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Alsallakh M, Adeloye D, Vasileiou E, Sivakumaran S, Akbari A, Lyons RA, Robertson C, Rudan I, Davies GA, Sheikh A. Impact of the COVID-19 Pandemic on Influenza Hospital Admissions and Deaths in Wales: Descriptive National Time Series Analysis. JMIR Public Health Surveill 2024; 10:e43173. [PMID: 39171430 PMCID: PMC11358661 DOI: 10.2196/43173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 04/25/2024] [Accepted: 05/16/2024] [Indexed: 08/23/2024] Open
Abstract
Background The COVID-19 pandemic and the ensuing implementation of control measures caused widespread societal disruption. These disruptions may also have affected community transmission and seasonal circulation patterns of endemic respiratory viruses. Objective We aimed to investigate the impact of COVID-19-related disruption on influenza-related emergency hospital admissions and deaths in Wales in the first 2 years of the pandemic. Methods A descriptive analysis of influenza activity was conducted using anonymized pathology, hospitalization, and mortality data from the Secure Anonymised Information Linkage Databank in Wales. The annual incidence of emergency hospitalizations and deaths with influenza-specific diagnosis codes between January 1, 2015, and December 31, 2021, was estimated. Case definitions of emergency hospitalization and death required laboratory confirmation with a polymerase chain reaction test. Trends of admissions and deaths were analyzed monthly and yearly. We conducted 2 sensitivity analyses by extending case definitions to include acute respiratory illnesses with a positive influenza test and by limiting admissions to those with influenza as the primary diagnosis. We also examined yearly influenza testing trends to understand changes in testing behavior during the pandemic. Results We studied a population of 3,235,883 Welsh residents in 2020 with a median age of 42.5 (IQR 22.9-61.0) years. Influenza testing in Wales increased notably in the last 2 months of 2020, and particularly in 2021 to 39,720 per 100,000 people, compared to the prepandemic levels (1343 in 2019). The percentage of influenza admissions matched to an influenza polymerase chain reaction test increased from 74.8% (1890/2526) in 2019 to 85.2% (98/115) in 2021. However, admissions with a positive test per 100,000 population decreased from 17.0 in 2019 to 2.7 and 0.6 in 2020 and 2021, respectively. Similarly, deaths due to influenza with a positive influenza test per 100,000 population decreased from 0.4 in 2019 to 0.0 in 2020 and 2021. Sensitivity analyses showed similar patterns of decreasing influenza admissions and deaths in the first 2 years of the COVID-19 pandemic. Conclusions Nonpharmaceutical interventions to control COVID-19 were associated with a substantial reduction in the transmission of the influenza virus, with associated substantial reductions in hospital cases and deaths observed. Beyond the pandemic context, consideration should be given to the role of nonpharmaceutical community-driven interventions to reduce the burden of influenza.
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Affiliation(s)
- Mohammad Alsallakh
- Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, United Kingdom
| | - Davies Adeloye
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | | | - Shanya Sivakumaran
- Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, United Kingdom
| | - Ashley Akbari
- Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, United Kingdom
| | - Ronan A Lyons
- Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, United Kingdom
| | - Chris Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, United Kingdom
- Health Protection, Public Health Scotland, Glasgow, United Kingdom
| | - Igor Rudan
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Gwyneth A Davies
- Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, United Kingdom
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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Thompson R, Hart W, Keita M, Fall I, Gueye A, Chamla D, Mossoko M, Ahuka-Mundeke S, Nsio-Mbeta J, Jombart T, Polonsky J. Using real-time modelling to inform the 2017 Ebola outbreak response in DR Congo. Nat Commun 2024; 15:5667. [PMID: 38971835 PMCID: PMC11227569 DOI: 10.1038/s41467-024-49888-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 06/19/2024] [Indexed: 07/08/2024] Open
Abstract
Important policy questions during infections disease outbreaks include: i) How effective are particular interventions?; ii) When can resource-intensive interventions be removed? We used mathematical modelling to address these questions during the 2017 Ebola outbreak in Likati Health Zone, Democratic Republic of the Congo (DRC). Eight cases occurred before 15 May 2017, when the Ebola Response Team (ERT; co-ordinated by the World Health Organisation and DRC Ministry of Health) was deployed to reduce transmission. We used a branching process model to estimate that, pre-ERT arrival, the reproduction number was R = 1.49 (95% credible interval ( 0.67, 2.81 ) ). The risk of further cases occurring without the ERT was estimated to be 0.97 (97%). However, no cases materialised, suggesting that the ERT's measures were effective. We also estimated the risk of withdrawing the ERT in real-time. By the actual ERT withdrawal date (2 July 2017), the risk of future cases without the ERT was only 0.01, indicating that the ERT withdrawal decision was safe. We evaluated the sensitivity of our results to the estimated R value and considered different criteria for determining the ERT withdrawal date. This research provides an extensible modelling framework that can be used to guide decisions about when to relax interventions during future outbreaks.
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Affiliation(s)
- R Thompson
- Mathematical Institute, University of Oxford, Oxford, UK.
| | - W Hart
- Mathematical Institute, University of Oxford, Oxford, UK
| | - M Keita
- World Health Organization, Regional Office for Africa, Brazzaville, Democratic Republic of the Congo
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - I Fall
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | - A Gueye
- World Health Organization, Regional Office for Africa, Brazzaville, Democratic Republic of the Congo
| | - D Chamla
- World Health Organization, Regional Office for Africa, Brazzaville, Democratic Republic of the Congo
| | - M Mossoko
- Institut National de Santé Publique, Ministry of Public Health, Hygiene and Prevention, Kinshasa, Democratic Republic of the Congo
| | - S Ahuka-Mundeke
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - J Nsio-Mbeta
- Institut National de Santé Publique, Ministry of Public Health, Hygiene and Prevention, Kinshasa, Democratic Republic of the Congo
| | - T Jombart
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College, London, UK
| | - J Polonsky
- Geneva Centre of Humanitarian Studies, University of Geneva, Geneva, Switzerland
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Ko Y, Lee J, Seo Y, Jung E. A comprehensive analysis of non-pharmaceutical interventions and vaccination on Ebolavirus disease outbreak: Stochastic modeling approach. PLoS Negl Trop Dis 2024; 18:e0011955. [PMID: 38848434 PMCID: PMC11189251 DOI: 10.1371/journal.pntd.0011955] [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: 02/01/2024] [Revised: 06/20/2024] [Accepted: 05/16/2024] [Indexed: 06/09/2024] Open
Abstract
Ebolavirus disease (EVD) outbreaks have intermittently occurred since the first documented case in the 1970s. Due to its transmission characteristics, large outbreaks have not been observed outside Africa. However, within the continent, significant outbreaks have been attributed to factors such as endemic diseases with similar symptoms and inadequate medical infrastructure, which complicate timely diagnosis. In this study, we employed a stochastic modeling approach to analyze the spread of EVD during the early stages of an outbreak, with an emphasis on inherent risks. We developed a model that considers healthcare workers and unreported cases, and assessed the effect of non-pharmaceutical interventions (NPIs) using actual data. Our results indicate that the implementation of NPIs led to a decrease in the transmission rate and infectious period by 30% and 40% respectively, following the declaration of the outbreak. We also investigated the risks associated with delayed outbreak recognition. Our simulations suggest that, when accounting for NPIs and recognition delays, prompt detection could have resulted in a similar outbreak scale, with approximately 50% of the baseline NPIs effect. Finally, we discussed the potential effects of a vaccination strategy as a follow-up measure after the outbreak declaration. Our findings suggest that a vaccination strategy can reduce both the burden of NPIs and the scale of the outbreak.
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Affiliation(s)
- Youngsuk Ko
- Department of Mathematics, Konkuk University, Seoul, Korea
| | - Jacob Lee
- Division of Infectious Disease, Hallym University College of Medicine, Seoul, Korea
| | - Yubin Seo
- Division of Infectious Disease, Hallym University College of Medicine, Seoul, Korea
| | - Eunok Jung
- Department of Mathematics, Konkuk University, Seoul, Korea
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Birhanu MY, Jemberie SS. Mortality rate and predictors of COVID-19 inpatients in Ethiopia: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1213077. [PMID: 37928474 PMCID: PMC10624109 DOI: 10.3389/fmed.2023.1213077] [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: 04/27/2023] [Accepted: 07/31/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an extremely rare virus that devastates the economy and claims human lives. Despite countries' urgent and tenacious public health responses to the COVID-19 pandemic, the disease is killing a large number of people. The results of prior studies have not been used by policymakers and programmers due to the presence of conflicting results. As a result, this study was conducted to fill the knowledge gap and develop a research agenda. Objective This study aimed to assess the mortality rate and predictors of COVID-19 hospitalized patients in Ethiopia. Methods Electronic databases were searched to find articles that were conducted using a retrospective cohort study design and published in English up to 2022. The data were extracted using a Microsoft Excel spreadsheet and exported to StataTM version 17.0 for further analysis. The presence of heterogeneity was assessed and presented using a forest plot. The subgroup analysis, meta-regression, and publication bias were computed to identify the source of heterogeneity. The pool COVID-19 mortality rate and its predictors were calculated and identified using the random effects meta-analysis model, respectively. The significant predictors identified were reported using a relative risk ratio and 95% confidence interval (CI). Results Seven studies with 31,498 participants were included. The pooled mortality rate of COVID-19 was 9.13 (95% CI: 5.38, 12.88) per 1,000 person-days of mortality-free observation. Those study participants who had chronic kidney disease had 2.29 (95% CI: 1.14, 4.60) times higher chance of experiencing mortality than their corresponding counterparts, diabetics had 2.14 (95% CI: 1.22, 3.76), HIV patients had 2.98 (95% CI: 1.26, 7.03), hypertensive patients had 1.63 (95% CI: 1.43, 1.85), and smoker had 2.35 (95% CI: 1.48, 3.73). Conclusion COVID-19 mortality rate was high to tackle the epidemic of the disease in Ethiopia. COVID-19 patients with chronic renal disease, diabetes, hypertension, smoking, and HIV were the significant predictors of mortality among COVID-19 patients in Ethiopia. COVID-19 patients with chronic diseases and comorbidities need special attention, close follow-up, and care from all stakeholders.
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Affiliation(s)
- Molla Yigzaw Birhanu
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Selamawit Shita Jemberie
- Department of Midwifery, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Zhang SX, Chen XX, Zheng Y, Cai BH, Shi W, Ru M, Li H, Zhang DD, Tian Y, Chen YL. Reduced SARS-CoV-2 infection risk is associated with the use of Seven-Flavor Herb Tea: A multi-center observational study in Shanghai, China. JOURNAL OF INTEGRATIVE MEDICINE 2023:S2095-4964(23)00047-X. [PMID: 37380565 DOI: 10.1016/j.joim.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 05/04/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE Omicron, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, is responsible for numerous infections in China. This study investigates the association between the use of Seven-Flavor Herb Tea (SFHT) and the risk of SARS-CoV-2 infection to develop precise and differentiated strategies for control of the coronavirus disease 2019 (COVID-19). METHODS This case-control study was conducted at shelter hospitals and quarantine hotels in China. A total of 5348 laboratory-confirmed COVID-19 patients were enrolled between April 1 and May 31, 2022, while 2190 uninfected individuals served as healthy controls. Structured questionnaires were used to collect data on demographics, underlying diseases, vaccination status, and use of SFHT. Patients were propensity-score-matched using 1:1 nearest-neighbor matching of the logit of the propensity score. Subsequently, a conditional logistic regression model was used for data analysis. RESULTS Overall, 7538 eligible subjects were recruited, with an average age of [45.54 ± 16.94] years. The age of COVID-19 patients was significantly higher than that of uninfected individuals ([48.25 ± 17.48] years vs [38.92 ± 13.41] years; t = 22.437, P < 0.001). A total of 2190 COVID-19 cases were matched with uninfected individuals at a 1:1 ratio. The use of SFHT (odds ratio = 0.753, 95% confidence interval: 0.692, 0.820) was associated with a lower risk of SARS-CoV-2 infection compared to untreated individuals. CONCLUSION Our findings suggest that taking SFHT reduces the risk of SARS-CoV-2 infection. This is a useful study in the larger picture of COVID-19 management, but data from large-sample multi-center, randomized clinical trial are warranted to confirm the finding. Please cite this article as: Zhang SX, Chen XX, Zheng Y, Cai BH, Shi W, Ru M, Li H, Zhang DD, Tian Y, Chen YL. Reduced SARS-CoV-2 infection risk is associated with the use of Seven-Flavor Herb Tea: a multi-center observational study in Shanghai, China. J Integr Med. 2023; Epub ahead of print.
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Affiliation(s)
- Shun-Xian Zhang
- Clinical Research Center, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Xiao-Xu Chen
- Medical Affairs Department, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Yong Zheng
- Medical Affairs Department of Minhang District Health Committee, Shanghai 201199, China
| | - Bing-Hua Cai
- Medical Affairs Department of Fengxian District Health Committee, Shanghai 201499, China
| | - Wei Shi
- Medical Affairs Department of Jinshan District Health Committee, Shanghai 200540, China
| | - Ming Ru
- Medical Affairs Department of Xuhui District Health Committee, Shanghai 200030, China
| | - Hui Li
- Medical Affairs Department of Changning District Health Committee, Shanghai 200050, China
| | - Dan-Dan Zhang
- Medical Affairs Department, Jinshan TCM-Integrated Hospital, Shanghai 201501, China
| | - Yu Tian
- Medical Affairs Department, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
| | - Yue-Lai Chen
- Sleep Medicine Center, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
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Keita M, Polonsky JA, Ahuka-Mundeke S, Ilumbulumbu MK, Dakissaga A, Boiro H, Anoko JN, Diassy L, Ngwama JK, Bah H, Tosalisana MK, Kitenge Omasumbu R, Chérif IS, Boland ST, Delamou A, Yam A, Flahault A, Dagron S, Gueye AS, Keiser O, Fall IS. A community-based contact isolation strategy to reduce the spread of Ebola virus disease: an analysis of the 2018-2020 outbreak in the Democratic Republic of the Congo. BMJ Glob Health 2023; 8:e011907. [PMID: 37263672 PMCID: PMC10254818 DOI: 10.1136/bmjgh-2023-011907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/06/2023] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Despite tremendous progress in the development of diagnostics, vaccines and therapeutics for Ebola virus disease (EVD), challenges remain in the implementation of holistic strategies to rapidly curtail outbreaks. We investigated the effectiveness of a community-based contact isolation strategy to limit the spread of the disease in the Democratic Republic of Congo (DRC). METHODS We did a quasi-experimental comparison study. Eligible participants were EVD contacts registered from 12 June 2019 to 18 May 2020 in Beni and Mabalako Health Zones. Intervention group participants were isolated to specific community sites for the duration of their follow-up. Comparison group participants underwent contact tracing without isolation. The primary outcome was measured as the reproduction number (R) in the two groups. Secondary outcomes were the delay from symptom onset to isolation and case management, case fatality rate (CFR) and vaccination uptake. RESULTS 27 324 EVD contacts were included in the study; 585 in the intervention group and 26 739 in the comparison group. The intervention group generated 32 confirmed cases (5.5%) in the first generation, while the comparison group generated 87 (0.3%). However, the 32 confirmed cases arising from the intervention contacts did not generate any additional transmission (R=0.00), whereas the 87 confirmed cases arising from the comparison group generated 99 secondary cases (R=1.14). The average delay between symptom onset and case isolation was shorter (1.3 vs 4.8 days; p<0.0001), CFR lower (12.5% vs 48.4%; p=0.0001) and postexposure vaccination uptake higher (86.0% vs 56.8%; p<0.0001) in the intervention group compared with the comparison group. A significant difference was also found between intervention and comparison groups in survival rate at the discharge of hospitalised confirmed patients (87.9% vs 47.7%, respectively; p=0.0004). CONCLUSION The community-based contact isolation strategy used in DRC shows promise as a potentially effective approach for the rapid cessation of EVD transmission, highlighting the importance of rapidly implemented, community-oriented and trust-building control strategies.
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Affiliation(s)
- Mory Keita
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jonathan A Polonsky
- Geneva Centre of Humanitarian Studies, University of Geneva, Geneva, Switzerland
| | - Steve Ahuka-Mundeke
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Congo (the Democratic Republic of the)
| | | | - Adama Dakissaga
- Direction Régionale de la Santé du Plateau Central, Ministère de la Santé et de l'Hygiène Publique, Ziniaré, Burkina Faso
| | - Hamadou Boiro
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Julienne Ngoundoung Anoko
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Lamine Diassy
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - John Kombe Ngwama
- Direction Générale de la Lutte contre la Maladie, Ministère de la Santé, Kinshasa, Democratic Republic of Congo
| | - Houssainatou Bah
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | | | - Richard Kitenge Omasumbu
- Equipe Médicale d'Urgence, Ministère de la Santé Publique, Kinshasa, Congo (the Democratic Republic of the)
| | | | | | - Alexandre Delamou
- African Centre of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Abdoulaye Yam
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Antoine Flahault
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Stéphanie Dagron
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Abdou Salam Gueye
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Olivia Keiser
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ibrahima Socé Fall
- Global Neglected Tropical Diseases programme, World Health Organization, Geneva, Switzerland
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Zheng JX, Lv S, Tian LG, Guo ZY, Zheng PY, Chen YL, Guan SY, Wang WM, Zhang SX. The rapid and efficient strategy for SARS-CoV-2 Omicron transmission control: analysis of outbreaks at the city level. Infect Dis Poverty 2022; 11:114. [PMID: 36434701 PMCID: PMC9694873 DOI: 10.1186/s40249-022-01043-2] [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: 06/14/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron (B.1.1.529) variant is highly transmissible with potential immune escape. Hence, control measures are continuously being optimized to guard against large-scale coronavirus disease 2019 (COVID-19) outbreaks. This study aimed to explore the relationship between the intensity of control measures in response to different SARS-CoV-2 variants and the degree of outbreak control at city level. METHODS A retrospective study was conducted in 49 cities with COVID-19 outbreaks between January 2020 and June 2022. Epidemiological data on COVID-19 were extracted from the National Health Commission, People's Republic of China, and the population flow data were sourced from the Baidu migration data provided by the Baidu platform. Outbreak control was quantified by calculating the degree of infection growth and the time-varying reproduction number ([Formula: see text]). The intensity of the outbreak response was quantified by calculating the reduction in population mobility during the outbreak period. Correlation and regression analyses of the intensity of the control measures and the degree of outbreak control for the Omicron variant and non-Omicron mutants were conducted, respectively. RESULTS Overall, 65 outbreaks occurred in 49 cities in China from January 2020 to June 2022. Of them, 66.2% were Omicron outbreaks and 33.8% were non-Omicron outbreaks. The intensity of the control measures was positively correlated with the degree of outbreak control (r = 0.351, P = 0.03). The degree of reduction in population mobility was negatively correlated with the Rt value (r = - 0.612, P < 0.01). Therefore, under the same control measure intensity, the number of new daily Omicron infections was 6.04 times higher than those attributed to non-Omicron variants, and the Rt value of Omicron outbreaks was 2.6 times higher than that of non-Omicron variants. In addition, the duration of non-Omicron variant outbreaks was shorter than that of the outbreaks caused by the Omicron variant (23.0 ± 10.7, 32.9 ± 16.3, t = 2.243, P = 0.031). CONCLUSIONS Greater intensity of control measures was associated with more effective outbreak control. Thus, in response to the Omicron variant, the management to restrict population movement should be used to control its spread quickly, especially in the case of community transmission occurs widely. Faster than is needed for non-Omicron variants, and decisive control measures should be imposed and dynamically adjusted in accordance with the evolving epidemic situation.
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Affiliation(s)
- Jin-Xin Zheng
- grid.16821.3c0000 0004 0368 8293Department of Nephrology, Ruijin Hospital, Institute of Nephrology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 People’s Republic of China
| | - Shan Lv
- grid.508378.1Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025 People’s Republic of China
| | - Li-Guang Tian
- grid.508378.1Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025 People’s Republic of China
| | - Zhao-Yu Guo
- grid.508378.1Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025 People’s Republic of China
| | - Pei-Yong Zheng
- grid.411480.80000 0004 1799 1816Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 People’s Republic of China
| | - Yue-Lai Chen
- grid.411480.80000 0004 1799 1816Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 People’s Republic of China
| | - Shi-Yang Guan
- grid.186775.a0000 0000 9490 772XDepartment of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032 People’s Republic of China
| | - Wei-Ming Wang
- grid.16821.3c0000 0004 0368 8293Department of Nephrology, Ruijin Hospital, Institute of Nephrology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 People’s Republic of China
| | - Shun-Xian Zhang
- grid.411480.80000 0004 1799 1816Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 People’s Republic of China ,grid.16821.3c0000 0004 0368 8293School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 People’s Republic of China ,grid.16821.3c0000 0004 0368 8293One Health Center, Shanghai Jiao Tong University–The University of Edinburgh, Shanghai, 200025 People’s Republic of China
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8
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Racioppi F, Rutter H, Nitzan D, Borojevic A, Carr Z, Grygaski TJ, Jarosińska D, Netanyahu S, Schmoll O, Stuetzle K, Van Den Akker A, Kluge HHP. The impact of war on the environment and health: implications for readiness, response, and recovery in Ukraine. Lancet 2022; 400:871-873. [PMID: 36116469 DOI: 10.1016/s0140-6736(22)01739-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Francesca Racioppi
- World Health Organization European Centre for Environment and Health, Bonn D-53113, Germany.
| | | | - Dorit Nitzan
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Anja Borojevic
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Zhanat Carr
- World Health Organization, Geneva, Switzerland
| | - Tanya Jean Grygaski
- United Nations Office for the Coordination of Humanitarian Affairs, Kyiv, Ukraine
| | - Dorota Jarosińska
- World Health Organization European Centre for Environment and Health, Bonn D-53113, Germany
| | - Sinaia Netanyahu
- World Health Organization European Centre for Environment and Health, Bonn D-53113, Germany
| | - Oliver Schmoll
- World Health Organization European Centre for Environment and Health, Bonn D-53113, Germany
| | - Karien Stuetzle
- World Health Organization Regional Office for Europe, Copenhagen, Denmark; World Health Organization Country Office in Ukraine, Kyiv, Ukraine
| | | | - Hans Henri P Kluge
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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9
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Keita M, Polonsky J, Finci I, Mbala-Kingebeni P, Ilumbulumbu MK, Dakissaga A, Ngwama JK, Tosalisana MK, Ahuka-Mundeke S, Gueye AS, Dagron S, Keiser O, Fall IS. Investigation of and Strategies to Control the Final Cluster of the 2018-2020 Ebola Virus Disease Outbreak in the Eastern Democratic Republic of Congo. Open Forum Infect Dis 2022; 9:ofac329. [PMID: 36168547 PMCID: PMC9499850 DOI: 10.1093/ofid/ofac329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background On April 10, 2020, while the independent committee of the International Health Regulation was meeting to decide whether the 10th Ebola outbreak in the Demogratic Republic of Congo still constituted a Public Health Emergency of International Concern, a new confirmed case was reported in the city of Beni, the last epicenter of the epidemic. This study aimed to understand the source of this cluster and learn from the implemented control strategies for improved response in the future. Methods We conducted a combined epidemiological and genomic investigation to understand the origins and dynamics of transmission within this cluster and describe the strategy that successfully controlled the outbreak. Results Eight cases were identified as belonging to this final cluster. A total of 1028 contacts were identified. Whole-genome sequencing revealed that all cases belonged to the same cluster, the closest sequence to which was identified as a case from the Beni area with symptom onset in July 2019 and a difference of just 31 nucleotides. Outbreak control measures included community confinement of high-risk contacts. Conclusions This study illustrates the high risk of additional flare-ups in the period leading to the end-of-outbreak declaration and the importance of maintaining enhanced surveillance and confinement activities to rapidly control Ebola outbreaks.
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Affiliation(s)
- Mory Keita
- Regional Office for Africa, World Health Organization, Brazzaville, Congo.,Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Jonathan Polonsky
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland.,World Health Organization, Geneva, Switzerland
| | - Iris Finci
- European Program for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Michel Kalongo Ilumbulumbu
- Division Provinciale de la Santé du Nord-Kivu, Ministère de la Santé, Goma, Democratic Republic of Congo
| | - Adama Dakissaga
- Ministère de la Santé, Direction Régionale de la Santé du Plateau central, Ziniaré, Burkina Faso
| | - John Kombe Ngwama
- Direction Générale de la Lutte contre la Maladie, Ministère de la Santé, Kinshasa, Democratic Republic of Congo
| | - Michel Kasereka Tosalisana
- Division Provinciale de la Santé du Nord-Kivu, Ministère de la Santé, Goma, Democratic Republic of Congo
| | - Steve Ahuka-Mundeke
- Institut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of Congo
| | - Abdou Salam Gueye
- Regional Office for Africa, World Health Organization, Brazzaville, Congo
| | - Stephanie Dagron
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Olivia Keiser
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
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10
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Zhang SX, Yang M, Zheng JX, Zhang BQ, Pan CH, Tian LG. Comprehensive strategies and measures to control COVID-19. Infect Dis Poverty 2022; 11:67. [PMID: 35690795 PMCID: PMC9188009 DOI: 10.1186/s40249-022-00994-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Shun-Xian Zhang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China. .,School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Ming Yang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Jin-Xin Zheng
- School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Bin-Qian Zhang
- School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Chen-Hui Pan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Li-Guang Tian
- School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
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11
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Charnley GEC, Yennan S, Ochu C, Kelman I, Gaythorpe KAM, Murray KA. The impact of social and environmental extremes on cholera time varying reproduction number in Nigeria. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000869. [PMID: 36962831 PMCID: PMC10022205 DOI: 10.1371/journal.pgph.0000869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 11/10/2022] [Indexed: 12/15/2022]
Abstract
Nigeria currently reports the second highest number of cholera cases in Africa, with numerous socioeconomic and environmental risk factors. Less investigated are the role of extreme events, despite recent work showing their potential importance. To address this gap, we used a machine learning approach to understand the risks and thresholds for cholera outbreaks and extreme events, taking into consideration pre-existing vulnerabilities. We estimated time varying reproductive number (R) from cholera incidence in Nigeria and used a machine learning approach to evaluate its association with extreme events (conflict, flood, drought) and pre-existing vulnerabilities (poverty, sanitation, healthcare). We then created a traffic-light system for cholera outbreak risk, using three hypothetical traffic-light scenarios (Red, Amber and Green) and used this to predict R. The system highlighted potential extreme events and socioeconomic thresholds for outbreaks to occur. We found that reducing poverty and increasing access to sanitation lessened vulnerability to increased cholera risk caused by extreme events (monthly conflicts and the Palmers Drought Severity Index). The main limitation is the underreporting of cholera globally and the potential number of cholera cases missed in the data used here. Increasing access to sanitation and decreasing poverty reduced the impact of extreme events in terms of cholera outbreak risk. The results here therefore add further evidence of the need for sustainable development for disaster prevention and mitigation and to improve health and quality of life.
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Affiliation(s)
- Gina E C Charnley
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Sebastian Yennan
- Surveillance and Epidemiology Department/IM Cholera, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Chinwe Ochu
- Surveillance and Epidemiology Department/IM Cholera, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Ilan Kelman
- Institute for Risk and Disaster Reduction, University College London, London, United Kingdom
- Institute for Global Health, University College London, London, United Kingdom
- University of Agder, Kristiansand, Norway
| | - Katy A M Gaythorpe
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Kris A Murray
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gamiba
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