BackgroundHAIs remain a frequent complication for hospitalised patients and pose a challenge that must be tackled by our health systems.MethodsQuasi-experimental study. In order to determine the antimicrobial effectiveness of surface coating agents containing silver ions (BactiBlock®) the degree of contamination of several surfaces in two ICU wards was compared.The association between application of Bactiblock® and surface contamination was analysed using a relative risk (RR). Multivariate logistic regressions were performed for each product applied and each sampling location to adjust for the RR of the contamination of surfaces treated with Bactiblock® for the independent variables.ResultsSurface contamination was observed in 31.5% of treated samples and 27.4 of untreated samples. Contamination was equally prominent on bedside Tables (38.7%), bed rails (38.4%) and sinks (38.3%), while the walls showed minimum contamination (2.6%). For beds under isolation protocols, contamination was higher (32.6%) than when no protocol was followed (26.5%) but the difference was not significant (p = 0.148). After stratification for application method and adjusting the multivariate models for period of the study and presence of isolated patients, the risk of contamination after the intervention increased when the coating agent was applied using a spray (OR = 1.79; 95% CI: 1.08-2.95, particularly in a dry and rugged surface such as that of bedside Tables (OR = 2.59; 95% CI: 1.22-5.52); and decreased when the product was applied using a roller on a smooth and continuously cleaned (or wet) Surface (OR = 0.42; 95% CI: 0.19-0.92).ConclusionCoating of hospital surfaces with substances containing silver ions may reduce bacterial growth. However, the effectiveness of the coating agent is affected by application method and environmental conditions and the type and cleanness of the surface.

Fundamentals: Migration movements between countries have enabled the extension of Chagas disease to non-endemic countries such as Spain, where only recently there has been awareness of this emerging global disease and procedures have been put in place for its management. The objective of this study is to determine the level of knowledge of Chagas disease, its symptoms, means of transmission and places where seropositive residents in Valencia (Spain) may seek medical assistance. Methods: Observational cross-sectional study of 96 Bolivian migrants living in Valencia (Spain). The sample was randomly selected and taking advantage of the bolivian elections in 2014. A specific epidemiological survey was conducted and screening blood tests were carried out using ELISA and confirmatory diagnosis by indirect immunofluorescence. After the bivariate analysis, logistic regression models were created to determine the variables that accounted for the lack of knowledge of the disease Results: The prevalence of Chagas was 35.4%. However, 24% of the total sample and 26.1% of seropositive participants do not know about the disease and 70.8% of participants do not know about the symptoms of the disease. While 58.3% (41.1% of seropositive participants) ignore what the means of transmission in non-endemic countries are and 47.1% do not know where to seek medical attention. This ignorance is predominant in participants over 45 years of age and with lower levels of education. Conclusions: There is an important lack of knowledge of the disease which, along with the issue of a high prevalence, elevates Chagas disease into being a potential public health problem which requires specific control and preventive measures.

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Background Breast cancer remains the most frequent tumour and first cancer related cause of death in the Valencian Community. Despite most of the population being aware of the existence of breast cancer screening programs (BCSP), there are great differences in uptake that are likely attributed to social determinants. The objective of this study, alligning with SDGs 3 and 10, is to assess inequalities in breast cancer screening uptake, diagnosis and treatment delay in the city of Valencia. Methods The population of study included 128 123 women invited to participate in the BCSP in the city of Valencia between 2014 and 2016. Uptake, diagnosis and treatment delay were assessed as outcomes. Covariates included country of origin, education level, size of family unit, risk of vulnerability, age, presence of disability, assigned health department and a social deprivation index. Bivariate analysis and logistic regression models were performed for each independent variable. Results BCSP uptake was of 63,8% with a diagnostic rate of 5,36‰. 76,7% of patients were below the 75th percentile of delay between diagnosis and treatment (52 days). Statistically significant relationships were found between uptake of BCSP and all studied covariates both in the bivariate analysis and regression model. Presence of disability, family unit size, age and health department had a statistically significant relationship with diagnosis in the bivariate analysis, of which only one health department and the social deprivation index’s second quintile remained significant in the regression model. No significant relations were found between treatment delay and any of the covariates. Conclusions Strong inequalities in the BCSP have been identified. Influencing factors must be targeted so as to ensure an egalitarian access to BCSP. Given its multifactorial nature, simple analyses must be avoided in the study of inequalities in breast cancer diagnosis. Data on lifestyle may contribute to future models. Key messages Social determinants continue to have an impact in the uptake of breast cancer screening programs in the city of Valencia. The assessment of inequalities in breast cancer diagnosis cannot be approached uniquely through the analysis of social determinants and may Benefit from the inclusion of data on lifestyle choices.