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Martonik R, Oleson C, Marder E. Spatiotemporal Cluster Detection for COVID-19 Outbreak Surveillance: Descriptive Analysis Study. JMIR Public Health Surveill 2024; 10:e49871. [PMID: 39412839 DOI: 10.2196/49871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 04/13/2024] [Accepted: 07/23/2024] [Indexed: 10/18/2024] Open
Abstract
BACKGROUND During the peak of the winter 2020-2021 surge, the number of weekly reported COVID-19 outbreaks in Washington State was 231; the majority occurred in high-priority settings such as workplaces, community settings, and schools. The Washington State Department of Health used automated address matching to identify clusters at health care facilities. No other systematic, statewide outbreak detection methods were in place. This was a gap given the high volume of cases, which delayed investigations and decreased data completeness, potentially leading to undetected outbreaks. We initiated statewide cluster detection using SaTScan, implementing a space-time permutation model to identify COVID-19 clusters for investigation. OBJECTIVE To improve outbreak detection, the Washington State Department of Health initiated a systematic cluster detection model to identify timely and actionable COVID-19 clusters for local health jurisdiction (LHJ) investigation and resource prioritization. This report details the model's implementation and the assessment of the tool's effectiveness. METHODS In total, 6 LHJs participated in a pilot to test model parameters including analysis type, geographic aggregation, cluster radius, and data lag. Parameters were determined through heuristic criteria to detect clusters early when they are smaller, making interventions more feasible. This study reviews all clusters detected after statewide implementation from July 17 to December 17, 2021. The clusters were analyzed by LHJ population and disease incidence. Clusters were compared with reported outbreaks. RESULTS A weekly, LHJ-specific retrospective space-time permutation model identified 2874 new clusters during this period. While the weekly analysis included case data from the prior 3 weeks, 58.25% (n=1674) of all clusters identified were timely-having occurred within 1 week of the analysis and early enough for intervention to prevent further transmission. There were 2874 reported outbreaks during this same period. Of those, 363 (12.63%) matched to at least one SaTScan cluster. The most frequent settings among reported and matched outbreaks were schools and youth programs (n=825, 28.71% and n=108, 29.8%), workplaces (n=617, 21.46% and n=56, 15%), and long-term care facilities (n=541, 18.82% and n=99, 27.3%). Settings with the highest percentage of clusters that matched outbreaks were community settings (16/72, 22%) and congregate housing (44/212, 20.8%). The model identified approximately one-third (119/363, 32.8%) of matched outbreaks before cases were associated with the outbreak event in our surveillance system. CONCLUSIONS Our goal was to routinely and systematically identify timely and actionable COVID-19 clusters statewide. Regardless of population or incidence, the model identified reasonably sized, timely clusters statewide, meeting the objective. Among some high-priority settings subject to public health interventions throughout the pandemic, such as schools and community settings, the model identified clusters that were matched to reported outbreaks. In workplaces, another high-priority setting, results suggest the model might be able to identify outbreaks sooner than existing outbreak detection methods.
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Affiliation(s)
| | - Caitlin Oleson
- Washington State Department of Health, Olympia, WA, United States
| | - Ellyn Marder
- Washington State Department of Health, Olympia, WA, United States
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McClymont H, Hu W. The effect of public health interventions on COVID-19 incidence in Queensland, Australia: a spatial cluster analysis. Infect Dis (Lond) 2024; 56:460-475. [PMID: 38446488 DOI: 10.1080/23744235.2024.2324355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Using SaTScan™ Geographical Information Systems (GIS), spatial cluster analysis was used to examine spatial trends and identify high-risk clusters of Coronavirus 2019 (COVID-19) incidence in response to changing levels of public health intervention phases including international and state border closures, statewide vaccination coverage, and masking requirements. METHODS Changes in COVID-19 incidence were mapped at the statistical area 2 (SA2) level using a GIS and spatial cluster analysis was performed using SaTScan™ to identify most-likely clusters (MLCs) during intervention phases. RESULTS Over the study period, significant high-risk clusters were identified in Brisbane city (relative risk = 30.83), the southeast region (RR = 1.71) and moving to Far North Queensland (FNQ) (RR = 2.64). For masking levels, cluster locations were similar, with MLC in phase 1 in the southeast region (RR = 2.56) spreading to FNQ in phase 2 (RR = 2.22) and phase 3 (RR = 2.64). All p values <.0001. CONCLUSIONS Movement restrictions in the form of state and international border closures were highly effective in delaying the introduction of COVID-19 into Queensland, with very low levels of transmission prior to border reopening while mandatory masking may have played a role in decreasing transmission through behavioural changes. Early clusters were in highly populated regions, as restrictions eased clusters were identified in regions more likely to be rural or remote, with higher numbers of Indigenous people, lower vaccination coverage or lower socioeconomic status.
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Affiliation(s)
- Hannah McClymont
- School of Public Health and Social Work, Ecosystem Change, Population Health and Early Warning (ECAPH) Research Group, Queensland University of Technology (QUT), Brisbane, Australia
| | - Wenbiao Hu
- School of Public Health and Social Work, Ecosystem Change, Population Health and Early Warning (ECAPH) Research Group, Queensland University of Technology (QUT), Brisbane, Australia
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Szwarcwald CL, Almeida WS, Boccolini CS, Soares Filho AM, Malta DC. The unequal impact of the pandemic at subnational levels and educational attainment-related inequalities in COVID-19 mortality, Brazil, 2020-2021. Public Health 2024; 231:39-46. [PMID: 38615470 DOI: 10.1016/j.puhe.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/26/2024] [Accepted: 03/06/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVES We estimated COVID-19 mortality indicators in 2020-2021 to show the epidemic's impact at subnational levels and to analyze educational attainment-related inequalities in COVID-19 mortality in Brazil. STUDY DESIGN This was an ecological study with secondary mortality information. METHODS Crude and age-standardized COVID-19 mortality rates were calculated by gender, major regions, and states. The COVID-19 proportional mortality (percentage) was estimated by gender and age in each region. Measures of education-related inequalities in COVID-19 mortality were calculated per state, in each of which the COVID-19 maternal mortality rate (MMR) was estimated by the number of COVID-19 maternal deaths per 100,000 live births (LBs). RESULTS The analysis of mortality rates at subnational levels showed critical regional differences. The North region proved to be the most affected by the pandemic, followed by the Center-West, with age-standardized COVID-19 mortality rates above 2 per 1000 inhabitants. The peak of COVID-19 mortality occurred in mid-March/April 2021 in all regions. Great inequality by educational level was found, with the illiterate population being the most negatively impacted in all states. The proportional mortality showed that males and females aged 50-69 years were the most affected. The MMR reached critical values (>100/100,000 LB) in several states of the North, Northeast, Southeast, and Center-West regions. CONCLUSIONS This study highlights stark regional and educational disparities in COVID-19 mortality in Brazil. Exacerbated by the pandemic, these inequalities reveal potential areas for intervention to reduce disparities. The results also revealed high MMRs in certain states, underscoring pre-existing healthcare access challenges that worsened during the pandemic.
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Affiliation(s)
- C L Szwarcwald
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | - W S Almeida
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - C S Boccolini
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - A M Soares Filho
- School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - D C Malta
- School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Yin X, Aiken JM, Harris R, Bamber JL. A Bayesian spatio-temporal model of COVID-19 spread in England. Sci Rep 2024; 14:10335. [PMID: 38710934 DOI: 10.1038/s41598-024-60964-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 04/29/2024] [Indexed: 05/08/2024] Open
Abstract
Exploring the spatio-temporal variations of COVID-19 transmission and its potential determinants could provide a deeper understanding of the dynamics of disease spread. This study aimed to investigate the spatio-temporal spread of COVID-19 infections in England, and examine its associations with socioeconomic, demographic and environmental risk factors. We obtained weekly reported COVID-19 cases from 7 March 2020 to 26 March 2022 at Middle Layer Super Output Area (MSOA) level in mainland England from publicly available datasets. With these data, we conducted an ecological study to predict the COVID-19 infection risk and identify its associations with socioeconomic, demographic and environmental risk factors using a Bayesian hierarchical spatio-temporal model. The Bayesian model outperformed the ordinary least squares model and geographically weighted regression model in terms of prediction accuracy. The spread of COVID-19 infections over space and time was heterogeneous. Hotspots of infection risk exhibited inconsistent clustering patterns over time. Risk factors found to be positively associated with COVID-19 infection risk were: annual household income [relative risk (RR) = 1.0008, 95% Credible Interval (CI) 1.0005-1.0012], unemployment rate [RR = 1.0027, 95% CI 1.0024-1.0030], population density on the log scale [RR = 1.0146, 95% CI 1.0129-1.0164], percentage of Caribbean population [RR = 1.0022, 95% CI 1.0009-1.0036], percentage of adults aged 45-64 years old [RR = 1.0031, 95% CI 1.0024-1.0039], and particulate matter ( PM 2.5 ) concentrations [RR = 1.0126, 95% CI 1.0083-1.0167]. The study highlights the importance of considering socioeconomic, demographic, and environmental factors in analysing the spatio-temporal variations of COVID-19 infections in England. The findings could assist policymakers in developing tailored public health interventions at a localised level.
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Affiliation(s)
- Xueqing Yin
- School of Geographical Sciences, University of Bristol, Bristol, BS8 1SS, UK.
| | - John M Aiken
- Expert Analytics, 0179, Oslo, Norway
- Njord Centre, Departments of Physics and Geosciences, University of Oslo, 0371, Oslo, Norway
| | - Richard Harris
- School of Geographical Sciences, University of Bristol, Bristol, BS8 1SS, UK
| | - Jonathan L Bamber
- School of Geographical Sciences, University of Bristol, Bristol, BS8 1SS, UK
- Department of Aerospace and Geodesy, Technical University of Munich, 80333, Munich, Germany
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Fang G, Wang Y, Yuan H, Yan N, Zhi S. Unraveling the core symptoms of mental health in senior grade three students- a network analysis. Front Psychiatry 2024; 15:1364334. [PMID: 38711876 PMCID: PMC11071079 DOI: 10.3389/fpsyt.2024.1364334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/09/2024] [Indexed: 05/08/2024] Open
Abstract
Background Adolescence is not only an important transitional period of many developmental challenges, but also a high risk period for mental health problems. Psychotherapy is recommended for mental health problems in adolescents, but its effectiveness is not always satisfactory. One possible contributing factor may be the lack of clarity surrounding core symptoms. Methods In this study, we investigated the mental health status of senior grade three students, a group of adolescents facing college entrance exams, by the Middle School Student Mental Health Test (MHT) and analyzed the core symptoms by network analysis. This study was conducted through an online survey platform (www.xiaodongai.com) from 15 February 2023 to 28 March 2024. The subjects scanned a QR code with their mobile phone to receive the questionnaire. Results The mean age of these 625 students were 18.11 ± 2.90 years. There are 238 male participants and 387 female participants. 107 individuals scored above 56 (107/461, 23.2%), with individual scale scores over 8 up to over 60% of participating students. Notably, the top three prominent symptoms were "academic anxiety", "allergic tendency" and "somatic symptoms". However, upon conducting network analysis, it became evident that three strongest edges in this network were "somatic symptoms" and "impulsive tendency", "academic anxiety" and "social anxiety" as well as "social anxiety" and "Loneliness tendency". "somatic symptoms", "social anxiety" and "self-blame tendency" exerted the highest expected influence. This suggests that, statistically speaking, these three symptoms exhibited the strongest interconnections within the network. Limitation Cross-sectional analysis; Bias in self-reported variables. Conclusion These findings can deepen the knowledge of mental health among senior grade three students and provide some implications (i.e., targeting symptoms having highest expected influence) for clinical prevention and intervention to address the mental health needs of this particular group.
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Affiliation(s)
- Guoxiang Fang
- Department of Emergency, Third Hospital of Xi’an, The Affiliated Hospital of Northwest University, Xi’an, Shaanxi, China
| | - Ying Wang
- Department of Psychiatry, Xi’an International Medical Center Hospital, The Affiliated Hospital of Northwest University, Xi’an, Shaanxi, China
| | - Huiling Yuan
- Department of Psychiatry, Xi’an International Medical Center Hospital, The Affiliated Hospital of Northwest University, Xi’an, Shaanxi, China
| | - Ne Yan
- Department of Psychology, Xi’an Physical Education University, Xi’an, Shaanxi, China
| | - Shaomin Zhi
- Department of Emergency, Third Hospital of Xi’an, The Affiliated Hospital of Northwest University, Xi’an, Shaanxi, China
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Feng Z. Spatiotemporal pattern of COVID-19 mortality and its relationship with socioeconomic and environmental factors in England. Spat Spatiotemporal Epidemiol 2023; 45:100579. [PMID: 37301594 PMCID: PMC9896884 DOI: 10.1016/j.sste.2023.100579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 12/21/2022] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
This paper investigated the spatiotemporal pattern of COVID-19 mortality and its socioeconomic and environmental determinants in the first and second wave of the pandemic in England. The COVID-19 mortality rates for middle super output areas from March 2020 to April 2021 were used in the analysis. SaTScan was used in the analysis of spatiotemporal pattern of COVID-19 mortality and geographically weighted Poisson regression (GWPR) was used to investigate the association with socioeconomic and environmental factors. The results show that there was significant spatiotemporal variation in hotspots of COVID-19 deaths with the hotspots moving from regions where the COVID-19 outbreak initiated and then spread to other parts of the country. The GWPR analysis revealed that age composition, ethnic composition, deprivation, care home and pollution were all related to COVID-19 mortality. Althoughthe relationship varied over space the association with these factors was fairly consistent over the first and second wave.
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Affiliation(s)
- Zhiqiang Feng
- Drummond Street, Institute of Geography, Scottish Centre for Administrative Data Research, School of Geosciences, University of Edinburgh, Edinburgh EH8 9XP, UK.
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Nikitin B, Zakharova M, Pilyasov A, Zamyatina N. The burden of big spaces: Russian regions and cities in the COVID-19 pandemic. LETTERS IN SPATIAL AND RESOURCE SCIENCES 2023; 16:16. [PMID: 37073269 PMCID: PMC10092935 DOI: 10.1007/s12076-023-00341-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 04/01/2023] [Indexed: 05/03/2023]
Affiliation(s)
- Boris Nikitin
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991 Russia
| | - Maria Zakharova
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991 Russia
| | - Alexander Pilyasov
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991 Russia
| | - Nadezhda Zamyatina
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991 Russia
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Steelesmith DL, Lindstrom MR, Le HTK, Root ED, Campo JV, Fontanella CA. Spatiotemporal Patterns of Deaths of Despair Across the U.S., 2000-2019. Am J Prev Med 2023:S0749-3797(23)00093-4. [PMID: 36964010 DOI: 10.1016/j.amepre.2023.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 02/08/2023] [Accepted: 02/12/2023] [Indexed: 03/26/2023]
Abstract
INTRODUCTION Deaths of despair (i.e., suicide, drug/alcohol overdose, and chronic liver disease and cirrhosis) have been increasing over the past 2 decades. However, no large-scale studies have examined geographic patterns of deaths of despair in the U.S. This ecologic study identifies geographic and temporal patterns of individual and co-occurring clusters of deaths of despair. METHODS All individuals aged ≥10 years who died in the U.S. between 2000 and 2019 and resided within the 48 contiguous states and Washington, District of Columbia were included (N=2,171,105). Causes of death were limited to deaths of despair, namely suicide, drug/alcohol overdose, and chronic liver disease and cirrhosis. Univariate and multivariate space-time scan statistics were used to identify individual and co-occurring clusters with excess risk of deaths of despair. County-level RRs account for heterogeneity within each cluster. Analyses were conducted from late 2021 to early 2022. RESULTS Six suicide clusters, 4 overdose clusters, 9 liver disease clusters, and 3 co-occurring clusters of all 3 types of deaths were identified. A large portion of the western U.S., southeastern U.S., and Appalachia/rust belt were contained within the co-occurring clusters. The co-occurring clusters had average county RRs ranging from 1.17 (p<0.001) in the southeastern U.S. to 4.90 (p<0.001) in the western U.S. CONCLUSIONS Findings support identifying and targeting risk factors common to all types of deaths of despair when planning public health interventions. Resources and policies that address all deaths of despair simultaneously may be beneficial for the areas contained within the co-occurring high-risk clusters.
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Affiliation(s)
- Danielle L Steelesmith
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
| | | | - Huyen T K Le
- Department of Geography, The Ohio State University, Columbus, Ohio
| | | | - John V Campo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Cynthia A Fontanella
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio; Department of Psychiatry and Behavioral Health, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Raymundo CE, Oliveira MC, de Araujo Eleuterio T, de Arruda Santos Junior ÉC, da Silva MG, André SR, Sousa AI, de Andrade Medronho R. Spatial-temporal distribution of incidence, mortality, and case-fatality ratios of coronavirus disease 2019 and its social determinants in Brazilian municipalities. Sci Rep 2023; 13:4139. [PMID: 36914858 PMCID: PMC10009864 DOI: 10.1038/s41598-023-31046-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023] Open
Abstract
The COVID-19 pandemic caused impact on public health worldwide. Brazil gained prominence during the pandemic due to the magnitude of disease. This study aimed to evaluate the spatial-temporal dynamics of incidence, mortality, and case fatality of COVID-19 and its associations with social determinants in Brazilian municipalities and epidemiological week. We modeled incidence, mortality, and case fatality rates using spatial-temporal Bayesian model. "Bolsa Família Programme" (BOLSAFAM) and "proportional mortality ratio" (PMR) were inversely associated with the standardized incidence ratio (SIR), while "health insurance coverage" (HEALTHINSUR) and "Gini index" were directly associated with the SIR. BOLSAFAM and PMR were inversely associated with the standardized mortality ratio (SMR) and standardized case fatality ratio (SCFR). The highest proportion of excess risk for SIR and the SMR started in the North, expanding to the Midwest, Southeast, and South regions. The highest proportion of excess risk for the SCFR outcome was observed in some municipalities in the North region and in the other Brazilian regions. The COVID-19 incidence and mortality in municipalities that most benefited from the cash transfer programme and with better social development decreased. The municipalities with a higher proportion of non-whites had a higher risk of becoming ill and dying from the disease.
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Affiliation(s)
- Carlos Eduardo Raymundo
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Avenida Horácio Macedo, 100 - Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-598, Brazil.
| | - Marcella Cini Oliveira
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Tatiana de Araujo Eleuterio
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Avenida Horácio Macedo, 100 - Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-598, Brazil
- Faculdade de Enfermagem, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Édnei César de Arruda Santos Junior
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Avenida Horácio Macedo, 100 - Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-598, Brazil
| | | | - Suzana Rosa André
- Escola de Enfermagem Anna Nery, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ana Inês Sousa
- Escola de Enfermagem Anna Nery, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Roberto de Andrade Medronho
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Avenida Horácio Macedo, 100 - Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-598, Brazil
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Hussain S, Mubeen M, Ahmad A, Fahad S, Nasim W, Hammad HM, Shah GM, Murtaza B, Tahir M, Parveen S. Using space-time scan statistic for studying the effects of COVID-19 in Punjab, Pakistan: a guideline for policy measures in regional agriculture. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:42495-42508. [PMID: 34800269 PMCID: PMC8605466 DOI: 10.1007/s11356-021-17433-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/04/2021] [Indexed: 04/13/2023]
Abstract
Pakistan is included in top 50 countries which are estimated to face serious agriculture and food deficiency related challenges due to the worldwide pandemic coronavirus 2019 (COVID-19). The aim of this study was to evaluate the effects of COVID-19 on food supply chain and agriculture in Punjab, Pakistan, by using space-time scan statistic (STSS). A survey was conducted at 720 points in different districts of the province. The STSS detected "active" and emerging clusters that are current at the end of our study area-particularly, 17 clusters were formed while adding the updated case data. Software ArcGIS 10.3 was used to find relative risk (RR) values; the maximum RR value was found to be 42.19 and maximum observed cases 53,265 during June 15-July 1, 2020. It was not always necessary that if the number of active cases in Punjab increased, there should be higher relative risk for more number of districts and vice versa. Due to the highest number of cases of COVID-19 and RR values during July, mostly farmers faced many difficulties during the cultivation of cotton and rice. Mostly farmers (72%) observed increase in prices of inputs (fertilizers and pesticides) during lockdown. If the supply chain of agriculture related inputs is disturbed, farmers may find it quite difficult to access markets, which could result in a decline in production and sales of crops and livestock in study area. It is suggested that to protect the food security and to decrease the effect of the lockdown, Punjab government needs to review food policy and analyse how market forces will respond to the imbalanced storage facilities and capacity, supply and demand and price control of products. The findings of this study can also help policy-makers to formulate an effective food security and agriculture adaptation strategy.
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Affiliation(s)
- Sajjad Hussain
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Islamabad, 61100, Pakistan.
| | - Muhammad Mubeen
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Islamabad, 61100, Pakistan.
| | - Ashfaq Ahmad
- Asian Disaster Preparedness Center (ADPC), Bangkok, Thailand
| | - Shah Fahad
- Department of Agronomy, The University of Haripur, Haripur, 22620, Pakistan
| | - Wajid Nasim
- Department of Agronomy, Faculty of Agriculture and Environment, The Islamia University of Bahawalpur (IUB), Bahawalpur, Pakistan
| | - Hafiz Mohkum Hammad
- Department of Computer Science, Institute of Southern Punjab, Multan, Pakistan
| | - Ghulam Mustafa Shah
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Islamabad, 61100, Pakistan
| | - Behzad Murtaza
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Islamabad, 61100, Pakistan
| | - Muhammad Tahir
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Islamabad, 61100, Pakistan
| | - Saima Parveen
- Department of Computer Science, Institute of Southern Punjab, Multan, Pakistan.
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Guchhait S, Das S, Das N, Patra T. Mapping of space-time patterns of infectious disease using spatial statistical models: a case study of COVID-19 in India. Infect Dis (Lond) 2023; 55:27-43. [PMID: 36199164 DOI: 10.1080/23744235.2022.2129778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Mapping of infectious diseases like COVID-19 is the foremost importance for diseases control and prevention. This study attempts to identify the spatio-temporal pattern and evolution trend of COVID-19 at the district level in India using spatial statistical models. MATERIALS AND METHODS Active cases of eleven time-stamps (30 March-2 December, 2020) with an approximately 20-day interval are considered. The study reveals applications of spatial statistical tools, i.e. optimised hotspot and outlier analysis (which follow Gi* and Moran I statistics) and emerging hotspot with the base of space time cube, are effective for the spatio-temporal evolution of disease clusters. RESULTS The result shows the overall increasing trend of COVID-19 infection with a Mann-Kendall trend score of 2.95 (p = 0.0031). The spatial clusters of high infection (hotspots) and low infection (coldspots) change their location over time but are limited to the districts of the south-western states (Kerala, Karnataka, Andhra Pradesh, Maharashtra, Gujarat) and the north-eastern states (West Bengal, Jharkhand, Assam, Tripura, Manipur, etc.) respectively. CONCLUSIONS A total of eight types of patterns are identified, but the most concerning types are consecutive (7.24% of districts), intensifying (15.13% districts) and persistent (24.34% of districts) which will help health policy makers and the government to prioritize-based resource allocation and control measures.
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Affiliation(s)
- Santu Guchhait
- Department of Geography, Panskura Banamali College, Purba Medinipur, India
| | - Subhrangsu Das
- Department of Geography, Utkal University, Bhubaneswar, India
| | - Nirmalya Das
- Department of Geography, Panskura Banamali College, Purba Medinipur, India
| | - Tanmay Patra
- Department of Geography, Panskura Banamali College, Purba Medinipur, India
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Lu Y, Cai G, Hu Z, He F, Jiang Y, Aoyagi K. Exploring spatiotemporal patterns of COVID-19 infection in Nagasaki Prefecture in Japan using prospective space-time scan statistics from April 2020 to April 2022. Arch Public Health 2022; 80:176. [PMID: 35883103 PMCID: PMC9315091 DOI: 10.1186/s13690-022-00921-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/24/2022] [Indexed: 12/03/2022] Open
Abstract
Background Up to April 2022, there were six waves of infection of coronavirus disease 2019 (COVID-19) in Japan. As the outbreaks continue to grow, it is critical to detect COVID-19’s clusters to allocate health resources and improve decision-making substantially. This study aimed to identify active clusters of COVID-19 in Nagasaki Prefecture and form the spatiotemporal pattern of high-risk areas in different infection periods. Methods We used the prospective space-time scan statistic to detect emerging COVID-19 clusters and examine the relative risk in five consecutive periods from April 1, 2020 to April 7, 2022, in Nagasaki Prefecture. Results The densely inhabited districts (DIDs) in Nagasaki City have remained the most affected areas since December 2020. Most of the confirmed cases in the early period of each wave had a history of travelling to other prefectures. Community-level transmissions are suggested by the quick expansion of spatial clusters from urban areas to rural areas and remote islands. Moreover, outbreaks in welfare facilities and schools may lead to an emerging cluster in Nagasaki Prefecture’s rural areas. Conclusions This study gives an overall analysis of the transmission dynamics of the COVID-19 pandemic in Nagasaki Prefecture, based on the number of machi-level daily cases. Furthermore, the findings in different waves can serve as references for subsequent pandemic prevention and control. This method helps the health authorities track and investigate outbreaks of COVID-19 that are specific to these environments, especially in rural areas where healthcare resources are scarce. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00921-3.
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Miguel CB, da Silva AL, Trindade-da-Silva CA, de Abreu MCM, Oliveira CJF, Rodrigues WF. Proximity matrix indicates heterogeneity in the ability to face child malnutrition and pandemics in Brazil: An ecological study. Front Public Health 2022; 10:1019300. [PMID: 36438240 PMCID: PMC9686321 DOI: 10.3389/fpubh.2022.1019300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
Background Among the social inequalities that continue to still surpasses the basic rights of several citizens, political and environmental organizations decisively "drag" the "ghost" of hunger between different countries of the world, including Brazil. The COVID-19 pandemic has increased the difficulties encountered in fighting poverty, which has led Brazil to a worrying situation regarding its fragility in the fight against new pandemics. Objectives The present study aims to estimate, compare, and report the prevalence of mortality due to child malnutrition among the macro-regions of Brazil and verify possible associations with the outcome of death by COVID-19. This would identify the most fragile macro-regions in the country with the greatest need for care and investments. Methods The prevalence of mortality was determined using data from the federal government database (DataSus). Child malnutrition was evaluated for the period from 1996 to 2017 and COVID-19 was evaluated from February to December 2020. The (dis)similarity between deaths from malnutrition and COVID-19 was evaluated by proximity matrix. Results The North and Northeast regions have above average number of deaths than expected for Brazil (p < 0.05). A prospective analysis reveals that the distribution of the North and Northeast macro-regions exceeds the upper limit of the CI in Brazil for up to the year 2024 (p < 0.05). The proximity matrix demonstrated the close relationship between deaths from COVID-19 and malnutrition for the Northern region followed by the Northeast region. Conclusions There are discrepancies in frequencies between macro-regions. Prospective data indicate serious problems for the North and Northeast regions for the coming years. Therefore, strategies to contain the outcome of health hazards must be intensified in the macro-regions North and Northeast of the country.
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Affiliation(s)
- Camila Botelho Miguel
- Biosciences Unit, Medicine Course, University Center of Mineiros (UNIFIMES), Mineiros, GO, Brazil,Postgraduate Program in Tropical Medicine and Infectious Diseases, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG, Brazil
| | - Arianny Lima da Silva
- Biosciences Unit, Medicine Course, University Center of Mineiros (UNIFIMES), Mineiros, GO, Brazil
| | | | | | - Carlo José Freire Oliveira
- Postgraduate Program in Tropical Medicine and Infectious Diseases, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG, Brazil
| | - Wellington Francisco Rodrigues
- Postgraduate Program in Tropical Medicine and Infectious Diseases, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG, Brazil,*Correspondence: Wellington Francisco Rodrigues
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Ferreira RV, Martines MR, Toppa RH, Assunção LMD, Desjardins MR, Delmelle E. Utilizing prospective space-time scan statistics to discover the dynamics of coronavirus disease 2019 clusters in the State of São Paulo, Brazil. Rev Soc Bras Med Trop 2022; 55:e0607. [PMID: 35946634 PMCID: PMC9344939 DOI: 10.1590/0037-8682-0607-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 06/06/2022] [Indexed: 11/21/2022] Open
Abstract
Background: The number of deaths and people infected with coronavirus disease 2019 (COVID-19) in Brazil has steadily increased in the first few months of the pandemic. Despite the underreporting of coronavirus cases by government agencies across the country, São Paulo has the highest rate among all Brazilian states. Methods: To identify the highest-risk municipalities during the initial outbreak, we utilized daily confirmed case data from official reports between February 25 and May 5, 2020, which were aggregated to the municipality level. A prospective space-time scan statistic was conducted to detect active clusters in three different time periods. Results: Our findings suggest that approximately 4.6 times more municipalities belong to a significant space-time cluster with a relative risk (RR) > 1 on May 5, 2020. Conclusions: Our study demonstrated the applicability of the space-time scan statistic for the detection of emerging clusters of COVID-19. In particular, we identified the clusters and RR of municipalities in the initial months of the pandemic, explaining the spatiotemporal patterns of COVID-19 transmission in the state of São Paulo. These results can be used to improve disease monitoring and facilitate targeted interventions.
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Affiliation(s)
- Ricardo Vicente Ferreira
- Universidade Federal do Triângulo Mineiro, Programa de Pós-graduação Stricto Sensu em Ciência e Tecnologia Ambiental, Uberaba, MG, Brasil
| | - Marcos Roberto Martines
- Universidade Federal de São Carlos, Centro de Ciências Humanas e Biológicas, Sorocaba, SP, Brasil
| | - Rogério Hartung Toppa
- Universidade Federal de São Carlos, Departamento de Ciências Ambientais, Sorocaba, SP, Brasil
| | - Luiza Maria de Assunção
- Universidade do Estado de Minas Gerais, Faculdade de Ciências Jurídicas, Ituiutaba, MG, Brasil
| | - Michael Richard Desjardins
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eric Delmelle
- University of North Carolina-Charlotte, Center for Applied Geographic Information Science, Department of Geography and Earth Sciences, Charlotte, NC, USA
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Welsh C, Albani V, Matthews F, Bambra C. Inequalities in the evolution of the COVID-19 pandemic: an ecological study of inequalities in mortality in the first wave and the effects of the first national lockdown in England. BMJ Open 2022; 12:e058658. [PMID: 35948380 PMCID: PMC9378950 DOI: 10.1136/bmjopen-2021-058658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 07/19/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To examine how ecological inequalities in COVID-19 mortality rates evolved in England, and whether the first national lockdown impacted them. This analysis aimed to provide evidence for important lessons to inform public health planning to reduce inequalities in any future pandemics. DESIGN Longitudinal ecological study. SETTING 307 lower-tier local authorities in England. PRIMARY OUTCOME MEASURE Age-standardised COVID-19 mortality rates by local authority, regressed on Index of Multiple Deprivation (IMD) and relevant epidemic dynamics. RESULTS Local authorities that started recording COVID-19 deaths earlier were more deprived, and more deprived authorities saw faster increases in their death rates. By 6 April 2020 (week 15, the earliest time that the 23 March lockdown could have begun affecting death rates) the cumulative death rate in local authorities in the two most deprived deciles of IMD was 54% higher than the rate in the two least deprived deciles. By 4 July 2020 (week 27), this gap had narrowed to 29%. Thus, inequalities in mortality rates by decile of deprivation persisted throughout the first wave, but reduced during the lockdown. CONCLUSIONS This study found significant differences in the dynamics of COVID-19 mortality at the local authority level, resulting in inequalities in cumulative mortality rates during the first wave of the pandemic. The first lockdown in England was fairly strict-and the study found that it particularly benefited those living in more deprived local authorities. Care should be taken to implement lockdowns early enough, in the right places-and at a sufficiently strict level-to maximally benefit all communities, and reduce inequalities.
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Affiliation(s)
- Claire Welsh
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Viviana Albani
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona Matthews
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Clare Bambra
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Luo W, Liu Z, Zhou Y, Zhao Y, Li YE, Masrur A, Yu M. Investigating Linkages Between Spatiotemporal Patterns of the COVID-19 Delta Variant and Public Health Interventions in Southeast Asia: Prospective Space-Time Scan Statistical Analysis Method. JMIR Public Health Surveill 2022; 8:e35840. [PMID: 35861674 PMCID: PMC9364972 DOI: 10.2196/35840] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/19/2022] [Accepted: 07/19/2022] [Indexed: 12/18/2022] Open
Abstract
Background The COVID-19 Delta variant has presented an unprecedented challenge to countries in Southeast Asia (SEA). Its transmission has shown spatial heterogeneity in SEA after countries have adopted different public health interventions during the process. Hence, it is crucial for public health authorities to discover potential linkages between epidemic progression and corresponding interventions such that collective and coordinated control measurements can be designed to increase their effectiveness at reducing transmission in SEA. Objective The purpose of this study is to explore potential linkages between the spatiotemporal progression of the COVID-19 Delta variant and nonpharmaceutical intervention (NPI) measures in SEA. We detected the space-time clusters of outbreaks of COVID-19 and analyzed how the NPI measures relate to the propagation of COVID-19. Methods We collected district-level daily new cases of COVID-19 from June 1 to October 31, 2021, and district-level population data in SEA. We adopted prospective space-time scan statistics to identify the space-time clusters. Using cumulative prospective space-time scan statistics, we further identified variations of relative risk (RR) across each district at a half-month interval and their potential public health intervention linkages. Results We found 7 high-risk clusters (clusters 1-7) of COVID-19 transmission in Malaysia, the Philippines, Thailand, Vietnam, and Indonesia between June and August, 2021, with an RR of 5.45 (P<.001), 3.50 (P<.001), 2.30 (P<.001), 1.36 (P<.001), 5.62 (P<.001), 2.38 (P<.001), 3.45 (P<.001), respectively. There were 34 provinces in Indonesia that have successfully mitigated the risk of COVID-19, with a decreasing range between –0.05 and –1.46 due to the assistance of continuous restrictions. However, 58.6% of districts in Malaysia, Singapore, Thailand, and the Philippines saw an increase in the infection risk, which is aligned with their loosened restrictions. Continuous strict interventions were effective in mitigating COVID-19, while relaxing restrictions may exacerbate the propagation risk of this epidemic. Conclusions The analyses of space-time clusters and RRs of districts benefit public health authorities with continuous surveillance of COVID-19 dynamics using real-time data. International coordination with more synchronized interventions amidst all SEA countries may play a key role in mitigating the progression of COVID-19.
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Affiliation(s)
- Wei Luo
- Department of Geography, National University of Singapore, Singapore, Singapore
| | - Zhaoyin Liu
- Department of Geography, National University of Singapore, Singapore, Singapore
| | - Yuxuan Zhou
- Department of Geography, National University of Singapore, Singapore, Singapore
| | - Yumin Zhao
- Department of Civil and Environmental Engineering, National University of Singapore, Singapore, Singapore
| | - Yunyue Elita Li
- Department of Earth, Atmospheric, and Planetary Sciences, Purdue University, West Lafayette, IN, United States
| | - Arif Masrur
- Department of Geography, Pennsylvania State University, State College, PA, United States
| | - Manzhu Yu
- Department of Geography, Pennsylvania State University, State College, PA, United States
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Nazia N, Butt ZA, Bedard ML, Tang WC, Sehar H, Law J. Methods Used in the Spatial and Spatiotemporal Analysis of COVID-19 Epidemiology: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8267. [PMID: 35886114 PMCID: PMC9324591 DOI: 10.3390/ijerph19148267] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 02/04/2023]
Abstract
The spread of the COVID-19 pandemic was spatially heterogeneous around the world; the transmission of the disease is driven by complex spatial and temporal variations in socioenvironmental factors. Spatial tools are useful in supporting COVID-19 control programs. A substantive review of the merits of the methodological approaches used to understand the spatial epidemiology of the disease is hardly undertaken. In this study, we reviewed the methodological approaches used to identify the spatial and spatiotemporal variations of COVID-19 and the socioeconomic, demographic and climatic drivers of such variations. We conducted a systematic literature search of spatial studies of COVID-19 published in English from Embase, Scopus, Medline, and Web of Science databases from 1 January 2019 to 7 September 2021. Methodological quality assessments were also performed using the Joanna Briggs Institute (JBI) risk of bias tool. A total of 154 studies met the inclusion criteria that used frequentist (85%) and Bayesian (15%) modelling approaches to identify spatial clusters and the associated risk factors. Bayesian models in the studies incorporated various spatial, temporal and spatiotemporal effects into the modelling schemes. This review highlighted the need for more local-level advanced Bayesian spatiotemporal modelling through the multi-level framework for COVID-19 prevention and control strategies.
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Affiliation(s)
- Nushrat Nazia
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada; (Z.A.B.); (M.L.B.); (W.-C.T.); (H.S.); (J.L.)
| | - Zahid Ahmad Butt
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada; (Z.A.B.); (M.L.B.); (W.-C.T.); (H.S.); (J.L.)
| | - Melanie Lyn Bedard
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada; (Z.A.B.); (M.L.B.); (W.-C.T.); (H.S.); (J.L.)
| | - Wang-Choi Tang
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada; (Z.A.B.); (M.L.B.); (W.-C.T.); (H.S.); (J.L.)
| | - Hibah Sehar
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada; (Z.A.B.); (M.L.B.); (W.-C.T.); (H.S.); (J.L.)
| | - Jane Law
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada; (Z.A.B.); (M.L.B.); (W.-C.T.); (H.S.); (J.L.)
- School of Planning, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada
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Siljander M, Uusitalo R, Pellikka P, Isosomppi S, Vapalahti O. Spatiotemporal clustering patterns and sociodemographic determinants of COVID-19 (SARS-CoV-2) infections in Helsinki, Finland. Spat Spatiotemporal Epidemiol 2022; 41:100493. [PMID: 35691637 PMCID: PMC8817446 DOI: 10.1016/j.sste.2022.100493] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 01/21/2022] [Accepted: 02/04/2022] [Indexed: 12/22/2022]
Abstract
This study aims to elucidate the variations in spatiotemporal patterns and sociodemographic determinants of SARS-CoV-2 infections in Helsinki, Finland. Global and local spatial autocorrelation were inspected with Moran's I and LISA statistics, and Getis-Ord Gi* statistics was used to identify the hot spot areas. Space-time statistics were used to detect clusters of high relative risk and regression models were implemented to explain sociodemographic determinants for the clusters. The findings revealed the presence of spatial autocorrelation and clustering of COVID-19 cases. High-high clusters and high relative risk areas emerged primarily in Helsinki's eastern neighborhoods, which are socioeconomically vulnerable, with a few exceptions revealing local outbreaks in other areas. The variation in COVID-19 rates was largely explained by median income and the number of foreign citizens in the population. Furthermore, the use of multiple spatiotemporal analysis methods are recommended to gain deeper insights into the complex spatiotemporal clustering patterns and sociodemographic determinants of the COVID-19 cases.
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Affiliation(s)
- Mika Siljander
- Earth Change Observation Laboratory, Department of Geosciences and Geography, P.O. Box 64, FI-00014 University of Helsinki, Helsinki, Finland; Department of Virology, Haartmaninkatu 3, P.O. Box 21, FI-00014 University of Helsinki, Helsinki, Finland.
| | - Ruut Uusitalo
- Earth Change Observation Laboratory, Department of Geosciences and Geography, P.O. Box 64, FI-00014 University of Helsinki, Helsinki, Finland; Department of Virology, Haartmaninkatu 3, P.O. Box 21, FI-00014 University of Helsinki, Helsinki, Finland; Department of Veterinary Biosciences, Agnes Sjöberginkatu 2, P.O. Box 66, FI-00014 University of Helsinki, Helsinki, Finland
| | - Petri Pellikka
- Earth Change Observation Laboratory, Department of Geosciences and Geography, P.O. Box 64, FI-00014 University of Helsinki, Helsinki, Finland; Helsinki Institute of Sustainability Science, University of Helsinki, Helsinki, Finland; Institute for Atmospheric and Earth System Research, University of Helsinki, Helsinki, Finland; State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan 430000, China
| | - Sanna Isosomppi
- Epidemiological Operations Unit, P.O. Box 8650, 00099 City of Helsinki, Finland
| | - Olli Vapalahti
- Department of Virology, Haartmaninkatu 3, P.O. Box 21, FI-00014 University of Helsinki, Helsinki, Finland; Department of Veterinary Biosciences, Agnes Sjöberginkatu 2, P.O. Box 66, FI-00014 University of Helsinki, Helsinki, Finland; Virology and Immunology, Diagnostic Center, HUSLAB, Helsinki University Hospital, Helsinki, Finland
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A Model for Highly Fluctuating Spatio-Temporal Infection Data, with Applications to the COVID Epidemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116669. [PMID: 35682250 PMCID: PMC9179960 DOI: 10.3390/ijerph19116669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/21/2022]
Abstract
Spatio-temporal models need to address specific features of spatio-temporal infection data, such as periods of stable infection levels (endemicity), followed by epidemic phases, as well as infection spread from neighbouring areas. In this paper, we consider a mixture-link model for infection counts that allows alternation between epidemic phases (possibly multiple) and stable endemicity, with higher AR1 coefficients in epidemic phases. This is a form of regime-switching, allowing for non-stationarity in infection levels. We adopt a generalised Poisson model appropriate to the infection count data and avoid transformations (e.g., differencing) to alternative metrics, which have been adopted in many studies. We allow for neighbourhood spillover in infection, which is also governed by adaptive regime-switching. Compared to existing models, the observational (in-sample) model is expected to better reflect the balance between epidemic and endemic tendencies, and short-term extrapolations are likely to be improved. Two case study applications involve COVID area-time data, one for 32 London boroughs (and 96 weeks) since the start of the COVID epidemic, the other for a shorter time span focusing on the epidemic phase in 144 areas of Southeast England associated with the Alpha variant. In both applications, the proposed methods produce a better in-sample fit and out-of-sample short term predictions. The spatial dynamic implications are highlighted in the case studies.
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Detection of space–time clusters using a topological hierarchy for geospatial data on COVID-19 in Japan. JAPANESE JOURNAL OF STATISTICS AND DATA SCIENCE 2022; 5:279-301. [PMID: 35578605 PMCID: PMC9097570 DOI: 10.1007/s42081-022-00159-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 03/15/2022] [Accepted: 04/01/2022] [Indexed: 01/04/2023]
Abstract
In this paper, we detected space–time clusters using data on coronavirus disease 2019 (COVID-19) collected daily by each prefecture in Japan. COVID-19 has spread globally since the first confirmed case in China, in December 2019. Several people have to date been infected in Japan since the first confirmed case in January 2020. The outbreak of COVID-19 has had a significant impact on many people’s lives. Studies are being conducted to detect regions, called clusters, which pose a significantly higher risk of infection than their surrounding areas, based on a spatial scan statistics of COVID-19 infections. Among these studies, space–time cluster detection has to date been actively performed to gain knowledge regarding infection status. Based on the spatial scan statistic, the cylindrical scan method is a widely used space–time cluster detection method. This method enables concurrent detection of the location and time of a cluster occurrence. However, this method cannot capture spatial changes in a cluster over time. When applying the existing method to a cluster whose shape changes over time, the number of calculations required becomes extremely large, and the analysis may become difficult. In this study, we focused on the hierarchical structure of the data obtained by conducting an echelon analysis and applied the space–time cluster detection method based on this structure to enable the capture of changes in a cluster’s shape. Furthermore, we visualized the location and period of a cluster’s occurrence and considered the cause of the cluster.
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21
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Congdon P. A spatio-temporal autoregressive model for monitoring and predicting COVID infection rates. JOURNAL OF GEOGRAPHICAL SYSTEMS 2022; 24:583-610. [PMID: 35496370 PMCID: PMC9039004 DOI: 10.1007/s10109-021-00366-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/07/2021] [Indexed: 06/14/2023]
Abstract
The COVID-19 epidemic has raised major issues with regard to modelling and forecasting outcomes such as cases, deaths and hospitalisations. In particular, the forecasting of area-specific counts of infectious disease poses problems when counts are changing rapidly and there are infection hotspots, as in epidemic situations. Such forecasts are of central importance for prioritizing interventions or making severity designations for different areas. In this paper, we consider different specifications of autoregressive dependence in incidence counts as these may considerably impact on adaptivity in epidemic situations. In particular, we introduce parameters to allow temporal adaptivity in autoregressive dependence. A case study considers COVID-19 data for 144 English local authorities during the UK epidemic second wave in late 2020 and early 2021, which demonstrate geographical clustering in new cases-linked to the then emergent alpha variant. The model allows for both spatial and time variation in autoregressive effects. We assess sensitivity in short-term predictions and fit to specification (spatial vs space-time autoregression, linear vs log-linear, and form of space decay), and show improved one-step ahead and in-sample prediction using space-time autoregression including temporal adaptivity.
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Affiliation(s)
- Peter Congdon
- School of Geography, Queen Mary University of London, Mile End Rd, London, E1 4NS UK
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22
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AlQadi H, Bani-Yaghoub M, Wu S, Balakumar S, Francisco A. Prospective spatial-temporal clusters of COVID-19 in local communities: case study of Kansas City, Missouri, United States. Epidemiol Infect 2022; 151:e178. [PMID: 35260205 PMCID: PMC10600737 DOI: 10.1017/s0950268822000462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/10/2022] [Accepted: 03/01/2022] [Indexed: 11/06/2022] Open
Abstract
Kansas City, Missouri, became one of the major United States hotspots for COVID-19 due to an increase in the rate of positive COVID-19 test results. Despite the large numbers of positive cases in Kansas City, MO, the spatial-temporal analysis of data has been less investigated. However, it is critical to detect emerging clusters of COVID-19 and enforce control and preventive policies within those clusters. We conducted a prospective Poisson spatial-temporal analysis of Kansas City, MO data to detect significant space-time clusters of COVID-19 positive cases at the zip code level in Kansas City, MO. The analysis focused on daily infected cases in four equal periods of 3 months. We detected temporal patterns of emerging and re-emerging space-time clusters between March 2020 and February 2021. Three statistically significant clusters emerged in the first period, mainly concentrated in downtown. It increased to seven clusters in the second period, spreading across a broader region in downtown and north of Kansas City. In the third period, nine clusters covered large areas of north and downtown Kansas City, MO. Ten clusters were present in the last period, further extending the infection along the State Line Road. The statistical results were communicated with local health officials and provided the necessary guidance for decision-making and allocating resources (e.g., vaccines and testing sites). As more data become available, statistical clustering can be used as a COVID-19 surveillance tool to measure the effects of vaccination.
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Affiliation(s)
- Hadeel AlQadi
- Department of Mathematics and Statistics, University of Missouri-Kansas City, Kansas City, MO 64110, USA
- Department of Mathematics, Jazan University, 45142 Jazan, Saudi Arabia
| | - Majid Bani-Yaghoub
- Department of Mathematics and Statistics, University of Missouri-Kansas City, Kansas City, MO 64110, USA
| | - Siqi Wu
- Department of Mathematics and Statistics, University of Missouri-Kansas City, Kansas City, MO 64110, USA
| | - Sindhu Balakumar
- Department of Mathematics and Statistics, University of Missouri-Kansas City, Kansas City, MO 64110, USA
| | - Alex Francisco
- City of Kansas City Health Department, 2400 Troost Ave, Kansas City, MO 64108, USA
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Li W, Zhang P, Zhao K, Zhao S. The Geographical Distribution and Influencing Factors of COVID-19 in China. Trop Med Infect Dis 2022; 7:45. [PMID: 35324592 PMCID: PMC8949350 DOI: 10.3390/tropicalmed7030045] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/20/2022] [Accepted: 03/03/2022] [Indexed: 12/10/2022] Open
Abstract
The study of the spatial differentiation of COVID-19 in cities and its driving mechanism is helpful to reveal the spatial distribution pattern, transmission mechanism and diffusion model, and evolution mechanism of the epidemic and can lay the foundation for constructing the spatial dynamics model of the epidemic and provide theoretical basis for the policy design, spatial planning and implementation of epidemic prevention and control and social governance. Geodetector (Origin version, Beijing, China) is a great tool for analysis of spatial differentiation and its influencing factors, and it provides decision support for differentiated policy design and its implementation in executing the city-specific policies. Using factor detection and interaction analysis of Geodetector, 15 indicators of economic, social, ecological, and environmental dimensions were integrated, and 143 cities were selected for the empirical research in China. The research shows that, first of all, risks of both infection and death show positive spatial autocorrelation, but the geographical distribution of local spatial autocorrelation differs significantly between the two. Secondly, the inequalities in urban economic, social, and residential environments interact with COVID-19 spatial heterogeneity, with stronger explanatory power especially when multidimensional inequalities are superimposed. Thirdly, the spatial distribution and spread of COVID-19 are highly spatially heterogeneous and correlated due to the complex influence of multiple factors, with factors such as Area of Urban Construction Land, GDP, Industrial Smoke and Dust Emission, and Expenditure having the strongest influence, the factors such as Area of Green, Number of Hospital Beds and Parks, and Industrial NOx Emissions having unignorable influence, while the factors such as Number of Free Parks and Industrial Enterprises, Per-GDP, and Population Density play an indirect role mainly by means of interaction. Fourthly, the factor interaction effect from the infected person's perspective mainly shows a nonlinear enhancement effect, that is, the joint influence of the two factors is greater than the sum of their direct influences; but from the perspective of the dead, it mainly shows a two-factor enhancement effect, that is, the joint influence of the two factors is greater than the maximum of their direct influences but less than their sum. Fifthly, some suggestions are put forward from the perspectives of building a healthy, resilient, safe, and smart city, providing valuable reference and decision basis for city governments to carry out differentiated policy design.
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Affiliation(s)
- Weiwei Li
- Department of Landscape and Architectural Engineering, Guangxi Agricultural Vocational University, Nanning 530007, China;
| | - Ping Zhang
- College of Civil Engineering and Architecture, Jiaxing University, Jiaxing 314001, China
- College of Architecture and Urban Planning, Lanzhou Jiaotong University, Lanzhou 730070, China
| | - Kaixu Zhao
- College of Urban and Environmental Science, Northwest University, Xi’an 710127, China;
| | - Sidong Zhao
- School of Architecture, Southeast University, Nanjing 210096, China;
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Zelner J, Masters NB, Naraharisetti R, Mojola SA, Chowkwanyun M, Malosh R. There are no equal opportunity infectors: Epidemiological modelers must rethink our approach to inequality in infection risk. PLoS Comput Biol 2022; 18:e1009795. [PMID: 35139067 PMCID: PMC8827449 DOI: 10.1371/journal.pcbi.1009795] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Mathematical models have come to play a key role in global pandemic preparedness and outbreak response: helping to plan for disease burden, hospital capacity, and inform nonpharmaceutical interventions. Such models have played a pivotal role in the COVID-19 pandemic, with transmission models—and, by consequence, modelers—guiding global, national, and local responses to SARS-CoV-2. However, these models have largely not accounted for the social and structural factors, which lead to socioeconomic, racial, and geographic health disparities. In this piece, we raise and attempt to clarify several questions relating to this important gap in the research and practice of infectious disease modeling: Why do epidemiologic models of emerging infections typically ignore known structural drivers of disparate health outcomes? What have been the consequences of a framework focused primarily on aggregate outcomes on infection equity? What should be done to develop a more holistic approach to modeling-based decision-making during pandemics? In this review, we evaluate potential historical and political explanations for the exclusion of drivers of disparity in infectious disease models for emerging infections, which have often been characterized as “equal opportunity infectors” despite ample evidence to the contrary. We look to examples from other disease systems (HIV, STIs) and successes in including social inequity in models of acute infection transmission as a blueprint for how social connections, environmental, and structural factors can be integrated into a coherent, rigorous, and interpretable modeling framework. We conclude by outlining principles to guide modeling of emerging infections in ways that represent the causes of inequity in infection as central rather than peripheral mechanisms.
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Affiliation(s)
- Jon Zelner
- Dept. of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
- * E-mail:
| | - Nina B. Masters
- Dept. of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Ramya Naraharisetti
- Dept. of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Sanyu A. Mojola
- Dept. of Sociology, School of Public and International Affairs & Office of Population Research, Princeton University, Princeton, New Jersey, United States of America
| | - Merlin Chowkwanyun
- Dept. of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Ryan Malosh
- Dept. of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
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25
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Eyles JP, Sharma S, Telles RW, Namane M, Hunter DJ, Bowden JL. Implementation of Best-Evidence Osteoarthritis Care: Perspectives on Challenges for, and Opportunities From, Low and Middle-Income Countries. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:826765. [PMID: 36188801 PMCID: PMC9397802 DOI: 10.3389/fresc.2021.826765] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/24/2021] [Indexed: 12/04/2022]
Abstract
The "Joint Effort Initiative" (JEI) is an international consortium of clinicians, researchers, and consumers under the auspices of the Osteoarthritis Research Society International (OARSI). The JEI was formed with a vision to improve the implementation of coordinated programs of best evidence osteoarthritis care globally. To better understand some of the issues around osteoarthritis care in low- and middle-income countries (LMICs), the JEI invited clinician researcher representatives from South Africa, Brazil, and Nepal to discuss their perspectives on challenges and opportunities to implementing best-evidence osteoarthritis care at the OARSI World Pre-Congress Workshop. We summarize and discuss the main themes of the presentations in this paper. The challenges to implementing evidence-based osteoarthritis care identified in LMICs include health inequities, unaffordability of osteoarthritis management and the failure to recognize osteoarthritis as an important disease. Fragmented healthcare services and a lack of health professional knowledge and skills are also important factors affecting osteoarthritis care in LMICs. We discuss considerations for developing strategies to improve osteoarthritis care in LMICs. Existing opportunities may be leveraged to facilitate the implementation of best-evidence osteoarthritis care. We also discuss strategies to support the implementation, such as the provision of high-quality healthcare professional and consumer education, and systemic healthcare reforms.
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Affiliation(s)
- Jillian P. Eyles
- Kolling Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Saurab Sharma
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia
| | - Rosa Weiss Telles
- Universidade Federal de Minas Gerais, Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Musculoskeletal, Belo Horizonte, Brazil
| | - Mosedi Namane
- School of Public Health and Family Medicine, The University of Cape Town, Cape Town, South Africa
| | - David J. Hunter
- Kolling Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Rheumatology Department, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Jocelyn L. Bowden
- Kolling Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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Libório MP, Ekel PY, de Abreu JF, Laudares S. Factors that most expose countries to COVID-19: a composite indicators-based approach. GEOJOURNAL 2021; 87:5435-5449. [PMID: 34873361 PMCID: PMC8636286 DOI: 10.1007/s10708-021-10557-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 05/04/2023]
Abstract
Studies carried out in different countries correlate social, economic, environmental, and health factors with the number of cases and deaths from COVID-19. However, such studies do not reveal which factors make one country more exposed to COVID-19 than other. Based on the composite indicators approach, this research identifies the factors that most impact the number of cases and deaths of COVID-19 worldwide and measures countries' exposure to COVID-19. Three composite indicators of exposure to COVID-19 were constructed through Principal Component Analysis, Simple Additive Weighting, and k-means clustering. The number of cases and deaths from COVID-19 is strongly correlated ( R > 0.60) with composite indicator scores and moderately concordant ( K > 0.4) with country clusters. Factors directly or indirectly associated with the age of the population are the ones that most expose countries to COVID-19. The population of countries most exposed to COVID-19 is 12 years older on average. The proportion of the elderly population in these countries is at least twice that of countries less exposed to COVID-19. Factors that can increase the population's life expectancy, such as Gross Domestic Product per capita and the Human Development Index, are four times and 1.3 times higher in more exposed countries to COVID-19. Providing better living conditions increases both the population's life expectancy and the country's exposure to COVID-19.
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Affiliation(s)
| | | | | | - Sandro Laudares
- Pontifical Catholic University of Minas Gerais, Belo Horizonte, 30535-012 Brazil
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Halpern D, Lin Q, Wang R, Yang S, Goldstein S, Kolak M. Dimensions of Uncertainty: A spatiotemporal review of five COVID-19 datasets. CARTOGRAPHY AND GEOGRAPHIC INFORMATION SCIENCE 2021; 51:200-221. [PMID: 38919877 PMCID: PMC11196018 DOI: 10.1080/15230406.2021.1975311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/29/2021] [Indexed: 06/27/2024]
Abstract
COVID-19 surveillance across the U.S. is essential to tracking and mitigating the pandemic, but data representing cases and deaths may be impacted by attribute, spatial, and temporal uncertainties. COVID-19 case and death data are essential to understanding the pandemic and serve as key inputs for prediction models that inform policy-decisions; consistent information across datasets is critical to ensuring coherent findings. We implement an exploratory data analytic approach to characterize, synthesize, and visualize spatial-temporal dimensions of uncertainty across commonly used datasets for case and death metrics (Johns Hopkins University, the New York Times, USAFacts, and 1Point3Acres). We scrutinize data consistency to assess where and when disagreements occur, potentially indicating underlying uncertainty. We observe differences in cumulative case and death rates to highlight discrepancies and identify spatial patterns. Data are assessed using pairwise agreement (Cohen's kappa) and agreement across all datasets (Fleiss' kappa) to summarize changes over time. Findings suggest highest agreements between CDC, JHU, and NYT datasets. We find nine discrete type-components of information uncertainty for COVID-19 datasets reflecting various complex processes. Understanding processes and indicators of uncertainty in COVID-19 data reporting is especially relevant to public health professionals and policymakers to accurately understand and communicate information about the pandemic.
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Affiliation(s)
- Dylan Halpern
- Center for Spatial Data Science, The University of Chicago, Chicago, IL, USA
| | - Qinyun Lin
- Center for Spatial Data Science, The University of Chicago, Chicago, IL, USA
| | - Ryan Wang
- Center for Spatial Data Science, The University of Chicago, Chicago, IL, USA
| | - Stephanie Yang
- Center for Spatial Data Science, The University of Chicago, Chicago, IL, USA
| | - Steve Goldstein
- Department of Botany, American Family Insurance Data Science Institute, University of Wisconsin-Madison, Madison, WI, USA
| | - Marynia Kolak
- Center for Spatial Data Science, The University of Chicago, Chicago, IL, USA
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Park YM, Kearney GD, Wall B, Jones K, Howard RJ, Hylock RH. COVID-19 Deaths in the United States: Shifts in Hot Spots over the Three Phases of the Pandemic and the Spatiotemporally Varying Impact of Pandemic Vulnerability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8987. [PMID: 34501577 PMCID: PMC8431027 DOI: 10.3390/ijerph18178987] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 01/27/2023]
Abstract
The geographic areas most impacted by COVID-19 may not remain static because public health measures/behaviors change dynamically, and the impacts of pandemic vulnerability also may vary geographically and temporally. The nature of the pandemic makes spatiotemporal methods essential to understanding the distribution of COVID-19 deaths and developing interventions. This study examines the spatiotemporal trends in COVID-19 death rates in the United States from March 2020 to May 2021 by performing an emerging hot spot analysis (EHSA). It then investigates the effects of the COVID-19 time-dependent and basic social vulnerability factors on COVID-19 death rates using geographically and temporally weighted regression (GTWR). The EHSA results demonstrate that over the three phases of the pandemic (first wave, second wave, and post-vaccine deployment), hot spots have shifted from densely populated cities and the states with a high percentage of socially vulnerable individuals to the states with relatively relaxed social distancing requirements, and then to the states with low vaccination rates. The GTWR results suggest that local infection and testing rates, social distancing interventions, and other social, environmental, and health risk factors show significant associations with COVID-19 death rates, but these associations vary over time and space. These findings can inform public health planning.
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Affiliation(s)
- Yoo Min Park
- Department of Geography, Planning and Environment, East Carolina University, Greenville, NC 27858, USA;
| | - Gregory D. Kearney
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA; (G.D.K.); (K.J.)
| | - Bennett Wall
- Vidant Medical Center, Greenville, NC 27835, USA;
| | - Katherine Jones
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA; (G.D.K.); (K.J.)
| | - Robert J. Howard
- Department of Geography, Planning and Environment, East Carolina University, Greenville, NC 27858, USA;
| | - Ray H. Hylock
- Department of Health Services and Information Management, East Carolina University, Greenville, NC 27834, USA;
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Fonseca-Rodríguez O, Gustafsson PE, San Sebastián M, Connolly AMF. Spatial clustering and contextual factors associated with hospitalisation and deaths due to COVID-19 in Sweden: a geospatial nationwide ecological study. BMJ Glob Health 2021; 6:bmjgh-2021-006247. [PMID: 34321234 PMCID: PMC8322019 DOI: 10.1136/bmjgh-2021-006247] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 07/15/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION In Sweden, thousands of hospitalisations and deaths due to COVID-19 were reported since the pandemic started. Considering the uneven spatial distribution of those severe outcomes at the municipality level, the objective of this study was, first, to identify high-risk areas for COVID-19 hospitalisations and deaths, and second, to determine the associated contextual factors with the uneven spatial distribution of both study outcomes in Sweden. METHODS The existences of spatial autocorrelation of the standardised incidence (hospitalisations) ratio and standardised mortality ratio were investigated using Global Moran's I test. Furthermore, we applied the retrospective Poisson spatial scan statistics to identify high-risk spatial clusters. The association between the contextual demographic and socioeconomic factors and the number of hospitalisations and deaths was estimated using a quasi-Poisson generalised additive regression model. RESULTS Ten high-risk spatial clusters of hospitalisations and six high-risk clusters of mortality were identified in Sweden from February 2020 to October 2020. The hospitalisations and deaths were associated with three contextual variables in a multivariate model: population density (inhabitants/km2) and the proportion of immigrants (%) showed a positive association with both outcomes, while the proportion of the population aged 65+ years (%) showed a negative association. CONCLUSIONS Our study identified high-risk spatial clusters for hospitalisations and deaths due to COVID-19 and the association of population density, the proportion of immigrants and the proportion of people aged 65+ years with those severe outcomes. Results indicate where public health measures must be reinforced to improve sustained and future disease control and optimise the distribution of resources.
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Affiliation(s)
| | - Per E Gustafsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Abstract
This study aimed to analyse the geographical distribution of coronavirus disease 2019 (COVID-19) and to identify high-risk areas in space and time for the occurrence of cases and deaths in the indigenous population of Brazil. This is an ecological study carried out between 24 March and 26 October 2020 whose units of analysis were the Special Indigenous Sanitary Districts. The Getis-Ord General G and Getis-Ord Gi* techniques were used to verify the spatial association of the phenomena and a retrospective space–time scan was performed. There were 32 041 confirmed cases of COVID-19 and 471 deaths. The non-randomness of cases (z score = 5.40; P < 0.001) and deaths (z score = 3.83; P < 0.001) were confirmed. Hotspots were identified for cases and deaths in the north and midwest regions of Brazil. Sixteen high-risk space–time clusters were identified for the occurrence of cases with a higher RR = 21.23 (P < 0.001) and four risk clusters for deaths with a higher RR = 80.33 (P < 0.001). These clusters were identified from 22 May and were active until 10 October 2020. The results indicate critical areas in the indigenous territories of Brazil and contribute to better directing the actions of control of COVID-19 in this population.
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Coura-Vital W, Cardoso DT, Ker FTDO, Magalhães FDC, Bezerra JMT, Viegas AM, Morais MHF, Bastos LS, Reis IA, Carneiro M, Barbosa DS. Spatiotemporal dynamics and risk estimates of COVID-19 epidemic in Minas Gerais State: analysis of an expanding process. Rev Inst Med Trop Sao Paulo 2021; 63:e21. [PMID: 33787741 PMCID: PMC7997666 DOI: 10.1590/s1678-9946202163021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/20/2021] [Indexed: 12/24/2022] Open
Abstract
COVID-19 is an infectious disease caused by the recently discovered coronavirus
SARS-Cov-2. The disease became pandemic affecting many countries globally,
including Brazil. Considering the expansion process and particularities during
the initial stages of the epidemic, we aimed to analyze the spatial and
spatiotemporal patterns of COVID-19 occurrence and to identify priority risk
areas in Minas Gerais State, Southeast Brazil. An ecological study was performed
considering all data from human cases of COVID-19 confirmed from the
epidemiological week (EW) 11 (March 08, 2020) to EW 26 (June 27, 2020). Crude
and smoothed incidence rates were used to analyze the distribution of disease
patterns based on global and local indicators of spatial association and
space-time risk assessment. Positive spatial autocorrelation and spatial
dependence were found. Our results suggest that the metropolitan region of the
State capital Belo Horizonte (MRBH) and Vale do Rio Doce mesoregions, as major
epidemic foci in the beginning of the expansion process, have had important
influence on the dispersion of SARS-CoV-2 in Minas Gerais State. Triangulo
Mineiro/Alto Paranaiba region presented the highest risk of infection. In
addition, six statistically significant spatiotemporal clusters were identified
in the State, three at high risk and three at low risk. Our findings contribute
to a greater understanding of the space-time disease dynamic and discuss
strategies for identification of priority areas for COVID-19 surveillance and
control.
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Affiliation(s)
- Wendel Coura-Vital
- Universidade Federal de Ouro Preto, Escola de Farmácia, Departamento de Análises Clínicas, Ouro Preto, Minas Gerais, Brazil
| | - Diogo Tavares Cardoso
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Belo Horizonte, Minas Gerais, Brazil
| | | | - Fernanda do Carmo Magalhães
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Belo Horizonte, Minas Gerais, Brazil
| | - Juliana Maria Trindade Bezerra
- Universidade Estadual do Maranhão, Campus de Lago da Pedra, Curso de Ciências Biológicas, Lago da Pedra, Maranhão, Brazil
| | - Ana Maria Viegas
- Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brasil.,Prefeitura Municipal de Contagem, Contagem, Minas Gerais, Brazil
| | - Maria Helena Franco Morais
- Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brasil.,Prefeitura Municipal de Contagem, Contagem, Minas Gerais, Brazil
| | - Leonardo Soares Bastos
- Fundação Oswaldo Cruz, Programa de Computação Científica, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ilka Afonso Reis
- Universidade Federal de Minas Gerais, Instituto de Ciências Exatas, Belo Horizonte, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Belo Horizonte, Minas Gerais, Brazil
| | - David Soeiro Barbosa
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Belo Horizonte, Minas Gerais, Brazil
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Fujita DM, Nali LHDS, Salvador FS, Luna EJDA. Lock or Down: Effectiveness of Isolation Measures Against COVID-19. Clinics (Sao Paulo) 2021; 76:e3218. [PMID: 34378732 PMCID: PMC8311638 DOI: 10.6061/clinics/2021/e3218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/21/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Dennis Minoru Fujita
- Laboratorio de Investigacao Medica (LIM49), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Instituto de Medicina Tropical, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Grupo de Pesquisa de Aspectos Epidemiologicos, Clinicos, Moleculares e Celulares das Molestias Infecciosas, CNPQ/UNISA, Sao Paulo, SP, BR
- Corresponding author. E-mail:
| | - Luiz Henrique da Silva Nali
- Grupo de Pesquisa de Aspectos Epidemiologicos, Clinicos, Moleculares e Celulares das Molestias Infecciosas, CNPQ/UNISA, Sao Paulo, SP, BR
- Programa de Pos-Graduacao em Ciencias da Saude, Universidade Santo Amaro, Sao Paulo, SP, BR
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