Global performance of epidemiologic surveillance of Zika virus: rapid assessment of an ongoing epidemic

Desempeño del sistema de vigilancia COVID-19 en Honduras 2020: Análisis de la ley de Benford

El COVID-19 es una enfermedad infecciosa responsable hasta la fecha de 6,369,703 muertes a nivel mundial. Para poder controlarla es importante adaptar y reforzar los sistemas nacionales de salud y ampliar las capacidades en materia de vigilancia, siendo el reporte diario de nuevos casos y muertes por COVID-19, una de las principales herramientas para comprender y dar respuesta a la pandemia. El trabajo se centró en identificar inconsistencias en los datos reportados sobre casos y muertes confirmadas de COVID-19, por el sistema de salud hondureño durante el año 2020. Se analizaron los datos oficiales publicados entre el 11 de marzo y el 31 de diciembre de 2020, por el centro de recursos coronavirus de la Universidad Johns Hopkins, los datos fueron divididos en cuatro segmentos de análisis, el primero correspondió a los primeros 50 días de pandemia en el país, el segundo incluyó datos hasta el 24 junio, el tercero hasta el 1 diciembre y el cuarto incluyó todos los datos del 2020. Para el análisis se hizo uso de la ley de Benford, el cual es un fenómeno estadístico ampliamente usado que permite detectar datos anómalos en los sistemas de vigilancia de cada país. Hasta el 31 de diciembre el sistema de salud hondureño confirmó 121,827 casos positivos y 3,130 muertes por COVID-19 en Honduras. Respecto a la detección de datos anómalos el segundo segmento de análisis obtuvo un mejor resultado, sin embargo, se observo que el análisis acumulado correspondiente al 2020 no se ajustó a la Ley de Benford. En general, la vigilancia tuvo una mejoría en el desempeñó después de los primeros 50 días de pandemia, no obstante, los datos referentes al 2020 revelan una disconformidad con la ley de Benford, lo que se interpreta como un desempeño de notificación no adecuado. Palabras clave .COVID-19, distribuciones estadísticas, Honduras, monitoreo epidemiológico, notificación de enfermedades.

Report From Bolsonaro's Brazil: The Consequences of Ignoring Science

Currently, the fast spread of COVID-19 is the cause of a sanitary emergency in Brazil. This situation is largely due to President Bolsonaro's denial and the uncoordinated actions between the federal and local governments. In addition, the Brazilian government has reported that it would change its method of sharing information about the pandemic. On June 6, 2020, the presentation of accumulated cases and deaths was stopped, and the Supreme Court of Brazil determined that the federal government should continue to consolidate and disseminate the accumulated figures of cases and deaths. However, doubt about the transparency of the data remained. We used data reported by the government from Situation Reports 38-209 of the World Health Organization to assess the Benford's law fulfillment as an indicator of data quality. This rapid evaluation of data quality during the ongoing COVID-19 pandemic in Brazil suggests that the Brazilian public health surveillance system had an acceptable performance at the beginning of the epidemic. Since the end of June, the quality of cumulative death data began to decrease and remains in that condition as of August 2020. A similar situation has existed since August, with the data of accumulated new cases.

On the authenticity of COVID-19 case figures

In this article, we study the applicability of Benford’s law and Zipf’s law to national COVID-19 case figures with the aim of establishing guidelines upon which methods of fraud detection in epidemiology, based on formal statistical analysis, can be developed. Moreover, these approaches may also be used in evaluating the performance of public health surveillance systems. We provide theoretical arguments for why the empirical laws should hold in the early stages of an epidemic, along with preliminary empirical evidence in support of these claims. Based on data published by the World Health Organization and various national governments, we find empirical evidence that suggests that both Benford’s law and Zipf’s law largely hold across countries, and deviations can be readily explained. To the best of our knowledge, this paper is among the first to present a practical application of Zipf’s law to fraud detection.

Benchmarking of public health surveillance of COVID-19 in Colombia: First semester

Introduction: Public health surveillance together with good sanitary decisions is essential for the proper management of the SARS-CoV-2 pandemic. Objective: To compare the performance of Colombian departments based on the quality of the data and to build the national ranking. Materials and methods: We analyzed the accumulated cases published between March 6 and September 1, 2020, by the Instituto Nacional de Salud. To achieve comparability, the analyses considered the day the first case was diagnosed as the first analysis date for each department. The fulfillment of Benford’s law was assessed with p-values in the log-likelihood ratio or chi-square tests. The analysis was completed with the lethality observed in each department and then the performance ranking was established. Results: Bogotá and Valle del Cauca had optimal public health surveillance performance all along. The data suggest that Antioquia, Nariño, and Tolima had good containment and adequate public health surveillance after the economic opening beginning on June 1, 2020. Conclusion: We obtained the ranking of the departments regarding the quality of public health surveillance data. The best five departments can be case studies to identify the elements associated with good performance.

Data Quality of Chinese Surveillance of COVID-19: Objective Analysis Based on WHO's Situation Reports

Was there quality in the Chinese epidemiological surveillance system during the COVID-19 pandemic? Using data of World Health Organization's situation reports (until situation report 55), an objective analysis was realized to answer this important question. Fulfillment of Benford's law (first digit law) is a rapid tool to suggest good data quality. Results suggest that China had an acceptable quality in its epidemiological surveillance system. Furthermore, more detailed and complete analyses could complement the evaluation of the Chinese surveillance system.

Zika Virus Infection during Pregnancy and Sensorineural Hearing Loss among Children at 3 and 24 Months Post-Partum

OBJECTIVE

The objectives of this study were to describe the findings of the auditory screening in children of mothers with ZIKV during pregnancy or suspicious of congenital ZIKV, and to determine whether hearing loss was in the first 2 years in life, regardless of whether microcephaly was also present.

METHODS

This is a cases report. The information was collected and recorded in a database between January 2016 and April 2018. We perform two auditory tests to 3 and 24 months of life. The study was developed in Aguachica (Cesar, Colombia). It is considered a high-risk area for ZIKV infection. Participants included children of mothers with confirmed ZIKV during pregnancy or suspicious of congenital ZIKV exposure of ZIKV infection during an epidemic period in a tropical area. We defined a positive case according to the epidemiological definition and clinical criteria based on maternal symptoms. However, other children of mothers without clinical signs of Zika were evaluated at the same time. The main outcome was the presence of sensorineural hearing loss.

RESULTS

The median age in the study group (n = 43) was 3.5 months (rank: 0-6) and the comparison group (n: 23, children of mothers without clinical signs of ZIKV) was 3 months (rank: 0-12). Screening hearing test was done using distortion product otoacustic emissions. At 3 months follow-up, children were evaluated using distortion product otoacustic emissions and automatized auditory brainstem response. None of the patients evaluated in this study were found to have sensorineural hearing loss.

CONCLUSIONS

We did not find hearing loss during the first 2 years in the children whose mother showed Zika during pregnancy. We recommend these children must be assessed to closed because there is a high risk the hearing loss as it usually may occur with CMV.

NS3 helicase from dengue virus specifically recognizes viral RNA sequence to ensure optimal replication

The protein–RNA interactions within the flavivirus replication complex (RC) are not fully understood. Our structure of dengue virus NS3 adenosine triphosphatase (ATPase)/helicase bound to the conserved 5′ genomic RNA 5′-AGUUGUUAGUCU-3′ reveals that D290 and R538 make specific interactions with G2 and G5 bases respectively. We show that single-stranded 12-mer RNA stimulates ATPase activity of NS3, however the presence of G2 and G5 leads to significantly higher activation. D290 is adjacent to the DEXH motif found in SF2 helicases like NS3 and interacts with R387, forming a molecular switch that activates the ATPase site upon RNA binding. Our structure guided mutagenesis revealed that disruption of D290–R387 interaction increases basal ATPase activity presumably as a result of higher conformational flexibility of the ATPase active site. Mutational studies also showed R538 plays a critical role in RNA interactions affecting translocation of viral RNA through dynamic interactions with bases at positions 4 and 5 of the ssRNA. Restriction of backbone flexibility around R538 through mutation of G540 to proline abolishes virus replication, indicating conformational flexibility around residue R538 is necessary for RNA translocation. The functionally critical sequence-specific contacts in NS3 RNA binding groove in subdomain III reveals potentially novel allosteric anti-viral drug targets.