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Banholzer N, Schmutz R, Middelkoop K, Hella J, Egger M, Wood R, Fenner L. Airborne transmission risks of tuberculosis and COVID-19 in schools in South Africa, Switzerland, and Tanzania: Modeling of environmental data. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002800. [PMID: 38236801 PMCID: PMC10796007 DOI: 10.1371/journal.pgph.0002800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 12/18/2023] [Indexed: 01/22/2024]
Abstract
The COVID-19 pandemic renewed interest in airborne transmission of respiratory infections, particularly in congregate indoor settings, such as schools. We modeled transmission risks of tuberculosis (caused by Mycobacterium tuberculosis, Mtb) and COVID-19 (caused by SARS-CoV-2) in South African, Swiss and Tanzanian secondary schools. We estimated the risks of infection with the Wells-Riley equation, expressed as the median with 2.5% and 97.5% quantiles (credible interval [CrI]), based on the ventilation rate and the duration of exposure to infectious doses (so-called quanta). We computed the air change rate (ventilation) using carbon dioxide (CO2) as a tracer gas and modeled the quanta generation rate based on reported estimates from the literature. The share of infectious students in the classroom is determined by country-specific estimates of pulmonary TB. For SARS-CoV-2, the number of infectious students was estimated based on excess mortality to mitigate the bias from country-specific reporting and testing. Average CO2 concentration (parts per million [ppm]) was 1,610 ppm in South Africa, 1,757 ppm in Switzerland, and 648 ppm in Tanzania. The annual risk of infection for Mtb was 22.1% (interquartile range [IQR] 2.7%-89.5%) in South Africa, 0.7% (IQR 0.1%-6.4%) in Switzerland, and 0.5% (IQR 0.0%-3.9%) in Tanzania. For SARS-CoV-2, the monthly risk of infection was 6.8% (IQR 0.8%-43.8%) in South Africa, 1.2% (IQR 0.1%-8.8%) in Switzerland, and 0.9% (IQR 0.1%-6.6%) in Tanzania. The differences in transmission risks primarily reflect a higher incidence of SARS-CoV-2 and particularly prevalence of TB in South Africa, but also higher air change rates due to better natural ventilation of the classrooms in Tanzania. Global comparisons of the modeled risk of infectious disease transmission in classrooms can provide high-level information for policy-making regarding appropriate infection control strategies.
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Affiliation(s)
- Nicolas Banholzer
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Remo Schmutz
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Keren Middelkoop
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Desmond Tutu Health Centre, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Jerry Hella
- Ifakara Health Institute, Dar-es-Salaam, Tanzania
| | - Matthias Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Robin Wood
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Desmond Tutu Health Centre, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Lukas Fenner
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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Islam MA, Sangkham S, Tiwari A, Vadiati M, Hasan MN, Noor STA, Mumin J, Bhattacharya P, Sherchan SP. Association between Global Monkeypox Cases and Meteorological Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15638. [PMID: 36497712 PMCID: PMC9740470 DOI: 10.3390/ijerph192315638] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
The emergence of an outbreak of Monkeypox disease (MPXD) is caused by a contagious zoonotic Monkeypox virus (MPXV) that has spread globally. Yet, there is no study investigating the effect of climatic changes on MPXV transmission. Thus, studies on the changing epidemiology, evolving nature of the virus, and ecological niche are highly paramount. Determination of the role of potential meteorological drivers including temperature, precipitation, relative humidity, dew point, wind speed, and surface pressure is beneficial to understand the MPXD outbreak. This study examines the changes in MPXV cases over time while assessing the meteorological characteristics that could impact these disparities from the onset of the global outbreak. To conduct this data-based research, several well-accepted statistical techniques including Simple Exponential Smoothing (SES), Auto-Regressive Integrated Moving Average (ARIMA), Automatic forecasting time-series model (Prophet), and Autoregressive Integrated Moving Average with Explanatory Variables (ARIMAX) were applied to delineate the correlation of the meteorological factors on global daily Monkeypox cases. Data on MPXV cases including affected countries spanning from 6 May 2022, to 9 November 2022, from global databases and meteorological data were used to evaluate the developed models. According to the ARIMAX model, the results showed that temperature, relative humidity, and surface pressure have a positive impact [(51.56, 95% confidence interval (CI): -274.55 to 377.68), (17.32, 95% CI: -83.71 to 118.35) and (23.42, 95% CI: -9.90 to 56.75), respectively] on MPXV cases. In addition, dew/frost point, precipitation, and wind speed show a significant negative impact on MPXD cases. The Prophet model showed a significant correlation with rising MPXD cases, although the trend predicts peak values while the overall trend increases. This underscores the importance of immediate and appropriate preventive measures (timely preparedness and proactive control strategies) with utmost priority against MPXD including awareness-raising programs, the discovery, and formulation of effective vaccine candidate(s), prophylaxis and therapeutic regimes, and management strategies.
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Affiliation(s)
- Md. Aminul Islam
- Advanced Molecular Lab, Department of Microbiology, President Abdul Hamid Medical College, Karimganj 2310, Bangladesh
- COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Sarawut Sangkham
- Department of Environmental Health, School of Public Health, University of Phayao, Muang District, Phayao 56000, Thailand
| | - Ananda Tiwari
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, 00014 Helsinki, Finland
- Department of Health Security, Expert Microbiology Research Unit, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland
| | - Meysam Vadiati
- Hubert H. Humphrey Fellowship Program, Global Affairs, University of California, Davis, 10 College Park, Davis, CA 95616, USA
| | - Mohammad Nayeem Hasan
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet 3114, Bangladesh
- Joint Rohingya Response Program, Food for the Hungry, Cox’s Bazar 4700, Bangladesh
| | - Syed Toukir Ahmed Noor
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet 3114, Bangladesh
| | - Jubayer Mumin
- Platform of Medical and Dental Society, Dhaka 1214, Bangladesh
| | - Prosun Bhattacharya
- COVID-19 Research, Department of Sustainable Development, Environmental Science and Engineering, KTH Royal Institute of Technology, Teknikringen 10B, SE 10044 Stockholm, Sweden
| | - Samendra P. Sherchan
- Department of Biology, Morgan State University, Baltimore, MD 11428, USA
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70118, USA
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Helfers A, Reiserer M, Schneider N, Ebersbach M, Sommer C. Should I Stay or Should I Go? Risk Perception and Use of Local Public Transport During the COVID-19 Pandemic. Front Psychol 2022; 13:926539. [PMID: 35874369 PMCID: PMC9306558 DOI: 10.3389/fpsyg.2022.926539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/17/2022] [Indexed: 11/17/2022] Open
Abstract
In light of the climate crisis, the transport sector needs to be urgently transformed and the number of users of local public transport needs to be increased. However, the first year of the COVID-19 pandemic severely affected public transport with passenger numbers declining up to 80% in Germany. In addition to a general decrease in mobility during lockdowns, we can observe a shift in decision-making in regards to modes of transportation, with public transport losing out. We argue that this change in behavior can be explained by the fact that people tend to overestimate the risk of COVID-19 transmission in public transport. In order to understand risk perception in users and non-users of public transport during the pandemic, a representative survey (N = 918) in a German major city was conducted at the peak of the third wave of the pandemic in April 2021. We identified four main target groups of public transport use during the pandemic: Loyal users (n = 193), reducers (n = 175), pandemic-dropouts (n = 331) and non-users (n = 219). We found reducers (r = 0.12), pandemic-dropouts (r = 0.32) and non-users (r = 0.22) to perceive an increased perception of infection risk for public transport as compared loyal users. This increased risk perception was specific to public transport - it did not generalize to other day-to-day situations, such as going to the grocery store or visiting a hairdresser. This finding can be taken as an indication that risk perception for an infection plays a crucial role in stepping back from public transport use during the pandemic. In addition, however, there were other differences in terms of needs and concerns between the different target groups during the pandemic. Based on our findings, we discuss which tools and interventions might convince these different groups to hop-(back)-on public transport. Our study highlights how risk perception will play an important role in attracting new and former passengers and is the basis for the interventions and developments that will build a pandemic-resistant public transport in the future.
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Affiliation(s)
- Anna Helfers
- Developmental Psychology, Institute of Psychology, Faculty of Human Sciences, University of Kassel, Kassel, Germany
- Transportation Planning and Traffic Systems, Faculty of Civil and Environmental Engineering, University of Kassel, Kassel, Germany
| | - Marissa Reiserer
- Transportation Planning and Traffic Systems, Faculty of Civil and Environmental Engineering, University of Kassel, Kassel, Germany
| | - Natalie Schneider
- Transportation Planning and Traffic Systems, Faculty of Civil and Environmental Engineering, University of Kassel, Kassel, Germany
| | - Mirjam Ebersbach
- Developmental Psychology, Institute of Psychology, Faculty of Human Sciences, University of Kassel, Kassel, Germany
| | - Carsten Sommer
- Transportation Planning and Traffic Systems, Faculty of Civil and Environmental Engineering, University of Kassel, Kassel, Germany
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