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Surveillance des infections respiratoires aiguës : rapport épidémiologique saisons 2022-2023 et 2023-2024
No full textCe rapport présente les résultats de la surveillance des infections respiratoires aiguës en Belgique pour les saisons 2022-2023 et 2023-2024. La période couverte par ce rapport est caractérisée par la transition de la phase pandémique à la phase post-pandémique du COVID-19. Durant cette période, la surveillance des infections respiratoires aiguës a connu des changements importants. Certains systèmes spécialement conçus pour surveiller le COVID-19 pendant la pandémie ont été abandonnés, tandis que d’autres ont été adaptés pour étendre leur utilisation au-delà de la surveillance du SARS-CoV-2. Le retour de la grippe saisonnière, du RSV, et d’autres pathogènes responsables de maladies respiratoires dans une circulation saisonnière, en plus du SARS-CoV-2, nécessite une approche globale et intégrée de la surveillance de ces infections en Belgique. Ce rapport vise à donner un aperçu des indicateurs de surveillance pendant cette transition, afin d’informer le grand public et de fournir un retour d’information aux fournisseurs de données de surveillance et aux autorités de santé publique, aux niveaux régional et national en Belgique. Les résultats présentés peuvent contribuer à la sensibilisation et à la participation à la surveillance, et guider les décideurs dans leurs efforts de préparation pour les futures saisons d’infections respiratoires.</p
General characteristics of the Sentinel General Practitioners (SGP) network in Belgium: report on 2024.
No full textFood Consumption Survey 2022-2023: Finger Prick Study Methodology
No full textThe objective of the Finger prick study falls within the overall objective of the Food Consumption Survey (FCS) 2022-2023, that is to better understand the relationship between nutrition and health, and to monitor the nutritional status of the population. The Finger prick exploratory study aims to test the feasibility of monitoring the nutritional status of the population in Belgium using biomarkers obtained from non-invasive data collection methods (i.e., using microsampling-at-home). Specifically the study aims to use biomarkers in order to:
estimate the vitamin D status of the population aged three years and older;
estimate the thiamine (vitamin B1) status of the adult population aged 18 years and older;
estimate the alcohol consumption of the adult population aged 18 years and older.
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Enquête de consommation alimentaire 2022-2023 : Évaluation des apports en macro- et micronutriments dans la population belge
No full textL’Enquête de consommation alimentaire est une enquête transversale visant à recueillir des informations détaillées et quantitatives sur la consommation alimentaire, l’apport en nutriments et l’état nutritionnel de la population. L’activité physique et le comportement sédentaire y sont également étudiés. La troisième édition de cette enquête a eu lieu en 2022-2023 dans la population belge âgée de 3 ans et plus. 3777 personnes – sélectionnées de manière aléatoire dans le Registre national – ont participé à cette enquête entre mars 2022 et décembre 2023.
Ce quatrième rapport résume les principaux résultats concernant l’apport en nutriments au sein de la population en Belgique, ainsi que la comparaison de cet apport avec les valeurs nutritionnelles de référence. Il comprend plus particulièrement des résultats sur l’apport habituel en macronutriments (glucides, acides gras et protéines), sous-groupes de macronutriments (acides gras saturées, acides gras monoinsaturées) et certains micronutriments (vitamines et minéraux). Selon le nutriment, la proportion de la population respectant les valeurs de référence nutritionnelles est estimée à l’aide du besoin moyen, des intervalles de référence, de l’apport adéquat, de l’apport de référence pour la population, ou de la limite supérieure de sécurité, tels que définis par l’Autorité européenne de sécurité des aliments ou les Recommandations nutritionnelles nordiques.
Les résultats sont analysés pour l’ensemble de la population, ainsi que par âge, sexe, niveau d’instruction et région. L’enquête de 2022-2023 fournit des résultats pour les adultes âgés de 65 ans et plus, ce qui est nouveau par rapport à l’édition précédente. Dans la mesure du possible, les résultats ont été comparés à ceux de l’enquête précédente menée en 2014-2015.
Davantage de résultats sont disponibles sur notre site web.</p
Mass Spectrometric Fingerprinting to Detect Fraud and Herbal Adulteration in Plant Food Supplements
No full textMass spectrometric (MS) fingerprinting coupled with chemometrics for the detection of plants in plant mixtures is sparsely researched. This paper aims to check its value for herbal adulteration concerning plants with slimming as an indication. Moreover, it is among the first to exploit the full three-dimensional dataset (i.e., time × intensity × mass) obtained with liquid chromatography hyphenated with MS for herbal fingerprinting purposes. The MS parameters were optimized to achieve highly specific fingerprints. Trituration’s (total 55), blanks (total 11) and reference plants were injected in the MS system to generate the dataset. The dataset was complex and humongous, necessitating the application of compression techniques. After compression, Partial Least Squares-Discriminant Analysis (PLS-DA) was performed to generate models validated for accuracy using cross-validation and an external test set. Confusion matrices were constructed to provide insight into the modeling predictions. A complimentary evaluation between data obtained using a previously developed Diode Array Detection (DAD) method and the MS data was performed by data fusion techniques and newly generated models. The fused dataset models were comparable to MS models. For ease of application, MS modeling was deemed to be superior. The future market studies would adopt MS modeling as the preferred choice. A proof of concept was carried out on 10 real-life samples obtained from illegal sources. The results indicated the need for stronger monitoring of (illegal) plant food supplements entering the market, especially via the internet</p
Synthetic cathinones in Belgium: a cluster of poly-drug intoxications involving α-pyrrolidinoisohexiophenone (α-PiHP)
No full textBackground: Synthetic cathinones, known as ‘gravel’ or ‘bath salts’, include α-pyrrolidinoisohexiophenone and its analogues α-pyrrolidinovalerophenone and α-pyrrolidinohexanophenone; often referred to as ‘flakka’ on the street or ‘zombie drug’ in media reports. Documented motivation for use includes libido enhancement and appetite suppression. Since its international scheduling, α-pyrrolidinoisohexiophenone has gained prevalence in European Union countries where α-pyrrolidinovalerophenone previously dominated.
Methods: Three Belgian hospitals in adjacent regions reported intoxications involving α-pyrrolidinoisohexiophenone to the national early warning system. This triggered a retrospective analysis of a convenience cluster of 39 cases. Toxicological screening was performed using standardised laboratory protocols. Patient data, encompassing demographics, drug use patterns, and clinical symptoms, were obtained from routine hospital records.
Results: α-Pyrrolidinoisohexiophenone was analytically confirmed in 37 urine samples. The distinction between α-pyrrolidinoisohexiophenone and α-pyrrolidinohexanophenone was not possible for two blood samples. Urine samples quantification, (n = 16), revealed α-pyrrolidinoisohexiophenone concentrations ranging from 1.0 μg/L to 1,366.0 μg/L. A variety of clinical symptoms were recorded, including anxiety, aggression, suicidal thoughts, psychosis, babbling, and decreased consciousness.
Discussion: Symptoms in this cluster matched those from previous synthetic cathinone intoxications. No correlation was found between α-pyrrolidinoisohexiophenone presence and intoxication severity. Synthetic cathinones remain popular due to their availability, low cost, and potency at doses as low as 5-10 mg, likely fuelling continued development of new analogues.
Conclusion: The cluster of patients with poly-drug intoxications involving α-pyrrolidinoisohexiophenone in Belgium highlights the challenges posed by synthetic cathinones. Symptoms such as agitation, hallucinations and aggression align with those seen in prior cases of bath salts, although they cannot be solely attributed to α-pyrrolidinoisohexiophenone due to the presence of multiple other substances. We provide insight into α-pyrrolidinoisohexiophenone poisoning and emphasize the need for active information sharing to improve healthcare responses and awareness of the risks associated with synthetic drugs.</p
Prediction of Treatment Failure After Excisional Treatment of Cervical Precancer: A Systematic Review and Meta-analysis.
No full textOBJECTIVE: To evaluate the diagnostic accuracy and clinical utility of posttreatment tests to predict treatment failure after excisional treatment of cervical intraepithelial neoplasia grade 2 or worse (CIN 2+).
DATA SOURCES: Electronic databases (EMBASE, PubMed MEDLINE) were searched for studies published from January 1975 to August 2024 assessing the occurrence of treatment failure in women who underwent excisional treatment for histologically confirmed CIN 2+ lesion.
METHODS OF STUDY SELECTION: Previously published meta-analyses were extended and updated. A total of 1,802 studies were reviewed. Studies that assessed the diagnostic accuracy of the margin status, cytologic testing, combination of cytology and high-risk human papillomavirus (HPV), or combination of margin status and high-risk HPV compared with high-risk HPV testing were included. The primary outcome was treatment failure (residual or recurrent CIN 2+) and the absolute and relative diagnostic accuracy to predict this outcome. Studies with at least 18 months of follow-up were included.
TABULATION, INTEGRATION, AND RESULTS: Forty-six studies and 20,385 women were included in the analysis. Treatment failure occurred in 6.6% of patients. The pooled sensitivity and specificity of high-risk HPV testing were 86.8% and 80.5%, respectively. Cytology had a sensitivity of 70.8% and a specificity of 85.7%, pooled from 34 studies. Compared with high-risk HPV testing in the same studies, cytology was 6.5% more specific (95% CI, 1.024-1.108) but 21.3% less sensitive (95% CI, 0.702-0.882). Assessment of the margin status was 39.9% less sensitive (95% CI, 0.532-0.678) but similarly specific (95% CI, 0.970-1.069) to high-risk HPV testing in 29 studies, with a pooled sensitivity and specificity of 48.9% and 82.5%, respectively. Co-testing with cytology and high-risk HPV was similarly sensitive (95% CI, 0.992-1.061) but 10.5% less specific (95% CI, 0.850-0.944) compared with high-risk HPV testing in 16 studies, with a pooled sensitivity and specificity of 94.7% and 69.9%, respectively. The pooled sensitivity and specificity of co-testing with margin status and high-risk HPV were 96.9% and 55.7%, respectively, 6.6% more sensitive (95% CI, 1.021-1.114) but 26.7% less specific (95% CI, 0.637-0.844) than high-risk HPV testing in eight studies. Involved resection margins, abnormal cytology, and a positive high-risk HPV test result were associated with a failure risk of 16.1%, 29.0%, and 26.1%, respectively. Women with negative margins, normal cytology, and a negative high-risk HPV test result had a failure risk of 3.6%, 2.3%, and 0.9%, respectively. The risk of treatment failure was highest for women with involved margins and a positive high-risk HPV test result (45.3%) and lowest for women with negative margins and a negative high-risk HPV test result (0.3%). Abnormal cytology and a positive high-risk HPV test result increased the risk of treatment failure to 42%, whereas normal cytology and a negative high-risk HPV test result decreased the risk to 0.6%.
CONCLUSION: High-risk HPV testing is highly sensitive and specific to predict residual or recurrent CIN 2+ after excisional treatment. Cytologic testing and assessment of the margin status are slightly more and similarly specific, respectively, but both are significantly less sensitive. High-risk HPV testing can sufficiently inform the posttreatment management based on the posttest risk of treatment failure, unlike both cytology and assessment of the margin status. High-risk HPV testing alone performs similarly to co-testing with cytology or margin status. Posttreatment high-risk HPV testing is therefore an accurate predictor of treatment failure in women treated for CIN 2+.</p
