Spatial distribution and temporal dynamics of invasive and native mosquitoes in a large Mediterranean city

Mosquitoes, including invasive species like the Asian tiger mosquito Aedes albopictus, alongside native species Culex pipiens s.l., pose a significant nuisance to humans and serve as vectors for mosquito-borne diseases in urban areas. Understanding the impact of water infrastructure characteristics, climatic conditions, and management strategies on mosquito occurrence and effectiveness of control measures to assess their implications on mosquito occurrence is crucial for effective vector control. In this study, we examined data collected during the local vector control program in Barcelona, Spain, focusing on 234,225 visits to 31,334 different sewers, as well as 1817 visits to 152 fountains between 2015 and 2019. We investigated both the colonization and recolonization processes of mosquito larvae within these water infrastructures. Our findings revealed higher larval presence in sandbox-sewers compared to siphonic or direct sewers, and the presence of vegetation and the use of naturalized water positively influenced larval occurrence in fountains. The application of larvicidal treatment significantly reduced larvae presence; however, recolonization rates were negatively affected by the time elapsed since treatment. Climatic conditions played a critical role in the colonization and recolonization of sewers and urban fountains, with mosquito occurrence exhibiting non-linear patterns and, generally, increasing at intermediate temperatures and accumulated rainfall levels. This study emphasizes the importance of considering sewers and fountains characteristics and climatic conditions when implementing vector control programs to optimize resources and effectively reduce mosquito populations.

[Contact tracing in patients infected with SARS-CoV-2. The fundamental role of Primary Health Care and Public Health]

Con el objetivo de favorecer la rápida identificación de los contactos de pacientes infectados por SARS-CoV-2 y por tanto el control de la pandemia, se revisaron diferentes metodologías y recomendaciones sobre estudio de contactos (EECC) aplicables a la Atención Primaria (AP) y a la Salud Pública (SP): artículos en Pubmed sobre COVID-19 y EECC, definiciones de contacto en documentos oficiales, el sistema clásico de EECC en tuberculosis (TB), informaciones sobre apps para EECC y el papel de las pruebas diagnósticas.

Para establecer medidas de prevención y control eficientes, se precisa actuar siempre bajo sospecha clínica, diagnóstico y aislamiento precoz de los casos y de los contactos y su seguimiento. El modelo clásico de EECC en TB es aplicable a esta nueva infección pero acelerando el proceso dado su carácter agudo y su potencial gravedad. Es imprescindible una buena coordinación entre AP y SP y disponer de recursos suficientes.

Use of IP-10 detection in dried plasma spots for latent tuberculosis infection diagnosis in contacts via mail

The aim of this study was to test the use of IP-10 detection in dried plasma from contact studies individuals (contacts of smear positive patients), by comparing it with IP-10 and IFN-γ detection in direct plasma, to establish IP-10 detection in DPS as a useful assay for LTBI diagnosis. Whole blood samples were collected from 80 subjects: 12 with active tuberculosis (TB), and 68 from contact studies. The amount of IFN-γ produced by sensitized T cells was determined in direct plasma by QuantiFERON Gold In-Tube test. IP-10 levels were determined in direct and dried plasma by an in-house ELISA. For dried plasma IP-10 determination, two 25 µl plasma drops were dried in Whatman903 filter paper and sent by mail to the laboratory. Regarding TB patients, 100.0%, 91.7% and 75.0% were positive for IFN-γ detection and IP-10 detection in direct and dried plasma, respectively. In contacts, 69.1%, 60.3% and 48.5% had positive results after IFN-γ and IP-10 in direct and dried plasma, respectively. The agreement among in vitro tests was substantial and IP-10 levels in direct and dried plasma were strongly correlated (r = 0.897). In conclusion, IP-10 detection in dried plasma is a simple and safe method that would help improve LTBI management.

Impact of socio-economic inequities on tuberculosis in a Southern European city: what is the effect of the recession?

INTRODUCTION

Economic crises affect a population's health, particularly among the most deprived. The increase in health inequalities in the latest recession may have influenced the incidence of tuberculosis (TB). We analysed the effect of socio-economic inequities and recession on TB incidence in Barcelona, Spain.

METHODS

We conducted a population-based incidence study of TB cases in Barcelona of patients who started treatment between 2003 and 2015. A multilevel interrupted time-series analysis was performed to analyse differences in incidence trends between the pre-recession (until 2008) and recession periods.

RESULTS

We found differences in TB incidence according to deprivation and immigration status. TB incidence among the most deprived neighbourhoods was 2.72 times higher than the least deprived neighbourhoods. Compared with native-born persons, incidence was nine times higher among those born in Africa, and six times higher among those born in Asia and Oceania. The previous decreasing trend in incidence (4%) was accentuated during the recession (7%).

CONCLUSIONS

TB incidence decreased during the recession, probably due to a reduction in the number of new immigrants and the TB programme. However, incidence was highly unequal between districts with different levels of deprivation, and between foreign-born persons from different geographic regions. Social measures are important to reduce inequalities and TB incidence in Barcelona.

Imported malaria among African immigrants: is there still a relationship between developed countries and their ex-colonies?

Background

The objective of this study was to compare cases of imported malaria originating from the Spanish ex-colony of Equatorial Guinea (EG) with those originating from the rest of Africa (RA).

Methods

All the African cases detected in Barcelona between 1989 and 2007 were investigated in a retrospective analysis. Clinical-epidemiological variables such as sex, age, visiting friends and relatives (VFR), species, hospital admission and chemo-prophylaxis were compared. Data were analysed by logistic regression, calculating the Odds Ratio (OR) and 95% Confidence Intervals (95% CI).

Results

Of the 489 African patients, 279 (57,1%) had been born in EG and 210 (42,9%) in the rest of Africa. The cumulative incidence of imported malaria among those from EG was 179.6 per thousand inhabitants, while in those from the RA it was 33.7 per thousand (p < 0.001). Compliance with chemoprophylaxis (CP) was very low, but there were no differences between the two groups. Comparing those from EG to those from RA, the former were characterized by having more patients in the visiting friends and relatives (VFR) category, and more individuals younger than 15 years or older than 37 years, and more women. They also visited a traveller's health centre more often, had fewer hospital admissions and were less likely to reside in the inner city.

Conclusion

Cases of imported malaria originating in Africa, are more likely to come from the Spanish ex-colony of EG, and VFR are more likely to be affected. It is recommended that developed countries promote prevention programmes, such as CP advice directed at African immigrants, and develop programmes of cooperation against malaria in their ex-colonies.

Imported malaria in a cosmopolitan European city: a mirror image of the world epidemiological situation

Background

International travel and migration have been related with an increase of imported malaria cases. There has been considerable immigration to Barcelona from low-income countries (LIC) in recent years. The objective is to describe the epidemiology and to determine the trends of the disease in Barcelona.

Methods

Analysis of the cases notified among city residents between 1989 and 2005. Patients were classified as: tourists, voluntary workers, resident immigrants (visiting friends and relatives, VFR) and recently arrived immigrants. An analysis was conducted using the chi² test and comparison of means. As a measure of association we calculated the Relative Risk (RR) and Odds Ratio (OR) with a Confidence Interval of 95% (CI) and carried out a trends analysis.

Results

Of the total of 1,579 imported cases notified, 997 (63.1%) lived in Barcelona city, and 55.1% were male. The mean age of patients was 32.7 years. The incidence increased from 2.4 cases/100,000 in 1989 to 3.5 cases/100,000 in 2005 (RR 1.46 CI:1.36–1.55). This increase was not statistically significant (trends analysis, p = 0.36). In terms of reason for travelling, 40.7% were VFR, 33.6% tourists, 12.1% voluntary workers and 13.6% were recently arrived immigrants. The most frequent species found was Plasmodium falciparum (71.3%), mainly in visitors to Africa (OR = 2.3, CI = 1.7–3.2). The vast majority (82.2%) had had some contact with Africa (35.9% with Equatorial Guinea, a Spanish ex-colony) and 96.6% had not completed chemoprophylaxis. Six deaths were observed, all tourists who had travelled to Africa and not taken chemoprophylaxis (3.9% fatality rate).

Conclusion

Over the period studied there is an increase in malaria incidence, however the trend is not statistically significant. Lack of chemoprophylaxis compliance and the association between Africa and P. falciparum are very clear in the imported cases. Most of the patients with malaria did not take chemoprophylaxis.

Acute calcific tendinitis in children

Acute calcific tendinitis is uncommon in children. Clinical manifestations are similar to those in adults. The abrupt onset, functional impairment, and frequent presence of fever suggest an infection. Radiographic findings establish the diagnosis, obviating the need for further investigations.

[Percutaneous catheterization of the subclavian vein and/or the Pirogoff angle]

The approach to the sub-clavian venous axis being carried out blindly, the difficulties encountered oblige one: - to avoid the danger (pleural dome in particular); - to guide the catheter along the sub-clavian axis (and not in the jugular vein) and therefore to know the anatomical landmarks and a precise method. A variant of the CARLE technique, that which is proposed is based on no other anatomical argument than the direction of the sub-clavian axis and of its junction. The puncture site is higher and more external, a guiding finger shows the pathway in such a way as to try and leave the dangers behind the pathway of the needle. The obligatory long tunnelization of the catheter, becomes an advantage (fights against the danger of infection) to be added to the already known advantages of this pathway.

[Necrosis and ischemia of the femoral head during arteritis of the lower extremities. Survey of 138 patients with arteritis and 159 aortographies]

Among 138 subjects suffering form arteritis of the lower limbs, the authors found clinical signs of lesions in one or both hips in 47.6 percent of cases and radiological signs in one or both hips in 42.8 percent of cases. Five patients presented a distinct flattening of the femoral head indicating necrosis at stage III, 19 showed voluminous or multiple dense islets in the femoral collar or head indicating necrotic lesions at stage II, and 26 showed narrowing of the superior joint space mostly on the internal side. The authors think ihat the latter sign indicates ischaemic chondropathy. Eleven of the 138 patients had undergone pertrochanteric phlebography : this was abnormal in all 11 cases. At the same time the authors studied the coxofemorals on 159 aortograms and found, among other anomalies, 2 cases of advanced necrosis at the stage of rupture (stage III). This study tends to confirm the occurrence of necrotic lesions of the femur that are secondary to arteriopathies.