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Pulido J, Barrio G, Donat M, Politi J, Moreno A, Cea-Soriano L, Guerras JM, Huertas L, Mateo-Urdiales A, Ronda E, Martínez D, Lostao L, Belza MJ, Regidor E. Excess Mortality During 2020 in Spain: The Most Affected Population, Age, and Educational Group by the COVID-19 Pandemic. Disaster Med Public Health Prep 2024; 18:e27. [PMID: 38372080 DOI: 10.1017/dmp.2024.17] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
OBJECTIVE The objective of this work was to study mortality increase in Spain during the first and second academic semesters of 2020, coinciding with the first 2 waves of the Covid-19 pandemic; by sex, age, and education. METHODS An observational study was carried out, using linked populations and deaths' data from 2017 to 2020. The mortality rates from all causes and leading causes other than Covid-19 during each semester of 2020, compared to the 2017-2019 averages for the same semester, was also estimated. Mortality rate ratios (MRR) and differences were used for comparison. RESULTS All-cause mortality rates increased in 2020 compared to pre-covid, except among working-age, (25-64 years) highly-educated women. Such increases were larger in lower-educated people between the working age range, in both 2020 semesters, but not at other ages. In the elderly, the MMR in the first semester in women and men were respectively, 1.14, and 1.25 among lower-educated people, and 1.28 and 1.23 among highly-educated people. In the second semester, the MMR were 1.12 in both sexes among lower-educated people and 1.13 in women and 1.16 in men among highly-educated people. CONCLUSION Lower-educated people within working age and highly-educated people at older ages showed the greatest increase in all-cause mortality in 2020, compared to the pre-pandemic period.
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Affiliation(s)
- José Pulido
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gregorio Barrio
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Donat
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Julieta Politi
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Almudena Moreno
- Department of Sociology, Universidad Pública de Navarra, Spain
| | - Lucía Cea-Soriano
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan Miguel Guerras
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Lidia Huertas
- Instituto Valenciano de Estadística, Valencia, Spain
- National Epidemiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Elena Ronda
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Preventive Medicine and Public Health Area, Universidad de Alicante, Alicante, Spain
| | - David Martínez
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Lourdes Lostao
- Department of Sociology, Universidad Pública de Navarra, Spain
| | - María José Belza
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Enrique Regidor
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Politi J, Donat M, Guerras JM, Ayerdi O, Palma D, García JN, Barrio G, Belza MJ. Gaps in HIV and Hepatitis C Testing Among 3486 HIV-Negative Men Who have Sex with Men in Spain in the Era of Highly Effective Antiviral Therapies. J Community Health 2024; 49:139-155. [PMID: 37561245 DOI: 10.1007/s10900-023-01259-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/11/2023]
Abstract
High uptake of HIV and hepatitis C (HCV) testing in Gay, bisexual, and other men who have sex with men (GBMSM) is needed to interrupt transmission. The objective was to identify subgroups with increased probability of lack of testing among HIV-negative GBMSM in Spain. Cross-sectional study including 3486 HIV-negative GBMSM attending prevention facilities in Madrid and Barcelona, 2018-2020. Data came from self-administered online sociodemographic, health, and risk behaviors questionnaires. Outcomes were lack of HCV (lifetime) and HIV (lifetime, last year) testing. Crude and adjusted prevalences and prevalence ratios were assessed for each outcome using negative binomial regression models. Lifetime lack of HIV and HCV testing prevalence was 6.3% and 35.8%, respectively, while lack of HIV testing in the last year was 22.4%. Prevalences were also substantial in GBMSM with high-risk behaviors. After sociodemographic adjustment, the highest probability of lack of HCV testing (lifetime) and HIV (last year) was among GBMSM with insufficient viral hepatitis knowledge, no history of STI, or HCV (or HIV) testing, aged < 25, non-outness about sex life with men, and less high-risk behaviors. Lack of HCV (lifetime) and HIV testing (last year) among HIV-negative GBMSM in Spain is still high, despite high-risk behaviors.
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Affiliation(s)
- Julieta Politi
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029, Madrid, Spain
| | - Marta Donat
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Juan Miguel Guerras
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029, Madrid, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Oskar Ayerdi
- Centro Sanitario Sandoval, Instituto de Investigación Sanitaria San Carlos, Hospital Clínico San Carlos, Madrid, Spain
| | - David Palma
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Servicio de Epidemiología, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Jorge Néstor García
- Unidad de ITS de Vall d'Hebron-Drassanes, Hospital Vall d'Hebron, Barcelona, Spain
| | - Gregorio Barrio
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María José Belza
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Donat M, Regidor E, Barrio G, Ambrosio E, Sordo L, Guerras JM, Politi J, Belza MJ. Increase in educational inequalities in alcohol-related mortality in Spain during a period of economic growth. Addiction 2023; 118:1920-1931. [PMID: 37203875 DOI: 10.1111/add.16264] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 05/04/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND AND AIMS Alcohol-related mortality risk is almost always greater in lower than higher socio-economic positions (SEPs). There is little information on the evolution of this SEP gradient and its relationship with the economic cycle. Some results suggest that during economic expansions, there is a hypersensitivity of low-SEP people to harmful drinking. The main objective of this study was to measure the evolution of educational inequality in alcohol-related and non-alcohol related mortality by sex and age group in Spain during 2012-19. DESIGN, SETTING AND MEASUREMENTS This is a repeated cross-sectional study. This study includes all residents in Spain aged 25 years and over from 2012 to 2019. (1) We calculated age-standardized mortality rates (ASMRs) from strongly/moderately alcohol-related causes (directly alcohol-attributable, unspecified liver cirrhosis, liver and upper aerodigestive tract cancers and moderately alcohol-related), weakly alcohol-related causes and other causes by educational level. (2) We used age-adjusted relative index of inequality (RII) and slope index of inequality (SII) to measure relative and absolute educational inequality in mortality, respectively. (3) Age-adjusted annual percentage change (APC) was also used to measure linear trends in mortality by educational level. RII, SII and APC were obtained from negative binomial regression. FINDINGS Between 2012-15 and 2016-19, economic growth accelerated, the RII in mortality from strongly/moderately alcohol-related causes increased from 2.0 to 2.2 among men and from 1.1 to 1.3 among women, and the SII in deaths/100 000 person-years from 181.4 to 190.9 among men and from 18.9 to 46.5 among women. It also increased relative and absolute inequality in mortality from weakly alcohol-related and other causes of death in both men and women. These increases in inequality were due primarily to a flattening or even reversal of the downward mortality trend among low- and medium-educated people. CONCLUSIONS During the economic expansion of 2012-19 in Spain, changes in mortality risk from strongly/moderately alcohol-related causes were especially unfavourable among low- and medium-educated people.
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Affiliation(s)
- Marta Donat
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Enrique Regidor
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Universidad Complutense, Madrid, Spain
- Health Research Institute of San Carlos (IdISSC), Madrid, Spain
| | - Gregorio Barrio
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Emilio Ambrosio
- Department of Psychobiology, Faculty of Psychology, National University of Distance Education (UNED), Madrid, Spain
| | - Luis Sordo
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Universidad Complutense, Madrid, Spain
| | - Juan Miguel Guerras
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Julieta Politi
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
| | - María J Belza
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Donat M, Sordo L, Guerras JM, Politi J, Pulido J, Barrio G. Methodology used to estimate alcohol-attributable mortality in Spain, 2001-2017. Adicciones 2023; 35:265-278. [PMID: 34171110 DOI: 10.20882/adicciones.1611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The objective is to describe and discuss methods and assumptions to estimate the mortality attributable to alcohol in Spain in 2001-2017. The annual mean number of deaths attributable to alcohol (DAAs) was estimated based on 19 groups of alcohol-related causes of death (18 partially attributable and one directly attributable), and 20 alcohol population-attributable fractions (PAFs), resulting from combining sex, 5 age groups, and the periods 2001-2009 and 2010-2017, for each cause group. Deaths from causes were obtained from the Spanish National Institute of Statistics. For partially attributable causes, Spain-specific PAFs were calculated using the Levin formula with alcohol exposure data from health surveys and sales statistics, and relative risks from international meta-analyses. Annual prevalences of ex-drinkers and seven levels of daily alcohol consumption were considered. The underestimation of self-reported daily average consumption with respect to the sales statistics was corrected by multiplying by a factor of 1.58-3.18, depending on the calendar year. DAA rates standardized by age and standardized proportions of general mortality attributable to alcohol, according to sex, age group, calendar period, type of drinker and autonomous community were calculated. Sensitivity analyses were performed to assess how the DAA estimates changed when changing some methodological options, such as the ex-drinker criterion or the introduction of a latency period.
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Affiliation(s)
- Marta Donat
- Escuela Nacional de Sanidad. Instituto de Salud Carlos III.Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP). Madrid..
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Pérez-Romero C, Barrio G, Hoyos J, Belza MJ, Regidor E, Donat M, Politi J, Guerras JM, Pulido J. Abrupt peaks in perceived risk of occasional drug use after changing the question order in a repeated self-administered survey. Front Public Health 2023; 11:971239. [PMID: 37124773 PMCID: PMC10140628 DOI: 10.3389/fpubh.2023.971239] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 03/14/2023] [Indexed: 05/02/2023] Open
Abstract
Background Question-order changes in repeated surveys can distort comparisons. We want to describe the evolution of drug risk perceptions among Spanish adolescents and assessing whether the 2006 peaks in perceived risk of occasional drug use can be explained by question-order changes. Methods The subjects were secondary students from a biennial national survey during 2000-2012. A one-off intervention was applied in 2006, replacing the two-adjacent items on perceived risk of occasional and regular use of each drug by non-adjacent items. Annual prevalence of high-risk perception were obtained for occasional and regular use of cannabis, heroin, cocaine and ecstasy. Subsequently, the 2006 percent level change (PC) in such were estimated prevalence using segmented Poisson regression, adjusting for various student and parent covariates. Results The 2006 PC in prevalence of high-risk perception of occasional drug use ranged from +63% (heroin) to +83% (ecstasy). These PCs were very high in all considered subgroups. However, the 2006 PC in prevalence of high-risk perception of regular drug use ranged from 1% (heroin) to 12% (cannabis). The evolution of preventive interventions does not suggest alternative causal hypotheses for 2006 peaks other than question-order changes. Conclusion Within the cognitive heuristics framework, the 2006 spikes in perceived risk of occasional drug use were most likely due to a release of the anchor exerted by perceived risk of regular drug use over that of occasional use triggered by 2006 question-order changes. In repeated surveys it is inexcusable to pre-test the effect of any change in questionnaire format.
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Affiliation(s)
- César Pérez-Romero
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
| | - Gregorio Barrio
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- The Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
- *Correspondence: Gregorio Barrio,
| | - Juan Hoyos
- The Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | - María J. Belza
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- The Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Enrique Regidor
- The Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Health Research Institute of San Carlos (IdISSC), Madrid, Spain
| | - Marta Donat
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- The Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Julieta Politi
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
| | - Juan Miguel Guerras
- The Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
- National Centre of Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - José Pulido
- The Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
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Politi J, Regidor E, Donat M, Pulido J, Guerras JM, Barrio G, Belza MJ. Free access to direct-acting antivirals in Spain: more favorable impact on hepatitis C mortality among highly educated people. Clin Infect Dis 2022; 76:1423-1430. [PMID: 36471910 DOI: 10.1093/cid/ciac928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
In 2015, hepatitis C treatment with direct-acting antivirals (DAA) became free and widespread in Spain, significantly reducing hepatitis C-related mortality. However, health interventions can sometimes widen health inequalities. The objective is to assess the impact of DAA treatment on hepatitis C-related mortality by educational level.
Methods
We analyzed deaths from hepatitis C, unspecified liver cirrhosis, hepatocellular carcinoma, alcohol-related liver diseases, other liver diseases, and HIV disease among individuals living in Spain during 2012-2019 and aged ≥25 years. We calculated age-standardized mortality rates per million person-years by period, sex, and education. Using Quasi-Poisson segmented regression models, we estimated the annual percent change in rates in pre-and post-intervention periods by education level and the relative inequality index (RII).
Results
Hepatitis C mortality rates among low, middle, and highly educated people decreased from 25.2, 23.2, and 20.3/million person-years in pre-intervention period to 15.8, 13.7, and 10.4 in post-intervention period. Mortality rates from other analyzed causes also decreased. Following the intervention, downward trends in hepatitis C mortality accelerated at all education levels, although more in highly educated people and the RII increased from 2.1 to 2.7. For other analyzed causes of death, no favorable changes were observed in mortality trends, except for liver cirrhosis, hepatocellular carcinoma, HIV disease, and alcohol-related liver disease among higher-educated people.
Conclusion
Results suggest that DAA treatments had a very favorable impact on hepatitis C mortality at all education levels. However, even in a universal and free health care system, highly educated people seem to benefit more from DAA treatment than less educated people.
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Affiliation(s)
- Julieta Politi
- National School of Public Health, Instituto de Salud Carlos III, Madrid , Spain
| | - Enrique Regidor
- CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense , Madrid , Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) , Madrid , Spain
| | - Marta Donat
- National School of Public Health, Instituto de Salud Carlos III, Madrid , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
| | - José Pulido
- CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense , Madrid , Spain
| | - Juan Miguel Guerras
- National School of Public Health, Instituto de Salud Carlos III, Madrid , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
| | - Gregorio Barrio
- National School of Public Health, Instituto de Salud Carlos III, Madrid , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
| | - María José Belza
- National School of Public Health, Instituto de Salud Carlos III, Madrid , Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
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7
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Politi J, Guerras JM, Donat M, Belza MJ, Ronda E, Barrio G, Regidor E. Favorable impact in hepatitis C-related mortality following free access to direct-acting antivirals in Spain. Hepatology 2022; 75:1247-1256. [PMID: 34773281 DOI: 10.1002/hep.32237] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 04/09/2021] [Revised: 11/01/2021] [Accepted: 11/05/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Free treatments for HCV infection with direct-acting antivirals became widespread in Spain in April 2015. We aimed to test whether, after this intervention, there was a more favorable change in population mortality from HCV-related than from non-HCV-related causes. APPROACH AND RESULTS Postintervention changes in mortality were assessed using uncontrolled before-after and single-group interrupted time series designs. All residents in Spain during 2001-2018 were included. Various underlying death causes were analyzed: HCV infection; other HCV-related outcomes (HCC, liver cirrhosis, and HIV disease); and non-C hepatitis, other liver diseases, and nonhepatic causes as control outcomes. Changes in mortality after the intervention were first assessed by rate ratios (RRs) between the postintervention and preintervention age-standardized mortality rates. Subsequently, using quasi-Poisson segmented regression models, we estimated the annual percent change (APC) in mortality rate in the postintervention and preintervention periods. All mortality rates were lower during the postintervention period, although RRs were much lower for HCV (0.53; 95% CI, 0.51-0.56) and HIV disease than other causes. After the intervention, there was a great acceleration of the downward mortality trend from HCV, whose APC went from -3.2% (95% CI, -3.6% to -2.8%) to -18.4% (95% CI, -20.6% to -16.3%). There were also significant accelerations in the downward trends in mortality from HCC and HIV disease, while they remained unchanged for cirrhosis and slowed or reversed for other causes. CONCLUSIONS These results suggest that the favorable changes in HCV-related mortality observed for Spain after April 2015 are attributable to scaling up free treatment with direct-acting antivirals and reinforce that HCV eradication is on the horizon.
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Affiliation(s)
- Julieta Politi
- National Epidemiology CenterInstituto de Salud Carlos IIIMadridSpain.,Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB (Parc de Salut Mar-Pompeu Fabra University, Agència de Salut Pública de Barcelona)BarcelonaSpain.,National School of Public HealthInstituto de Salud Carlos IIIMadridSpain
| | - Juan-Miguel Guerras
- National Epidemiology CenterInstituto de Salud Carlos IIIMadridSpain.,CIBER Epidemiología y Salud PúblicaMadridSpain
| | - Marta Donat
- National School of Public HealthInstituto de Salud Carlos IIIMadridSpain.,CIBER Epidemiología y Salud PúblicaMadridSpain
| | - María J Belza
- National School of Public HealthInstituto de Salud Carlos IIIMadridSpain.,CIBER Epidemiología y Salud PúblicaMadridSpain
| | - Elena Ronda
- CIBER Epidemiología y Salud PúblicaMadridSpain.,Preventive Medicine and Public Health AreaUniversidad de AlicanteAlicanteSpain
| | - Gregorio Barrio
- National School of Public HealthInstituto de Salud Carlos IIIMadridSpain.,CIBER Epidemiología y Salud PúblicaMadridSpain
| | - Enrique Regidor
- CIBER Epidemiología y Salud PúblicaMadridSpain.,Department of Public Health & Maternal and Child HealthFaculty of MedicineUniversidad ComplutenseMadridSpain.,Instituto de Investigación Sanitaria del Hospital Clínico San CarlosMadridSpain
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8
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Politi J, Queralt A, Valero N, Martín-Gómez MT, Durán RG, Parra E, Camps SS, Avellanés I, Hernández-Pineda A, Masdeu E, Rius C, Álamo-Junquera D. Vehicle Windshield Wiper Fluid as Potential Source of Sporadic Legionnaires’ Disease in Commercial Truck Drivers. Emerg Infect Dis 2022; 28:841-843. [PMID: 35318929 PMCID: PMC8962911 DOI: 10.3201/eid2804.210814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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9
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Álamo-Junquera D, Politi J, Simón P, Dieli-Crimi R, Borrell RP, Colobran R, Martínez-Gallo M, Campins M, Antón A, Esperalba J, Andrés C, Codina MG, Polverino E, Narciso MR, Molinero E, Rius C. Coordinated Response to Imported Vaccine-Derived Poliovirus Infection, Barcelona, Spain, 2019-2020. Emerg Infect Dis 2021; 27:1513-1516. [PMID: 33900188 PMCID: PMC8084499 DOI: 10.3201/eid2705.204675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In 2019, the Public Health Agency of Barcelona, Spain, was notified of a vaccine-derived poliovirus infection. The patient had an underlying common variable immunodeficiency and no signs of acute flaccid paralysis. We describe the ongoing coordinated response to contain the infection, which included compassionate-use treatment with pocapavir.
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Politi J, Martín-Sánchez M, Mercuriali L, Borras-Bermejo B, Lopez-Contreras J, Vilella A, Villar J, Orcau A, de Olalla PG, Rius C. Epidemiological characteristics and outcomes of COVID-19 cases: mortality inequalities by socio-economic status, Barcelona, Spain, 24 February to 4 May 2020. ACTA ACUST UNITED AC 2021; 26. [PMID: 34018483 PMCID: PMC8138960 DOI: 10.2807/1560-7917.es.2021.26.20.2001138] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Population-based studies characterising outcomes of COVID-19 in European settings are limited, and effects of socio-economic status (SES) on outcomes have not been widely investigated. Aim We describe the epidemiological characteristics of COVID-19 cases, highlighting incidence and mortality rate differences across SES during the first wave in Barcelona, Catalonia, Spain. Methods This population-based study reports individual-level data of laboratory-confirmed COVID-19 cases diagnosed from 24 February to 4 May 2020, notified to the Public Health Agency of Barcelona and followed until 15 June 2020. We analysed end-of-study vital status and the effects of chronic conditions on mortality using logistic regression. Geocoded addresses were linked to basic health area SES data, estimated using the composed socio-economic index. We estimated age-standardised incidence, hospitalisation, and mortality rates by SES. Results Of 15,554 COVID-19-confirmed cases, the majority were women (n = 9,028; 58%), median age was 63 years (interquartile range: 46–83), 8,046 (54%) required hospitalisation, and 2,287 (15%) cases died. Prevalence of chronic conditions varied across SES, and multiple chronic conditions increased risk of death (≥ 3, adjusted odds ratio: 2.3). Age-standardised rates (incidence, hospitalisation, mortality) were highest in the most deprived SES quartile (incidence: 1,011 (95% confidence interval (CI): 975–1,047); hospitalisation: 619 (95% CI: 591–648); mortality: 150 (95% CI: 136–165)) and lowest in the most affluent (incidence: 784 (95% CI: 759–809); hospitalisation: 400 (95% CI: 382–418); mortality: 121 (95% CI: 112–131)). Conclusions COVID-19 outcomes varied markedly across SES, underscoring the need to implement effective preventive strategies for vulnerable populations.
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Affiliation(s)
- Julieta Politi
- Preventive Medicine and Public Health Training Unit, PSMar-UPF-PHAB (Parc de Salut Mar - Pompeu Fabra University - Public Health Agency of Barcelona), Barcelona, Spain.,Epidemiology Service, Public Health Agency of Barcelona (PHAB), Barcelona, Spain
| | - Mario Martín-Sánchez
- Preventive Medicine and Public Health Training Unit, PSMar-UPF-PHAB (Parc de Salut Mar - Pompeu Fabra University - Public Health Agency of Barcelona), Barcelona, Spain.,Epidemiology Service, Public Health Agency of Barcelona (PHAB), Barcelona, Spain
| | - Lilas Mercuriali
- Epidemiology Service, Public Health Agency of Barcelona (PHAB), Barcelona, Spain
| | - Blanca Borras-Bermejo
- Department of Preventive Medicine and Epidemiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joaquín Lopez-Contreras
- Infectious Diseases-Internal Medicine, Hospital de Sant Pau-Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Vilella
- Preventive Medicine and Epidemiology Department, Hospital Clínic, Barcelona, Spain
| | - Judit Villar
- Service of Infectious Diseases, Hospital del Mar, Barcelona, Spain
| | -
- Members are listed under Investigators
| | - Angels Orcau
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Epidemiology Service, Public Health Agency of Barcelona (PHAB), Barcelona, Spain
| | - Patricia Garcia de Olalla
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Epidemiology Service, Public Health Agency of Barcelona (PHAB), Barcelona, Spain
| | - Cristina Rius
- Department of Pediatrics, Obstetrics, Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Epidemiology Service, Public Health Agency of Barcelona (PHAB), Barcelona, Spain
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11
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Politi J, Sala M, Domingo L, Vernet-Tomas M, Román M, Macià F, Castells X. Readmissions and complications in breast ductal carcinoma in situ: A retrospective study comparing screen- and non-screen-detected patients. ACTA ACUST UNITED AC 2020; 16:1745506520965899. [PMID: 33076785 PMCID: PMC7594253 DOI: 10.1177/1745506520965899] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objective: Population-wide mammographic screening programs aim to reduce breast cancer
mortality. However, a broad view of the harms and benefits of these programs
is necessary to favor informed decisions, especially in the earliest stages
of the disease. Here, we compare the outcomes of patients diagnosed with
breast ductal carcinoma in situ in participants and non-participants of a
population-based mammographic screening program. Methods: A retrospective cohort study of all patients diagnosed with breast ductal
carcinoma in situ between 2000 and 2010 within a single hospital. A total of
211 patients were included, and the median follow-up was 8.4 years. The
effect of detection mode (screen-detected and non-screen-detected) on breast
cancer recurrences, readmissions, and complications was evaluated through
multivariate logistic regression analysis. Results: In the majority of women, breast ductal carcinoma in situ was screen-detected
(63.5%). Screen-detected breast ductal carcinoma in situ was smaller in size
compared to those non-screen-detected (57.53% < 20 mm versus 78.03%,
p = 0.002). Overall, breast-conserving surgery was the most frequent surgery
(86.26%); however, mastectomy was higher in non-screen-detected breast
ductal carcinoma in situ (20.78% versus 9.7%, p = 0.024). Readmissions for
mastectomy were more frequent in non-screen-detected breast ductal carcinoma
in situ. Psychological complications, such as fatigue, anxiety, and
depression, had a prevalence of 15% within our cohort. Risk of readmissions
and complications was higher within the non-screen-detected group, as
evidenced by an odds ratio = 6.25 (95% confidence interval = 1.95–19.99) for
readmissions and an odds ratio = 2.41 (95% confidence interval = 1.95–4.86)
for complications. Conclusions: Our findings indicate that women with breast ductal carcinoma in situ breast
cancer diagnosed through population-based breast cancer screening program
experience a lower risk of readmissions and complications than those
diagnosed outside these programs. These findings can help aid women and
health professionals make informed decisions regarding screening.
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Affiliation(s)
- Julieta Politi
- Department of Epidemiology and Evaluation, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Preventive Medicine and Public Health Training Unit, Parc de Salut Mar-Pompeu Fabra University-Agència de Salut Pública de Barcelona (PSMar-UPF-ASPB), Barcelona, Spain
| | - María Sala
- Department of Epidemiology and Evaluation, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laia Domingo
- Department of Epidemiology and Evaluation, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
| | - María Vernet-Tomas
- Breast Surgery, Obstetrics and Gynaecology Department, Hospital del Mar, Barcelona, Spain
| | - Marta Román
- Department of Epidemiology and Evaluation, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
| | - Francesc Macià
- Department of Epidemiology and Evaluation, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Xavier Castells
- Department of Epidemiology and Evaluation, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
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12
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Lasater EA, Massi ES, Stecula A, Politi J, Tan SK, Smith CC, Gunthorpe M, Holmes JP, Chehab F, Sali A, Shah NP. Novel TKI-resistant BCR-ABL1 gatekeeper residue mutations retain in vitro sensitivity to axitinib. Leukemia 2015; 30:1405-9. [PMID: 26511402 DOI: 10.1038/leu.2015.303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- E A Lasater
- Division of Hematology/Oncology, University of California, San Francisco, CA, USA
| | - E S Massi
- Division of Hematology/Oncology, University of California, San Francisco, CA, USA
| | - A Stecula
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
| | - J Politi
- Division of Hematology/Oncology, University of California, San Francisco, CA, USA
| | - S K Tan
- Division of Hematology/Oncology, University of California, San Francisco, CA, USA
| | - C C Smith
- Division of Hematology/Oncology, University of California, San Francisco, CA, USA
| | - M Gunthorpe
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - J P Holmes
- Annadel Medical Group, Santa Rosa, CA, USA
| | - F Chehab
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - A Sali
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA.,Department of Pharmaceutical Chemistry, University of California, San Francisco, CA, USA.,California Institute for Quantitative Biosciences, University of California, San Francisco, CA, USA
| | - N P Shah
- Division of Hematology/Oncology, University of California, San Francisco, CA, USA.,Helen Diller Comprehensive Cancer Center, University of California, San Francisco, CA, USA
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13
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Affiliation(s)
- Julieta Politi
- Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco, CA
| | - Neil P. Shah
- Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco, CA
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14
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Hill JM, Mervis RF, Politi J, McCune SK, Gozes I, Fridkin M, Brenneman DE. Blockade of VIP during neonatal development induces neuronal damage and increases VIP and VIP receptors in brain. Ann N Y Acad Sci 1994; 739:211-25. [PMID: 7832475 DOI: 10.1111/j.1749-6632.1994.tb19823.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- J M Hill
- Section on Molecular and Developmental Pharmacology, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892
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