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In Spain, leishmaniasis is an endemic zoonosis present in most of the Iberian Peninsula and the Balearic Islands. The parasite detected is Leishmania infantum and the main reservoir is the dog. Competent vectors to transmit the parasite are sandflies, of which there are two species distributed throughout the Iberian Peninsula and the Balearic Islands. This article reviews the current situation and the behaviour of leishmaniasis in Spain. It analyzes and compares information about the disease from hospital discharges and from the National Epidemiological Surveillance Network. It also analyses the risk factors that facilitate transmission identified in previous studies. Since 2009 an outbreak is occurring in the southwest part of the Community of Madrid, with a significant number of cases, about 400 and the detection of a new reservoir, the hare. The conditions that can increase the incidence of leishmaniasis are linked to the increase number of infected vectors, increase sandfly density, increase hosts or the appearance of new reservoirs in a geographic area. This infection has got a complex transmission dynamic. To timely respond to outbreaks a comprehensive and multisectoral action plan should be developed joined by all the institutions involved in the preparation and response. Before an outbreak occurs, it is important to study all the factors affecting the transmission in that place and to adapt the action plan to the specific characteristics. Source

Jimenez-Garcia R.,Rey Juan Carlos University | Rodriguez-Rieiro C.,Rey Juan Carlos University | Hernandez-Barrera V.,Rey Juan Carlos University | Andres A.L.D.,Rey Juan Carlos University | And 3 more authors.
Vaccine | Year: 2011

We aim to assess the effectiveness of age-based strategies to increase influenza vaccination coverage among high risk subjects. To do so, we describe and compare the influenza vaccination coverage in the 2006/2007 campaign between the Autonomous Community of Madrid (ACM), where in year 2005 the recommendation was extended by 5 years to cover all those aged 60 and over, and other regions of Spain where the universally recommended age was 65 years and above. We used individualized secondary data provided by two surveys carried out in 2007 in ACM and in the rest of Spain. The total number of subjects included in the study was 21,948. For the 60-64 years age group influenza vaccination coverage was significantly higher 40.1% (CI 95% 36.4-43.8) in ACM residents than among residents in the Rest of Spain 29.1% (CI 95% 24.5-33.7). The difference in vaccine uptake was even greater, 59% (CI 95% 51.8-66.2) vs. 43.5%(CI 95% 34.3-52.7), when we compared subjects who suffered a chronic condition, which represents an indication for the anti-influenza vaccination. The results of the multivariate analysis show that the probability of a subject aged 60-64 living in ACM of being vaccinated was almost two times higher (OR 1.95 CI 95% 1.46-2.61) than a person of the same age who lived in a region of Spain where the universal recommendation for influenza vaccine started at 65 years. In conclusion, the available evidence indicates the effectiveness of age-based strategies to increase influenza vaccination coverage among high risk subjects aged 60-64 years in our population. © 2011 Elsevier Ltd. 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 26 more authors.
Journal of Epidemiology and Community Health | Year: 2015

Background: Socioeconomic inequalities are increasingly recognised as an important public health issue, although their role in the leading causes of mortality in urban areas in Europe has not been fully evaluated. In this study, we used data from the INEQCITIES study to analyse inequalities in cause-specific mortality in 15 European cities at the beginning of the 21st century. Methods: A cross-sectional ecological study was carried out to analyse 9 of the leading specific causes of death in small areas from 15 European cities. Using a hierarchical Bayesian spatial model, we estimated smoothed Standardized Mortality Ratios, relative risks and 95% credible intervals for cause-specific mortality in relation to a socioeconomic deprivation index, separately for men and women. Results: We detected spatial socioeconomic inequalities for most causes of mortality studied, although these inequalities differed markedly between cities, being more pronounced in Northern and Central-Eastern Europe. In the majority of cities, most of these causes of death were positively associated with deprivation among men, with the exception of prostatic cancer. Among women, diabetes, ischaemic heart disease, chronic liver diseases and respiratory diseases were also positively associated with deprivation in most cities. Lung cancer mortality was positively associated with deprivation in Northern European cities and in Kosice, but this association was non-existent or even negative in Southern European cities. Finally, breast cancer risk was inversely associated with deprivation in three Southern European cities. Conclusions: The results confirm the existence of socioeconomic inequalities in many of the main causes of mortality, and reveal variations in their magnitude between different European cities. Source

Rodriguez-Rieiro C.,Hospital General Universitario Gregorio Maranon | Esteban-Vasallo M.D.,Subdireccion de Promocion de la Salud y Prevencion | Dominguez-Berjon M.F.,Subdireccion de Promocion de la Salud y Prevencion | Astray-Mochales J.,Subdireccion de Promocion de la Salud y Prevencion | And 4 more authors.
Vaccine | Year: 2011

This study aimed to ascertain the coverage of vaccination against pandemic influenza in individuals aged over 6 months for whom vaccination is indicated due to a chronic health condition using as data source clinical information recorded in the primary care clinical history. Of all those for whom vaccination was indicated (1,114,632), 14.6% (162,616) finally received the vaccine. There were statistically significance differences in coverage for sex (16.5% for men and 13.1% for women), age groups (5% for people under 30 years and 20% for those over 60), number of chronic conditions (11.1% for one condition, 22.5% for two conditions, and 31.3% for three or more conditions) and depending on the chronic health condition considered. The probability of being vaccinated increased with male sex, age, number of indications, type of medical card (lower among no income) and having been vaccinated against 2009 season influenza. We concluded that the coverage finally reached for those people with an indication due to chronic health condition in the H1N1 campaign was much lower than expected and wished. It is essential to investigate the different factors that could have intervened in the behavior of the population so that more efficient approaches can be adopted in future influenza pandemics. © 2010 Elsevier Ltd. Source

Rodriguez-Rieiro C.,Hospital General Universitario Gregorio Maranon | Dominguez-Berjon M.F.,Subdireccion de Promocion de la Salud y Prevencion | Esteban-Vasallo M.D.,Subdireccion de Promocion de la Salud y Prevencion | Sanchez-Perruca L.,Subdireccion de Gestion Y Seguimiento de Objetivos de Atencion Primaria | And 4 more authors.
Vaccine | Year: 2010

Using electronic clinical records in primary care (ECRPC) of the entire population living in the Autonomous Community of Madrid, Spain (5,102,568 persons) as a data source, this study aimed to ascertain seasonal anti-influenza vaccination coverage in the chronically ill at-risk children (aged 6 months to14 years) and adults (15-59 years).Of the total population aged 6 months to 59 years with a medical card in the Autonomous Community of Madrid, 10.3% (n=528,095 patients) had a chronic condition for which anti-influenza vaccination was indicated. In children with chronic conditions, coverage was 27.1% and it was particularly high among diabetics (41.1%) and particularly low in children with " other pulmonary conditions" (15.2%). In adults with chronic conditions, coverage was 22.1% and in patients with diagnosed heart failure coverage reached 39.1%; with the lowest coverage was observed in patients suffering neuromuscular diseases (12.8%).The factors associated with vaccination among children and adults suffering a chronic condition included: having been vaccinated during the previous campaign, national origin (lower among immigrants), and having more than one chronic condition.In conclusion, our study shows that vaccination coverage for 2009 seasonal influenza in children and adults with chronic conditions living in Madrid (Spain) was less than acceptable. © 2010 Elsevier Ltd. Source

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