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Ezpeleta G, Navascués A, Viguria N, Herranz-Aguirre M, Juan Belloc SE, Gimeno Ballester J, Muruzábal JC, García-Cenoz M, Trobajo-Sanmartín C, Echeverria A, Martínez-Baz I, Vera-Punzano N, Casado I, López-Mendoza H, Ezpeleta C, Castilla J. Effectiveness of Nirsevimab Immunoprophylaxis Administered at Birth to Prevent Infant Hospitalisation for Respiratory Syncytial Virus Infection: A Population-Based Cohort Study. Vaccines (Basel) 2024; 12:383. [PMID: 38675765 PMCID: PMC11054679 DOI: 10.3390/vaccines12040383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Respiratory syncytial virus (RSV) infection is a frequent cause of hospitalisation in the first few months of life; however, this risk rapidly decreases with age. Nirsevimab immunoprophylaxis was approved in the European Union for the prevention of RSV-associated lower respiratory tract disease in infants during their first RSV season. We evaluated the effectiveness of nirsevimab in preventing hospitalisations for confirmed RSV infection and the impact of a strategy of immunisation at birth. A population-based cohort study was performed in Navarre, Spain, where nirsevimab was offered at birth to all children born from October to December 2023. Cox regression was used to estimate the hazard ratio of hospitalisation for PCR-confirmed RSV infection between infants who received and did not receive nirsevimab. Of 1177 infants studied, 1083 (92.0%) received nirsevimab. The risk of hospitalisation for RSV was 8.5% (8/94) among non-immunised infants versus 0.7% (8/1083) in those that were immunised. The estimated effectiveness of nirsevimab was 88.7% (95% confidence interval, 69.6-95.8). Immunisation at birth of infants born between October and December 2023 prevented one hospitalisation for every 15.3 immunised infants. Immunisation of children born from September to January might prevent 77.5% of preventable hospitalisations for RSV in infants born in 2023-2024. These results support the recommendation of nirsevimab immunisation at birth to children born during the RSV epidemic or in the months immediately before to prevent severe RSV infections and alleviate the overload of paediatric hospital resources.
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Affiliation(s)
- Guillermo Ezpeleta
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
| | - Ana Navascués
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
| | - Natividad Viguria
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- Paediatrics Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Mercedes Herranz-Aguirre
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- Paediatrics Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | | | | | - Juan Carlos Muruzábal
- Gynecology and Obstetrics Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Manuel García-Cenoz
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 31003 Pamplona, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 31003 Pamplona, Spain
| | - Aitziber Echeverria
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 31003 Pamplona, Spain
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 31003 Pamplona, Spain
| | - Noelia Vera-Punzano
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 31003 Pamplona, Spain
| | - Héctor López-Mendoza
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
| | - Carmen Ezpeleta
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 31003 Pamplona, Spain
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López-Mendoza H, González-Álvarez MA, Montañés A. Assessing the effectiveness of international government responses to the COVID-19 pandemic. Econ Hum Biol 2024; 52:101353. [PMID: 38262187 DOI: 10.1016/j.ehb.2024.101353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/10/2023] [Accepted: 01/16/2024] [Indexed: 01/25/2024]
Abstract
This paper examines the effectiveness of non-pharmaceutical measures adopted by governments to control the evolution of the COVID-19 pandemic. Using a Panel VAR model for the OECD countries, we test for Granger causality between the 7-day cumulative incidence, mortality rate, and government response indexes. Granger-type statistics reveal evidence that the evolution of the COVID-19 pandemic influenced the measures taken by governments. However, limited or nonexistent evidence supports the reverse situation. This suggests that government measures were not highly effective in controlling the pandemic. While not implying total ineffectiveness, our results indicate a considerable lack of efficacy, emphasizing a lesson for governments to learn from and correct in preparation for similar events in the future.
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Affiliation(s)
- Héctor López-Mendoza
- CASSETEM Research Group, Department of Economic Analysis, University of Zaragoza, Zaragoza 50005, Spain; Instituto de Salud Pública de Navarra, Pamplona 31003, Spain
| | - María A González-Álvarez
- CASSETEM Research Group, Department of Economic Analysis, University of Zaragoza, Zaragoza 50005, Spain
| | - Antonio Montañés
- CASSETEM Research Group, Department of Economic Analysis, University of Zaragoza, Zaragoza 50005, Spain.
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Del Cura-Bilbao A, López-Mendoza H, Chaure-Pardos A, Vergara-Ugarriza A, Guimbao-Bescós J. Effectiveness of 3 COVID-19 Vaccines in Preventing SARS-CoV-2 Infections, January–May 2021, Aragon, Spain. Emerg Infect Dis 2022; 28:591-598. [PMID: 35195514 PMCID: PMC8888243 DOI: 10.3201/eid2803.212027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Reducing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is a worldwide challenge; widespread vaccination could be one strategy for control. We conducted a prospective, population-based cohort study of 964,258 residents of Aragon, Spain, during December 2020–May 2021. We used the Cox proportional-hazards model with vaccination status as the exposure condition to estimate the effectiveness of 3 coronavirus disease vaccines in preventing SARS-CoV-2 infection. Pfizer-BioNTech had 20.8% (95% CI 11.6%–29.0%) vaccine effectiveness (VE) against infection after 1 dose and 70.0% (95% CI 65.3%–74.1%) after 2 doses, Moderna had 52.8% (95% CI 30.7%–67.8%) VE after 1 dose and 70.3% (95% CI 52.2%–81.5%) after 2 doses, and Oxford-AstraZeneca had 40.3% (95% CI 31.8%–47.7%) VE after 1 dose. All estimates were lower than those from previous studies. Results imply that, although high vaccination coverage remains critical to protect people from disease, it will be difficult to effectively minimize transmission opportunities.
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López-Mendoza H, Montañés A, Moliner-Lahoz FJ. Disparities in the Evolution of the COVID-19 Pandemic between Spanish Provinces. Int J Environ Res Public Health 2021; 18:5085. [PMID: 34064938 PMCID: PMC8151898 DOI: 10.3390/ijerph18105085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/04/2021] [Accepted: 05/09/2021] [Indexed: 12/11/2022]
Abstract
Spain experienced a second wave of the COVID-19 pandemic in autumn 2020, which has been approached with different measures by regional authorities. We analyze the presence of convergence in the cumulative incidence for 14 days (CI14) in provinces and self-governing cities. The Phillips-Sul methodology was used to study the grouping of behavior between provinces, and an ordered logit model was estimated to understand the forces that drive creating the different convergence clubs. We reject the presence of a single pattern of behavior in the evolution of the CI14 across territories. Four statistically different convergence clubs and an additional province (Madrid) with divergent behavior are observed. Provinces with developed agricultural and industrial economic sectors, high mobility, and a high proportion of Central and South American immigrants had the highest level of CI14. We show that the transmission of the virus is not homogeneous in the Spanish national territory. Our results are helpful for identifying differences in determinants that could explain the pandemic's evolution and for formulating hypotheses about the effectiveness of implemented measures.
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Affiliation(s)
- Héctor López-Mendoza
- Directorate-General of Public Health, Aragon Department of Health, 50017 Zaragoza, Spain;
- Preventive Medicine and Public Health Department, Lozano Blesa University Hospital, 50009 Zaragoza, Spain;
| | - Antonio Montañés
- Economic Analysis Department, University of Zaragoza, 50005 Zaragoza, Spain
| | - F. Javier Moliner-Lahoz
- Preventive Medicine and Public Health Department, Lozano Blesa University Hospital, 50009 Zaragoza, Spain;
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Hernández-García I, Román-Calderón F, López-Mendoza H, Aibar-Remón C. [Impact of an intervention to improve the vaccination coverage against streptococcus pneumoniae in hiv patients]. Rev Esp Salud Publica 2019; 93:e201912114. [PMID: 31782756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 11/19/2019] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE People affected by the human immunodeficiency virus (HIV) have a higher risk of invasive pneumococcal disease. Therefore, vaccination against streptococcus pneumoniae is recommended for that group. The objective of this study was to analyze the impact of implementing a hospital appointment to assess vaccination status as part of the vaccination schedule of HIV patients. METHODS We carried out a quasi-experimental uncontrolled before and after study with a sampling of consecutive cases of HIV patients referred to our department from November 1, 2014 to June 30, 2018. The study compared the vaccination coverage on the date of the appointment for an assessment of their vaccination status in our department and after the appointment. The analysis used the chi-squared test and the values on the date of the first appointment were taken as a reference. RESULTS 209 patients were analyzed, and a statistically significant improvement was observed regarding their vaccination coverage: 2.9% of the patients had been vaccinated on the date in which they made an appointment for assessment by our department, and 88.0% were vaccinated after they left (OR [95%CI]: 30.7 [13.92-67.58]) with the 13-valent pneumococcal conjugate vaccine; and 16.3% had been vaccinated on the date they made the first appointment vs. 83.7% after they came to the appointment (OR [95%CI]: 5.2 [3.76-7.04]) with the 23-valent polysaccharide pneumococcal vaccine. CONCLUSIONS Implementing a hospital appointment for vaccination is an effective intervention to improve vaccination coverage against streptococcus pneumoniae in HIV patients.
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Affiliation(s)
- Ignacio Hernández-García
- Servicio de Medicina Preventiva y Salud Pública. Hospital Clínico Universitario Lozano Blesa. Zaragoza. España
| | - Francisco Román-Calderón
- Servicio de Medicina Preventiva y Salud Pública. Hospital Clínico Universitario Lozano Blesa. Zaragoza. España
| | - Héctor López-Mendoza
- Servicio de Medicina Preventiva y Salud Pública. Hospital Clínico Universitario Lozano Blesa. Zaragoza. España
| | - Carlos Aibar-Remón
- Servicio de Medicina Preventiva y Salud Pública. Hospital Clínico Universitario Lozano Blesa. Zaragoza. España
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Hernández-García I, Chaure-Pardos A, Moliner-Lahoz J, Prieto-Andrés P, Mareca-Doñate R, Giménez-Júlvez T, López-Mendoza H, García-Montero JI, Aibar-Remón C. [Absenteeism and associated factors in scheduled visits to a Preventive Medicine outpatient clinic]. J Healthc Qual Res 2018. [PMID: 29530605 DOI: 10.1016/j.cali.2017.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Patient absenteeism in outpatient clinics represents a significant obstacle to the cost-effectiveness of healthcare. The aim of this study was to assess the frequency of absence of patients and its associated factors in scheduled visits to a Preventive Medicine department. PATIENTS AND METHODS The cross-sectional study was carried out in the Service of Preventive Medicine of the Lozano Blesa University Clinical Hospital of Zaragoza. It included all the visits scheduled from 3 January to 31 March 2017. For each visit, the date and time were registered, together with the type (first or consecutive appointments), age, gender, town of residence, country of birth, and underlying disease. The Chi-squared test was used to determine the association between the variables and making the visit, with a multiple logistic regression analysis being performed on the variables in which a significant association was found. RESULTS Of the total of 582 appointments studied, the absenteeism rate was 12.5% (73 out of 582; 13.7% for first appointments and 11.7% for consecutive appointments). Variables that revealed a significant association with patients not attending were: time (9.00-11:15 a. m.; OR=1.84; 95%CI: 1.10-3.08), day of the week (Mondays-Thursdays; OR=3.19; 95%CI: 1.12-9.07), country of birth (outside of Spain; OR=2.09; 95%CI:1.09-3.99), vaccination group (chronic kidney disease during pre-dialysis or dialysis; OR=3.59; 95%CI: 1.57-8.18), and age group (under 52 years old; OR=1.85; 95%CI: 1.08-3.19). CONCLUSIONS The rate of absenteeism is at an intermediate position compared to the outpatient visits for other departments. The detection of associated factors makes it possible to plan specific measures for improvements that may reduce absences.
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Affiliation(s)
- I Hernández-García
- Servicio de Medicina Preventiva y Salud Pública, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
| | - A Chaure-Pardos
- Servicio de Medicina Preventiva y Salud Pública, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - J Moliner-Lahoz
- Servicio de Medicina Preventiva y Salud Pública, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - P Prieto-Andrés
- Servicio de Medicina Preventiva y Salud Pública, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - R Mareca-Doñate
- Servicio de Medicina Preventiva y Salud Pública, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - T Giménez-Júlvez
- Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Miguel Servet, Zaragoza, España
| | - H López-Mendoza
- Servicio de Medicina Preventiva y Salud Pública, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - J I García-Montero
- Servicio de Medicina Preventiva y Salud Pública, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - C Aibar-Remón
- Servicio de Medicina Preventiva y Salud Pública, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
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Lobo A, Campayo A, de-la-Cámara C, Saz P, Salvador H, Lobo-Escolar L, López-Mendoza H, Pírez G, Calvo ME, Ventura T, Lobo E, Marco C. The teaching of liaison psychiatry. J Psychosom Res 2012; 72:457-9. [PMID: 22656443 DOI: 10.1016/j.jpsychores.2012.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 01/13/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To document performance and satisfaction of medical students in a short course on liaison psychiatry. METHODS The emphasis in this optional course is placed on the discussion of clinical cases, bed-side clinical teaching, and a research-oriented part. The "Innovative Teaching Plan" (ITP) is intended to train student-leaders to guide small groups (SG) of students. Trainee performance was assessed by the marks in the final examination, and a reliable and valid tool, the Medical Teaching Quality Questionnaire (MTQQ) was used to document trainee satisfaction. The results of four academic courses are presented in this report. RESULTS External experts consulted assured that the content of the course was adequate. It has been completed by more than 200 medical students, and high marks have been obtained by most. Above average scores (AA, "high" or "very high") were given by substantial proportions of students in most items, related to the "relevance" of the subject, the "usefulness of the clinical cases" or the "enhancement of student-teacher interaction". Compared to the first academic course, students' satisfaction has improved. "Enhancement of a researcher's mind" was rated AA by 61.1% of students in the last academic course, and "global satisfaction" by 88.8%. CONCLUSIONS Good performance and high satisfaction of medical students was documented in a course on liaison psychiatry. Lessons may be drawn to inform about efficient and effective ways of teaching and learning this subject.
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Affiliation(s)
- Antonio Lobo
- Department of Psychiatry, University of Zaragoza, Zaragoza, Spain.
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