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猴痘病例发现:对西班牙巴塞罗那北部都会区一项初级保健检测项目的评估

Mpox cases finding: Evaluation of a Primary Care detection program in the Northern Metropolitan area from Barcelona (Spain).

作者信息

Martínez-Arias Andrés, Valerio Lluís, Vallès Xavier, Díez Sílvia Roure, Langa Laura Soldevila, Pedregal Èlia Fernandez, Rodríguez Àgueda Hernàndez, Isnard-Blanchard Mar, Simó Josep Maria Bonet, Gil Núria Prat, Cirera Anna, Clotet Bonaventura, Gené Tous Emili

机构信息

Consorci Corporació Sanitària Parc Taulí, Emergency Service, Universitat Autònoma de Barcelona, Medicine Department, Bellaterra, Catalonia, Spain.

Programa de Salut Internacional (PROSICS) Metropolitana nord, Primary Care Service, Universitat Autònoma de Barcelona, Badalona, Catalonia, Spain.

出版信息

Aten Primaria. 2025 Mar;57(3):103089. doi: 10.1016/j.aprim.2024.103089. Epub 2024 Sep 24.

Abstract

MAIN AIM

In July 2022, an extensive outbreak of Mpox (monkeypox) was considered by WHO as a Public Health Emergency. The objective of this study is to describe the obtained results from a Mpox case detection program in a semi-urban healthcare area where approximately 420 Primary Care physicians work.

DESIGN

An observational prospective study performed between June 01, 2022 and December 31, 2023.

SETTING

The Northern Metropolitan area of Barcelona, with 1400.000hab (Catalonia, Spain).

METHODS

An unified Mpox management procedure was agreed, including a prior online training of Primary Care professionals, to individually assess all Mpox suspected cases from a clinical and epidemiological perspective.

PARTICIPANTS

All patients who met clinical and/or epidemiological criteria of Mpox.

DATA COLLECTION

Age, gender, risk classification (suspected/probable), cluster-linked (yes/no), high-risk sexual contact (yes/no), general symptoms, genital lesion and final diagnostic.

RESULTS

A total of 68 suspected Mpox cases were included, from which 16 (26.6%) were Mpox confirmed by PCR. Up to 13 (81.2%) were male and, among them, 12 (75%) men who have sex with men (MSM). The series, however, included two minors and three women. Among MSM, 3 (18.7%) were HIV positive and 3 had no regular access to the Public Healthcare system. Among discarded patients, any infectious disease was diagnosed in 55% of cases.

CONCLUSIONS

In spite of the short series, this Primary Care community-based study identified a sub-population group showing a different profile of Mpox cases compared to other published series (lower HIV prevalence, higher representativeness of heterosexual transmission and hard to reach population).

摘要

主要目的

2022年7月,世界卫生组织将大规模猴痘疫情视为突发公共卫生事件。本研究的目的是描述在一个约有420名初级保健医生工作的半城市医疗保健区域内的猴痘病例检测项目所取得的结果。

设计

2022年6月1日至2023年12月31日进行的一项观察性前瞻性研究。

地点

巴塞罗那北部大都市区,有140万居民(西班牙加泰罗尼亚)。

方法

商定了统一的猴痘管理程序,包括对初级保健专业人员进行预先在线培训,以便从临床和流行病学角度对所有猴痘疑似病例进行个体评估。

参与者

所有符合猴痘临床和/或流行病学标准的患者。

数据收集

年龄、性别、风险分类(疑似/可能)、与聚集性相关(是/否)、高风险性接触(是/否)、一般症状、生殖器病变和最终诊断。

结果

共纳入68例猴痘疑似病例,其中16例(26.6%)经聚合酶链反应确诊为猴痘。多达13例(81.2%)为男性,其中12例(75%)为男男性行为者(MSM)。然而,该系列包括两名未成年人和三名女性。在男男性行为者中,3例(18.7%)为艾滋病毒阳性,3例无法正常使用公共医疗系统。在被排除的患者中,55%的病例被诊断为患有其他传染病。

结论

尽管该系列病例数量较少,但这项基于初级保健社区的研究确定了一个亚人群组,与其他已发表的系列相比,该组猴痘病例呈现出不同的特征(艾滋病毒感染率较低、异性传播的代表性较高以及难以接触到的人群)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6743/11459901/2caa15813227/gr1.jpg

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