http://edoc.rki.de:80 The edoc-Server, the insitutional digital repository system of the Robert Koch Institute captures, stores, indexes, preserves, and distributes digital research material. Tue, 10 Mar 2026 16:20:22 GMT 2026-03-10T16:20:22Z http://edoc.rki.de/176904/13510 Social inequalities in health care and long-term care for the very old: a scoping review Hasseler, Martina; Heitmann-Möller, André; Ruppert, Sven Nelson; Nowossadeck, Enno; Fuchs, Judith; Hahm, Deborah Aim: Despite broad discussions in the scientific literature concerning the connection between social and health inequalities, the group of the very old (people aged 80 years and older) is not sufficiently represented in the research concerning health and long-term care. Are there inequalities among the very old in home and institutional care in the so-called industrialized Western countries and Asian countries? What differences can be detected regarding social determinants, gender, and region? Are there mutual aspects of health and long-term care on an international level? Is there a kind of tipping point in the progressive aging process at which the need for long-term care becomes inevitable? Subject and methods: Based on these four guiding questions, a scoping review of the literature in the last 10 years was conducted with German and English search terms. CINAHL, PubMed, ProQuest, and Scopus were searched in December 2022 and January 2023. In addition, a manual search was performed. Results: The very old are still not adequately represented in the research on the issue of social and health inequalities and implications for health and long-term care. Nevertheless, evidence of inequalities in care design was found. Market-based health and long-term care systems appear to show these more frequently. Also, market-based health and long-term care systems seems to rely more heavily on family structures than supply-oriented systems like in the Scandinavian countries. System structures tend to provide for an accumulation of inequalities in health and long-term care, as is also seen for low incomes. Conclusion: The scoping review showed that the group of the very old is underrepresented in health services research. At the same time, there are indications of a perpetuation of social inequality at old age. There is a need for more research on appropriate research terminologies and methods as well as research-based health care and long-term care measures and interventions. Sat, 23 Nov 2024 00:00:00 GMT http://edoc.rki.de/176904/13510 2024-11-23T00:00:00Z http://edoc.rki.de/176904/13509 Lifting COVID-19-associated non-pharmaceutical interventions: potential impact on notifications of infectious diseases transmitted from person to person in 2022 in Bavaria, Germany Hausmann, Judith; Dörre, Achim; Katz, Katharina; van de Berg, Sarah Background: The COVID-19 pandemic and associated non-pharmaceutical interventions (NPIs) have led to substantial decreases in case numbers of infectious diseases in several countries worldwide. As NPIs were gradually lifted, intense or out-of-season outbreaks of respiratory and gastrointestinal diseases were reported, raising the hypothesis of a potential catch-up effect of infections. By analysing surveillance data from the federal reporting system for notifiable infectious diseases, we aimed to assess the potential impact of lifting COVID-19 associated NPIs on notifications of selected infectious diseases in Bavaria, 2022. Methods: We compared influenza, chickenpox, norovirus gastroenteritis, rotavirus gastroenteritis weekly case numbers in a pre-pandemic period (2016–2019) and 2022 using two time series analyses approaches: (i) a predictive model forecasting weekly case numbers for the pandemic years 2020–2022, based on 2016–2019 data, (ii) interrupted time series model, based on 2016–2022 data, including a term per pandemic period. Results: In 2022, incidence rates were higher compared to pre-pandemic period for influenza (IRR = 3.47, 95%CI: 1.49–7.94) and rotavirus gastroenteritis (IRR = 1.36, 95%CI: 0.95–1.93), though not significant for rotavirus gastroenteritis. Conversely, case numbers remained significantly below pre-pandemic levels for chickenpox (IRR = 0.52, 95%CI: 0.41–0.65) and norovirus gastroenteritis (IRR = 0.59, 95%CI: 0.42–0.82). Seasonality changed notably for influenza, showing an earlier influenza wave compared to pre-pandemic periods. Conclusion: The lifting of NPIs was associated with heterogenic epidemiological patterns depending on the selected disease. The full impact of NPIs and their discontinuation may only become clear with continued monitoring and assessment of potential additional contributing factors. Wed, 31 Jul 2024 00:00:00 GMT http://edoc.rki.de/176904/13509 2024-07-31T00:00:00Z http://edoc.rki.de/176904/13508 Genomic perspective on the bacillus causing paratyphoid B fever Hawkey, Jane; Frézal, Lise; Tran Dien, Alicia; Zhukova, Anna; Brown, Derek; Chattaway, Marie Anne; Simon, Sandra; Izumiya, Hidemasa; Fields, Patricia I.; De Lappe, Niall; Kaftyreva, Lidia; Xu, Xuebin; Isobe, Junko; Clermont, Dominique; Njamkepo, Elisabeth; Akeda, Yukihiro; Issenhuth-Jeanjean, Sylvie; Makarova, Mariia; Wang, Yanan; Hunt, Martin; Jenkins, Brent M.; Ravel, Magali; Guibert, Véronique; Serre, Estelle; Matveeva, Zoya; Fabre, Laëtitia; Cormican, Martin; Yue, Min; Zhu, Baoli; Morita, Masatomo; Iqbal, Zamin; Nodari, Carolina Silva; Pardos de la Gandara, Maria; Weill, François-Xavier Paratyphoid B fever (PTB) is caused by an invasive lineage (phylogroup 1, PG1) of Salmonella enterica serotype Paratyphi B (SPB). However, little was known about the global population structure, geographic distribution, and evolution of this pathogen. Here, we report a whole-genome analysis of 568 historical and contemporary SPB PG1 isolates, obtained globally, between 1898 and 2021. We show that this pathogen existed in the 13th century, subsequently diversifying into 11 lineages and 38 genotypes with strong phylogeographic patterns. Following its discovery in 1896, it circulated across Europe until the 1970s, after which it was mostly reimported into Europe from South America, the Middle East, South Asia, and North Africa. Antimicrobial resistance recently emerged in various genotypes of SPB PG1, mostly through mutations of the quinolone-resistance-determining regions of gyrA and gyrB. This study provides an unprecedented insight into SPB PG1 and essential genomic tools for identifying and tracking this pathogen, thereby facilitating the global genomic surveillance of PTB. Tue, 10 Dec 2024 00:00:00 GMT http://edoc.rki.de/176904/13508 2024-12-10T00:00:00Z http://edoc.rki.de/176904/13507 Subjektive Gesundheit in der Frühphase der COVID-19-Pandemie – ein Vergleich von soziodemografischen Gruppen und pandemiebezogenen Risikofaktoren Heil, Carolin; Beese, Florian; Du, Yong; Hövener, Claudia; Michalski, Niels Hintergrund: In der Frühphase der COVID-19-Pandemie im Jahr 2020 war der Alltag durch die Eindämmungsmaßnahmen des ersten Lockdowns vergleichsweise stark eingeschränkt, während die SARS-CoV-2-Inzidenzen noch gering ausfielen. Der vorliegende Beitrag analysiert soziodemografische und sozioökonomische Gruppen im Hinblick auf die Beeinträchtigung der subjektiven Gesundheit in dieser Phase. Methoden: Daten der Hauptbefragung des Sozio-oekonomischen Panels (n = 14.856, März–Juli 2020) wurden verwendet, um die relative Häufigkeit selbstberichteter guter Gesundheit, großer Sorgen um die eigene Gesundheit und hoher Lebenszufriedenheit von Männern und Frauen stratifiziert nach Alter, Bildung, Einkommen, Migrationserfahrung, Vorerkrankungen und Risikoberufen zu schätzen. Die Ergebnisse wurden mittels logistischer Regressionen wechselseitig adjustiert und monatsweise dargestellt sowie mit der vorpandemischen Zeit verglichen. Ergebnisse: Personen in höherem Alter, mit niedriger Bildung oder niedrigem Einkommen sowie mit Vorerkrankungen berichteten seltener positive Gesundheitsoutcomes und häufiger Sorgen. Die Unterschiede zwischen den Merkmalsgruppen blieben im Vergleich zur vorpandemischen Zeit weitgehend stabil. Personen mit niedriger Bildung oder niedrigem Einkommen berichteten im Vergleich zu Personen der mittleren und höheren Bildungs- beziehungsweise Einkommensgruppen zum Zeitpunkt der stärksten Einschränkungen durch Infektionsschutzmaßnahmen seltener eine gute Gesundheit. Diskussion: Der Einfluss der Frühphase der Pandemie auf die subjektive Gesundheit und Lebenszufriedenheit ist für den Großteil der untersuchten Gruppen gering. Nur für Frauen in niedrigen sozioökonomischen Positionen konnten relative Verschlechterungen identifiziert werden.; Background: In the early stages of the COVID-19 pandemic in 2020, daily life was significantly restricted due to the containment measures of the initial lockdown while SARS-CoV‑2 incidences remained relatively low. This study analyses socio-demographic and socio-economic groups in terms of changes in their subjective health during this phase. Methods: Data from the Socio-Economic Panel (n = 14,856, March–July 2020) were used to estimate the relative frequency of self-reported good health, great worries about one’s own health, and high life satisfaction of men and women stratified by age, education, income, migration history, pre-existing medical conditions, and high-risk occupation. The results were mutually adjusted using logistic regression, displayed on a monthly basis, and compared with the pre-pandemic period. Results: Individuals of higher age, with lower education or income, and with pre-existing medical conditions reported positive health outcomes less frequently and worries more often. The differences between the subgroups remained largely stable compared to the pre-pandemic period. During the period of strongest restrictions due to infection-control measures, good health was reported less frequently by individuals with lower education or income compared to individuals with higher education or income. Discussion: The impact of the early phase of the pandemic on subjective health and life satisfaction was low for the majority of the examined groups. Relative impairments were only identified for women in low socio-economic positions. Fri, 24 May 2024 00:00:00 GMT http://edoc.rki.de/176904/13507 2024-05-24T00:00:00Z