on the effectiveness of the vaccine may be a predictor of vaccination coverage in their patients. Further studies are required to confirm this.

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